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Sample records for del balanced scorecard

  1. Balanced scorecards for performance management.

    PubMed

    Park, Eun-Jun; Huber, Diane L

    2007-01-01

    Nurse administrators who manage nursing case management programs are challenged to demonstrate the improved quality of patient care and financial outcomes to their organization that result from such programs. This article introduces the balanced scorecard and discusses its benefits and practical concerns for adopting the scorecard. The balanced scorecard is a useful performance management tool used to both evaluate and direct case management performance in meeting organizational missions and strategies.

  2. [Balanced scorecard in health].

    PubMed

    Leyton-Pavez, Carolina Elena; Huerta-Riveros, Patricia Carolina; Paúl-Espinoza, Iván Renato

    2015-01-01

    To evaluate the installation of strategies in the higher complexity hospitals (HMC, in Spanish) of public health in Chile starting from the results of the Balanced Scorecard (BSC), during the years 2011-2012. The implementation of the BSC is described, the strategies and indicators identified, and the results of the 57 HMC compared and analyzed. Starting from the comparison of the results it is discovered that the BSC allows to evaluate the installation of the strategies. Differences are identified in the installation of the strategies by geographical area, with North presenting a higher score (20.21), followed by Center (10.41) and South (19.50), which can be explained by the size and complexity of this establishments, variables that should be incorporated in the evaluation of the results of the BSC.

  3. Going International: The Balanced Scorecard.

    ERIC Educational Resources Information Center

    Rojas, Alicia M.

    2001-01-01

    Explains the balanced scorecard as a management system that provides a framework for strategic measurement which translates the vision and strategy of the organization in operational terms by four indicators: financial, process, employee and client satisfaction, and results. Also considers the importance of cultural differences in performance…

  4. Identifying Balance in a Balanced Scorecard System

    ERIC Educational Resources Information Center

    Aravamudhan, Suhanya; Kamalanabhan, T. J.

    2007-01-01

    In recent years, strategic management concepts seem to be gaining greater attention from the academicians and the practitioner's alike. Balanced Scorecard (BSC) concept is one such management concepts that has spread in worldwide business and consulting communities. The BSC translates mission and vision statements into a comprehensive set of…

  5. Driving Improvement with a Balanced Scorecard

    ERIC Educational Resources Information Center

    Cowart, Scott K.

    2010-01-01

    This article describes how a school district's use of a transparent tool coalesced support for systemic improvement. The author was looking for a way to push improvement in his 4,000-student school system when he discovered the balanced scorecard, a strategic tool for performance management. The author details how the balanced scorecard helped him…

  6. Umsetzung der Unternehmensstrategie mit der Balanced Scorecard

    NASA Astrophysics Data System (ADS)

    Crespo, Isabel; Bergmann, Lars; Portmann, Stefan; Lacker, Thomas; Lacker, Michael; Fleischmann, Jürgen; Kozó, Hans

    Die Balanced Scorecard (BSC) ist ein Ansatz zum strategischen Management, der neben der Ausrichtung des Unternehmens auf finanzielle Zielwerte ebenso großes Gewicht auf so genannte weiche Faktoren legt, die den wirtschaftlichen Erfolg eines Unternehmens erst ermöglichen. Das entscheidende Merkmal der Balanced Scorecard ist dabei, dass sie ein ausgewogenes System strategischer Ziele herstellt, welches das Unternehmen hinsichtlich der vier Perspektiven Finanzen, Kunden, interne Prozesse und Mitarbeiter und Potenziale strategisch ausrichtet (Kaplan u. Norton 1997).

  7. Managing Service Quality with the Balanced Scorecard.

    ERIC Educational Resources Information Center

    Poll, Roswitha

    In order to evaluate and utilize library data for the management process, a German project, sponsored by the German Research Council, uses the Balanced Scorecard as the concept for integrated quality management. Performance indicators across the following four perspectives are combined to produce a balanced evaluation of the library: (1) users,…

  8. A Balanced Scorecard Approach to Public Relations Management Assessment.

    ERIC Educational Resources Information Center

    Fleisher, Craig S.; Mahaffy, Darren

    1997-01-01

    Describes a new managerial approach to assessing public relations/communications (PR/C) performance using a "balanced scorecard." Reviews the current state of PR/C management assessment; illustrates the balanced scorecard framework; highlights its strengths and weaknesses; describes the process of applying the scorecard to PR/C units;…

  9. Applying the Balanced Scorecard to Education

    ERIC Educational Resources Information Center

    Karathanos, Demetrius; Karathanos, Patricia

    2005-01-01

    Although the application of the balanced scorecard (BSC) in the business sector is well documented, very little research has been reported regarding the adaptation or application of the BSC in the education sector. In this article, the authors (a) describe how the Baldrige Education Criteria for Performance Excellence has adapted the concept of…

  10. The Balanced Scorecard: Beyond Reports and Rankings.

    ERIC Educational Resources Information Center

    Stewart, Alice C.; Carpenter-Hubin, Julie

    2001-01-01

    Discusses the use of performance indicators by higher education institutions for internal assessment as well as external reporting. Describes the balanced scorecard developed by Robert S. Kaplan and David P. Norton in 1992, a set of measures that allow for a holistic, integrated view of business performance. Explores how to create and use the…

  11. Teaching the Balanced Scorecard through Simulation

    ERIC Educational Resources Information Center

    Capelo, Carlos; Lopes, Ana Isabel; Mata, Ana

    2012-01-01

    Kaplan and Norton introduced the Balanced Scorecard (BSC) which is based on a systems perspective of the business strategy and performance measurement. Many organizations around the world are using the BSC to define, implement and manage strategy. Nevertheless there exist studies that identify problems and limitations associated with the…

  12. Applying the balanced scorecard in healthcare provider organizations.

    PubMed

    Inamdar, Noorein; Kaplan, Robert S; Bower, Marvin

    2002-01-01

    Several innovative healthcare executives have recently introduced a new business strategy implementation tool: the Balanced Scorecard. The scorecard's measurement and management system provides the following potential benefits to healthcare organizations: It aligns the organization around a more market-oriented, customer-focused strategy It facilitates, monitors, and assesses the implementation of the strategy It provides a communication and collaboration mechanism It assigns accountability for performance at all levels of the organization It provides continual feedback on the strategy and promotes adjustments to marketplace and regulatory changes. We surveyed executives in nine provider organizations that were implementing the Balanced Scorecard. We asked about the following issues relating to its implementation and effect: 1. The role of the Balanced Scorecard in relation to a well-defined vision, mission, and strategy 2. The motivation for adopting the Balanced Scorecard 3. The difference between the Balanced Scorecard and other measurement systems 4. The process followed to develop and implement the Balanced Scorecard 5. The challenges and barriers during the development and implementation process 6. The benefits gained by the organization from adoption and use. The executives reported that the Balanced Scorecard strategy implementation and performance management tool could be successfully applied in the healthcare sector, enabling organizations to improve their competitive market positioning, financial results, and customer satisfaction. This article concludes with guidelines for other healthcare provider organizations to capture the benefits of the Balanced Scorecard performance management system.

  13. Measuring and monitoring IT using a balanced scorecard approach.

    PubMed

    Gash, Deborah J; Hatton, Todd

    2007-01-01

    Ensuring that the information technology department is aligned with the overall health system strategy and is performing at a consistently high level is a priority at Saint Luke's Health System in Kansas City, Mo. The information technology department of Saint Luke's Health System has been using the balanced scorecard approach described in this article to measure and monitor its performance for four years. This article will review the structure of the IT department's scorecard; the categories and measures used; how benchmarks are determined; how linkage to the organizational scorecard is made; how results are reported; how changes are made to the scorecard; and tips for using a scorecard in other IT departments.

  14. Balanced Scorecards in Managing Higher Education Institutions: An Indian Perspective

    ERIC Educational Resources Information Center

    Umashankar, Venkatesh; Dutta, Kirti

    2007-01-01

    Purpose: The paper aims to look at the balanced scorecard (BSC) concept and discuss in what way it should be applied to higher education programs/institutions in the Indian context. Design/methodology/approach: The paper is based on extant literature on the balanced scorecard concept per se, as well as applications of BSC in higher education as…

  15. Introducing the Balanced Scorecard: Creating Metrics to Measure Performance

    ERIC Educational Resources Information Center

    Gumbus, Andra

    2005-01-01

    This experiential exercise presents the concept of the Balanced Scorecard (BSC) and applies it in a university setting. The Balanced Scorecard was developed 12 years ago and has grown in popularity and is used by more than 50% of the Fortune 500 companies as a performance measurement and strategic management tool. The BSC expands the traditional…

  16. The balanced scorecard: sustainable performance assessment for forensic laboratories.

    PubMed

    Houck, Max; Speaker, Paul J; Fleming, Arron Scott; Riley, Richard A

    2012-12-01

    The purpose of this article is to introduce the concept of the balanced scorecard into the laboratory management environment. The balanced scorecard is a performance measurement matrix designed to capture financial and non-financial metrics that provide insight into the critical success factors for an organization, effectively aligning organization strategy to key performance objectives. The scorecard helps organizational leaders by providing balance from two perspectives. First, it ensures an appropriate mix of performance metrics from across the organization to achieve operational excellence; thereby the balanced scorecard ensures that no single or limited group of metrics dominates the assessment process, possibly leading to long-term inferior performance. Second, the balanced scorecard helps leaders offset short term performance pressures by giving recognition and weight to long-term laboratory needs that, if not properly addressed, might jeopardize future laboratory performance. Copyright © 2012 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

  17. The balanced scorecard: an integrative approach to performance evaluation.

    PubMed

    Oliveira, J

    2001-05-01

    In addition to strict financial outcomes, healthcare financial managers should assess intangible assets that affect the organization's bottom line, such as clinical processes, staff skills, and patient satisfaction and loyalty. The balanced scorecard, coupled with data-warehousing capabilities, offers a way to measure an organization's performance against its strategic objectives while focusing on building capabilities to achieve these objectives. The balanced scorecard examines performance related to finance, human resources, internal processes, and customers. Because the balanced scorecard requires substantial amounts of data, it is a necessity to establish an organizational data warehouse of clinical, operational, and financial data that can be used in decision support. Because it presents indicators that managers and staff can influence directly by their actions, the balanced-scorecard approach to performance measurement encourages behavioral changes aimed at achieving corporate strategies.

  18. Medical records department and balanced scorecard approach

    PubMed Central

    Ajami, Sima; Ebadsichani, Afsaneh; Tofighi, Shahram; Tavakoli, Nahid

    2013-01-01

    Context: The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously. Aims: The main goal of this study was to assess the MRD performance with BSC approach in a hospital. Materials and Methods: This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran. Statistical Analysis Used: To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed. Results: The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively. Conclusions: The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital. PMID:24083257

  19. Medical records department and balanced scorecard approach.

    PubMed

    Ajami, Sima; Ebadsichani, Afsaneh; Tofighi, Shahram; Tavakoli, Nahid

    2013-01-01

    The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously. The main goal of this study was to assess the MRD performance with BSC approach in a hospital. This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran. To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed. The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively. The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital.

  20. Achieving excellence in veterans healthcare--a balanced scorecard approach.

    PubMed

    Biro, Lawrence A; Moreland, Michael E; Cowgill, David E

    2003-01-01

    This article provides healthcare administrators and managers with a framework and model for developing a balanced scorecard and demonstrates the remarkable success of this process, which brings focus to leadership decisions about the allocation of resources. This scorecard was developed as a top management tool designed to structure multiple priorities of a large, complex, integrated healthcare system and to establish benchmarks to measure success in achieving targets for performance in identified areas. Significant benefits and positive results were derived from the implementation of the balanced scorecard, based upon benchmarks considered to be critical success factors. The network's chief executive officer and top leadership team set and articulated the network's primary operating principles: quality and efficiency in the provision of comprehensive healthcare and support services. Under the weighted benchmarks of the balanced scorecard, the facilities in the network were mandated to adhere to one non-negotiable tenet: providing care that is second to none. The balanced scorecard approach to leadership continuously ensures that this is the primary goal and focal point for all activity within the network. To that end, systems are always in place to ensure that the network is fully successful on all performance measures relating to quality.

  1. Balanced Scorecard--A Strategic Management System of the Higher Education Institution

    ERIC Educational Resources Information Center

    Hladchenko, Myroslava

    2015-01-01

    Purpose: The purpose of this paper is to focus on the comparative analysis of the Balanced Scorecards of four higher education institutions and aims to define the general framework of the Balanced Scorecard for the higher education institution which concerns: the structure and elements of the Balanced Scorecard; development of the Balanced…

  2. Strategic Management of Electronic Commerce: An Adaptation of the Balanced Scorecard.

    ERIC Educational Resources Information Center

    Hasan, Helen; Tibbits, Hendrika

    2000-01-01

    The balanced scorecard is a formal management technique built on the premise that measurement is a prerequisite to strategic management. A case study of the implementation of the balanced scorecard in a public utility is analyzed to suggest how the basic concepts and philosophy of the balanced scorecard can be retained in its adaptation to the…

  3. Building a balanced scorecard for a burn center.

    PubMed

    Wachtel, T L; Hartford, C E; Hughes, J A

    1999-08-01

    The Balanced Scorecard provides a model that can be adapted to the management of any burn center, burn service or burn program. This model enables an organization to translate its mission and vision into specific strategic objectives across the four perspective: (1) the financial perspective; (2) the customer service perspective; (3) the internal business perspective; and (4) the growth and learning perspective. Once the appropriate objectives are identified, the Balanced Scorecard guides the organization to develop reasonable performance measures and establishes targets, initiatives and alternatives to meet programmatic goals and pursue longer-term visionary improvements. We used the burn center at the University of Colorado Health Sciences Center to test whether the Balanced Scorecard methodology was appropriate for the core business plan of a healthcare strategic business unit (i.e. a burn center).

  4. Use of the balanced scorecard in health care.

    PubMed

    Zelman, William N; Pink, George H; Matthias, Catherine B

    2003-01-01

    Since Kaplan and Norton published their article proposing a balanced scorecard, the concept has been widely adopted by industry and health care provider organizations. This article reviews the use of the balanced scorecard in health care and concludes that the balanced scorecard: (1) is relevant to health care, but modification to reflect industry and organizational realities is necessary; (2) is used by a wide range of health care organizations; (3) has been extended to applications beyond that of strategic management; (4) has been modified to include perspectives, such as quality of care, outcomes, and access; (5) increases the need for valid, comprehensive, and timely information; and (6) has been used by two large-scale efforts across many health care organizations in a health care sector, which differ, namely in the units of analysis, purposes, audiences, methods, data, and results.

  5. Using Balanced Scorecard (BSC) approach to improve ergonomics programs.

    PubMed

    Fernandes, Marcelo Vicente Forestieri

    2012-01-01

    The purpose of this paper is to propose foundations for a theory of using the Balanced Scorecard (BSC) methodology to improve the strategic view of ergonomics inside the organizations. This approach may help to promote a better understanding of investing on an ergonomic program to obtain good results in quality and production, as well as health maintenance. It is explained the basics of balanced scorecard, and how ergonomists could use this to work with strategic enterprises demand. Implications of this viewpoint for the development of a new methodology for ergonomics strategy views are offered.

  6. The balanced scorecard--measures that drive performance.

    PubMed

    Kaplan, R S; Norton, D P

    1992-01-01

    Frustrated by the inadequacies of traditional performance measurement systems, some managers have abandoned financial measures like return on equity and earnings per share. "Make operational improvements and the numbers will follow," the argument goes. But managers do not want to choose between financial and operational measures. Executives want a balanced presentation of measures that allow them to view the company from several perspectives simultaneously. During a year-long research project with 12 companies at the leading edge of performance measurement, the authors developed a "balanced scorecard," a new performance measurement system that gives top managers a fast but comprehensive view of the business. The balanced scorecard includes financial measures that tell the results of actions already taken. And it complements those financial measures with three sets of operational measures having to do with customer satisfaction, internal processes, and the organization's ability to learn and improve--the activities that drive future financial performance. Managers can create a balanced scorecard by translating their company's strategy and mission statements into specific goals and measures. To create the part of the scorecard that focuses on the customer perspective, for example, executives at Electronic Circuits Inc. established general goals for customer performance: get standard products to market sooner, improve customers' time-to-market, become customers' supplier of choice through partnerships, and develop innovative products tailored to customer needs. Managers translated these elements of strategy into four specific goals and identified a measure for each.

  7. Delivering Training Strategies: The Balanced Scorecard at Work

    ERIC Educational Resources Information Center

    Baraldi, Stefano; Cifalinò, Antonella

    2015-01-01

    Aligning the value of training to organizational goals is an emerging need in human resource management. This study, aiming at expanding the research on training evaluation from a strategic management perspective, examines whether the use of the Balanced Scorecard approach can enable an effective delivery of training strategies, thus strengthening…

  8. [BALANCED SCORECARD AS A MANAGEMENT TOOL IN CLINICAL NUTRITION].

    PubMed

    Gutiérrez López, Cristina; Mauriz, Jose L; Culebras, Jesús M

    2015-07-01

    Nowadays, balanced scorecards have updated traditional management systems in the business sector. In this way, Kaplan and Norton propose performance measurement through several perspectives with a logical sequence: internal processes and learning impact client services, so that financial performance is affected. The aim of the present paper is to analyze the main characteristics of balanced scorecard when it is applied to non-for-profit companies and, specifically to the health sector in the clinical nutrition field. This model improves the economic vision of management with clinical indicators that represent healthcare professional's perspective. The balanced scorecard would allow a proper monitoring and tracking system for the main healthcare indicators. This contributes to a better control in comparison with standards that are associated with adequate quality assistance. Owing to the role of management accounting and cost calculations, the definition of healthcare professionals as clients or users, and clinical results relevance, it is necessary to adapt the balanced scorecard to the specific characteristics of the clinical field, redefining both perspectives and indicators. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Implementation and Performance Evaluation Using the Fuzzy Network Balanced Scorecard

    ERIC Educational Resources Information Center

    Tseng, Ming-Lang

    2010-01-01

    The balanced scorecard (BSC) is a multi-criteria evaluation concept that highlights the importance of performance measurement. However, although there is an abundance of literature on the BSC framework, there is a scarcity of literature regarding how the framework with dependence and interactive relationships should be properly implemented in…

  10. Ratify, Reject or Revise: Balanced Scorecard and Universities

    ERIC Educational Resources Information Center

    Sayed, Naqi

    2013-01-01

    Purpose: The purpose of this paper is to examine the use of the Balanced Scorecard (BSC) in universities. Initially directed toward profit-oriented businesses, the BSC has since been adopted by many non-profit organisations with seemingly diverse objectives. A number of primarily publicly-funded universities and institutions, which are part of…

  11. Performance Management in Schools: Could the Balanced Scorecard Help?

    ERIC Educational Resources Information Center

    Storey, Anne

    2002-01-01

    Describes and examines the nature of the Balanced Scorecard as a conceptual framework and as a management information tool. Identifies and discusses the potential and the limitations of the approach in a school context. Outlines a research agenda. (Contains 3 figures and 33 references.) (AUTHOR/WFA)

  12. Successful Applications of the Balanced Scorecard in Higher Education

    ERIC Educational Resources Information Center

    Beard, Deborah F.

    2009-01-01

    Are there management tools that professionals use in business that academics have used successfully in higher education? The answer to that question is "yes", and the balanced scorecard (BSC) is one such tool. The author reports on measures that administrators chose for the BSCs of 2 educational institutions whose successes have been…

  13. Strategy Revitalization in Academe: A Balanced Scorecard Approach

    ERIC Educational Resources Information Center

    McDevitt, Roselie; Giapponi, Catherine; Solomon, Norman

    2008-01-01

    Purpose: The purpose of this paper is to present a unique version of the balanced scorecard developed and applied by the faculty of a university division. Design/methodology/approach: The paper uses a case study approach and uses the experiences of the faculty of a business school to describe the process and benefits of developing a custom…

  14. Strategic Reporting Tool: Balanced Scorecards in Higher Education

    ERIC Educational Resources Information Center

    Lyddon, Jan W.; McComb, Bruce E.

    2008-01-01

    In this toolbox article, the authors describe the recommended steps for creating a community college balanced scorecard that measures and reports on key performance indicators based on targets and signal values to end-users, college constituents and external stakeholders. Based on extensive experience in the field, the authors provide a…

  15. Design Principles for the Development of the Balanced Scorecard

    ERIC Educational Resources Information Center

    Keser Ozmantar, Zehra; Gedikoglu, Tokay

    2016-01-01

    Purpose: The purpose of this paper is to investigate the development and implementation process of the balanced scorecard (BSC) approach in an educational institution in the context of the Turkish educational system. It also aims, on the basis of the results of the applications in a particular school, to define principles through which the…

  16. Using the balanced scorecard in the development of community partnerships.

    PubMed

    Tsasis, Peter; Owen, Susan M

    2009-02-01

    The benefits of community partnerships have been well established in the health service literature. However, measuring these benefits and associated outcomes is relatively new. This paper presents an innovative initiative in the application of a balanced scorecard framework for measuring and monitoring partnership activity at the community level, while adopting principles of evidence-based practice to the partnership process. In addition, it serves as an excellent example of how organizations can apply scorecard methodology to move away from relationship-based partnerships and into new collaborations of which they can select - using a formal skill and competency assessment for partnership success.

  17. Competing values in healthcare: balancing the (un)balanced scorecard.

    PubMed

    Wicks, Angela M; St Clair, Lynda

    2007-01-01

    Facing a complex environment driven by two decades of dramatic change, healthcare organizations are adopting new strategic frameworks such as the Balanced Scorecard (BSC) to evaluate performance (Kaplan and Norton 1992). The BSC was not originally developed as a performance management tool, however. Rather, it was designed as a tool to communicate strategy and, as such, provides little guidance when actual outcomes fall short of desired outcomes. In addition, although the BSC is an improvement over exclusively financial measures, it has three conceptual limitations that are especially problematic for evaluating healthcare organizations: (1) it underemphasizes the employee perspective, (2) it is founded on a control-based management philosophy, and (3) it emphasizes making trade-offs. To address these limitations, we propose using the Competing Values Framework (CVF), a theoretically grounded, comprehensive approach to understanding and improving organizational and managerial performance by focusing on four action imperatives: competing, controlling, collaborating, and creating. The CVF pays particular attention to the employee perspective, is consistent with a commitment-based management philosophy, and emphasizes transcending apparent paradoxes to identify win-win solutions. Rather than focusing on customer satisfaction or employee satisfaction, the CVF looks for ways to satisfy customers and employees while still addressing financial constraints and growth opportunities. The CVF also can be used to assess both the culture of the organization and the competencies of individual managers, thereby providing a clear link between strategy and implementation.

  18. Implement balanced scorecard to translate strategic plan into actionable objectives.

    PubMed

    2004-09-01

    Faced with challenges ranging from declining reimbursement to staff shortages, health care organizations--integrated delivery systems, physician group practices, disease management providers, and others--increasingly are turning to general business models to map out step-by-step action plans for performance measurement and process improvement. Creating a "balanced scorecard" is an obvious starting point for assessing and improving clinical and financial performance.

  19. Evaluating the Fraser Health Balanced Scorecard--a formative evaluation.

    PubMed

    Barnardo, Catherine; Jivanni, Amin

    2009-01-01

    Fraser Health (FH), a large, Canadian, integrated health care network, adopted the Balanced Scorecard (BSC) approach to monitor organizational performance in 2006. This paper reports on the results of a formative evaluation, conducted in April, 2008, to assess the usefulness of the BSC as a performance-reporting system and a performance management tool. Results indicated that the BSC has proven to be useful for reporting performance but is not currently used for performance management in a substantial way.

  20. Balanced scorecards for specialists: a tool for quality improvement.

    PubMed

    Marr, Thomas J; Mullen, Deborah M

    2004-04-01

    This article describes a program that HealthPartners uses to assess and compare the performance of specialists that serve its members. HealthPartners' Balanced Scorecards program focuses on cardiologist and orthopedist practices in the Minneapolis/St. Paul metro area and St. Cloud, Minnesota. The scorecards assess the clinical and business processes of specialist practices, their use of resources, the degree to which patients and referring physicians are satisfied with their performance, and their patient outcomes. Unblinded comparative data is made available to referring physicians, employers, and consumers only after each individual specialist group has had the opportunity to review its own data against blinded results, discuss the methodology, and comment on the results.

  1. Quality Measures for Dialysis: Time for a Balanced Scorecard

    PubMed Central

    2016-01-01

    Recent federal legislation establishes a merit-based incentive payment system for physicians, with a scorecard for each professional. The Centers for Medicare and Medicaid Services evaluate quality of care with clinical performance measures and have used these metrics for public reporting and payment to dialysis facilities. Similar metrics may be used for the future merit-based incentive payment system. In nephrology, most clinical performance measures measure processes and intermediate outcomes of care. These metrics were developed from population studies of best practice and do not identify opportunities for individualizing care on the basis of patient characteristics and individual goals of treatment. The In-Center Hemodialysis (ICH) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey examines patients' perception of care and has entered the arena to evaluate quality of care. A balanced scorecard of quality performance should include three elements: population-based best clinical practice, patient perceptions, and individually crafted patient goals of care. PMID:26316622

  2. Balanced Scorecard in Higher Education Institutions: Congruence and Roles to Quality Assurance Practices

    ERIC Educational Resources Information Center

    Reda, Nigusse W.

    2017-01-01

    Purpose: The purpose of this paper is twofold: first, to highlight the congruence and roles of the balanced scorecard in the quality assurance practices in higher education institutions, and second, to propose a balanced scorecard model for higher education institutions. Design/methodology/approach: A descriptive literature review was used to…

  3. Creating a balanced scorecard for a hospital system.

    PubMed

    Pink, G H; McKillop, I; Schraa, E G; Preyra, C; Montgomery, C; Baker, G R

    2001-01-01

    In 1999, hospitals in Ontario, Canada, collaborated with a university-based research team to develop a report on the relative performance of individual hospitals in Canada's most populated province. The researchers used the balanced-scorecard framework advocated by Kaplan and Norton. Indicators of performance were developed in four areas: clinical utilization and outcomes, patient satisfaction, system integration and change, and financial performance and condition. The process of selecting, calculating, and validating meaningful indicators of financial performance and condition is outlined. Lessons learned along the way are provided. These lessons may prove valuable to other finance researchers and practitioners who are engaged in performance measurement endeavors.

  4. Summarizing health inequalities in a Balanced Scorecard. Methodological considerations.

    PubMed

    Auger, Nathalie; Raynault, Marie-France

    2006-01-01

    The association between social determinants and health inequalities is well recognized. What are now needed are tools to assist in disseminating such information. This article describes how the Balanced Scorecard may be used for summarizing data on health inequalities. The process begins by selecting appropriate social groups and indicators, and is followed by the measurement of differences across person, place, or time. The next step is to decide whether to focus on absolute versus relative inequality. The last step is to determine the scoring method, including whether to address issues of depth of inequality.

  5. [Application of the balanced scorecard for evaluating the training process].

    PubMed

    Venturoli, Cristiana; Gamberoni, Loredana

    2009-01-01

    A training project in which nurses acted as tutors to novice nurses was introduced in the Ferrara University Hospital, with the aim of helping them to achieve the skills and professional expertise required in an operating theatre environment. Owing to the involvement of all the surgical divisions of the hospital and the continual addition of new staff, the Balanced Scorecard method (BSC) was used to assess the impact of training on the entire organization. The BSC method, a multidimensional method born in the USA in the 1990's, made it possible to assess the utility of training in the light of achieving institutional goals.

  6. [The balanced scorecard. "Tool or toy" in hospitals].

    PubMed

    Brinkmann, A; Gebhard, F; Isenmann, R; Bothner, U; Mohl, U; Schwilk, B

    2003-10-01

    The change in hospital funding with diagnosis related groups (DRG), medical advances as well as demographic changes will call for new quantitative and qualitative standards imposed on German hospitals. Increasing costs and competition in the health care sector requires new and innovative strategies for resource management. Today's policy is mainly defined by rationing and intensified workload. The introduction of DRGs will presumably further constrict management perspectives on pure financial aspects. However, to ensure future development, compassionate services and continued existence of hospitals, a balance of seemingly conflicting perspectives, such as finance, customer, process, learning and growth are of utmost importance. Herein doctors and nurses in leading positions should play a key role in changing management practice. For several years the balanced scorecard has been successfully used as a strategic management concept in non-profit organizations, even in the health care sector. This concept complies with the multidimensional purposes of hospitals and focuses on policy deployment. Finally it gives the opportunity to involve all employees in the original development, communication and execution of a balanced scorecard approach.

  7. [Application of the balanced scorecard in nursing practice].

    PubMed

    Huang, Tsai-Yu; Chwo, Miao-Ju

    2004-02-01

    Kaplan and Norton's balanced scorecard (BSC) was developed in 1992. It was designed to be both a performance framework and a management methodology. The BSC enables an organization to convert its mission and vision into specific strategic objectives across four perspectives: (1) the financial perspective, (2) the customer perspective, (3) the internal business process perspective, and (4) the learning and growth perspective. Emphasis is focused on the balance of internal and external, outcome and future, and subjective and objective measures. Currently, some health care organizations have implemented the concept of the BSC as a performance measurement tool and are convinced that the BSC can be of great value to an organization. This paper provides development of the BSC and its application in the health care system and nursing practice.

  8. Implementing a balanced scorecard as a strategic management tool in a long-term care organization.

    PubMed

    Schalm, Corinne

    2008-01-01

    The Capital Care Group, the largest public sector continuing care organization in Canada, had no ready access to information on its own performance and therefore was limited in its pursuit of evidence-informed decision-making. To remedy this, it was decided to introduce a balanced scorecard. A literature review was conducted together with interviews with 10 other health care organizations which had implemented balanced scorecards. With this information, a workshop was held that resulted in a framework and about 120 potential indicators. Subsequently the number of indicators was reduced to 29, using pre-determined criteria. Development of a corporate balanced scorecard facilitated executive strategic thinking and clarified the organization's strategic direction. In parallel, scorecards were developed at the level of care centres. These had a common core of indicators, plus some site-specific ones. Development of the corporate scorecard took three years and an additional six months for the care centre scorecards. A formal implementation plan has been accepted by the executive team. Key to this is communicating to staff the role of scorecards for strategic management and not just performance measurement. Traditional thinking needs to change from a short-term operational focus to long-term strategy. In addition, champions need to be identified in each care centre and they need to be networked together. Finally, the scorecard is being integrated into existing operational management as a routine component together with resources to support its use. The balanced scorecard has focused on its role as a strategic management tool. The indicators and dimensions need to be customized to the organization. Senior management must be seen to be driving its introduction. It is worth spending sufficient time developing and implementing a scorecard rather than trying to rush its introduction. The scorecard needs to be integrated with existing management processes and sufficient

  9. Cultural Change and a Balanced Scorecard. Does Your Organization Measure Up?

    ERIC Educational Resources Information Center

    McAlary, Chris K.

    2001-01-01

    Discusses the balanced scorecard concept, a customer-based planning and process improvement system for measuring the success of campus business enterprises and helping to better achieve organizational goals. Scorecard design and implementation are described as are selected success stories. (GR)

  10. Quality Measures for Dialysis: Time for a Balanced Scorecard.

    PubMed

    Kliger, Alan S

    2016-02-05

    Recent federal legislation establishes a merit-based incentive payment system for physicians, with a scorecard for each professional. The Centers for Medicare and Medicaid Services evaluate quality of care with clinical performance measures and have used these metrics for public reporting and payment to dialysis facilities. Similar metrics may be used for the future merit-based incentive payment system. In nephrology, most clinical performance measures measure processes and intermediate outcomes of care. These metrics were developed from population studies of best practice and do not identify opportunities for individualizing care on the basis of patient characteristics and individual goals of treatment. The In-Center Hemodialysis (ICH) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey examines patients' perception of care and has entered the arena to evaluate quality of care. A balanced scorecard of quality performance should include three elements: population-based best clinical practice, patient perceptions, and individually crafted patient goals of care. Copyright © 2016 by the American Society of Nephrology.

  11. [The balanced scorecard--applications in a radiology department].

    PubMed

    Maurer, M H; Teichgräber, U; Kröncke, T J; Hamm, B; Lemke, A J

    2012-12-01

    The balanced scorecard (BSC) represents a comprehensive management tool for organizations with the aim to focus all activities on a chosen strategy. Targets for various perspectives of the environment such as the customer, financial, process, and potential perspective are linked with concrete measures, and cause-effect relationships between the objectives are analyzed. This article shows that the BSC can also be used for the comprehensive control of a radiology department and thus provides a meaningful contribution in organizing the various diagnostic and treatment services, the management of complex clinical environment and can be of help with the tasks in research and teaching. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Environmental performance evaluation and strategy management using balanced scorecard.

    PubMed

    Hsu, Yu-Lung; Liu, Chun-Chu

    2010-11-01

    Recently, environmental protection and regulations such as WEEE, ELV, and RoHS are rapidly emerging as an important issue for business to consider. The trend of swinging from end-of-pipe control to product design, green innovation, and even the establishment of image or brand has affected corporations in almost every corner in the world, and enlarged to the all modern global production network. Corporations must take proactive environmental strategies to response the challenges. This study adopts balanced scorecard structure and aim at automobile industries to understand the relationships of internal and external, financial and non-financial, and outcome and driving factors. Further relying on these relationships to draw the "map of environment strategy" to probe and understand the feasibility of environmental performance evaluation and environmental strategy control.

  13. Strategic performance in hospitals: the use of the balanced scorecard by nurse managers.

    PubMed

    Naranjo-Gil, David

    2009-01-01

    The competitive and dynamic health care sector has spurred hospitals into delivering greater flexibility and quality of services while cutting the hospital cost at the same time. However, hospitals differ in the extent to which they achieve these strategic goals. This article explores the use of a new management tool-the balanced scorecard-which facilitates managers to meet multiple strategic goals. It also analyzes how nurse managers use the balanced scorecard in an interactive or diagnostic way and its subsequent effect on strategic goal achievement (cost reduction and flexibility). It also examines how "balanced" is the balanced scorecard in terms of financial versus nonfinancial measures. Data were collected from a mail survey sent to 218 nurse managers in Spanish public hospitals. A satisfactory response rate was achieved, with 114 (52.29%) useful answered questionnaires. The results show that younger, more tenured, and clinically trained nurse managers would be more likely to use the balanced scorecard in an interactive way. Conversely, older, less tenured, and administratively trained managers would use it diagnostically. The results also indicate that the balanced scorecard facilitates the cost reduction and flexibility in hospitals only when it is used interactively. This article provides evidence that not only the technical design of the balanced scorecard matters, but also an appropriate use of the balanced scorecard is paramount for achievement of multiple strategic goals. An effective use of the balanced scorecard requires managers to actively stimulate dialogue and agreement among hospital's staff about desirable financial and nonfinancial performance measures in alignment with multiple strategic goals.

  14. The balanced scorecard: an incremental approach model to health care management.

    PubMed

    Pineno, Charles J

    2002-01-01

    The balanced scorecard represents a technique used in strategic management to translate an organization's mission and strategy into a comprehensive set of performance measures that provide the framework for implementation of strategic management. This article develops an incremental approach for decision making by formulating a specific balanced scorecard model with an index of nonfinancial as well as financial measures. The incremental approach to costs, including profit contribution analysis and probabilities, allows decisionmakers to assess, for example, how their desire to meet different health care needs will cause changes in service design. This incremental approach to the balanced scorecard may prove to be useful in evaluating the existence of causality relationships between different objective and subjective measures to be included within the balanced scorecard.

  15. Performance enhancement using a balanced scorecard in a Patient-centered Medical Home.

    PubMed

    Fields, Scott A; Cohen, Deborah

    2011-01-01

    Oregon Health & Science University Family Medicine implemented a balanced scorecard within our clinics that embraces the inherent tensions between care quality, financial productivity, and operational efficiency. This data-driven performance improvement process involved: (1) consensus-building around specific indicators to be measured, (2) developing and refining the balanced scorecard, and (3) using the balanced scorecard in the quality improvement process. Developing and implementing the balanced scorecard stimulated an important culture shift among clinics; practice members now actively use data to recognize successes, understand emerging problems, and make changes in response to these problems. Our experience shows how Patient-centered Medical Homes can be enhanced through use of information technology and evidence-based tools that support improved decision making and performance and help practices develop into learning organizations.

  16. A Balanced Scorecard With Strategy Map: Measuring the Value of a Nursing Sabbatical.

    PubMed

    Embree, Jennifer L; Swenty, Constance F; Schaar, Gina

    2015-01-01

    Seasoned nurses frequently resign from their positions due to burnout. An innovative idea that could support nurse retention is nurse sabbaticals. Balanced scorecards with strategy maps can display financial benefit, positive customer experience, and operational and human capital development required to initiate and sustain a professional nurse sabbatical. A balanced scorecard with strategy map is an effective tool that demonstrates connection between the organizational mission and the outcomes of a nurse sabbatical program.

  17. Designing and implementing a balanced scorecard: lessons learned in nonprofit implementation.

    PubMed

    Gumbus, Andra; Wilson, Tom

    2004-01-01

    The balanced scorecard has been referred to as the management innovation of the century, and extensive articles have been written using case studies of organizations that use this performance measurement system. This article addresses the key issues of design and implementation with a step-by-step guide to how to design a balanced scorecard and lessons to avoid implementation problems in government and nonprofit settings.

  18. [The Balanced Scorecard as a management tool in a public health organization].

    PubMed

    Villalbí, Joan R; Villalbí, Joan; Guix, Joan; Casas, Conrad; Borrell, Carme; Duran, Júlia; Artazcoz, Lucía; Camprubí, Esteve; Cusí, Meritxell; Rodríguez-Montuquín, Pau; Armengol, Josep M; Jiménez, Guy

    2007-01-01

    The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board.

  19. Issues for academic health centers to consider before implementing a balanced-scorecard effort.

    PubMed

    Zelman, W N; Blazer, D; Gower, J M; Bumgarner, P O; Cancilla, L M

    1999-12-01

    Because of changes in the health care environment, it is likely that strategic planning and management will become much more important to academic health centers (AHCs) than in the past. One approach to strategic planning and management that is gaining the considerable interest of health care organizations is the balanced scorecard. Based on a year's experience in examining this management tool, and on early implementation efforts, the authors critically evaluate the applicability of the balanced-scorecard approach at AHCs in relation to two fundamental questions: Does the decentralized nature of most AHCs mitigate the potential usefulness of the balanced-scorecard approach? Are the balanced scorecard's four perspectives (learning and growth, internal; customer; and financial) appropriate for AHCs, which are neither for-profit nor manufacturing organizations? The authors conclude that (1) the unique characteristics of AHCs may mitigate the full benefit of the balanced-scorecard approach, and (2) in cases where it is used, some key modifications must be made in the balanced-scorecard approach to account for those unique characteristics. For example, in a corporation, the key question from the financial perspective is "To succeed financially, how should we appear to our stockholders?" But in an AHC, this question must be revised to "What financial condition must we achieve to allow us to accomplish our mission?"

  20. Quantitative performance targets by using balanced scorecard system: application to waste management and public administration.

    PubMed

    Mendes, Paula; Nunes, Luis Miguel; Teixeira, Margarida Ribau

    2014-09-01

    This article demonstrates how decision-makers can be guided in the process of defining performance target values in the balanced scorecard system. We apply a method based on sensitivity analysis with Monte Carlo simulation to the municipal solid waste management system in Loulé Municipality (Portugal). The method includes two steps: sensitivity analysis of performance indicators to identify those performance indicators with the highest impact on the balanced scorecard model outcomes; and sensitivity analysis of the target values for the previously identified performance indicators. Sensitivity analysis shows that four strategic objectives (IPP1: Comply with the national waste strategy; IPP4: Reduce nonrenewable resources and greenhouse gases; IPP5: Optimize the life-cycle of waste; and FP1: Meet and optimize the budget) alone contribute 99.7% of the variability in overall balanced scorecard value. Thus, these strategic objectives had a much stronger impact on the estimated balanced scorecard outcome than did others, with the IPP1 and the IPP4 accounting for over 55% and 22% of the variance in overall balanced scorecard value, respectively. The remaining performance indicators contribute only marginally. In addition, a change in the value of a single indicator's target value made the overall balanced scorecard value change by as much as 18%. This may lead to involuntarily biased decisions by organizations regarding performance target-setting, if not prevented with the help of methods such as that proposed and applied in this study. © The Author(s) 2014.

  1. Balancing the balanced scorecard for a New Zealand mental health service.

    PubMed

    Coop, Colleen F

    2006-05-01

    Given the high prevalence of mental disorders, there is a need to evaluate mental health services to ensure they are efficient, effective, responsive and accessible. One method that is being used is the "balanced scorecard" which uses performance indicators in four quadrants to assess various dimensions of service provision. This case study describes the steps taken by a New Zealand mental health service to improve service management through greater use of key performance indicators in relation to preset targets using this approach.

  2. The balanced scorecard: a potent tool for energizing and focusing healthcare organization management.

    PubMed

    Chow, C W; Ganulin, D; Teknika, O; Haddad, K; Williamson, J

    1998-01-01

    The current environment for healthcare organizations contains many forces demanding unprecedented levels of change. These forces include changing demographics, increased customer expectations, increased competition, and intensified governmental pressure. Meeting these challenges will require healthcare organizations to undergo fundamental changes and to continuously seek new ways to create future value. This article provides explanation of a potent new management tool-the balanced scorecard-that can be used by healthcare organizations to meet these challenges. The article also presents the opinions of many high-level healthcare administrators that the balanced scorecard can be highly beneficial to healthcare organizations. It also summarizes these administrators' suggestions regarding the goals and measures that can make up an effective scorecard for a hospital as a whole, as well as for a specific subunit of a hospital. Interestingly, while no published report of balanced scorecard implementations in healthcare organizations exists, a number of administrators stated that they had fully implemented systems similar to the scorecard. These actions can be considered support for the scorecard's potential usefulness; at the same time, they suggest that some sharing of experiences will likely be available in the future. As all administrators are well aware, moving from concept to practice is often difficult. While the article includes some suggestions for scorecard development and implementation, each organization must engage in the full range of activities, from defining its mission to the selection of goals and strategies, and develop its own unique scorecard to assist progress toward the selected goals. As a starting point, Table 3 provides a timeline of some general events that may be common to all organizations during this process.

  3. The Balanced Scorecard of acute settings: development process, definition of 20 strategic objectives and implementation.

    PubMed

    Groene, Oliver; Brandt, Elimer; Schmidt, Werner; Moeller, Johannes

    2009-08-01

    Strategy development and implementation in acute care settings is often restricted by competing challenges, the pace of policy reform and the existence of parallel hierarchies. To describe a generic approach to strategy development, illustrate the use of the Balanced Scorecard as a tool to facilitate strategy implementation and demonstrate how to break down strategic goals into measurable elements. Multi-method approach using three different conceptual models: Health Promoting Hospitals Standards and Strategies, the European Foundation for Quality Management (EFQM) Model and the Balanced Scorecard. A bundle of qualitative and quantitative methods were used including in-depth interviews, standardized organization-wide surveys on organizational values, staff satisfaction and patient experience. Three acute care hospitals in four different locations belonging to a German holding group. Chief executive officer, senior medical officers, working group leaders and hospital staff. Development and implementation of the Balanced Scorecard. Twenty strategic objectives with corresponding Balanced Scorecard measures. A stepped approach from strategy development to implementation is presented to identify key themes for strategy development, drafting a strategy map and developing strategic objectives and measures. The Balanced Scorecard, in combination with the EFQM model, is a useful tool to guide strategy development and implementation in health care organizations. As for other quality improvement and management tools not specifically developed for health care organizations, some adaptations are required to improve acceptability among professionals. The step-wise approach of strategy development and implementation presented here may support similar processes in comparable organizations.

  4. Introduction of the Balanced Scorecard into an academic department of medicine: creating a road map to success.

    PubMed

    Bouland, Daniel L; Fink, Ed; Fontanesi, John

    2011-01-01

    In this paper, we describe: 1) the environmental forces driving performance measurement and management in the University of California San Diego Department of Medicine; 2) the systematic process used by the department to implement a Balanced Scorecard; 3) the initial direct and indirect outcomes of this effort; 4) the opportunities and challenges to the Balanced Scorecard as a management directive; and 5) future directions.

  5. A balanced scorecard for health services in Afghanistan.

    PubMed

    Peters, David H; Noor, Ayan Ahmed; Singh, Lakhwinder P; Kakar, Faizullah K; Hansen, Peter M; Burnham, Gilbert

    2007-02-01

    The Ministry of Public Health (MOPH) in Afghanistan has developed a balanced scorecard (BSC) to regularly monitor the progress of its strategy to deliver a basic package of health services. Although frequently used in other health-care settings, this represents the first time that the BSC has been employed in a developing country. The BSC was designed via a collaborative process focusing on translating the vision and mission of the MOPH into 29 core indicators and benchmarks representing six different domains of health services, together with two composite measures of performance. In the absence of a routine health information system, the 2004 BSC for Afghanistan was derived from a stratified random sample of 617 health facilities, 5719 observations of patient-provider interactions, and interviews with 5597 patients, 1553 health workers, and 13,843 households. Nationally, health services were found to be reaching more of the poor than the less-poor population, and providing for more women than men, both key concerns of the government. However, serious deficiencies were found in five domains, and particularly in counselling patients, providing delivery care during childbirth, monitoring tuberculosis treatment, placing staff and equipment, and establishing functional village health councils. The BSC also identified wide variations in performance across provinces; no province performed better than the others across all domains. The innovative adaptation of the BSC in Afghanistan has provided a useful tool to summarize the multidimensional nature of health-services performance, and is enabling managers to benchmark performance and identify strengths and weaknesses in the Afghan context.

  6. Cooperation and competition: balanced scorecard and hospital privatization.

    PubMed

    Aidemark, Lars-Göran

    2010-01-01

    In 2000 the Skåne Region (a public authority) and a private contractor made a five-year agreement for the provision of both in-patient care and out-patient medical services to about 30,000 inhabitants in the south-east part of the region. The Skåne Region is the main provider of health care to about one million inhabitants in the south of Sweden and is responsible for all health care (private and public), including ten hospitals. This paper seeks to answer the question of how the Skåne Region can control and cooperate with a private contractor, entering into competition with the public health care providers in the region. This is a longitudinal study conducted between 2001-2006. It is based on 28 taped interviews with employees responsible for the contracting process, participating observations and comprehensive secondary material. The study presents experiences made by the contractor and the public authority on how to work out and follow-up assignments within the health care sector regarding patient interest, public interest and professional medical interest. Measurement within the frames of the balanced scorecard (BSC) made it possible to control both volumes and health care quality delivered by the private competing contractor. The political purchaser claims that the Skåne Region has established a cost-effective and successful control system based on trust and measurement. This paper reports on a control system, between public purchaser and a private provider within health care, that focuses on and follow-up not only health care production but also health care quality.

  7. Balanced scorecard application in the health care industry: a case study.

    PubMed

    Kocakülâh, Mehmet C; Austill, A David

    2007-01-01

    Balanced scorecards became a popular strategic performance measurement and management tool in the 1990s by Robert Kaplan and David Norton. Mainline companies accepted balanced scorecards quickly, but health care organizations were slow to adopt them for use. A number of problems face the health care industry, including cost structure, payor limitations and constraints, and performance and quality issues that require changes in how health care organizations, both profit and nonprofit, manage operations. This article discusses balanced scorecards generally from theoretical and technical views, and why they should be used by health care organizations. The authors argue that balanced scorecards are particularly applicable to hospitals, clinics, and other health care companies. Finally, the authors perform a case study of the development, implementation, and use of balance scorecards by a regional Midwestern health care system. The positive and negative aspects of the subject's balanced scorecard are discussed. Leaders in today's health care industry are under great pressure to meet their financial goals. The industry is faced with financial pressures from consumers, insurers, and governments. Inflation in the industry is much higher than it is within the overall economy. Employers can no longer bear the burden of rising group health insurance costs for its employees. Too many large companies have used bankruptcy law as a shield to reduce or shift some of their legal obligations to provide health insurance coverage to present or retired employees. Stakeholders of health care providers are demanding greater control over costs. As the segment of un- or underinsured within the United States becomes larger as a percentage of the population, voters are seriously beginning to demand some form of national health insurance, which will drastically change the health care industry.

  8. Using the balanced scorecard to align strategy and performance in long-term care.

    PubMed

    Macdonald, M

    1998-01-01

    The Sisters of Charity of Ottawa Health Service (SCOHS) is a Canadian health care corporation that has adapted Kaplan and Norton's balanced scorecard to enhance strategic management and measurement in a multisite health care facility comprising long term care, continuing complex care, rehabilitative services, palliative care and ambulatory care. This article discusses how the SCOHS has incorporated the following principles into the balanced scorecard: demonstration of cause and effect; inclusion of outcomes and performance drivers; linkage to fiscal and utilization indicators; and integration of the mission and values of the organization. Examples of corporate level outcomes and performance measures are provided in the form of lead and lag indicators.

  9. [The balanced scorecard used as a management tool in a clinical laboratory: internal business processes indicators].

    PubMed

    Salinas La Casta, Maria; Flores Pardo, Emilio; Uris Selles, Joaquín

    2009-01-01

    to propose a set of indicators as a management tool for a clinical laboratory, by using the balanced scorecard internal business processes perspective. indicators proposed are obtained from different sources; external proficiency testing of the Valencia Community Government, by means of internal surveys and laboratory information system registers. One year testing process proportion indicators results are showed. internal management indicators are proposed (process, appropriateness and proficiency testing). The process indicators results show gradual improvement since its establishment. after one years of using a conceptually solid Balanced Scorecard Internal business processes perspective indicators, the obtained results validate the usefulness as a laboratory management tool.

  10. 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.

  11. Improving health services to displaced persons in Aceh, Indonesia: a balanced scorecard

    PubMed Central

    Parco, Kristin B; Sihombing, Melva E; Tredwell, Susan P; O'Rourke, Edward J

    2010-01-01

    Abstract Problem After the Indian Ocean tsunami in December 2004, the International Organization for Migration constructed temporary health clinics to provide medical services to survivors living in temporary accommodation centres throughout Aceh, Indonesia. Limited resources, inadequate supervision, staff turnover and lack of a health information system made it challenging to provide quality primary health services. Approach A balanced scorecard was developed and implemented in collaboration with local health clinic staff and district health officials. Performance targets were identified. Staff collected data from clinics and accommodation centres to develop 30 simple performance measures. These measures were monitored periodically and discussed at meetings with stakeholders to guide the development of health interventions. Local setting Two years after the tsunami, 34 000 displaced persons continued to receive services from temporary health clinics in two districts of Aceh province. From March to December 2007, the scorecard was implemented in seven temporary health clinics. Relevant changes Interventions stimulated and tracked by the scorecard showed measurable improvements in preventive medicine, child health, capacity building of clinic staff and availability of essential drugs. By enhancing communication, the scorecard also led to qualitative benefits. Lessons learnt The balanced scorecard is a practical tool to focus attention and resources to facilitate improvement in disaster rehabilitation settings where health information infrastructure is poor. Introducing a mechanism for rapid improvement fostered communication between nongovernmental organizations, district health officials, clinic health workers and displaced persons. PMID:20865077

  12. Improving health services to displaced persons in Aceh, Indonesia: a balanced scorecard.

    PubMed

    Chan, Grace J; Parco, Kristin B; Sihombing, Melva E; Tredwell, Susan P; O'Rourke, Edward J

    2010-09-01

    After the Indian Ocean tsunami in December 2004, the International Organization for Migration constructed temporary health clinics to provide medical services to survivors living in temporary accommodation centres throughout Aceh, Indonesia. Limited resources, inadequate supervision, staff turnover and lack of a health information system made it challenging to provide quality primary health services. A balanced scorecard was developed and implemented in collaboration with local health clinic staff and district health officials. Performance targets were identified. Staff collected data from clinics and accommodation centres to develop 30 simple performance measures. These measures were monitored periodically and discussed at meetings with stakeholders to guide the development of health interventions. Two years after the tsunami, 34 000 displaced persons continued to receive services from temporary health clinics in two districts of Aceh province. From March to December 2007, the scorecard was implemented in seven temporary health clinics. Interventions stimulated and tracked by the scorecard showed measurable improvements in preventive medicine, child health, capacity building of clinic staff and availability of essential drugs. By enhancing communication, the scorecard also led to qualitative benefits. The balanced scorecard is a practical tool to focus attention and resources to facilitate improvement in disaster rehabilitation settings where health information infrastructure is poor. Introducing a mechanism for rapid improvement fostered communication between nongovernmental organizations, district health officials, clinic health workers and displaced persons.

  13. A Balanced Scorecard for Open Innovation: Measuring the Impact of Industry-University Collaboration

    NASA Astrophysics Data System (ADS)

    Flores, Myrna; Al-Ashaab, Ahmed; Magyar, Andrea

    The Balanced Scorecard (BSC) can be considered as a strategic measurement tool. Since its first publication by Norton and Kaplan in the early 1990’s, many companies have applied it to measure four key aspects of their organisations’ performance: Financial, Customer, Internal Business Process, Learning and Growth. Although it is widely used in the business arena, this original BSC was not developed to assess the impact of collaborative research projects under an open innovation strategy, where the outputs of research and development (R&D) developed by collaborative projects undertaken by industry and universities should be measured in a different way. In fact, many companies are losing important opportunities to spur their R&D results by not being able to quantify the results of such collaborations. Therefore, this paper will propose a Scorecard to measure the outcomes of collaborative research. It is important to recall that this scorecard has been developed during a collaborative research project by CEMEX Research Group AG (Switzerland) and Cranfield University (UK). During such project, a survey was developed to carry out eleven face-to-face interviews in a sample of ten companies in UK, which provided important inputs to design such strategic scorecard. It was confirmed that a collaborative balanced scorecard is a very useful tool to measure, track and improve the impact of conducting collaborative projects with universities.

  14. Introducing a balanced scorecard management system in a university anesthesiology department.

    PubMed

    Zbinden, Alex M

    2002-12-01

    The study goal was to show how Balanced Scorecard, a modern management tool based on score numbers, can efficiently be applied to a university anesthesiology department. Nineteen score numbers were established in four perspectives. Meaningful results were obtained with limited resources to support a process of innovation and improvement.

  15. [The use of the balanced scorecard and the budget in the strategic management of public hospitals].

    PubMed

    Naranjo Gil, David

    2010-01-01

    To analyze the relationship between hospital managers' characteristics and the use of the balanced scorecard and the budget. A further aim was to analyze how these two techniques influence strategic goals aimed at cost reduction and enhancing service flexibility. Data were collected through a questionnaire sent to 884 members of top management teams in 218 public hospitals in Spain. The response rate was 53.51% with 473 useful questionnaires. Structural equation techniques were used to validate the metric scales and the model used. Younger managers and less tenured managers were more likely to use the balanced scorecard than the budget. Diversity in the top management team was related to the use of distinct management control techniques. The use of the balanced scorecard was positively associated with the implementation of healthcare strategies focused on enhancing service flexibility and reducing healthcare cost. The adoption of management control systems is not only a function of the outcome of a rational decision-making process and institutional pressures but also crucially depends on the characteristics of the individuals ultimately responsible for such decisions. The use of the balanced scorecard facilitates hospitals' implementation of plans with multiple strategic goals. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

  16. Performance Evaluation of Extension Education Centers in Universities Based on the Balanced Scorecard

    ERIC Educational Resources Information Center

    Wu, Hung-Yi; Lin, Yi-Kuei; Chang, Chi-Hsiang

    2011-01-01

    This study aims at developing a set of appropriate performance evaluation indices mainly based on balanced scorecard (BSC) for extension education centers in universities by utilizing multiple criteria decision making (MCDM). Through literature reviews and experts who have real practical experiences in extension education, adequate performance…

  17. The E-Balanced Scorecard (e-BSC) for Measuring Academic Staff Performance Excellence

    ERIC Educational Resources Information Center

    Yu, May Leen; Hamid, Suraya; Ijab, Mohamad Taha; Soo, Hsaio Pei

    2009-01-01

    This research paper is a pilot study that investigated the suitability of adopting an automated balanced scorecard for managing and measuring the performance excellence of academic staffs in the higher education setting. A comprehensive study of related literature with requirements elicited from the target population in a selected premier…

  18. Relationship between Balanced Scorecard and Professors' Job Characteristics at Ekiti State University, Nigeria

    ERIC Educational Resources Information Center

    Fatile, Mopelola

    2017-01-01

    The purpose of this quantitative, correlational study was to understand the relationship between a balanced scorecard, professors' job characteristics, and the leadership styles of higher education leaders at Ekiti State University, Ado-Ekiti State, Nigeria, which was the site of the study. The problem statement addressed whether or not a…

  19. The Design of Curriculum Development Based on Entrepreneurship through Balanced Scorecard Approach

    ERIC Educational Resources Information Center

    Hidayat, Muhammad; Musa, Chalid Imran; Haerani, Siti; Sudirman, Indrianti

    2015-01-01

    This research is intended to develop curriculum based on entrepreneurship through balanced scorecard approach at the School of Business or "Sekolah Tinggi Ilmu Ekonomi" (STIE) Nobel Indonesia. In order to develop the curriculum, a need analysis in terms of curriculum development that involves all stakeholders at STIE Nobel in Indonesia…

  20. Ubuntu-Praxis: Re-Modelling the Balanced Scorecard Model at a University, an Afrocentric Perspective

    ERIC Educational Resources Information Center

    Ndoda, Gladys Ruvimbo; Sikwila, Mike Nyamazana

    2014-01-01

    The authors design the innovation and learning perspective of the Balanced Scorecard (BSC) of "Ubuntu and client service charter nexus." This article borrows and advances the research carried out by Khomba, Vermaak and Gouws (2011). The point of departure is on praxis of ubuntu/unhu as a holistic approach in the re-modelling of the BSC…

  1. Performance, Process, and Costs: Managing Service Quality with the Balanced Scorecard.

    ERIC Educational Resources Information Center

    Poll, Roswitha

    2001-01-01

    Describes a cooperative project among three German libraries that used the Balanced Scorecard as a concept for an integrated quality management system. Considers performance indicators across four perspectives that will help academic libraries establish an integrated controlling system and to collect and evaluate performance as well as cost data…

  2. Microworlds of the dynamic balanced scorecard for university (DBSC-UNI)

    NASA Astrophysics Data System (ADS)

    Hawari, Nurul Nazihah; Tahar, Razman Mat

    2015-12-01

    This research focuses on the development of a Microworlds of the dynamic balanced scorecard for university in order to enhance the university strategic planning process. To develop the model, we integrated both the balanced scorecard method and the system dynamics modelling method. Contrasting the traditional university planning tools, the developed model addresses university management problems holistically and dynamically. It is found that using system dynamics modelling method, the cause-and-effect relationships among variables related to the four conventional balanced scorecard perspectives are better understand. The dynamic processes that give rise to performance differences between targeted and actual performances also could be better understood. So, it is expected that the quality of the decisions taken are improved because of being better informed. The developed Microworlds can be exploited by university management to design policies that can positively influence the future in the direction of desired goals, and will have minimal side effects. This paper integrates balanced scorecard and system dynamics modelling methods in analyzing university performance. Therefore, this paper demonstrates the effectiveness and strength of system dynamics modelling method in solving problem in strategic planning area particularly in higher education sector.

  3. [Balanced Scorecard--a business tool for profit calculations--usable in gynecology and obstetrics?].

    PubMed

    Goerke, K

    2001-08-01

    The balanced scorecard (BSC) is an instrument of business administration using score numbers, that not only includes financial aspects but also levels of communication, motivation and customer relations. Thus it seems usable in service oriented companies including hospitals. The next years will have to show, whether the results rectify the immense expenses necessary with the implementation of the BSC.

  4. A Survey and Analysis of Aircraft Maintenance Metrics: A Balanced Scorecard Approach

    DTIC Science & Technology

    2014-03-27

    Metrics Set Theory /Framework .................................................................................... 16 Balanced Scorecard overview...a useful form Figure 1: Metric Evaluation Criteria (Caplice & Sheffi, 1994, p. 14) Metrics Set Theory /Framework The researcher included an...examination of established theory and frameworks on how metrics sets are constructed in the literature review. The purpose of this examination was to

  5. Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

    PubMed

    Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

    2016-06-01

    This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases. © The Author(s) 2014.

  6. The Balanced Scorecard as a management tool for assessing and monitoring strategy implementation in health care organizations.

    PubMed

    Bisbe, Josep; Barrubés, Joan

    2012-10-01

    Both prior literature and reported managerial practices have claimed that the Balanced Scorecard is a management tool that can help organizations to effectively implement strategies. In this article, we examine some of the contributions, dilemmas, and limitations of Balanced Scorecards in health care organizations. First, we describe the evolution of Balanced Scorecards from multidimensional performance measurement systems to causal representations of formulated strategies, and analyze the applicability of Balanced Scorecards in health care settings. Next, we discuss several issues under debate regarding Balanced Scorecard adoption in health care organizations. We distinguish between issues related to the design of Balanced Scorecards and those related to the use of these tools. We conclude that the Balanced Scorecard has the potential to contribute to the implementation of strategies through the strategically-oriented performance measurement systems embedded within it. However, effective adoption requires the adaptation of the generic instrument to the specific realities of health care organizations. Full English text available from:www.revespcardiol.org. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  7. Determining the causal relationships among balanced scorecard perspectives on school safety performance: case of Saudi Arabia.

    PubMed

    Alolah, Turki; Stewart, Rodney A; Panuwatwanich, Kriengsak; Mohamed, Sherif

    2014-07-01

    In the public schools of many developing countries, numerous accidents and incidents occur because of poor safety regulations and management systems. To improve the educational environment in Saudi Arabia, the Ministry of Education seeks novel approaches to measure school safety performance in order to decrease incidents and accidents. The main objective of this research was to develop a systematic approach for measuring Saudi school safety performance using the balanced scorecard framework philosophy. The evolved third generation balanced scorecard framework is considered to be a suitable and robust framework that captures the system-wide leading and lagging indicators of business performance. The balanced scorecard architecture is ideal for adaptation to complex areas such as safety management where a holistic system evaluation is more effective than traditional compartmentalised approaches. In developing the safety performance balanced scorecard for Saudi schools, the conceptual framework was first developed and peer-reviewed by eighteen Saudi education experts. Next, 200 participants, including teachers, school executives, and Ministry of Education officers, were recruited to rate both the importance and the performance of 79 measurement items used in the framework. Exploratory factor analysis, followed by the confirmatory partial least squares method, was then conducted in order to operationalise the safety performance balanced scorecard, which encapsulates the following five salient perspectives: safety management and leadership; safety learning and training; safety policy, procedures and processes; workforce safety culture; and safety performance. Partial least squares based structural equation modelling was then conducted to reveal five significant relationships between perspectives, namely, safety management and leadership had a significant effect on safety learning and training and safety policy, procedures and processes, both safety learning and training

  8. Tallying the U.S.-China Military Scorecard: Relative Capabilities and the Balance of Power, 1996-2017

    DTIC Science & Technology

    2015-01-01

    C O R P O R A T I O N RESE ARCH BR IEF Tallying the U.S.-China Military Scorecard Relative Capabilities and the Balance of Power, 1996–2017 Over the...sources, the scorecards provide a basis for deeper public discussion of how the balance of power in Asia has evolved and the challenges the United...SUBTITLE Tallying the U.S.-China Military Scorecard : Relative Capabilities and the Balance of Power, 1996-2017 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

  9. Balanced scorecard as a framework for driving performance in managed care organizations.

    PubMed

    Sahney, V K

    1998-01-01

    Managed care organizations in a highly competitive environment constantly face the pressure of improving their financial performance. At the same time, customers of the organization expect the organization to deliver high-quality outcomes and improve customer service. Payers expect the organization to develop innovative new products to meet their needs. This article presents an approach called "Balanced Scorecard" for measurement, development of strategy, and performance improvement in a managed care organization.

  10. Using the balanced scorecard to mobilize human resources in organizational transformation.

    PubMed

    Tsasis, Peter; Harber, Bruce

    2008-05-01

    Traditionally, the balanced scorecard (BSC) has been an effective tool in linking measurement to strategy. However, what is least understood is how the BSC can be used to redefine organizational relationships, re-engineer fundamental processes and transform organizational culture, for superior performance in an organization with the same people, services and technology that previously delivered dismal performance. This paper highlights the process and uses York Central Hospital in Toronto, Ontario, Canada as an illustrative example.

  11. Evaluating the balanced scorecard at the University Health Network: an impact assessment.

    PubMed

    Young, Justin; Bell, Robert; Khalfan, Adil; Lindquist, Evert

    2008-01-01

    The balanced scorecard (BSC) has become increasing popular in healthcare organizations. A recent study conducted at the University Health Network in Toronto explored the extent to which the BSC has focused and aligned various organizational units and departments around shared goals and objectives. The evaluation also assessed the BSC's impact on front-line staff and how the development and rollout of the BSC should be modified in the next planning iteration.

  12. A critical review of financial measures as reported in the Ontario hospital balanced scorecard.

    PubMed

    Parkinson, John; Tsasis, Peter; Porporato, Marcela

    2007-01-01

    For Ontario hospitals in Canada, the Financial Performance and Condition measures in the Ontario hospital balanced scorecard are especially of interest since in the foreseeable future, they may be linked to provincial government funding decisions. However, we find that these measures lack valuable information on key attributes that affect organizational performance. We suggest changes that focus on key drivers of performance and reflect the operational realities of Ontario hospitals.

  13. [Development and evolution of a balanced scorecard in primary health care: Lessons learned].

    PubMed

    Bartolomé-Benito, E; Jiménez-Carramiñana, J; Sánchez-Perruca, L; Bartolomé-Casado, M S; Dominguez-Mandueño, A B; Marti-Argandoña, M; Hernández-Pascual, M; Miquel-Gómez, A

    To describe the design, implementation, and monitoring of eSOAP (Primary Health Care Balanced Scorecard) and its role in the deployment of strategic objectives and clinical management, as well as to show the lessons learned during six years of follow-up. Descriptive study areas: methodology (conceptual framework, strategic matrix, strategic map, and processes map), technology and standardisation. As of December 2014, 9,046 (78%) professionals are registered in eSOAP. A total of 381 indicators were measured from 16 data sources, of which 36% were of results (EFQM model), 39.1% of clinical management, and 20% were included in the Program Centre Contract. The Balanced Scorecard has enabled to deploy all strategic lines of Primary Health Care, and has enabled the healthcare professionals to evaluate the evolution of results over time, and at patient level (e.g. 16% increase in control of diabetic patients). A total of 295,779 reports were generated and 13,080 professionals were evaluated by goals. There was an increased use of the eSOAP application by the professionals. The Balanced Scorecard was the key in deploying Primary Health Care strategies. It has helped clinical management and improved relevant indicators (health, patient experience, and costs), such as the management models that we used as references (EFQM Kaplan and Norton), and new emerging scenarios (Triple aim). Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Balanced Scorecard Goal Four: Provide Policy Management, Advocacy and Problem Solving Measuring Achievement of Internal Customer Objectives

    DTIC Science & Technology

    2002-06-01

    Achievement of Internal Customer Objectives A Graduate Management Project Submitted to The Residency Committee In Candidacy for the Degree of Masters in...internal customer relations, the GPRMC has incorporated use of a Balanced Scorecard within its management scheme. The scorecard serves as a strategy map...headquarters. The goal, "Provide Policy Management , Advocacy and Problem Solving", addresses the relationship between the headquarters and its internal

  15. An Examination of the Department of Defense Financial Improvement and Audit Readiness Plan Using a Balanced Scorecard

    DTIC Science & Technology

    2011-06-01

    BEIS Business Enterprise Information Services BEP Business Enterprise Priorities BMMP Business Management Modernization Program BTA Business...Scorecard framework . Initially published in December 2005, the FIAR is the DoD’s strategy towards achieving audit readiness. The FIAR provides a timeline and...Secretary of Defense Comptroller, n.d.). The Balanced Scorecard, a strategic management framework developed in 1987 by Arthur Schneiderman and popularized

  16. Adapting the balanced scorecard for mental health and addictions: an inpatient example.

    PubMed

    Lin, Elizabeth; Durbin, Janet

    2008-05-01

    The Balanced Scorecard (BSC) is a performance-monitoring framework that originated in the business sector but has more recently been applied to health services. The province of Ontario is using the BSC approach to monitor quality of inpatient care in five service areas. Feasibility of the scorecard framework for each area has been assessed using a standard approach. This paper reports results of the feasibility study for the mental health sector, focusing on three issues: framework relevance, underlying strategic goals and indicator selection. Based on a literature review and extensive stakeholder input, the BSC quadrant structure was recommended with some modifications, and indicators were selected that aligned with provincial mental health reform policy goals. The mental health report has completed two cycles of reporting, and has received good support from the field. Copyright © 2008 Longwoods Publishing.

  17. Balanced Scorecards As a Tool for Developing Patient-Centered Pharmacy Services

    PubMed Central

    Enwere, Emmanuel N.; Keating, Ellen A.; Weber, Robert J.

    2014-01-01

    Having accurate data is essential for the pharmacy director to manage the department and develop patient-centered pharmacy services. A balanced scorecard (BSC) of essential department data, which is a broad view of a department’s function beyond its financial performance, is an important part of any department’s strategic plan. This column describes how the pharmacy director builds and promotes a department’s BSC. Specifically, this article reviews how the BSC supports the department’s mission and vision, describes the metrics of the BSC and how they are collected, and recommends how the pharmacy director can effectively use the scorecard results in promoting the pharmacy. If designed properly and updated consistently, a BSC can present a broad view of the pharmacy’s performance, serve as a guide for strategic decision making, and improve on the quality of its services. PMID:24958976

  18. Developing and using a balanced scorecard: a case study with SWOT analysis.

    PubMed

    Gumbus, Andra; Lussier, Robert N

    2003-01-01

    Have you tried to measure your laboratory's performance lately? Do you measure and assess financial results, customer satisfaction, internal process efficiency, and learning and growth? If any of these metrics are missing from your performance measurement system, you are not using the latest management tool that is sweeping the health-care industry--the balanced scorecard (BSC). This article begins with a discussion of the BSC and why you should use it in your laboratory, followed by SWOT analysis to assess the strengths, weaknesses, opportunities, and threats (SWOT) a BSC offers your laboratory. A laboratory case study is then presented to assist you in developing and using a BSC in your laboratory.

  19. The Balanced Scorecard versus Total Quality Management: which is better for your organization?

    PubMed

    Schwartz, Jay

    2005-10-01

    Today's health care organizations must deal with managed care, government oversight, aging baby boomers, new technologies, and increasing pharmaceutical prices. It is imperative that health care organizations adopt some form of business strategy to manage the vast amount of information available. Two of the more popular strategies among health care organizations are the Balanced Scorecard and Total Quality Management. Which one of the strategies is best for an organization? The answer to this question is that it depends on the organization. This article provides the fundamentals of each strategy and contrasts their strengths and weaknesses, so that interested organizations can make informed decisions regarding the best strategy for each organization.

  20. Reviewing the application of the balanced scorecard with implications for low-income health settings.

    PubMed

    Rabbani, Fauziah; Jafri, S M Wasin; Abbas, Farhat; Pappas, Gregory; Brommels, Mats; Tomson, Goran

    2007-01-01

    High-income countries (HICs) are increasingly making use of the balanced scorecard (BSC) in healthcare. Evidence about BSC usage in low-income countries (LICs) is deficient. This study assessed feasibility of BSC use in LICs. Systematic review of electronic databases shows that the BSC improved patient, staff, clinical, and financial outcomes in HICs. To translate the experience of BSC use in HICs to their use in LICs, the applicability parameters of the National Committee for Quality Assurance were applied. Despite contextual challenges, pilot testing of BSC use can be undertaken in selected LICs. Committed leadership, cultural readiness, quality information systems, viable strategic plans, and optimum resources are required.

  1. Bringing human resources to the table: utilization of an HR balanced scorecard at Mayo Clinic.

    PubMed

    Fottler, Myron D; Erickson, Eric; Rivers, Patrick A

    2006-01-01

    Rather than viewing HR as a critical driver of organizational strategy and outcomes, most health care organizations see HR as a drain on the organization's bottom line. Only by aligning HR with the organizational strategy will HR leaders truly get a seat at the leadership table. HR professionals can overcome impediments and gain a seat at the table by learning the language of business and the ways in which organizational leaders use data to drive their decisions. This article shows how Mayo Clinic uses the popular Balanced Scorecard approach to align its measures of HR performance to the organization's strategic plan.

  2. Balanced scorecard: application in the General Panarcadian Hospital of Tripolis, Greece.

    PubMed

    Koumpouros, Yiannis

    2013-01-01

    The purpose of this paper is to discuss the application of the balanced scorecard (BSC) in the Greek public health sector. The basic balanced scorecard theory has been adopted in the characteristics and individualities of the Greek public health system. The theoretical model developed was applied in the General Panarcadian Hospital of Tripolis (GPHT) in Greece. GPHT is a representative paradigm of a big regional Greek public hospital. It has about 300 beds and many clinics and specialties (internal medicine, cardiology, general surgery, intensive care unit, artificial kidney unit, etc.). Strategic management was performed for almost three years. The BSC model was formulated in an appropriate software program. The problems (both technical and managerial) faced during a three-year period along with the results of this management approach are presented in the current paper. The paper highlights some important gaps in the Greek public health system, while proposing actions to be taken. The BSC theory can be very successful under certain conditions. Special attention is given to the peculiarities of the Greek public health situation. The paper presents for the first time a real life example of applying BSC in the Greek public health sector.

  3. Balanced scorecard-based performance evaluation of Chinese county hospitals in underdeveloped areas.

    PubMed

    Gao, Hongda; Chen, He; Feng, Jun; Qin, Xianjing; Wang, Xuan; Liang, Shenglin; Zhao, Jinmin; Feng, Qiming

    2018-05-01

    Objective Since the Guangxi government implemented public county hospital reform in 2009, there have been no studies of county hospitals in this underdeveloped area of China. This study aimed to establish an evaluation indicator system for Guangxi county hospitals and to generate recommendations for hospital development and policymaking. Methods A performance evaluation indicator system was developed based on balanced scorecard theory. Opinions were elicited from 25 experts from administrative units, universities and hospitals and the Delphi method was used to modify the performance indicators. The indicator system and the Topsis method were used to evaluate the performance of five county hospitals randomly selected from the same batch of 2015 Guangxi reform pilots. Results There were 4 first-level indicators, 9 second-level indicators and 36 third-level indicators in the final performance evaluation indicator system that showed good consistency, validity and reliability. The performance rank of the hospitals was B > E > A > C > D. Conclusions The performance evaluation indicator system established using the balanced scorecard is practical and scientific. Analysis of the results based on this indicator system identified several factors affecting hospital performance, such as resource utilisation efficiency, medical service price, personnel structure and doctor-patient relationships.

  4. Designing and Using Projects with Real World Application in a MBA Managerial Accounting Class: The Case of The Balanced Scorecard

    ERIC Educational Resources Information Center

    Houke, Charlotte

    2017-01-01

    This paper explores the purpose of designing and using projects with real world application in a M.B.A. managerial accounting class. Included is a discussion of how and why the Balanced Scorecard (BSC) Project has been used in classes to link theory with practice by providing real world application of the BSC framework. M.B.A. students represent a…

  5. Using the Balanced Scorecard to Enhance Undergraduate Education in a First Year Business Course: A Pilot Study

    ERIC Educational Resources Information Center

    Hunt, Irma; Taylor, Ronald K.; Winter, Anthony; Mackie, J. Jay; Fisher, Daniel

    2016-01-01

    Several research studies found that managers lacked a basic understanding of a balanced scorecard (BSC) approach to evaluate an organization. Because of this, the authors saw an opportunity to reorganize a course in order to provide students with an opportunity to address this issue. Therefore, a recent pilot study was conducted to ascertain…

  6. Applicability of Balanced Scorecard System in Primary Schools According to Opinions of Education Inspectors, Managers and Teachers

    ERIC Educational Resources Information Center

    Gündüzalp, Seda; Arabaci, Imam Bakir

    2017-01-01

    This study was carried out in order to specify the opinions of the staff working as manager, teacher and educational inspectors at primary schools about the implementation of balanced scorecard in education institutions. To perform that aim the staffs serving as manager, teacher and inspector at the primary Schools nearby center of Elazig Province…

  7. A Commentary on "Rhetoric or Reality? Do Accounting Education and Experience Increase Weighting on Environmental Performance in a Balanced Scorecard?"

    ERIC Educational Resources Information Center

    Larrinaga, Carlos

    2013-01-01

    In the paper, "Rhetoric or Reality? Do Accounting Education and Experience Increase Weighting on Environmental Performance in a Balanced Scorecard?" (Wynder, Wellner, and Reinhard 2013), researchers test whether business education and (controller) experience influence decision-makers to consider a longer-term perspective and,…

  8. Analysis of performance measurement at HR-GR Department using the balance scorecard method

    NASA Astrophysics Data System (ADS)

    Vienni; Bachtiar, M.

    2017-12-01

    PT. X is a company engaged in logistics service in Indonesia. Every company will certainly face a dynamic business environment. Competitors not only from domestic but also from overseas. To be successful in achieving its objectives, company should have a comprehensive measurement system as a strategy feedback that will drive the performance of company. HR-GA department is department that coordinate directly with company’s management. Company through departments expect development goals in individual and also support of infrastructure will run smoothly. In 2015, company has taken steps to conduct a balanced scorecard as performance measurement. Nevertheless, a number of factors so it cannot run optimally. This study aims to analyse the current system and provided suggestions in order to give an overview to department related to its current performance. The results of data processing show that there are 8 objective strategies that have been formulated with 9 key performance indicators. Based on the results of scorecard, obtained values of 4.44 for customer perspective, 4.32 for internal business process perspective & 5.00 for learning and growth perspective. It concludes that performance based on perspectives are categorized very well

  9. Designing a balanced scorecard for a tertiary care hospital in Pakistan: a modified Delphi group exercise.

    PubMed

    Rabbani, Fauziah; Jafri, Syed M Wasim; Abbas, Farhat; Shah, Mairaj; Azam, Syed Iqbal; Shaikh, Babar Tasneem; Brommels, Mats; Tomson, Goran

    2010-01-01

    Balanced Scorecards (BSC) are being implemented in high income health settings linking organizational strategies with performance data. At this private university hospital in Pakistan an elaborate information system exists. This study aimed to make best use of available data for better performance management. Applying the modified Delphi technique an expert panel of clinicians and hospital managers reduced a long list of indicators to a manageable size. Indicators from existing documents were evaluated for their importance, scientific soundness, appropriateness to hospital's strategic plan, feasibility and modifiability. Panel members individually rated each indicator on a scale of 1-9 for the above criteria. Median scores were assigned. Of an initial set of 50 indicators, 20 were finally selected to be assigned to the four BSC quadrants. These were financial (n = 4), customer or patient (n = 4), internal business or quality of care (n = 7) and innovation/learning or employee perspectives (n = 5). A need for stringent definitions, international benchmarking and standardized measurement methods was identified. BSC compels individual clinicians and managers to jointly work towards improving performance. This scorecard is now ready to be implemented by this hospital as a performance management tool for monitoring indicators, addressing measurement issues and enabling comparisons with hospitals in other settings. Copyright 2010 John Wiley & Sons, Ltd.

  10. Applying the balanced scorecard to local public health performance measurement: deliberations and decisions.

    PubMed

    Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

    2009-05-08

    All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

  11. Applying the Balanced Scorecard approach in teaching hospitals: a literature review and conceptual framework.

    PubMed

    Trotta, Annarita; Cardamone, Emma; Cavallaro, Giusy; Mauro, Marianna

    2013-01-01

    Teaching hospitals (THs) simultaneously serve three different roles: offering medical treatment, teaching future doctors and promoting research. The international literature recognises such organisations as 'peaks of excellence' and highlights their economic function in the health system. In addition, the literature describes the urgent need to manage the complex dynamics and inefficiency issues that threaten the survival of teaching hospitals worldwide. In this context, traditional performance measurement systems that focus only on accounting and financial measures appear to be inadequate. Given that THs are highly specific and complex, a multidimensional system of performance measurement, such as the Balanced Scorecard (BSC), may be more appropriate because of the multitude of stakeholders, each of whom seek a specific type of accountability. The aim of the paper was twofold: (i) to review the literature on the BSC and its applications in teaching hospitals and (ii) to propose a scorecard framework that is suitable for assessing the performance of THs and serving as a guide for scholars and practitioners. In addition, this research will contribute to the ongoing debate on performance evaluation systems by suggesting a revised BSC framework and proposing specific performance indicators for THs. Copyright © 2012 John Wiley & Sons, Ltd.

  12. Using a nursing balanced scorecard approach to measure and optimize nursing performance.

    PubMed

    Jeffs, Lianne; Merkley, Jane; Richardson, Sandy; Eli, Jackie; McAllister, Mary

    2011-04-01

    The authors give an overview of one healthcare organization's experience in developing a nursing strategic plan and nursing balanced scorecard (NBS) using a focused planning process involving strategy mapping. The NBS is being used at this organization to manage the nursing strategic plan by leveraging and improving nursing processes and organizational capabilities as required, based on data and transparent communication of performance results to key stakeholders. Key strategies and insights may help other nurse leaders in developing or refining strategic approaches to measuring nursing performance. Vital to the success of an organization's strategic plan are ongoing endorsement, engagement and visibility of senior leaders. Quality of decisions made depends on the organization's ability to collect data from multiple sources using standardized definitions, mine data and extract them for statistical analysis and effectively present them in a compelling and understandable way to users and decision-makers.

  13. Success factors for implementation of the balanced scorecard in a NHS multi-agency setting.

    PubMed

    Radnor, Zoe; Lovell, Bill

    2003-01-01

    Even though the balanced scorecard (BSC) has become a highly popular performance management tool, usage in local public sector National Health Service (NHS) organisations is still rare. This paper conditionally outlines some grounds in supporting such usage. In particular underlying conceptual concerns with the BSC system and its implementation pitfalls require full consideration. This paper then outlines some factors to be taken into account for "successful" BSC implementation in a NHS multi-agency setting. These findings emerged from a series of focus groups that took place with contributors drawn from all the key organisations within the Bradford Health Action Zone. Finally, this paper argues that if key criteria are met, successful implementation of the BSC may then proceed. However, "blind" BSC implementation without consideration of these factors may result in potential "failure".

  14. Modifying the Balanced Scorecard for a Network Industry The Case of the Clearing Industry

    NASA Astrophysics Data System (ADS)

    Chlistalla, Michael; Schaper, Torsten

    The Balanced Scorecard (BSC) is a well-established framework for the management of a company as it integrates financial and non-financial perspectives. Little attention has been given to its theoretical and conceptual valuation. We illustrate how the stakeholder value theory corresponds with the concept of the BSC and show the importance of underlying cause-and-effect relationships between its perspectives. For the case of clearing in Europe which is currently facing profound changes, we present our three-phased approach how to adjust and to extend Kaplan and Norton’s original concept. We modify the generic BSC by adding risk management as a separate perspective and by integrating competition and IT. Based on multiple case studies, we then validate whether the modified BSC is suited to meet the specifics of the clearing industry.

  15. Implementation of indicators through balanced scorecards in a nutritional therapy company.

    PubMed

    de Matos Nasser, Emanuele; Reis da Costa, Stella Regina

    2013-01-01

    The Balanced Scorecard (BSC) is a tool that helps in strategic management under the four following perspectives: the financial one, the client s, the internal processes of the company's, the growth and learning processes. In order to measure the performance of the entities, the BSC uses as a basis financial and non-financial indicators. To implement the BSC in a nutrional therapy company. This research deals with a case study that took place in a nutrional therapy company from January to November 2010. For analysis of the learning and growth perspective all 45 of the company's collaborators were considered and for client analysis 124 home-care clients were considered. The study sample consisted of 39 collaborators and 44 clients participating in the research. Material was elaborated for collection of data and verification of perspective tendencies through analysis of the main processes of the company, questionnaires of client's satisfaction, questionnaires of collaborator s satisfaction and spread sheets for the verification of net renvenue and percentage of disallowances. The data was launched in the spread sheet of the Excel Application Program. The indicators were chosen conforming to the strategic objectives and organizational profiles. Learning perspectives and personal growth: efficacy in capacitaion 94%, participation 77%, fidelity/retention 93%, satisfaction 75%, organizational environment 88%, well being 100%, process perspective: microbiological analysis 100%, internal auditing 100%, productivity 100%, nutritional evaluation 81%, nutritional support 100%, indication for domicile hospital care 94%, home-care visits 98%, client perspective: company perception 97%, prioritizating 94%, retention 59%, insatisfaction 24%, logistics 94%, customers ervice (SAC) 88%, motivation: trust, financial perspectives, disallowances 5% and positive company net revenue. The implementation of indicators under the four perspectives of the Balanced Scorecard were favourable in

  16. Configuring balanced scorecards for measuring health system performance: evidence from 5 years' evaluation in Afghanistan.

    PubMed

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H

    2011-07-01

    In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0-100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3-84.5, p<0.0001); provider satisfaction (65.4-79.2, p<0.01); capacity for service provision (47.4-76.4, p<0.0001); quality of services (40.5-67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0-52.6). The financial domain also showed improvement until 2007 (84.4-95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary.

  17. Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

    PubMed Central

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

    2011-01-01

    Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, p<0.0001); provider satisfaction (65.4–79.2, p<0.01); capacity for service provision (47.4–76.4, p<0.0001); quality of services (40.5–67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0–52.6). The financial domain also showed improvement until 2007 (84.4–95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. Conclusions The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

  18. Applying the balanced scorecard to local public health performance measurement: deliberations and decisions

    PubMed Central

    Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

    2009-01-01

    Background All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Discussion Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? Summary An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process. PMID:19426508

  19. [Balanced scorecard for performance measurement of a nursing organization in a Korean hospital].

    PubMed

    Hong, Yoonmi; Hwang, Kyung Ja; Kim, Mi Ja; Park, Chang Gi

    2008-02-01

    The purpose of this study was to develop a balanced scorecard (BSC) for performance measurement of a Korean hospital nursing organization and to evaluate the validity and reliability of performance measurement indicators. Two hundred fifty-nine nurses in a Korean hospital participated in a survey questionnaire that included 29-item performance evaluation indicators developed by investigators of this study based on the Kaplan and Norton's BSC (1992). Cronbach's alpha was used to test the reliability of the BSC. Exploratory and confirmatory factor analysis with a structure equation model (SEM) was applied to assess the construct validity of the BSC. Cronbach's alpha of 29 items was .948. Factor analysis of the BSC showed 5 principal components (eigen value >1.0) which explained 62.7% of the total variance, and it included a new one, community service. The SEM analysis results showed that 5 components were significant for the hospital BSC tool. High degree of reliability and validity of this BSC suggests that it may be used for performance measurements of a Korean hospital nursing organization. Future studies may consider including a balanced number of nurse managers and staff nurses in the study. Further data analysis on the relationships among factors is recommended.

  20. A balanced scorecard approach in assessing IT value in healthcare sector: an empirical examination.

    PubMed

    Wu, Ing-Long; Kuo, Yi-Zu

    2012-12-01

    Healthcare sector indicates human-based and knowledge-intensive property. Massive IT investments are necessary to maintain competitiveness in this sector. The justification of IT investments is the major concern of senior management. Empirical studies examining IT value have found inconclusive results with little or no improvement in productivity. Little research has been conducted in healthcare sector. The balanced scorecard (BSC) strikes a balance between financial and non-financial measure and has been applied in evaluating organization-based performance. Moreover, healthcare organizations often consider their performance goal at customer satisfaction in addition to financial performance. This research thus proposed a new hierarchical structure for the BSC with placing both finance and customer at the top, internal process at the next, and learning and growth at the bottom. Empirical examination has found the importance of the new BSC structure in assessing IT investments. Learning and growth plays the initial driver for reaching both customer and financial performance through the mediator of internal process. This can provide deep insight into effectively managing IT resources in the hospitals.

  1. Accountability in public health units: using a modified nominal group technique to develop a balanced scorecard for performance measurement.

    PubMed

    Robinson, Victoria A; Hunter, Duncan; Shortt, Samuel E D

    2003-01-01

    Little attention has been paid to the need for accountability instruments applicable across all health units in the public health system. One tool, the balanced scorecard was created for industry and has been successfully adapted for use in Ontario hospitals. It consists of 4 quadrants: financial performance, outcomes, customer satisfaction and organizational development. The aim of the present study was to determine if a modified nominal group technique could be used to reach consensus among public health unit staff and public health specialists in Ontario about the components of a balanced scorecard for public health units. A modified nominal group technique consensus method was used with the public health unit staff in 6 Eastern Ontario health units (n=65) and public health specialists (n=18). 73.8% of the public health unit personnel from all six health units in the eastern Ontario region participated in the survey of potential indicators. A total of 74 indicators were identified in each of the 4 quadrants: program performance (n=44); financial performance (n=11); public perceptions (n=11); and organizational performance (n=8). The modified nominal group technique was a successful method of incorporating the views of public health personnel and specialists in the development of a balanced scorecard for public health.

  2. Multidimensional evaluation of performance: experimental application of the balanced scorecard in Ferrara university hospital

    PubMed Central

    Verzola, Adriano; Bentivegna, Roberto; Carandina, Gianni; Trevisani, Lucio; Gregorio, Pasquale; Mandini, Alberto

    2009-01-01

    Background and Aims One of the best-known performance planning and evaluation techniques utilising both monetary and non-monetary data is the Balanced Scorecard (BSC). This is a means of rationalising the global activity of a business in the attempt to create value, and to translate the company vision into a set of tactical objectives and measurable strategies. The aim of this study was to implement and evaluate the use of BSC in two departments of the St. Anna University Hospital, Ferrara: the Analysis Laboratory and Digestive Endoscopy operating units (OU). Materials and methods With the collaboration of the health workers involved, a precise methodological programme was pursued: Definition of the strategic map from 4 perspectives, according to Kaplan and Norton, Definition of the Key Performance Areas (KPA), or macro-objectives, Identification of the cause-effect relationships between KPAs, Identification of the sub-objectives of each KPA, Definition of the Key Performance Indicators (KPI), Definition of the weight/importance of each objective in the global evaluation. Results The information gathered permitted the definition of macro- and sub-objectives for each perspective, as well as determining the relevant indicators, standards, weights, frequency of detection and means of acquisition. Strategic maps showing the cause/effect relationships in each OU were created, as were 'evaluation panels', which describe the global performance of each department. For each perspective, the fundamental data were summarised in one table. Evaluation of each perspective yielded a positive result for the majority of the objectives, and the global result (including all 4 perspectives) was found to be satisfactory. Discussion-Conclusion The Balanced Scorecard was implemented in the abovementioned OUs of St. Anna University Hospital, Ferrara, after the health workers themselves realised the need for change. In our research the employees were pleased to be evaluated, not only for

  3. Multidimensional evaluation of performance: experimental application of the balanced scorecard in Ferrara university hospital.

    PubMed

    Verzola, Adriano; Bentivegna, Roberto; Carandina, Gianni; Trevisani, Lucio; Gregorio, Pasquale; Mandini, Alberto

    2009-09-08

    One of the best-known performance planning and evaluation techniques utilising both monetary and non-monetary data is the Balanced Scorecard (BSC). This is a means of rationalising the global activity of a business in the attempt to create value, and to translate the company vision into a set of tactical objectives and measurable strategies. The aim of this study was to implement and evaluate the use of BSC in two departments of the St. Anna University Hospital, Ferrara: the Analysis Laboratory and Digestive Endoscopy operating units (OU). With the collaboration of the health workers involved, a precise methodological programme was pursued: Definition of the strategic map from 4 perspectives, according to Kaplan and Norton, Definition of the Key Performance Areas (KPA), or macro-objectives, Identification of the cause-effect relationships between KPAs, Identification of the sub-objectives of each KPA, Definition of the Key Performance Indicators (KPI), Definition of the weight/importance of each objective in the global evaluation. The information gathered permitted the definition of macro- and sub-objectives for each perspective, as well as determining the relevant indicators, standards, weights, frequency of detection and means of acquisition. Strategic maps showing the cause/effect relationships in each OU were created, as were 'evaluation panels', which describe the global performance of each department. For each perspective, the fundamental data were summarised in one table. Evaluation of each perspective yielded a positive result for the majority of the objectives, and the global result (including all 4 perspectives) was found to be satisfactory. The Balanced Scorecard was implemented in the abovementioned OUs of St. Anna University Hospital, Ferrara, after the health workers themselves realised the need for change.In our research the employees were pleased to be evaluated, not only for the financial outcomes, but also for the satisfaction of improving

  4. Development and implementation of a balanced scorecard in an academic hospitalist group.

    PubMed

    Hwa, Michael; Sharpe, Bradley A; Wachter, Robert M

    2013-03-01

    Academic hospitalist groups (AHGs) are often expected to excel in multiple domains: quality improvement, patient safety, education, research, administration, and clinical care. To be successful, AHGs must develop strategies to balance their energies, resources, and performance. The balanced scorecard (BSC) is a strategic management system that enables organizations to translate their mission and vision into specific objectives and metrics across multiple domains. To date, no hospitalist group has reported on BSC implementation. We set out to develop a BSC as part of a strategic planning initiative. Based on a needs assessment of the University of California, San Francisco, Division of Hospital Medicine, mission and vision statements were developed. We engaged representative faculty to develop strategic objectives and determine performance metrics across 4 BSC perspectives. There were 41 metrics identified, and 16 were chosen for the initial BSC. It allowed us to achieve several goals: 1) present a broad view of performance, 2) create transparency and accountability, 3) communicate goals and engage faculty, and 4) ensure we use data to guide strategic decisions. Several lessons were learned, including the need to build faculty consensus, establish metrics with reliable measureable data, and the power of the BSC to drive goals across the division. We successfully developed and implemented a BSC in an AHG as part of a strategic planning initiative. The BSC has been instrumental in allowing us to achieve balanced success in multiple domains. Academic groups should consider employing the BSC as it allows for a data-driven strategic planning and assessment process. Copyright © 2013 Society of Hospital Medicine.

  5. Constructing a strategy map for banking institutions with key performance indicators of the balanced scorecard.

    PubMed

    Wu, Hung-Yi

    2012-08-01

    This study presents a structural evaluation methodology to link key performance indicators (KPIs) into a strategy map of the balanced scorecard (BSC) for banking institutions. Corresponding with the four BSC perspectives (finance, customer, internal business process, and learning and growth), the most important evaluation indicators of banking performance are synthesized from the relevant literature and screened by a committee of experts. The Decision Making Trial and Evaluation Laboratory (DEMATEL) method, a multiple criteria analysis tool, is then employed to determine the causal relationships between the KPIs, to identify the critical central and influential factors, and to establish a visualized strategy map with logical links to improve banking performance. An empirical application is provided as an example. According to the expert evaluations, the three most essential KPIs for banking performance are customer satisfaction, sales performance, and customer retention rate. The DEMATEL results demonstrate a clear road map to assist management in prioritizing the performance indicators and in focusing attention on the strategy-related activities of the crucial indicators. According to the constructed strategy map, management could better invest limited resources in the areas that need improvement most. Although these strategy maps of the BSC are not universal, the research results show that the presented approach is an objective and feasible way to construct strategy maps more justifiably. The proposed framework can be applicable to institutions in other industries as well. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Does performance evaluation help public managers? A Balanced Scorecard approach in urban waste services.

    PubMed

    Guimarães, Bernardo; Simões, Pedro; Marques, Rui Cunha

    2010-12-01

    The urban waste market has evolved significantly in the past decades, which among other changes, has led to the creation of new utilities and new business models. However, very few things have changed for the users. Urban waste collection remains mainly under the responsibility of local authorities and the charges paid by the users in most countries are very low compared to the provision costs. This situation forces the injection of public money into the system, encouraging the 'quiet-life' within the utilities and, therefore, inefficiency. The present study intends to analyze the potential for the application of the Balanced Scorecard (BSc) methodology into the waste utilities. After a comprehensive revision of the urban waste sector in Portugal, the methodology of BSc and its application in local public services is described and discussed. Focusing on implementation rather than on strategy, a set of performance indicators is proposed to be utilized in the different management models of waste utilities in Portugal: the municipalities, semi-autonomous utilities, municipal companies and mixed companies. This implementation is then exemplified through four case studies, one for each type of utility. This paper provides a flexible framework proposal to be applied to waste utilities operating both in Portugal and abroad. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. Using the balanced scorecard to measure Chinese and Japanese hospital performance.

    PubMed

    Chen, Xiao-yun; Yamauchi, Kazunobu; Kato, Ken; Nishimura, Akio; Ito, Katuski

    2006-01-01

    The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries. One hospital from China and another from Japan were chosen and key indicators were selected according to the BSC framework. A comparative hospital performance measurement model was set up using the BSC framework to comprehensively compare hospital performance in two countries. The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the hospitals' contribution to performance improvement of each country's total health system. Hospital performance comparisons between countries using the BSC depend on the selection of feasible and appropriate key performance indicators, which is occasionally limited by data collection problems. The first use of the BSC to compare hospital performance between China and Japan shows benefits that not only suggests performance improvements in individual hospitals but also reveals effective health factors allowing implementation of valid national health policies.

  8. Performance evaluation of extension education centers in universities based on the balanced scorecard.

    PubMed

    Wu, Hung-Yi; Lin, Yi-Kuei; Chang, Chi-Hsiang

    2011-02-01

    This study aims at developing a set of appropriate performance evaluation indices mainly based on balanced scorecard (BSC) for extension education centers in universities by utilizing multiple criteria decision making (MCDM). Through literature reviews and experts who have real practical experiences in extension education, adequate performance evaluation indices have been selected and then utilizing the decision making trial and evaluation laboratory (DEMATEL) and analytic network process (ANP), respectively, further establishes the causality between the four BSC perspectives as well as the relative weights between evaluation indices. According to this previous result, an empirical analysis of the performance evaluation of extension education centers of three universities at Taoyuan County in Taiwan is illustrated by applying VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR). From the analysis results, it indicates that "Learning and growth" is the significant influential factor and it would affect the other three perspectives. In addition, it is discovered that "Internal process" perspective as well as "Financial" perspective play important roles in the performance evaluation of extension education centers. The top three key performance indices are "After-sales service", "Turnover volume", and "Net income". The proposed evaluation model could be considered as a reference for extension education centers in universities to prioritize their improvements on the key performance indices after performing VIKOR analyses. 2010 Elsevier Ltd. All rights reserved.

  9. Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia

    PubMed Central

    Teklehaimanot, Hailay D.; Teklehaimanot, Awash; Tedella, Aregawi A.; Abdella, Mustofa

    2016-01-01

    In 2004, Ethiopia introduced a community-based Health Extension Program to deliver basic and essential health services. We developed a comprehensive performance scoring methodology to assess the performance of the program. A balanced scorecard with six domains and 32 indicators was developed. Data collected from 1,014 service providers, 433 health facilities, and 10,068 community members sampled from 298 villages were used to generate weighted national, regional, and agroecological zone scores for each indicator. The national median indicator scores ranged from 37% to 98% with poor performance in commodity availability, workforce motivation, referral linkage, infection prevention, and quality of care. Indicator scores showed significant difference by region (P < 0.001). Regional performance varied across indicators suggesting that each region had specific areas of strength and deficiency, with Tigray and the Southern Nations, Nationalities and Peoples Region being the best performers while the mainly pastoral regions of Gambela, Afar, and Benishangul-Gumuz were the worst. The findings of this study suggest the need for strategies aimed at improving specific elements of the program and its performance in specific regions to achieve quality and equitable health services. PMID:26928842

  10. A management approach that drives actions strategically: balanced scorecard in a mental health trust case study.

    PubMed

    Schmidt, Stefan; Bateman, Ian; Breinlinger-O'Reilly, Jochen; Smith, Peter

    2006-01-01

    Achieving excellence is a current preoccupation in U.K. public health organisations. This article aims to use a case study to explain how a mental health trust delivers excellent performance using a balanced scorecard (BSC) management approach. Reports a project to implement a BSC approach in the South West Yorkshire Mental Health NHS Trust to achieve its "excellence" objectives. The authors were participants in the project. The design of the pilot project was informed theoretically by the work of Kaplan and Norton and practically by in-house discussions on a strategy to achieve excellence. Explains the process of building a BSC strategy step-by-step. Discusses how the vision and strategies of a mental health trust can be translated into tangible measures, which are the basis for actions that are driven strategically. There are many possibilities for a BSC management approach and this case study is specific to mental health trusts in the UK, although it is believed that the case has a universally applicable modus operandi. This article will help healthcare managers to evaluate the benefits of a BSC management approach. This article explains how actions can be structured in connection with a BSC management approach.

  11. Applications of the balanced scorecard for strategic management and performance measurement in the health sector.

    PubMed

    Behrouzi, Farshad; Shaharoun, Awaluddin Mohamed; Ma'aram, Azanizawati

    2014-05-01

    In order to attain a useful balanced scorecard (BSC), appropriate performance perspectives and indicators are crucial to reflect all strategies of the organisation. The objectives of this survey were to give an insight regarding the situation of the BSC in the health sector over the past decade, and to afford a generic approach of the BSC development for health settings with specific focus on performance perspectives, performance indicators and BSC generation. After an extensive search based on publication date and research content, 29 articles published since 2002 were identified, categorised and analysed. Four critical attributes of each article were analysed, including BSC generation, performance perspectives, performance indicators and auxiliary tools. The results showed that 'internal business process' was the most notable BSC perspective as it was included in all reviewed articles. After investigating the literature, it was concluded that its comprehensiveness is the reason for the importance and high usage of this perspective. The findings showed that 12 cases out of 29 reviewed articles (41%) exceeded the maximum number of key performance indicators (KPI) suggested in a previous study. It was found that all 12 cases were large organisations with numerous departments (e.g. national health organisations). Such organisations require numerous KPI to cover all of their strategic objectives. It was recommended to utilise the cascaded BSC within such organisations to avoid complexity and difficulty in gathering, analysing and interpreting performance data. Meanwhile it requires more medical staff to contribute in BSC development, which will result in greater reliability of the BSC.

  12. Customising turnaround time indicators to requesting clinician: a 10-year study through balanced scorecard indicators.

    PubMed

    Salinas, Maria; López-Garrigós, Maite; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

    2014-09-01

    The purpose of this study is, first to present a 10-year monitoring of postanalytical turnaround time (TAT) adapted to different clinicians and patient situations, second to evaluate and analyse the indicators results during that period of time, and finally to show a synthetic appropriate indicator to be included in the balanced scorecard management system. TAT indicator for routine samples was devised as the percentage of certain key tests that were verified before a specific time on the phlebotomy day. A weighted mean synthetic indicator was also designed. They were calculated for inpatients at 15:00 and 12:00 and for primary care patients only at 15:00. The troponin TAT of emergency department patients, calculated as the difference between the troponin verification and registration time, was selected as the stat laboratory TAT indicator. The routine and stat TAT improved along the 10-year study period. The synthetic indicator showed the same trend. The implementation of systematic and continuous monitoring over years, promoted a continuous improvement in TAT which will probably benefit patient outcome and safety.

  13. [Development of nursing key performance indicators for an intensive care unit by using a balanced scorecard].

    PubMed

    Choi, Yun Jeong; Lim, Ji Young; Lee, Young Whee; Kim, Hwa Soon

    2008-10-01

    The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC). This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs. Two main visions of nursing service for ICUs were established. These were 'realization of harmonized professional nursing with human respect' and 'recovery of health through specialized nursing' respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC. The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

  14. Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia.

    PubMed

    Teklehaimanot, Hailay D; Teklehaimanot, Awash; Tedella, Aregawi A; Abdella, Mustofa

    2016-05-04

    In 2004, Ethiopia introduced a community-based Health Extension Program to deliver basic and essential health services. We developed a comprehensive performance scoring methodology to assess the performance of the program. A balanced scorecard with six domains and 32 indicators was developed. Data collected from 1,014 service providers, 433 health facilities, and 10,068 community members sampled from 298 villages were used to generate weighted national, regional, and agroecological zone scores for each indicator. The national median indicator scores ranged from 37% to 98% with poor performance in commodity availability, workforce motivation, referral linkage, infection prevention, and quality of care. Indicator scores showed significant difference by region (P < 0.001). Regional performance varied across indicators suggesting that each region had specific areas of strength and deficiency, with Tigray and the Southern Nations, Nationalities and Peoples Region being the best performers while the mainly pastoral regions of Gambela, Afar, and Benishangul-Gumuz were the worst. The findings of this study suggest the need for strategies aimed at improving specific elements of the program and its performance in specific regions to achieve quality and equitable health services. © The American Society of Tropical Medicine and Hygiene.

  15. Understanding the context of balanced scorecard implementation: a hospital-based case study in Pakistan.

    PubMed

    Rabbani, Fauziah; Lalji, Sabrina Nh; Abbas, Farhat; Jafri, Sm Wasim; Razzak, Junaid A; Nabi, Naheed; Jahan, Firdous; Ajmal, Agha; Petzold, Max; Brommels, Mats; Tomson, Goran

    2011-03-31

    As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation. Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data

  16. Multidimensional evaluation of performance with experimental application of balanced scorecard: a two year experience

    PubMed Central

    2011-01-01

    Background In today's dynamic health-care system, organizations such as hospitals are required to improve their performance for multiple stakeholders and deliver an integrated care that means to work effectively, be innovative and organize efficiently. Achieved goals and levels of quality can be successfully measured by a multidimensional approach like Balanced Scorecard (BSC). The aim of the study was to verify the opportunity to introduce BSC framework to measure performance in St. Anna University Hospital of Ferrara, applying it to the Clinical Laboratory Operative Unit in order to compare over time performance results and achievements of assigned targets. Methods In the first experience with BSC we distinguished four perspectives, according to Kaplan and Norton, identified Key Performance Areas and Key Performance Indicators, set standards and weights for each objective, collected data for all indicators, recognized cause-and-effect relationships in a strategic map. One year later we proceeded with the next data collection and analysed the preservation of framework aptitude to measure Operative Unit performance. In addition, we verified the ability to underline links between strategic actions belonging to different perspectives in producing outcomes changes. Results The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the specific perspective contribution to overall performance enhancement. After time results comparison was possible depending on the selection of feasible and appropriate key performance indicators, which was occasionally limited by data collection problems. Conclusions The first use of BSC to compare performance at Operative Unit level, in course of time, suggested this framework can be successfully adopted for results measuring and revealing effective health factors, allowing health-care quality improvements. PMID:21586111

  17. Multidimensional evaluation of performance with experimental application of balanced scorecard: a two year experience.

    PubMed

    Lupi, Silvia; Verzola, Adriano; Carandina, Gianni; Salani, Manuela; Antonioli, Paola; Gregorio, Pasquale

    2011-05-17

    In today's dynamic health-care system, organizations such as hospitals are required to improve their performance for multiple stakeholders and deliver an integrated care that means to work effectively, be innovative and organize efficiently. Achieved goals and levels of quality can be successfully measured by a multidimensional approach like Balanced Scorecard (BSC). The aim of the study was to verify the opportunity to introduce BSC framework to measure performance in St. Anna University Hospital of Ferrara, applying it to the Clinical Laboratory Operative Unit in order to compare over time performance results and achievements of assigned targets. In the first experience with BSC we distinguished four perspectives, according to Kaplan and Norton, identified Key Performance Areas and Key Performance Indicators, set standards and weights for each objective, collected data for all indicators, recognized cause-and-effect relationships in a strategic map. One year later we proceeded with the next data collection and analysed the preservation of framework aptitude to measure Operative Unit performance. In addition, we verified the ability to underline links between strategic actions belonging to different perspectives in producing outcomes changes. The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the specific perspective contribution to overall performance enhancement. After time results comparison was possible depending on the selection of feasible and appropriate key performance indicators, which was occasionally limited by data collection problems. The first use of BSC to compare performance at Operative Unit level, in course of time, suggested this framework can be successfully adopted for results measuring and revealing effective health factors, allowing health-care quality improvements.

  18. Understanding the context of balanced scorecard implementation: a hospital-based case study in pakistan

    PubMed Central

    2011-01-01

    Background As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation. Results Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing

  19. Prevention and control of blood stream infection using the balanced scorecard approach.

    PubMed

    Rohsiswatmo, Rinawati; Rafika, Sarah; Marsubrin, Putri M T

    2014-07-01

    to obtain formulation of an effective and efficient strategy to overcome blood stream infection (BSI). operational research design with qualitative and quantitative approach. The study was divided into two stages. Stage I was an operational research with problem solving approach using qualitative and quantitative method. Stage II was performed using quantitative method, a form of an interventional study on strategy implementation, which was previously established in stage I. The effective and efficient strategy for the prevention and control of infection in neonatal unit Cipto Mangunkusumo (CM) Hospital was established using Balanced Scorecard (BSC) approach, which involved several related processes. the BSC strategy was proven to be effective and efficient in substantially reducing BSI from 52.31°/oo to 1.36°/oo in neonates with birth weight (BW) 1000-1499 g (p=0.025), and from 29.96°/oo to 1.66°/oo in BW 1500-1999 g (p=0.05). Gram-negative bacteria still predominated as the main cause of BSI in CMH Neonatal Unit. So far, the sources of the microorganisms were thought to be from the environment of treatment unit (tap water filter and humidifying water in the incubator). Significant reduction was also found in neonatal mortality rate weighing 1000-1499 g at birth, length of stay, hospitalization costs, and improved customer satisfaction. effective and efficient infection prevention and control using BSC approach could significantly reduce the rate of BSI. This approach may be applied for adult patients in intensive care unit with a wide range of adjustment.

  20. The balanced scorecard as a strategic management tool: its application in the regional public health system in Campania.

    PubMed

    Impagliazzo, Cira; Ippolito, Adelaide; Zoccoli, Paola

    2009-01-01

    Health, as a primary and advanced need, can only be guaranteed through the appropriate management of dedicated resources. As in any situation where funds are limited, it is vital to have logical frameworks and tools to set up structures capable of making a complex system like the health service work. Only through an appropriate and competent activity of governance can such structures be identified, organized, and rendered operational. This can be achieved by using ad hoc tools such as the Balanced Scorecard. Its application in the case of the Regional Government of Campania indicates that it is a valid tool in all circumstances except in situations of crisis.

  1. Modern management instruments--control of a water resources management association by means of an agreement on targets (balanced scorecard).

    PubMed

    von Seidlitz, A E; Londong, J

    2001-01-01

    Since the matter of water supply and sewage disposal is safeguarded in Germany, public concern would no longer appear to be directed at questions of disposal reliability, but almost exclusively to economic efficiency. The requirements with respect to sewage disposal are dominated not only by growing environmental regulations and technical challenges, but also to a major extent by a discussion on the costs arising. In order to ensure a viable and at the same time economic water supply and sewage disposal despite this, it is necessary to have a holistic corporate control system. As a counterpart to the river basin management approach adopted at the Wupperverband there is, on the business management side, the agreement on targets (balanced scorecard) as a management and controlling approach. This incorporates purely financial variables as well as non-financial variables in the economic valuation of corporate success. The starting point is the formulation of strategic goals, while including customer-oriented, in-company and forward-looking perspectives, taking into account at the same time the interactions between them. A major perspective of such balanced scorecards is customer satisfaction. By means of an intensive dialogue with members, licensing and supervisory authorities of the Wupperverband within the framework of a holistic corporate control, it has been possible not only to improve corporate success, but also, and more importantly, to achieve an appreciable increase in confidence.

  2. Priority Determination for Higher Education Strategic Planning Using Balanced Scorecard, FAHP and TOPSIS (Case study: XYZ University)

    NASA Astrophysics Data System (ADS)

    Yudatama, Uky; Sarno, Riyanarto

    2016-01-01

    The process of strategic planning is needed by a higher education in some cases, especially in preparing to face the challenges and competition. The results of strategic planning will help the higher education to provide a framework for achieving a competitive advantage as well as determine the direction of future policy in accordance with the desired objectives. In recent decades, the Balanced Scorecard has been applied in the field of information technology as a very popular tool and is used extensively, because it is a model that can explain between information technologies with "Business Objectives" in a comprehensive manner. This study uses 4 perspectives in the Balanced Scorecard and 7 standards in higher education quality assessment as sub-criteria. Fuzzy AHP and Fuzzy TOPSIS are used to determine the priority as making strategic policy recommendations in a higher education. The final result of this research shows the score of Customer Perspective 0.35365 is higher than other perspective, while the score in Research and Student Affairs gains significant score when compared with the others, namely 0.69753948 is also higher. This means that both of them get very serious attention as a strategic planning basis for policy making.

  3. [Usefulness of the budget and the balanced scorecard in managing Primary Care Centres. Impact on staff motivation].

    PubMed

    Ramón-Jerónimo, Juan Manuel; Flórez-López, Raquel; Domínguez-Lario, Natalia

    2018-03-01

    To analyse the utility perceived by managers of centers of primary care about management tools (budget and balanced scorecard), together their impact on human resources motivation. Qualitative study (case study) based on grounded theory performed between January and June 2014. Units of Clinical Management of Primary Health (UGCAP) in Metropolitan Health Area of Seville, Spain. UGCAP managers and Health Area (CEO) managers. Data were collected through 8 semi-structured interviews using non-probabilistic intentional sampling with representation and sufficiency criteria of discourse. Interviews were recorded, literally transcripted and analysis through in-vivo codes. Both tools are fully implemented but differently used in primary care centers. Budget is perceived as a coercive management tool, which has been imposed for cost saving; however, it is scarcely adequate for day-by-day management. While balanced scorecard is a more flexible tool that allows identifying financial and welfare problems, budgeting limits heavily reduce the possibility of implementing adequate solutions. The policy of incentives is not adequate either, leading on de-motivation. This study shows that budgeting restrictions have led to a significant reduction in autonomy of Spanish Primary Care centers. Management decision making is much centralised, also focused on cost saving over quality of healthcare. As a result, two needs emerge for the future: increasing centers' autonomy and improving staff commitment through training and professional development programs. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. Computational intelligence for the Balanced Scorecard: studying performance trends of hemodialysis clinics.

    PubMed

    Cattinelli, Isabella; Bolzoni, Elena; Chermisi, Milena; Bellocchio, Francesco; Barbieri, Carlo; Mari, Flavio; Amato, Claudia; Menzer, Marcus; Stopper, Andrea; Gatti, Emanuele

    2013-07-01

    The Balanced Scorecard (BSC) is a general, widely employed instrument for enterprise performance monitoring based on the periodic assessment of strategic Key Performance Indicators that are scored against preset targets. The BSC is currently employed as an effective management support tool within Fresenius Medical Care (FME) and is routinely analyzed via standard statistical methods. More recently, the application of computational intelligence techniques (namely, self-organizing maps) to BSC data has been proposed as a way to enhance the quantity and quality of information that can be extracted from it. In this work, additional methods are presented to analyze the evolution of clinic performance over time. Performance evolution is studied at the single-clinic level by computing two complementary indexes that measure the proportion of time spent within performance clusters and improving/worsening trends. Self-organizing maps are used in conjunction with these indexes to identify the specific drivers of the observed performance. The performance evolution for groups of clinics is modeled under a probabilistic framework by resorting to Markov chain properties. These allow a study of the probability of transitioning between performance clusters as time progresses for the identification of the performance level that is expected to become dominant over time. We show the potential of the proposed methods through illustrative results derived from the analysis of BSC data of 109 FME clinics in three countries. We were able to identify the performance drivers for specific groups of clinics and to distinguish between countries whose performances are likely to improve from those where a decline in performance might be expected. According to the stationary distribution of the Markov chain, the expected trend is best in Turkey (where the highest performance cluster has the highest probability, P=0.46), followed by Portugal (where the second best performance cluster dominates

  5. Alignment of University Information Technology Resources with the Malcolm Baldrige Results Criteria for Performance Excellence in Education: A Balanced Scorecard Approach

    ERIC Educational Resources Information Center

    Beard, Deborah F.; Humphrey, Roberta L.

    2014-01-01

    The authors suggest using a balanced scorecard (BSC) approach to evaluate information technology (IT) resources in higher education institutions. The BSC approach illustrated is based on the performance criteria of the Malcolm Baldrige National Quality Award in Education. This article suggests areas of potential impact of IT on BSC measures in…

  6. Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model

    PubMed Central

    Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

    2012-01-01

    Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community

  7. Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model.

    PubMed

    Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

    2012-01-01

    Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. This is a combination (quantitative-qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and

  8. A study of a nursing department performance measurement system: using the Balanced Scorecard and the Analytic Hierarchy Process.

    PubMed

    Chu, Hsuan-Lien; Wang, Chen-Chin; Dai, Yu-Tzu

    2009-01-01

    The health care industry is under pressure from government and private entities as well as from market conditions to contain costs. In an effort to respond to these pressures, the case hospital in this study implemented a Balanced Scorecard (BSC) in January 2003 and integrated it with the hospital's formal incentive plan for non-physicians in January 2005. The nursing department's performance improved in the 2 years following the introduction of the plan. This study contributes to the literature by demonstrating the performance improvement that results from integrating the BSC with an incentive plan in the nursing field. The results provide insight into the current BSC performance metrics applied by the case nursing department, and could be used as guidelines by other health care organizations that wish to implement BSC-based incentive plans.

  9. Meeting the challenge in performance management: the diffusion and implementation of the balanced scorecard in Chinese hospitals.

    PubMed

    Gao, Tian; Gurd, Bruce

    2015-03-01

    The bonus system used in Chinese hospitals has been criticized for eroding doctors' professional ethics and aggravating patient expense. This research article focuses on one system to improve hospital performance, the balanced scorecard (BSC). We use three data sources to examine the diffusion and implementation of the BSC in China: a questionnaire survey in Shandong Province, a print-media indicators and content analysis of the published BSC papers and semi-structured interviews with managers of Chinese hospitals that use the BSC. The research evidence shows that bonus systems are important, partially because of the poor pay of hospital professionals, and the BSC is perceived as providing a fair system to award such bonuses. This helps explain the relative endurance of the BSC in Chinese hospitals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  10. Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia

    PubMed Central

    Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

    2013-01-01

    Introduction There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. Methodology The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Results Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff −0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). Conclusion The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery

  11. Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

    PubMed

    Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

    2013-01-01

    There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could

  12. Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

    PubMed

    Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

    2008-01-01

    The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. 2007 John Wiley & Sons, Ltd

  13. Hands-on Scorecarding in the Higher Education Sector

    ERIC Educational Resources Information Center

    Scholey, Cam; Armitage, Howard

    2006-01-01

    The balanced scorecard, introduced by Robert Kaplan and David Norton, has evolved from an improved performance measurement system to an integrated strategic planning, implementation, and scorecarding system. Simple yet powerful second-generation balanced scorecards depict the organization's strategy through a series of strategy maps and scorecards…

  14. The development of an integrated Indonesian health care model using Kano's model, quality function deployment and balanced scorecard

    NASA Astrophysics Data System (ADS)

    Jonny, Zagloed, Teuku Yuri M.

    2017-11-01

    This paper aims to present an integrated health care model for Indonesian health care industry. Based on previous researches, there are two health care models in the industry such as decease- and patient-centered care models. In their developments, the patient-centered care model is widely applied due to its capability in reducing cost and improving quality simultaneously. However, there is still no comprehensive model resulting in cost reduction, quality improvement, patient satisfaction and hospital profitability simultaneously. Therefore, this research is intended to develop that model. In doing so, first, a conceptual model using Kano's Model, Quality Function Deployment (QFD) and Balanced Scorecard (BSC) is developed to generate several important elements of the model as required by stakeholders. Then, a case study of an Indonesian hospital is presented to evaluate the validity of the model using correlation analysis. As a result, it can be concluded that the model is validated implying several managerial insights among its elements such as l) leadership (r=0.85) and context of the organization (r=0.77) improve operations; 2) planning (r=0.96), support process (r=0.87) and continual improvement (r=0.95) also improve operations; 3) operations improve customer satisfaction (r=0.89) and financial performance (r=0.93) and 4) customer satisfaction improves the financial performance (0.98).

  15. Designing Performance Measurement For Supply Chain's Actors And Regulator Using Scale Balanced Scorecard And Data Envelopment Analysis

    NASA Astrophysics Data System (ADS)

    Kusrini, Elisa; Subagyo; Aini Masruroh, Nur

    2016-01-01

    This research is a sequel of the author's earlier conducted researches in the fields of designing of integrated performance measurement between supply chain's actors and regulator. In the previous paper, the design of performance measurement is done by combining Balanced Scorecard - Supply Chain Operation Reference - Regulator Contribution model and Data Envelopment Analysis. This model referred as B-S-Rc-DEA model. The combination has the disadvantage that all the performance variables have the same weight. This paper investigates whether by giving weight to performance variables will produce more sensitive performance measurement in detecting performance improvement. Therefore, this paper discusses the development of the model B-S-Rc-DEA by giving weight to its performance'variables. This model referred as Scale B-S-Rc-DEA model. To illustrate the model of development, some samples from small medium enterprises of leather craft industry supply chain in province of Yogyakarta, Indonesia are used in this research. It is found that Scale B-S-Rc-DEA model is more sensitive to detecting performance improvement than B-S- Rc-DEA model.

  16. Use of Self-Organizing Maps for Balanced Scorecard analysis to monitor the performance of dialysis clinic chains.

    PubMed

    Cattinelli, Isabella; Bolzoni, Elena; Barbieri, Carlo; Mari, Flavio; Martin-Guerrero, José David; Soria-Olivas, Emilio; Martinez-Martinez, José Maria; Gomez-Sanchis, Juan; Amato, Claudia; Stopper, Andrea; Gatti, Emanuele

    2012-03-01

    The Balanced Scorecard (BSC) is a validated tool to monitor enterprise performances against specific objectives. Through the choice and the evaluation of strategic Key Performance Indicators (KPIs), it provides a measure of the past company's outcome and allows planning future managerial strategies. The Fresenius Medical Care (FME) BSC makes use of 30 KPIs for a continuous quality improvement strategy within its dialysis clinics. Each KPI is monthly associated to a score that summarizes the clinic efficiency for that month. Standard statistical methods are currently used to analyze the BSC data and to give a comprehensive view of the corporate improvements to the top management. We herein propose the Self-Organizing Maps (SOMs) as an innovative approach to extrapolate information from the FME BSC data and to present it in an easy-readable informative form. A SOM is a computational technique that allows projecting high-dimensional datasets to a two-dimensional space (map), thus providing a compressed representation. The SOM unsupervised (self-organizing) training procedure results in a map that preserves similarity relations existing in the original dataset; in this way, the information contained in the high-dimensional space can be more easily visualized and understood. The present work demonstrates the effectiveness of the SOM approach in extracting useful information from the 30-dimensional BSC dataset: indeed, SOMs enabled both to highlight expected relationships between the KPIs and to uncover results not predictable with traditional analyses. Hence we suggest SOMs as a reliable complementary approach to the standard methods for BSC interpretation.

  17. Application of Balanced Scorecard in the Evaluation of a Complex Health System Intervention: 12 Months Post Intervention Findings from the BHOMA Intervention: A Cluster Randomised Trial in Zambia

    PubMed Central

    Mutale, Wilbroad; Stringer, Jeffrey; Chintu, Namwinga; Chilengi, Roma; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Balabanova, Dina; Spicer, Neil; Lewis, James; Ayles, Helen

    2014-01-01

    Introduction In many low income countries, the delivery of quality health services is hampered by health system-wide barriers which are often interlinked, however empirical evidence on how to assess the level and scope of these barriers is scarce. A balanced scorecard is a tool that allows for wider analysis of domains that are deemed important in achieving the overall vision of the health system. We present the quantitative results of the 12 months follow-up study applying the balanced scorecard approach in the BHOMA intervention with the aim of demonstrating the utility of the balanced scorecard in evaluating multiple building blocks in a trial setting. Methods The BHOMA is a cluster randomised trial that aims to strengthen the health system in three rural districts in Zambia. The intervention aims to improve clinical care quality by implementing practical tools that establish clear clinical care standards through intensive clinic implementations. This paper reports the findings of the follow-up health facility survey that was conducted after 12 months of intervention implementation. Comparisons were made between those facilities in the intervention and control sites. STATA version 12 was used for analysis. Results The study found significant mean differences between intervention(I) and control (C) sites in the following domains: Training domain (Mean I:C; 87.5.vs 61.1, mean difference 23.3, p = 0.031), adult clinical observation domain (mean I:C; 73.3 vs.58.0, mean difference 10.9, p = 0.02 ) and health information domain (mean I:C; 63.6 vs.56.1, mean difference 6.8, p = 0.01. There was no gender differences in adult service satisfaction. Governance and motivation scores did not differ between control and intervention sites. Conclusion This study demonstrates the utility of the balanced scorecard in assessing multiple elements of the health system. Using system wide approaches and triangulating data collection methods seems to be key to successful

  18. Application of balanced scorecard in the evaluation of a complex health system intervention: 12 months post intervention findings from the BHOMA intervention: a cluster randomised trial in Zambia.

    PubMed

    Mutale, Wilbroad; Stringer, Jeffrey; Chintu, Namwinga; Chilengi, Roma; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Balabanova, Dina; Spicer, Neil; Lewis, James; Ayles, Helen

    2014-01-01

    In many low income countries, the delivery of quality health services is hampered by health system-wide barriers which are often interlinked, however empirical evidence on how to assess the level and scope of these barriers is scarce. A balanced scorecard is a tool that allows for wider analysis of domains that are deemed important in achieving the overall vision of the health system. We present the quantitative results of the 12 months follow-up study applying the balanced scorecard approach in the BHOMA intervention with the aim of demonstrating the utility of the balanced scorecard in evaluating multiple building blocks in a trial setting. The BHOMA is a cluster randomised trial that aims to strengthen the health system in three rural districts in Zambia. The intervention aims to improve clinical care quality by implementing practical tools that establish clear clinical care standards through intensive clinic implementations. This paper reports the findings of the follow-up health facility survey that was conducted after 12 months of intervention implementation. Comparisons were made between those facilities in the intervention and control sites. STATA version 12 was used for analysis. The study found significant mean differences between intervention(I) and control (C) sites in the following domains: Training domain (Mean I:C; 87.5.vs 61.1, mean difference 23.3, p = 0.031), adult clinical observation domain (mean I:C; 73.3 vs.58.0, mean difference 10.9, p = 0.02 ) and health information domain (mean I:C; 63.6 vs.56.1, mean difference 6.8, p = 0.01. There was no gender differences in adult service satisfaction. Governance and motivation scores did not differ between control and intervention sites. This study demonstrates the utility of the balanced scorecard in assessing multiple elements of the health system. Using system wide approaches and triangulating data collection methods seems to be key to successful evaluation of such complex health

  19. The Balanced Scorecard

    ERIC Educational Resources Information Center

    Kaplan, Robert S.; Miyake, Dylan N.

    2010-01-01

    Ten years ago, the Atlanta Public Schools had low and declining student achievement, demoralized teachers, crumbling buildings, high turnover among superintendents (average tenure of two years) and disaffected parents pulling their children out of the system. More than 60 percent of the city's high school students missed at least two weeks of…

  20. Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: the case of a public hospital system in Taiwan.

    PubMed

    Yang, Ming-Chin; Tung, Yu-Chi

    2006-01-01

    Examining whether the causal relationships among the performance indicators of the balanced scorecard (BSC) framework exist in hospitals is the aim of this article. Data were collected from all twenty-one general hospitals in a public hospital system and their supervising agency for the 3-year period, 2000-2002. The results of the path analyses identified significant causal relationships among four perspectives in the BSC model. We also verified the relationships among indicators within each perspective, some of which varied as time changed. We conclude that hospital administrators can use path analysis to help them identify and manage leading indicators when adopting the BSC model. However, they should also validate causal relationships between leading and lagging indicators periodically because the management environment changes constantly.

  1. Dueling Scorecards: How Two Colleges Utilize the Popular Planning Method

    ERIC Educational Resources Information Center

    Ballentine, Howard; Eckles, Jay

    2009-01-01

    The Balanced Scorecard is a planning model used extensively in business to provide direction and accountability to an organization. Despite the demonstrated success of the model, it has not been widely used in higher education. This article compares and contrasts the use of the Balanced Scorecard by two small, private colleges. The article…

  2. Design, implementation and scaling up of the balanced scorecard for hospitals in Lebanon: policy coherence and application lessons for low and middle income countries.

    PubMed

    El-Jardali, Fadi; Saleh, Shadi; Ataya, Nour; Jamal, Diana

    2011-12-01

    This paper describes the development and implementation of the first national hospital performance indicators in Lebanon including its institutionalization within existing policy framework and the initiation of independent governance structure for sustainability. Guided by the Ontario Acute Care Balanced Scorecard framework, a step-wise approach was used. Guiding principles were non-punitive reporting, anonymity, voluntary participation, stakeholder involvement, consensus and feasibility. Modified Delphi technique was used, readiness assessment surveys in 52 hospitals were conducted, pilot testing and evaluation were completed in 14 hospitals. Initial balanced set of 21 indicators were selected. Findings showed wide variations in indicators' measurement in hospitals including formulas and tools. Barriers to measurement included lack of quality culture, physician resistance and resources. A gradual implementation strategy was developed and selected indicators were divided into two levels. Most piloted indicators proved to be valid, feasible and reliable. The initiative was linked to the national hospital accreditation system resulting in a balanced set of 40 indicators. An independent, not-for-profit, arm's-length organization was established. This is among the first attempts made in the East Mediterranean Region to adapt the BSC approach and translate the experience of its development to addresses local needs and contextual reality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. Establishment proper of the balanced scorecard indicators to support decision making in a university: a case study in Institut Teknologi Indonesia

    NASA Astrophysics Data System (ADS)

    Theresia, L.; Lahuddin, A. H.; Bangun, R.

    2017-12-01

    Balanced Scorecard (BSC) is a powerful tool in decision making process. Nevertheless, it is not rare that the BSC does not give satisfactory results because the indicators chosen do not reflect the needs of the organization. Therefore, indicator establishment is very crucial in the utilization of BSC. This research aims to determine the indicators BSC for a university and the research is a case study in Institut Teknologi Indonesia (ITI). In this study, BSC structure and indicators, comparison made by 4 previous researchers was used as the initial guide to determine the structure and indicators of ITI. And then, questionnaires were distributed to selected respondents and a focus group discussion (FGD) was conducted in order to produce indicators of BSC based on the mental model of the ITI. It is found 15 indicators based on the mental model of ITI. Furthermore, the relationships between the indicators are seen as dynamic relationships, and by using system dynamics, some feedback loops that are considered critical to organizational success can be identified and isolated.

  4. [Development and Application of a Performance Prediction Model for Home Care Nursing Based on a Balanced Scorecard using the Bayesian Belief Network].

    PubMed

    Noh, Wonjung; Seomun, Gyeongae

    2015-06-01

    This study was conducted to develop key performance indicators (KPIs) for home care nursing (HCN) based on a balanced scorecard, and to construct a performance prediction model of strategic objectives using the Bayesian Belief Network (BBN). This methodological study included four steps: establishment of KPIs, performance prediction modeling, development of a performance prediction model using BBN, and simulation of a suggested nursing management strategy. An HCN expert group and a staff group participated. The content validity index was analyzed using STATA 13.0, and BBN was analyzed using HUGIN 8.0. We generated a list of KPIs composed of 4 perspectives, 10 strategic objectives, and 31 KPIs. In the validity test of the performance prediction model, the factor with the greatest variance for increasing profit was maximum cost reduction of HCN services. The factor with the smallest variance for increasing profit was a minimum image improvement for HCN. During sensitivity analysis, the probability of the expert group did not affect the sensitivity. Furthermore, simulation of a 10% image improvement predicted the most effective way to increase profit. KPIs of HCN can estimate financial and non-financial performance. The performance prediction model for HCN will be useful to improve performance.

  5. Application of the balanced scorecard to an academic medical center in Taiwan: the effect of warning systems on improvement of hospital performance.

    PubMed

    Chen, Hsueh-Fen; Hou, Ying-Hui; Chang, Ray-E

    2012-10-01

    The balanced scorecard (BSC) is considered to be a useful tool for management in a variety of business environments. The purpose of this article is to utilize the experimental data produced by the incorporation and implementation of the BSC in hospitals and to investigate the effects of the BSC red light tracking warning system on performance improvement. This research was designed to be a retrospective follow-up study. The linear mixed model was applied for correcting the correlated errors. The data used in this study were secondary data collected by repeated measurements taken between 2004 and 2010 by 67 first-line medical departments of a public academic medical center in Taipei, Taiwan. The linear mixed model of analysis was applied for multilevel analysis. Improvements were observed with various time lags, from the subsequent month to three months after red light warning. During follow-up, the red light warning system more effectively improved controllable costs, infection rates, and the medical records completion rate. This further suggests that follow-up management promotes an enhancing and supportive effect to the red light warning. The red light follow-up management of BSC is an effective and efficient tool where improvement depends on ongoing and consistent attention in a continuing effort to better administer medical care and control costs. Copyright © 2012. Published by Elsevier B.V.

  6. The balanced scorecard framework-a case study of patient and employee satisfaction: what happens when it does not work as planned?

    PubMed

    Lorden, Andrea; Coustasse, Alberto; Singh, Karan P

    2008-01-01

    The successful utilization of the balanced scorecard (BSC) framework in health care has been demonstrated in the literature. Given these successes, a financially struggling hospital implemented a BSC framework intervention which attempted a culture change centered upon patient satisfaction which it hoped would translate to improved financial stability. Despite the evidence of BSC successes, the intervention, entitled Route 99, did not succeed in this hospital. This case study was conducted to identify learnable lessons and confounding factors associated with the successes and failures of Route 99. Metrics for patient satisfaction and employee satisfaction were examined as reflections of the intervention, the BSC framework, and the confounding financial condition of the hospital. Through case study methodology, mean quarterly patient satisfaction scores tabulated by an outside vendor for inpatient and outpatient services were divided into four time intervals and compared through analysis of variance. Employee satisfaction was measured through a hospital-provided 12-question employee survey, administered through convenience sampling at the beginning and 7 months into Route 99. Each question utilized a 5-point Likert scale and generated two samples which were verified for sample independence through chi-square analysis. Mann-Whitney U test was used for comparison. Inpatient patient satisfaction scores exhibited a nonsignificant upward trend. However, the analysis of variance demonstrated a significant rise in outpatient patient satisfaction (p < .05). An interesting finding was that employee satisfaction declined (p < .05) significantly for supervisors and directors in three areas. The inverse relationship between patient satisfaction and employee satisfaction is in contrast to that found in the literature by the authors. Examination of the BSC framework, the hospital's financial standing, and the metrics for patient satisfaction and employee satisfaction illuminated

  7. Multi-Attribute Strategy and Performance Architectures in R&D: The Case of The Balanced Scorecard

    DTIC Science & Technology

    2006-03-01

    learning.    We also found that balance, accessibility, transparency, and participation are increasingly  being  seen  as desirable features of the strategy...project would have never  seen  the light of the day. I am especially  thankful to Steven Popper for giving me the confidence to take on this challenging...among a ranking of 16 R&D  related problems perceived by the members for two years, 1993 & 1995 (Ellis, 1997.)  Traditionally R&D was  seen  as a rather

  8. Palliative Care Scorecard.

    PubMed

    Kittelson, Sheri; Pierce, Read; Youngwerth, Jeanie

    2017-05-01

    In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public. Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard. The scorecard was organized into a format of quality measures identified by the Measuring What Matters (MWM) project that are defined as important to the team, automatically extracted from the electronic health record, valid, and can be impacted over time. The scorecard was initially created using University of Florida Health (UF) data, a new PC program, and successfully applied and implemented at University of Colorado Anschutz Medical Campus (CU), a second institution with a mature PC program. Clinical metrics are organized in the scorecard based on MWM and described in terms of the metric definition, rationale for selection, measure type (structure, process, or outcome), and whether this represents a direct or proxy measure. The process of constructing the scorecard helped identify areas within both systems for potential improvement in team structure, clinical processes, and outcomes. In addition, by automating data extraction, the scorecard decreases costs associated with manual data entry and extraction, freeing clinical staff to care for patients and increasing the value of PC delivered to patients.

  9. The Integrated Scorecard in support of corporate sustainability strategies.

    PubMed

    Journeault, Marc

    2016-11-01

    Organizations have increasingly recognized the importance and benefits of developing a sustainability strategy that incorporates environmental and social responsibilities. However, the simultaneous integration of the economic, environmental and social aspects remains a major concern for organizations. The Sustainability Balanced Scorecard (SBSC) represents one of the most promising strategic tools to help organizations face these challenges and support their sustainability strategy. However, past research has provided unclear, incomplete and even contradictory SBSC frameworks while offering little knowledge about how to integrate stakeholder management as well as environmental and social performance within the balanced scorecard to successfully support a corporate sustainability strategy. The aim of this study is to address these issues and limitations by proposing the Integrated Scorecard, a specific SBSC that integrates the three pillars of sustainability performance within four different perspectives, namely environmental, social and economic performance, stakeholder management, internal business processes, and skills and capabilities. This study provides a conceptual approach to the Integrated Scorecard and illustrates, through the use of two practical illustrations, the ability of this framework to support the corporate sustainability strategy by identifying the core sustainability objectives that organizations should achieve when creating value, facilitating the understanding of the contribution of environmental and social initiatives on economic performance, allowing the monitoring and measurement of the strategy's level of achievement, and creating synergy between sustainability performance management and reporting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. BALANCE

    DOEpatents

    Carmichael, H.

    1953-01-01

    A torsional-type analytical balance designed to arrive at its equilibrium point more quickly than previous balances is described. In order to prevent external heat sources creating air currents inside the balance casing that would reiard the attainment of equilibrium conditions, a relatively thick casing shaped as an inverted U is placed over the load support arms and the balance beam. This casing is of a metal of good thernnal conductivity characteristics, such as copper or aluminum, in order that heat applied to one portion of the balance is quickly conducted to all other sensitive areas, thus effectively preventing the fornnation of air currents caused by unequal heating of the balance.

  11. SCOPE: a scorecard for osteoporosis in Europe.

    PubMed

    Kanis, J A; Borgström, F; Compston, J; Dreinhöfer, K; Nolte, E; Jonsson, L; Lems, W F; McCloskey, E V; Rizzoli, R; Stenmark, J

    2013-01-01

    The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis. The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union (EU27). The information researched covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap). There was a marked difference in fracture risk among the EU27. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27, only a minority of patients at high risk receive treatment for osteoporosis even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. The scorecard will enable healthcare professionals and policy makers to assess their country's general approach to the disease and provide indicators to inform future provision of healthcare.

  12. The innovation scorecard for continuous improvement applied to translational science.

    PubMed

    Kotarba, Joseph A; Wooten, Kevin

    2017-10-01

    This paper reports on the baseline stage of a qualitative evaluation of the application of the Innovative Scorecard (ISC) to the Clinical and Translational Science Award (CTSA) at the University of Texas Medical Branch (UTMB) at Galveston. The ISC is adopted from the established Balanced Scorecard system for strategic planning and performance management. In formulating the evaluation, we focused on the organizational identity literature. The initial evaluation consisted of a series of semi-structured interviews with 22 participants of the ISC Boot Camp conducted in July 2015. The logic of grounded theory pointed to the clustering of perceptions of the ISC around respondents' occupational locations at UTMB. Administrators anticipate the expansion of planning activities to include a wider range of participants under the current CTSA award period (2015-2020) than under our first CTSA approval period (2009-2014). A common viewpoint among the senior scientists was that the scientific value of their work will continue to speak for itself without requiring the language of business. Junior scientists looked forward to the ISC's emphasis on increasingly horizontal leadership that will give them more access to and more control over their work and resources. Postdocs and senior staff welcomed increased involvement in the total research process at UTMB. The report concludes with strategies for future follow-up.

  13. Balancing

    NASA Astrophysics Data System (ADS)

    Harteveld, Casper

    At many occasions we are asked to achieve a “balance” in our lives: when it comes, for example, to work and food. Balancing is crucial in game design as well as many have pointed out. In games with a meaningful purpose, however, balancing is remarkably different. It involves the balancing of three different worlds, the worlds of Reality, Meaning, and Play. From the experience of designing Levee Patroller, I observed that different types of tensions can come into existence that require balancing. It is possible to conceive of within-worlds dilemmas, between-worlds dilemmas, and trilemmas. The first, the within-world dilemmas, only take place within one of the worlds. We can think, for example, of a user interface problem which just relates to the world of Play. The second, the between-worlds dilemmas, have to do with a tension in which two worlds are predominantly involved. Choosing between a cartoon or a realistic style concerns, for instance, a tension between Reality and Play. Finally, the trilemmas are those in which all three worlds play an important role. For each of the types of tensions, I will give in this level a concrete example from the development of Levee Patroller. Although these examples come from just one game, I think the examples can be exemplary for other game development projects as they may represent stereotypical tensions. Therefore, to achieve harmony in any of these forthcoming games, it is worthwhile to study the struggles we had to deal with.

  14. Management Information System Based on the Balanced Scorecard

    ERIC Educational Resources Information Center

    Kettunen, Juha; Kantola, Ismo

    2005-01-01

    Purpose: This study seeks to describe the planning and implementation in Finland of a campus-wide management information system using a rigorous planning methodology. Design/methodology/approach: The structure of the management information system is planned on the basis of the management process, where strategic management and the balanced…

  15. Performance Management in UK Universities: Implementing the Balanced Scorecard

    ERIC Educational Resources Information Center

    Taylor, John; Baines, Claire

    2012-01-01

    In recent years, UK universities have become increasingly concerned with performance management. This trend reflects both growing competition and marketisation within higher education, and the increasing requirements for accountability. In response, institutions have begun to explore the application of formal methodologies for performance…

  16. [Application of the balanced scorecard for evaluating the training process].

    PubMed

    Picogna, Michele

    2009-01-01

    Over the last 20 years systems for standardizing nursing care have been elaborated and refined. Such systems are widely employed in teaching and research but very little in clinical practice (Kautz D., et al., 2006) ) However, it would be useful to integrate these systems with synthetic descriptions of nursing intervention to improve our knowledge of "offer and demand" in this field (Jungher, 2006). It is no coincidence that these systems are used more in countries where the type of health system makes it necessary to quantify the contribution of each single health operator in the overall care procedure. The aim of the study was to assess the relevance of the different classifications , considering them not only influenced by nursing but also to some degree influential.

  17. The occupational safety and health scorecard--a business case example for strategic management.

    PubMed

    Köper, Birgit; Möller, Klaus; Zwetsloot, Gerard

    2009-12-01

    Human resources and health issues are crucial in terms of corporate competitiveness. However, systematic, continuous and strategically aligned occupational safety and health (OSH) management is scarcely applied in companies. One major reason for this could be the lack of generally accepted and standardised OSH control methods. Our objective was thus to conceptualize a method by which qualitative factors such as human resources and OSH aspects contribute to the performance or value-added layer of an organization. We developed a business case based on the well-known and accepted Balanced Scorecard approach, which we adapted and applied to the management of OSH issues. The concept was implemented in the course of a comprehensive case study at a German automobile manufacturer. We gathered health as well as finance data in order to test which health-related indicators had an impact on financial performance. The demonstration of, and reporting on, how the promotion of workplace health contributes strategically to the organization is crucial for both health and human resource managers. Based on multivariate regression analyses, our main finding was that the Balanced Scorecard approach is an adequate means to control OSH issues in terms of strategic health management. Our analyses demonstrated that health-related interventions contribute significantly to performance aspects such as quality, productivity, absenteeism, and cost reduction. Therefore, the financial impact of health-related aspects / interventions could be demonstrated by means of the OSH scorecard. The availability and quality of health data within the context of overall corporate performance data needs to be improved in order to bridge OSH-related and performance issues of an organization.

  18. Developing a Security Metrics Scorecard for Healthcare Organizations.

    PubMed

    Elrefaey, Heba; Borycki, Elizabeth; Kushniruk, Andrea

    2015-01-01

    In healthcare, information security is a key aspect of protecting a patient's privacy and ensuring systems availability to support patient care. Security managers need to measure the performance of security systems and this can be achieved by using evidence-based metrics. In this paper, we describe the development of an evidence-based security metrics scorecard specific to healthcare organizations. Study participants were asked to comment on the usability and usefulness of a prototype of a security metrics scorecard that was developed based on current research in the area of general security metrics. Study findings revealed that scorecards need to be customized for the healthcare setting in order for the security information to be useful and usable in healthcare organizations. The study findings resulted in the development of a security metrics scorecard that matches the healthcare security experts' information requirements.

  19. Human-System Integration Scorecard Update to VB.Net

    NASA Technical Reports Server (NTRS)

    Sanders, Blaze D.

    2009-01-01

    The purpose of this project was to create Human-System Integration (HSI) scorecard software, which could be utilized to validate that human factors have been considered early in hardware/system specifications and design. The HSI scorecard is partially based upon the revised Human Rating Requirements (HRR) intended for NASA's Constellation program. This software scorecard will allow for quick appraisal of HSI factors, by using visual aids to highlight low and rapidly changing scores. This project consisted of creating a user-friendly Visual Basic program that could be easily distributed and updated, to and by fellow colleagues. Updating the Microsoft Word version of the HSI scorecard to a computer application will allow for the addition of useful features, improved easy of use, and decreased completion time for user. One significant addition is the ability to create Microsoft Excel graphs automatically from scorecard data, to allow for clear presentation of problematic areas. The purpose of this paper is to describe the rational and benefits of creating the HSI scorecard software, the problems and goals of project, and future work that could be done.

  20. The imaging 3.0 informatics scorecard.

    PubMed

    Kohli, Marc; Dreyer, Keith J; Geis, J Raymond

    2015-04-01

    Imaging 3.0 is a radiology community initiative to empower radiologists to create and demonstrate value for their patients, referring physicians, and health systems. In image-guided health care, radiologists contribute to the entire health care process, well before and after the actual examination, and out to the point at which they guide clinical decisions and affect patient outcome. Because imaging is so pervasive, radiologists who adopt Imaging 3.0 concepts in their practice can help their health care systems provide consistently high-quality care at reduced cost. By doing this, radiologists become more valuable in the new health care setting. The authors describe how informatics is critical to embracing Imaging 3.0 and present a scorecard that can be used to gauge a radiology group's informatics resources and capabilities. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. A Methodological Critique of the ProPublica Surgeon Scorecard

    PubMed Central

    Friedberg, Mark W.; Pronovost, Peter J.; Shahian, David M.; Safran, Dana Gelb; Bilimoria, Karl Y.; Elliott, Marc N.; Damberg, Cheryl L.; Dimick, Justin B.; Zaslavsky, Alan M.

    2016-01-01

    Abstract On July 14, 2015, ProPublica published its Surgeon Scorecard, which displays “Adjusted Complication Rates” for individual, named surgeons for eight surgical procedures performed in hospitals. Public reports of provider performance have the potential to improve the quality of health care that patients receive. A valid performance report can drive quality improvement and usefully inform patients' choices of providers. However, performance reports with poor validity and reliability are potentially damaging to all involved. This article critiques the methods underlying the Scorecard and identifies opportunities for improvement. Until these opportunities are addressed, the authors advise users of the Scorecard—most notably, patients who might be choosing their surgeons—not to consider the Scorecard a valid or reliable predictor of the health outcomes any individual surgeon is likely to provide. The authors hope that this methodological critique will contribute to the development of more-valid and more-reliable performance reports in the future. PMID:28083411

  2. Scorecard implementation improves identification of postpartum patients at risk for venous thromboembolism.

    PubMed

    Berkin, Jill A; Lee, Colleen; Landsberger, Ellen; Chazotte, Cynthia; Bernstein, Peter S; Goffman, Dena

    2016-07-01

    To evaluate if an intensive educational intervention in the use of a standardized venous thromboembolism (VTE) risk assessment tool (scorecard) improves physicians' identification and chemoprophylaxis of postpartum patients at risk for VTE. After implementation of a VTE scorecard and prior to an intensive educational intervention, postpartum patients (n = 140) were evaluated to assess scorecard completion, risk factors, and chemoprophylaxis. A performance improvement campaign focusing on patient safety, VTE prevention, and scorecard utilization was then conducted. Evaluation of the same parameters was subsequently performed for a similar group of patients (n = 133). Differences in scorecard utilization and risk assessment were tested for statistical significance. Population-at-risk rates were similar in both assessment periods (31.4% vs 28.6%; p = NS). The greatest risk factors included cesarean delivery, body mass index (BMI) >30 and age >35. Scorecard completion rates for all patients increased in the postintervention period (15.7% vs 67.7%; p < .001). Postintervention scorecard completion rates for the at-risk population also improved (20% vs 79%; p < .001). In the postintervention group, those at risk with completed scorecards had higher prophylaxis rates than those at risk without scorecards (73% vs 25%; p = .03). At-risk patients with completed scorecards had 2.6 times more orders for chemoprophylaxis than at-risk patients without scorecards in both time periods (odds ratio [OR] = 8.4; 95% confidence interval [CI] 3.1-22.8). Utilization of a VTE scorecard coupled with an educational intervention for health care providers increases detection and chemoprophylaxis orders for at-risk patients. Encouraging universal scorecard assessment standardizes identification and chemoprophylaxis of at-risk patients who were otherwise not perceived to be at risk. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

  3. VERB [TM] Summer Scorecard: Increasing Tween Girls' Vigorous Physical Activity

    ERIC Educational Resources Information Center

    Alfonso, Moya L.; Thompson, Zachary; McDermott, Robert J.; Colquitt, Gavin; Jones, Jeffery A.; Bryant, Carol A.; Courtney, Anita H.; Davis, Jenna L.; Zhu, Yiliang

    2013-01-01

    Objective: We assessed changes in the frequency of self-reported physical activity (PA) among tween girls exposed and not exposed to the VERB [TM] Summer Scorecard (VSS) intervention in Lexington, Kentucky, during 2004, 2006, and 2007. Methods: Girls who reported 0-1 day per week of PA were classi?ed as having "little or no" PA. Girls…

  4. Tool for Human-Systems Integration Assessment: HSI Scorecard

    NASA Technical Reports Server (NTRS)

    Whitmore, Nihriban; Sandor, Aniko; McGuire, Kerry M.; Berdich, Debbie

    2009-01-01

    This paper describes the development and rationale for a human-systems integration (HSI) scorecard that can be used in reviews of vehicle specification and design. This tool can be used to assess whether specific HSI related criteria have been met as part of a project milestone or critical event, such as technical reviews, crew station reviews, mockup evaluations, or even review of major plans or processes. Examples of HSI related criteria include Human Performance Capabilities, Health Management, Human System Interfaces, Anthropometry and Biomechanics, and Natural and Induced Environments. The tool is not intended to evaluate requirements compliance and verification, but to review how well the human related systems have been considered for the specific event and to identify gaps and vulnerabilities from an HSI perspective. The scorecard offers common basis, and criteria for discussions among system managers, evaluators, and design engineers. Furthermore, the scorecard items highlight the main areas of system development that need to be followed during system lifecycle. The ratings provide a repeatable quantitative measure to what has been often seen as only subjective commentary. Thus, the scorecard is anticipated to be a useful HSI tool to communicate review results to the institutional and the project office management.

  5. Evaluation of the Service Review Model with Performance Scorecards

    ERIC Educational Resources Information Center

    Szabo, Thomas G.; Williams, W. Larry; Rafacz, Sharlet D.; Newsome, William; Lydon, Christina A.

    2012-01-01

    The current study combined a management technique termed "Service Review" with performance scorecards to enhance staff and consumer behavior in a human service setting consisting of 11 supervisors and 56 front-line staff working with 9 adult consumers with challenging behaviors. Results of our intervention showed that service review and…

  6. Validation and Adjustment of the Leipzig-Halifax Acute Aortic Dissection Type A Scorecard.

    PubMed

    Mejàre-Berggren, Hanna; Olsson, Christian

    2017-11-01

    The novel Leipzig-Halifax (LH) scorecard for acute aortic dissection type A (AADA) stratifies risk of in-hospital death based on age, malperfusion syndromes, critical preoperative state, and coronary disease. The study aim was to externally validate the LH scorecard performance and, if adequate, propose adjustments. All consecutive AADA patients operated on from 1996 to 2016 (n = 509) were included to generate an external validation cohort. Variables related to in-hospital death were analyzed using univariable and multivariable analysis. The LH scorecard was applied to the validation cohort, compared with the original study, and variable selection was adjusted using validation measures for discrimination and calibration. In-hospital mortality rate was 17.7% (LH cohort 18.7%). Critical preoperative state and Penn class non-Aa were independent predictors (odds ratio [OR] 2.42 and 2.45, respectively) of in-hospital death. The LH scorecard was adjusted to include Penn class non-Aa, critical preoperative state, and coronary disease. Assessing discrimination, area under receiver operator characteristic curve for the LH scorecard was 0.61 versus 0.66 for the new scorecard (p = 0.086). In-hospital mortality rates in low-, medium-, and high-risk groups were 14%, 15%, and 48%, respectively (LH scorecard) versus 11%, 23%, and 43%, respectively (new scorecard), and goodness-of-fit p value was 0.01 versus 0.86, indicating better calibration by the new scorecard. A lower Akaike information criterion value, 464 versus 448, favored the new scorecard. Through adjustment of the LH scorecard after external validation, prognostic performance improved. Further validated, the LH scorecard could be a valuable risk prediction tool. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  7. The palliative care scorecard as an innovative approach in long-term care

    PubMed Central

    Esslinger, Adelheid Sussanne; Alzinger, Dagmar; Rager, Edeltraud

    2009-01-01

    Introduction In long-term care facilities professional concepts for palliative care are of great interest as individual needs of clients (residents, relatives, and friends) are in the focus of services. Case Within a long-term care facility of the Red Cross Organization in Germany, we developed a palliative care concept in 2008. It is integrated in the strategy of the whole organization. As the strategic management concept is based on the balanced scorecard, we introduced a palliative care scorecard. The facility offers 200 places for residents. It has established 27 strategic targets to achieve. One of these is to provide individual care. Another one is to integrate relatives of residents. One more deals with the integration of volunteers. We decided to implement a palliative care concept within the target system (e.g. develop individual pain therapy, create and coordinate interdisciplinary palliative care teams). Results The case shows how it is possible to integrate and strengthen the subject of palliative care within the existing management system of the organization. In order to translate the concept into action, it will be necessary to change the organizational culture into an ‘open minded house’. This especially means that all members of the organization have to be trained and sensitized for the matters of care at the end of life. Conclusion The development and implementation of an integrated concept of palliative care, which fits into the existing management system, is the base of a sustainable offer of specialized care for the residents and their social network. Therefore, not only the quality of care and life of the clients, but also the surviving of the facility on the market of care will be assured.

  8. Scorecard cardiovascular medicine. Its impact and future directions.

    PubMed

    Topol, E J; Califf, R M

    1994-01-01

    Public release of operator-specific data for cardiovascular procedures has set a new precedent, introducing the "scorecard" era. Justification exists for public disclosure, but the mechanics of appropriate data release are complex from a clinical, statistical, and logistic standpoint. Scorecard medicine may appropriately promote regionalization of medical centers and consolidation of services, but unless the process is directed effectively, it may impair the development of new treatments because of a more restrictive clinical practice environment. We propose revamping our current system to facilitate rapid and accurate access to outcome data in the local practice environment so that improvement in practice occurs on a voluntary basis rather than in response to punitive restrictions. A rational plan needs to be developed for dealing with high-risk patients, perhaps through compensation in regression models used to calculate expected outcomes, and for the start-up of novice physicians. Special provisions are needed to promote clinical research. Before procedures are done, it would be ideal to provide a full disclosure informed consent, whereby the physician reports operator-specific data and the patient's decision-making process is facilitated. Overall, appropriate implementation of scorecards could ultimately lead to a substantial improvement in the quality of U.S. cardiovascular medicine.

  9. Improving the College Scorecard: Using Student Feedback to Create an Effective Disclosure

    ERIC Educational Resources Information Center

    Morgan, Julie Margetta; Dechter, Gadi

    2012-01-01

    The White House will soon unveil a final version of its "college scorecard"--an online tool giving college-bound students and their families a hype-free snapshot of reliable information about any U.S. campus: real costs, graduation rates, student debt statistics, and earning potential of graduates. The college scorecard is a good idea…

  10. The potential of an online and mobile health scorecard for preventing chronic disease.

    PubMed

    Miron-Shatz, Talya; Ratzan, Scott C

    2011-08-01

    This article proposes a digital or electronic health scorecard to help prevent chronic disease. Today, chronic diseases--such as diabetes, cardiovascular diseases, and cancer--are among the most prevalent, costly, and preventable of all health problems. Yet, no credible, broadly distributed tool exists for monitoring and promoting health of large populations. The Take Care scorecard, we propose, will be a parsimonious way to both convey to people what measures they need to take to maintain their health and prevent or control chronic disease. The scorecard will aggregate several health and lifestyle indicators, such as blood pressure, body mass index, smoking and exercising, and allow the person to score him- or herself, coming up with a single number that assesses where he or she stands in terms of health. The terms used in the scorecard are easily comprehended by laypeople and are intended for usage that is not necessarily mediated by a physician, although it can be easily applied in the clinical setting. The measures included in the scorecard were selected on the basis of converging medical evidence attesting to their significance in curbing chronic disease. While the scorecard can also be used in a pen-and-paper manner, the increasing global popularity and accessibility of online and mobile content makes such a scorecard a potentially powerful and cost-effective means of increasing health.

  11. Balanced performance measurement in research hospitals: the participative case study of a haematology department.

    PubMed

    Catuogno, Simona; Arena, Claudia; Saggese, Sara; Sarto, Fabrizia

    2017-08-03

    The paper aims to review, design and implement a multidimensional performance measurement system for a public research hospital in order to address the complexity of its multifaceted stakeholder requirements and its double institutional aim of care and research. The methodology relies on a participative case study performed by external researchers in close collaboration with the staff of an Italian research hospital. The paper develops and applies a customized version of balanced scorecard based on a new set of performance measures. Our findings suggest that it can be considered an effective framework for measuring the research hospital performance, thanks to a combination of generalizable and context-specific factors. By showing how the balanced scorecard framework can be customized to research hospitals, the paper is especially of interest for complex healthcare organizations that are implementing management accounting practices. The paper contributes to the body of literature on the application of the balanced scorecard in healthcare through an examination of the challenges in designing and implementing this multidimensional performance tool. This is one of the first papers that show how the balanced scorecard model can be adapted to fit the specific requirements of public research hospitals.

  12. The predictive validity of the HERO Scorecard in determining future health care cost and risk trends.

    PubMed

    Goetzel, Ron Z; Henke, Rachel Mosher; Benevent, Richele; Tabrizi, Maryam J; Kent, Karen B; Smith, Kristyn J; Roemer, Enid Chung; Grossmeier, Jessica; Mason, Shawn T; Gold, Daniel B; Noeldner, Steven P; Anderson, David R

    2014-02-01

    To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into "high" versus "low" scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends. "High" scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of -1.6% over 3 years) compared with "low" scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring "low." The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.

  13. Wheels, hubs and spokes: incorporating a scorecard into a business continuity programme.

    PubMed

    Stourac, Tracy

    2014-01-01

    A scorecard can provide much more than periodic measurements; it can actually serve as the 'hub' of a programme. By taking a strategic look at what one is trying to accomplish, using consistent messaging, following a flexible but defined process and creating an actionable report for the senior leadership, a programme can be built that not only gets attention but is also efficient and effective. The scorecard establishes accountability and consistency while creating a brand for a business continuity programme.

  14. Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

    PubMed

    Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

  15. Association Between Surgeon Scorecard Use and Operating Room Costs.

    PubMed

    Zygourakis, Corinna C; Valencia, Victoria; Moriates, Christopher; Boscardin, Christy K; Catschegn, Sereina; Rajkomar, Alvin; Bozic, Kevin J; Soo Hoo, Kent; Goldberg, Andrew N; Pitts, Lawrence; Lawton, Michael T; Dudley, R Adams; Gonzales, Ralph

    2017-03-01

    Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting. Intervention participants were attending surgeons in orthopedic surgery, otolaryngology-head and neck surgery, and neurological surgery (n = 63). Control participants were attending surgeons in cardiothoracic surgery, general surgery, vascular surgery, pediatric surgery, obstetrics/gynecology, ophthalmology, and urology (n = 186). From January 1 to December 31, 2015, each surgeon in the intervention group received standardized monthly scorecards showing the median surgical supply direct cost for each procedure type performed in the prior month compared with the surgeon's baseline (July 1, 2012, to November 30, 2014) and compared with all surgeons at the institution performing the same procedure at baseline. All surgical departments were eligible for a financial incentive if they met a 5% cost reduction goal. The primary outcome was each group's median surgical supply cost per case. Secondary outcome measures included total departmental surgical supply costs, case mix index-adjusted median surgical supply costs, patient outcomes (30-day readmission, 30-day mortality, and discharge status), and surgeon responses to a postintervention study-specific health care value survey. The median surgical supply direct costs per case decreased 6.54% in the intervention group, from $1398 (interquartile range [IQR], $316-$5181) (10 637 cases) in 2014 to $1307 (IQR, $319-$5037) (11 820 cases) in 2015. In contrast, the median surgical supply direct cost increased 7.42% in the control group, from $712 (IQR, $202-$1602) (16 441 cases

  16. A Research on Performance Measurement Based on Economic Valued-Added Comprehensive Scorecard

    NASA Astrophysics Data System (ADS)

    Chen, Qin; Zhang, Xiaomei

    With the development of economic, the traditional performance mainly rely on financial indicators could not satisfy the need of work. In order to make the performance measurement taking the best services for business goals, this paper proposed Economic Valued-Added Comprehensive Scorecard based on research of shortages and advantages of EVA and BSC .We used Analytic Hierarchy Process to build matrix to solve the weighting of EVA Comprehensive Scorecard. At last we could find the most influence factors for enterprise value forming the weighting.

  17. Working toward More Engaged and Successful Accounting Students: A Balanced Scorecard Approach

    ERIC Educational Resources Information Center

    Fredin, Amy; Fuchsteiner, Peter; Portz, Kris

    2015-01-01

    Prior research indicates that student engagement is the key to student success, as measured by college grades, degree completion, and graduate school enrollment. We propose a set of goals and objectives for accounting students, in particular, to help them become engaged not only in the educational process, but also in the accounting profession.…

  18. Balanced Scorecard: Evaluation of Air Force Materiel Command’s Implementation and Use

    DTIC Science & Technology

    2008-03-01

    Department of Operational Sciences Graduate School of Engineering and Management Air Force Institute of Technology Air University Air Education...and Alignment (2006). Operational experience has also been accumulated through a number of BSC implementations. Together, organizations now have a...sustain operations . By 1994, it was the least profitable company in its sector. Executives knew things needed to change and decided to roll out

  19. Balanced Scorecard: A Strategy for the Quality Improvement of Islamic Higher Education

    ERIC Educational Resources Information Center

    Ilyasin, Mukhamd; Zamroni

    2017-01-01

    The main issue in improving the quality of Islamic Higher Education is to increase the competence and professionalism of teachers and education personnel to achieve its vision and mission in the middle of the complexity of the demands of society and the changing times. so that the quality of education and governance of Islamic Religion clean and…

  20. Motivations-Attributes-Skills-Knowledge Model as Framework for Leadership Assessment Balanced Scorecards: An Empirical Study

    ERIC Educational Resources Information Center

    Bellamy, Chris D.

    2013-01-01

    Over the course of history many leaders have made their mark on society. These leaders have led uprisings, movements, and organizations that have left legacy's in today's society. Leaders such as Martin Luther King, Adolph Hitler, and Jack Welch have displayed behaviors and leadership competencies which motivated their followers. These…

  1. Resource Allocation with the Use of the Balanced Scorecard and the Triple Bottom Line in Education

    ERIC Educational Resources Information Center

    Nguyen, Chi Hong

    2007-01-01

    In terms of the economic bottom line, effective school leaders are now supposed to pay close attention to two central tasks which involve managing resources and devising operational strategies in their action plans. Taking a postmodern viewpoint, the first part of this paper aims to discuss the significance of resource allocation in education and…

  2. Developing an Indicator System for Schools of Choice: A Balanced Scorecard Approach

    ERIC Educational Resources Information Center

    Brown, Richard S.; Wohlstetter, Priscilla; Liu, Sunny

    2008-01-01

    This article describes the process of developing an indicator system that goes beyond a single indicator of school progress or performance. The system relies on a set of school indicators that uses data that public schools routinely report to state agencies for compliance purposes. The framework for the indicator system is based on the idea of…

  3. Using a Balance Scorecard Approach to Evaluate the Value of Service Learning Projects in Online Courses

    ERIC Educational Resources Information Center

    Schwieger, Dana

    2015-01-01

    Service learning projects serve as a valuable tool for applying course concepts in a way to benefit both the students and community. However, they often require a significant amount of additional effort beyond that required of assigning conventional homework problems. When the projects take place in an online course setting, the level of…

  4. Building an International Student Market: Educational-Balanced Scorecard Solutions for Regional Australian Cities

    ERIC Educational Resources Information Center

    Forbes, Linda; Hamilton, John

    2004-01-01

    There is an international student market suitable for regional Australia, but each region is different. Hence, each region must determine, target and niche market to its best potential international student customer base. For international education there remains scant, relevant, data for regional Australia, hence complete regional approaches to…

  5. 12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

  6. 12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

  7. 12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

  8. What Leaders Need to Know and Do: A Leadership Competencies Scorecard

    ERIC Educational Resources Information Center

    Ruben, Brent D.

    2006-01-01

    Brent Ruben introduces readers to a framework that surveys, summarizes, and synthesizes a broad cross section of the contemporary writings on leadership. The book organizes that literature into five broad competency areas, each of which is composed of a number of themes, and provides a Leadership Competencies Scorecard Inventory that allows…

  9. A Scorecard on Gender Equality and Girls' Education in Asia, 1990-2000. Advocacy Brief

    ERIC Educational Resources Information Center

    Unterhalter, Elaine; Rajagopalan, Rajee; Challender, Chloe

    2005-01-01

    Background: Existing measures for access to and efficiency in the school system are very limited as measures of gender equality, even though there have been marked improvements in sex-disaggregated data. A methodology for developing a scorecard which measures gender equality in schooling and education partly based on Amartya Sen's capability…

  10. Response to ProPublica's Rebuttal of Our Critique of the Surgeon Scorecard

    PubMed Central

    Friedberg, Mark W.; Bilimoria, Karl Y.; Pronovost, Peter J.; Shahian, David M.; Damberg, Cheryl L.; Zaslavsky, Alan M.

    2016-01-01

    Abstract In the summer of 2015, ProPublica published its Surgeon Scorecard, which displays “Adjusted Complication Rates” for individual, named surgeons for eight surgical procedures performed in hospitals. Public reports of provider performance have the potential to improve the quality of health care that patients receive. A valid performance report can drive quality improvement and usefully inform patients' choices of providers. However, performance reports with poor validity and reliability are potentially damaging to all involved. In September 2015, RAND released a critique of the Scorecard authored by a group of health policy researchers from RAND and other institutions, and on October 7, 2015 ProPublica published a rebuttal of our critique. In this follow-on Perspective, we revisit the main points in our initial critique, summarize ProPublica's rebuttal, explain why this rebuttal fails to address our methodological concerns, provide suggestions on how to validate and improve the Scorecard, and explain why we continue to advise potential users of the Scorecard, as it is currently constructed, not to consider it a valid or reliable predictor of the health outcomes any individual surgeon is likely to provide. PMID:28083432

  11. Confronting Equity Issues on Campus: Implementing the Equity Scorecard in Theory and Practice

    ERIC Educational Resources Information Center

    Bensimon, Estela Mara, Ed.; Malcom, Lindsey, Ed.

    2012-01-01

    How can it be that 50 years after the passage of the Civil Rights Act, our institutions of higher education have still not found ways of reducing the higher education gaps for racial and ethnic groups? That is the question that informs and animates the Equity Scorecard model of organizational change. It shifts institutions' focus from what…

  12. Impacting Student Access through Federal Policy Changes: How College Presidents Interpret "The College Scorecard"

    ERIC Educational Resources Information Center

    Posillico, Joseph J.

    2017-01-01

    There has been significant growth in the number of regulations placed on colleges and universities in recent years. This type of growth contributes to the complex environment that exists for colleges and universities. The study focuses on the federal government's consumer information mandate and the release of "The College Scorecard."…

  13. A Framework for Six Sigma Project Selection in Higher Educational Institutions, Using a Weighted Scorecard Approach

    ERIC Educational Resources Information Center

    Holmes, Monica C.; Jenicke, Lawrence O.; Hempel, Jessica L.

    2015-01-01

    Purpose: This paper discusses the importance of the Six Sigma selection process, describes a Six Sigma project in a higher educational institution and presents a weighted scorecard approach for project selection. Design/Methodology/Approach: A case study of the Six Sigma approach being used to improve student support at a university computer help…

  14. The climate change performance scorecard and carbon estimates for national forest

    Treesearch

    John W. Coulston; Kellen Nelson; Christopher W. Woodall; David Meriwether; Gregory A. Reams

    2012-01-01

    The U.S. Forest Service manages 20 percent of the forest land in the United States. Both the Climate Change Performance Scorecard and the revised National Forest Management Act require the assessment of carbon stocks on these lands. We present circa 2010 estimates of carbon stocks for each national forest and recommendations to improve these estimates.

  15. Predicting in-hospital mortality after redo cardiac operations: development of a preoperative scorecard.

    PubMed

    Launcelott, Sebastian; Ouzounian, Maral; Buth, Karen J; Légaré, Jean-Francois

    2012-09-01

    The present study generated a risk model and an easy-to-use scorecard for the preoperative prediction of in-hospital mortality for patients undergoing redo cardiac operations. All patients who underwent redo cardiac operations in which the initial and subsequent procedures were performed through a median sternotomy were included. A logistic regression model was created to identify independent preoperative predictors of in-hospital mortality. The results were then used to create a scorecard predicting operative risk. A total of 1,521 patients underwent redo procedures between 1995 and 2010 at a single institution. Coronary bypass procedures were the most common previous (58%) or planned operations (54%). The unadjusted in-hospital mortality for all redo cases was higher than for first-time procedures (9.7% vs. 3.4%; p<0.001). Independent predictors of in-hospital mortality were a composite urgency variable (odds ratio [OR], 3.47), older age (70-79 years, OR, 2.74; ≥80 years, OR, 3.32), more than 2 previous sternotomies (OR, 2.69), current procedure other than isolated coronary or valve operation (OR, 2.64), preoperative renal failure (OR, 1.89), and peripheral vascular disease (PVD) (OR, 1.55); all p<0.05. A scorecard was generated using these independent predictors, stratifying patients undergoing redo cardiac operations into 6 risk categories of in-hospital mortality ranging from <5% risk to >40%. Reoperation represents a significant proportion of modern cardiac surgical procedures and is often associated with significantly higher mortality than first-time operations. We created an easy-to-use scorecard to assist clinicians in estimating operative mortality to ensure optimal decision making in the care of patients facing redo cardiac operations. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Comparison of Colonoscopy Quality Measures Across Various Practice Settings and the Impact of Performance Scorecards.

    PubMed

    Inra, Jennifer A; Nayor, Jennifer; Rosenblatt, Margery; Mutinga, Muthoka; Reddy, Sarathchandra I; Syngal, Sapna; Kastrinos, Fay

    2017-04-01

    Quality performance measures for screening colonoscopy vary among endoscopists. The impact of practice setting is unknown. We aimed to (1) compare screening colonoscopy performance measures among three different US practice settings; (2) evaluate factors associated with adenoma detection; and (3) assess a scorecard intervention on performance metrics. This multi-center prospective study compared patient, endoscopist, and colonoscopy characteristics performed at a tertiary care hospital (TCH), community-based hospital (CBH), and private practice group (PPG). Withdrawal times (WT), cecal intubation, and adenoma detection rates (ADR) were compared by site at baseline and 12 weeks following scorecard distribution. Generalized linear mixed models identified factors associated with adenoma detection. Twenty-eight endoscopists performed colonoscopies on 1987 asymptomatic, average-risk individuals ≥50 years. Endoscopist and patient characteristics were similar across sites. The PPG screened more men (TCH: 42.8%, CBH: 45.0%, PPG: 54.2%; p < 0.0001). Preparation quality varied with good/excellent results in 70.6, 88.3, and 92% of TCH, CBH, and PPG cases, respectively (p < 0.0001). Male ADRs, cecal intubation, and WT exceeded recommended benchmarks despite variable results at each site; female ADRs were <15% at the PPG which screened the fewest females. Performance remained unchanged following scorecard distribution. Adenoma detection was associated with increasing patient age, male gender, WT, adequate preparation, but not practice setting. Each practice performed high-quality screening colonoscopy. Scorecards did not improve performance metrics. Preparation quality varies among practice settings and can be modified to improve adenoma detection.

  17. Use of Balanced Indicators as a Management Tool in Nursing.

    PubMed

    Fugaça, Neidamar Pedrini Arias; Cubas, Marcia Regina; Carvalho, Deborah Ribeiro

    2015-01-01

    To develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. A single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. We identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators.

  18. Using the CDC Worksite Health ScoreCard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine.

    PubMed

    Safeer, Richard; Bowen, Wendy; Maung, Zaw; Lucik, Meg

    2018-02-01

    The aim of this study was to determine whether the Centers for Disease Control and Prevention Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers. Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks. Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two. Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

  19. Governing patient safety: lessons learned from a mixed methods evaluation of implementing a ward-level medication safety scorecard in two English NHS hospitals.

    PubMed

    Ramsay, Angus I G; Turner, Simon; Cavell, Gillian; Oborne, C Alice; Thomas, Rebecca E; Cookson, Graham; Fulop, Naomi J

    2014-02-01

    Relatively little is known about how scorecards presenting performance indicators influence medication safety. We evaluated the effects of implementing a ward-level medication safety scorecard piloted in two English NHS hospitals and factors influencing these. We used a mixed methods, controlled before and after design. At baseline, wards were audited on medication safety indicators; during the 'feedback' phase scorecard results were presented to intervention wards on a weekly basis over 7 weeks. We interviewed 49 staff, including clinicians and managers, about scorecard implementation. At baseline, 18.7% of patients (total n=630) had incomplete allergy documentation; 53.4% of patients (n=574) experienced a drug omission in the preceding 24 h; 22.5% of omitted doses were classified as 'critical'; 22.1% of patients (n=482) either had ID wristbands not reflecting their allergy status or no ID wristband; and 45.3% of patients (n=237) had drugs that were either unlabelled or labelled for another patient in their drug lockers. The quantitative analysis found no significant improvement in intervention wards following scorecard feedback. Interviews suggested staff were interested in scorecard feedback and described process and culture changes. Factors influencing scorecard implementation included 'normalisation' of errors, study duration, ward leadership, capacity to engage and learning preferences. Presenting evidence-based performance indicators may potentially influence staff behaviour. Several practical and cultural factors may limit feedback effectiveness and should be considered when developing improvement interventions. Quality scorecards should be designed with care, attending to evidence of indicators' effectiveness and how indicators and overall scorecard composition fit the intended audience.

  20. Governing patient safety: lessons learned from a mixed methods evaluation of implementing a ward-level medication safety scorecard in two English NHS hospitals

    PubMed Central

    Ramsay, Angus I G; Turner, Simon; Cavell, Gillian; Oborne, C Alice; Thomas, Rebecca E; Cookson, Graham; Fulop, Naomi J

    2014-01-01

    Background Relatively little is known about how scorecards presenting performance indicators influence medication safety. We evaluated the effects of implementing a ward-level medication safety scorecard piloted in two English NHS hospitals and factors influencing these. Methods We used a mixed methods, controlled before and after design. At baseline, wards were audited on medication safety indicators; during the ‘feedback’ phase scorecard results were presented to intervention wards on a weekly basis over 7 weeks. We interviewed 49 staff, including clinicians and managers, about scorecard implementation. Results At baseline, 18.7% of patients (total n=630) had incomplete allergy documentation; 53.4% of patients (n=574) experienced a drug omission in the preceding 24 h; 22.5% of omitted doses were classified as ‘critical’; 22.1% of patients (n=482) either had ID wristbands not reflecting their allergy status or no ID wristband; and 45.3% of patients (n=237) had drugs that were either unlabelled or labelled for another patient in their drug lockers. The quantitative analysis found no significant improvement in intervention wards following scorecard feedback. Interviews suggested staff were interested in scorecard feedback and described process and culture changes. Factors influencing scorecard implementation included ‘normalisation’ of errors, study duration, ward leadership, capacity to engage and learning preferences. Discussion Presenting evidence-based performance indicators may potentially influence staff behaviour. Several practical and cultural factors may limit feedback effectiveness and should be considered when developing improvement interventions. Quality scorecards should be designed with care, attending to evidence of indicators’ effectiveness and how indicators and overall scorecard composition fit the intended audience. PMID:24029440

  1. A diabetes scorecard does not improve HbA(1c), blood pressure, lipids, aspirin usage, exercise and diabetes knowledge over 9 months: a randomized controlled trial.

    PubMed

    Irwig, M S; Sood, P; Ni, D; Amass, T; Khurana, P S; Jayanthi, V V; Wang, L; Adler, S M

    2012-09-01

    To test (1) whether a diabetes scorecard can improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage and exercise; (2) if the scorecard will motivate and/or educate patients to improve their scores for subsequent visits; and (3) whether the scorecard will improve rates of clinical inertia. Five physicians enrolled 103 patients ≥ 40 years old with uncontrolled Type 2 diabetes [HbA(1c) ≥ 64 mmol/mol (8.0%)] to randomly receive either a diabetes scorecard or not during four clinical visits over a 9-month period. The population was predominantly urban with a disproportionately higher percentage of black people than the general population. Our scorecard assigned points to six clinical variables, with a perfect total score of 100 points corresponding to meeting all targets. The primary outcomes were total scores and HbA(1c) in the scorecard and control groups at 9 months. There were no significant differences between the control and scorecard groups at visits 1 and 4 in total score, HbA(1c) , blood pressure, LDL cholesterol, aspirin usage, exercise or knowledge about diabetic targets. By visit 4 both the control and scorecard groups had statistically significant improvements with their mean total score (9 and 7 points, respectively), HbA(1c) [-9 mmol/mol (-0.8%) and -15 mmol/mol (-1.4%), respectively] and aspirin usage (33% increase and 16% increase, respectively). Rates of clinical inertia were low throughout the study. A diabetes scorecard did not improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage, exercise or diabetic knowledge in an urban population with uncontrolled Type 2 diabetes. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  2. Monitoring intensive care unit performance—impact of a novel individualised performance scorecard in critical care medicine: a mixed-methods study protocol

    PubMed Central

    Neilipovitz, David; Sarti, Aimee J; Rosenberg, Erin; Ishaq, Rabia; Thornton, Mary; Kim, John

    2018-01-01

    Introduction Patients admitted to a critical care medicine (CCM) environment, including an intensive care unit (ICU), are susceptible to harm and significant resource utilisation. Therefore, a strategy to optimise provider performance is required. Performance scorecards are used by institutions for the purposes of driving quality improvement. There is no widely accepted or standardised scorecard that has been used for overall CCM performance. We aim to improve quality of care, patient safety and patient/family experience in CCM practice through the utilisation of a standardised, repeatable and multidimensional performance scorecard, designed to provide a continuous review of ICU physician and nurse practice, as well as departmental metrics. Methods and analysis This will be a mixed-methods, controlled before and after study to assess the impact of a CCM-specific quality scorecard. Scorecard metrics were developed through expert consensus and existing literature. The study will include 19 attending CCM physicians and approximately 300 CCM nurses. Patient data for scorecard compilation are collected daily from bedside flow sheets. Preintervention baseline data will be collected for 6 months for each participant. After this, each participant will receive their scorecard measures. Following a 3-month washout period, postintervention data will be collected for 6 months. The primary outcome will be change in performance metrics following the provision of scorecard feedback to subjects. A cost analysis will also be performed, with the purpose of comparing total ICU costs prior to implementation of the scorecard with total ICU costs following implementation of the scorecard. The qualitative portion will include interviews with participants following the intervention phase. Interviews will be analysed in order to identify recurrent themes and subthemes, for the purposes of driving scorecard improvement. Ethics and dissemination This protocol has been approved by the local

  3. Perioperative prediction of agitated (hyperactive) delirium after cardiac surgery in adults - The development of a practical scorecard.

    PubMed

    Mufti, Hani N; Hirsch, Gregory M

    2017-12-01

    Delirium is a temporary mental disorder that occurs frequently among hospitalized patients. In this study we sought to develop a user-friendly scorecard based on perioperative features to identify patients at risk of developing agitated delirium after cardiac surgery. Retrospective analysis was performed on adult patients undergoing cardiac surgery in a single center. A parsimonious predictive model was created, with subsequent internal validation. Then a simple scorecard was developed that can be used to predict the probability of agitated delirium. Among the 5584 patients who met the study criteria, 614 (11.4%) developed postoperative agitated delirium. Independent predictors of postoperative agitated delirium were age, male gender, history of cerebrovascular disease, procedure other than isolated Coronary Arteries Bypass Surgery, transfusion of blood products within the first 48h, mechanical ventilation for >24h, length of stay in the Intensive Care Unit. The scorecard stratified patients into 4 categories at risk of postoperative agitated delirium ranging from <5% to >30%. Using a large cohort of adult patient's undergoing cardiac surgery, a user-friendly scorecard was developed and validated, which will facilitate the implementation of timely interventions to mitigate adverse effects of agitated delirium in this high risk population. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Social and Student Engagement and Support: The Sloan-C Quality Scorecard for the Administration of Online Programs

    ERIC Educational Resources Information Center

    Moore, Janet C.; Shelton, Kaye

    2013-01-01

    As combinations of place-based, blended and fully online education proliferate, so do options for support and services. Aligning with regional accreditation criteria, the Sloan-C Quality Scorecard for the Administration of Online Programs is a useful way for institutions to measure and compare the quality of social and student engagement and…

  5. Characteristics of "Tween" Participants and Non-Participants in the VERB[TM] Summer Scorecard Physical Activity Promotion Program

    ERIC Educational Resources Information Center

    Nickelson, Jen; Alfonso, Moya L.; McDermott, Robert J.; Bumpus, Elizabeth C.; Bryant, Carol A.; Baldwin, Julie A.

    2011-01-01

    Creating community-based opportunities for youth to be physically active is challenging for many municipalities. A Lexington, Kentucky community coalition designed and piloted a physical activity program, "VERB[TM] summer scorecard (VSS)", leveraging the brand equity of the national VERB[TM]--It's What You Do! campaign. Key elements of…

  6. Laser Balancing

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Mechanical Technology, Incorporated developed a fully automatic laser machining process that allows more precise balancing removes metal faster, eliminates excess metal removal and other operator induced inaccuracies, and provides significant reduction in balancing time. Manufacturing costs are reduced as a result.

  7. Balancing Act

    Cancer.gov

    Part of being an Active, More Powerful You means finding balance in your daily life: taking on the Must-dos and finding time for some Should Dos and Want-to-Dos. Sometimes, emotions and commitments can come into play and upset the balance.

  8. A rapid assessment scorecard to identify informal settlements at higher maternal and child health risk in Mumbai.

    PubMed

    Osrin, David; Das, Sushmita; Bapat, Ujwala; Alcock, Glyn A; Joshi, Wasundhara; More, Neena Shah

    2011-10-01

    The communities who live in urban informal settlements are diverse, as are their environmental conditions. Characteristics include inadequate access to safe water and sanitation, poor quality of housing, overcrowding, and insecure residential status. Interventions to improve health should be equity-driven and target those at higher risk, but it is not clear how to prioritise informal settlements for health action. In implementing a maternal and child health programme in Mumbai, India, we had conducted a detailed vulnerability assessment which, though important, was time-consuming and may have included collection of redundant information. Subsequent data collection allowed us to examine three issues: whether community environmental characteristics were associated with maternal and newborn healthcare and outcomes; whether it was possible to develop a triage scorecard to rank the health vulnerability of informal settlements based on a few rapidly observable characteristics; and whether the scorecard might be useful for future prioritisation. The City Initiative for Newborn Health documented births in 48 urban slum areas over 2 years. Information was collected on maternal and newborn care and mortality, and also on household and community environment. We selected three outcomes-less than three antenatal care visits, home delivery, and neonatal mortality-and used logistic regression and classification and regression tree analysis to test their association with rapidly observable environmental characteristics. We developed a simple triage scorecard and tested its utility as a means of assessing maternal and newborn health risk. In analyses on a sample of 10,754 births, we found associations of health vulnerability with inadequate access to water, toilets, and electricity; non-durable housing; hazardous location; and rental tenancy. A simple scorecard based on these had limited sensitivity and positive predictive value, but relatively high specificity and negative

  9. China's Efforts on Management, Surveillance, and Research of Noncommunicable Diseases: NCD Scorecard Project.

    PubMed

    Zhu, Xiao-Lei; Luo, Jie-Si; Zhang, Xiao-Chang; Zhai, Yi; Wu, Jing

    The incidence of noncommunicable diseases (NCDs) is rising dramatically throughout the world. Aspects of researches concerned with the improvement and development of prevention and control of NCDs have been conducted. Furthermore, the influence of most determinants of the major NCDs has showed that a broad and deep response involving stakeholders in different sectors is required in the prevention and control of NCDs. China has experienced an increase in NCDs in a short period compared with many countries. To address the burden of NCDs in China, it is important to learn about the progress that has been made in prevention and control of NCDs in China and worldwide, informed by opinions of stakeholders in different areas. In 2014, GRAND South developed the NCD Scorecard instrument to evaluate progress of NCD prevention and control in 23 countries through a 2-round Delphi process. The scorecard included 51 indicators in 4 domains: governance, surveillance and research, prevention and risk factors, and health system response. Stakeholders were then selected in the areas of government, nongovernmental organizations, private sectors, and academia to join the NCD Scorecard survey. Indicators of progress were scored by stakeholders from 0 (no activity), 1 (present but not adequate), and 2 (adequate) to 3 (highly adequate) and then the percentage of progress in each domain was calculated, representing the current situation in each country. There were 14 indicators in the domains of governance and surveillance and research. Of 429 stakeholders worldwide, 41 in China participated in the survey. China scored in the top 5 out of all participating countries in those 2 domains, scoring 67% in governance and 64% in surveillance and research. Indicators on which China scored particularly well included having a well-resourced unit or department responsible for NCDs, having a strong national system for recording the cause of all deaths, and having a system of NCD surveillance. Areas

  10. Increasing physical activity in children 8 to 12 years old: experiences with VERB Summer Scorecard.

    PubMed

    McDermott, Robert J; Davis, Jenna L; Bryant, Carol A; Courtney, Anita H; Alfonso, Moya L

    2010-08-01

    Interventions which facilitate physical activity of youth are vital for promoting community health and reducing obesity. This study assessed the results of a community-driven program, VERB Summer Scorecard, as knowledge of exposure to and awareness of community-based interventions for physical activity among youth could inform design and implementation of such interventions. A total of 2,215 youth ages 8 to 12 years responded to a survey about physical activity. Ordinal logistic regression suggested that youth who participated in this program were 1.73 times (95% CI = 1.41, 2.11) more likely to report high physical activity than nonparticipating youth 9 mo. after the intervention's first full-scale application. The program appeared to appeal more to girls than boys. Such results are encouraging for use in communities.

  11. The ADE scorecards: a tool for adverse drug event detection in electronic health records.

    PubMed

    Chazard, Emmanuel; Băceanu, Adrian; Ferret, Laurie; Ficheur, Grégoire

    2011-01-01

    Although several methods exist for Adverse Drug events (ADE) detection due to past hospitalizations, a tool that could display those ADEs to the physicians does not exist yet. This article presents the ADE Scorecards, a Web tool that enables to screen past hospitalizations extracted from Electronic Health Records (EHR), using a set of ADE detection rules, presently rules discovered by data mining. The tool enables the physicians to (1) get contextualized statistics about the ADEs that happen in their medical department, (2) see the rules that are useful in their department, i.e. the rules that could have enabled to prevent those ADEs and (3) review in detail the ADE cases, through a comprehensive interface displaying the diagnoses, procedures, lab results, administered drugs and anonymized records. The article shows a demonstration of the tool through a use case.

  12. The U.S.-China Military Scorecard: Forces, Geography, and the Evolving Balance of Power, 1996-2017

    DTIC Science & Technology

    2015-01-01

    forces. The Base Force study (1990), the Bottom- Up Review (1993), the Commission on the Roles and Missions of the Armed Forces (1995), the first...Report on the Bottom- Up Review , Washington, D.C.: Office of the Secretary of Defense, October 1993; Commission on the Roles and Missions of the...could be used to counter the sensors carried onboard the ASBMs. Other counters may be passive in nature , including strict emission control on the part

  13. Bringing Cost-Wise Readiness to the Deckplates of a Strike Fighter Squadron Using the Balanced Scorecard

    DTIC Science & Technology

    2013-12-01

    equity employed). Customer measures, such as customer satisfaction , are intended to measure the company’s performance from the customer’s perspective...link between a non-financial measure and a firm’s financial performance. For example, one could meet objectives relating to customer satisfaction ... customer satisfaction . Who then is the customer of a strike fighter squadron? Kaplan and Norton (2004) write extensively about 61 the value

  14. Leading to High Performance: A Case Study of the Role of the Balanced Scorecard in Improving Urban Secondary Schools

    ERIC Educational Resources Information Center

    Brown, Pamela C.

    2010-01-01

    The onset of the standards-based movement in education in the early 1980's, bolstered by the passing of the No Child Left Behind Act (NCLBA) of 2002, led many school districts to shift from a culture of regulatory, process-oriented compliance to one that is more results-oriented, primarily based on state-adopted summative assessment targets in…

  15. Rhetoric or Reality? Do Accounting Education and Experience Increase Weighting on Environmental Performance in a Balanced Scorecard?

    ERIC Educational Resources Information Center

    Wynder, Monte; Wellner, Kai-Uwe; Reinhard, Karin

    2013-01-01

    We are nearing the end of the United Nations' Decade of Education for Sustainable Development (2005-2014). There has been substantial rhetoric in education and business forums, and many universities have integrated sustainability into their accounting curricula, but what effect is accounting education having? This study considers whether the…

  16. A Balanced Scorecard-Based Model for Evaluating E-Learning and Conventional Pedagogical Activities in Nursing

    ERIC Educational Resources Information Center

    Hovelja, Tomaž; Vavpotic, Damjan; Žvanut, Boštjan

    2016-01-01

    The evaluation of e-learning and conventional pedagogical activities in nursing programmes has focused either on a single pedagogical activity or the entire curriculum, and only on students' or teachers' perspective. The goal of this study was to design and test a novel approach for evaluation of e-learning and conventional pedagogical activities…

  17. Nurse staffing and system integration and change indicators in acute care hospitals: evidence from a balanced scorecard.

    PubMed

    McGillis Hall, Linda; Peterson, Jessica; Baker, G Ross; Brown, Adalsteinn D; Pink, George H; McKillop, Ian; Daniel, Imtiaz; Pedersen, Cheryl

    2008-01-01

    This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.

  18. [Management and accounting solution required in clinical laboratory department in the hospital and the balanced scorecard (BSC)].

    PubMed

    Takahashi, Toshiro

    2006-11-01

    This is to describe required accounting knowledge and the techniques for the clinical laboratory department management level people to operate their division from the viewpoint of management. Especially, the necessity and the efficacy of the BSC implementation in the clinical laboratory department are being explained.

  19. The Balanced Scorecard: A Management System for Wilford Hall Medical Center - The Premier Air Force Medical Enterprise

    DTIC Science & Technology

    1999-04-01

    meanings and functions of human actions. These meanings and functions take the form of qualitative descriptions and explanations ( Denzin , Lincoln 1994...a value-free framework ( Denzin , 1994). Equally important was the learning and educating about performance drivers versus outcome measures. Performance

  20. Evaluation of the ProPublica Surgeon Scorecard "Adjusted Complication Rate" Measure Specifications.

    PubMed

    Ban, Kristen A; Cohen, Mark E; Ko, Clifford Y; Friedberg, Mark W; Stulberg, Jonah J; Zhou, Lynn; Hall, Bruce L; Hoyt, David B; Bilimoria, Karl Y

    2016-10-01

    The ProPublica Surgeon Scorecard is the first nationwide, multispecialty public reporting of individual surgeon outcomes. However, ProPublica's use of a previously undescribed outcome measure (composite of in-hospital mortality or 30-day related readmission) and inclusion of only inpatients have been questioned. Our objectives were to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. Using ACS-NSQIP data (2012-2014) for 8 ProPublica procedures and for All Operations, the proportion of cases meeting all ProPublica inclusion criteria was determined. We assessed the proportion of complications occurring inpatient, and thus not considered by ProPublica's measure. Finally, we compared risk-adjusted performance based on ProPublica's measure specifications to established ACS-NSQIP outcome measure performance (eg, death/serious morbidity, mortality). ProPublica's inclusion criteria resulted in elimination of 82% of all operations from assessment (range: 42% for total knee arthroplasty to 96% for laparoscopic cholecystectomy). For all ProPublica operations combined, 84% of complications occur during inpatient hospitalization (range: 61% for TURP to 88% for total hip arthroplasty), and are thus missed by the ProPublica measure. Hospital-level performance on the ProPublica measure correlated weakly with established complication measures, but correlated strongly with readmission (R = 0.834, P < 0.001). ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes. Thus, the validity of the ProPublica Surgeon Scorecard is questionable.

  1. Balance System

    NASA Technical Reports Server (NTRS)

    1988-01-01

    TherEx Inc.'s AT-1 Computerized Ataxiameter precisely evaluates posture and balance disturbances that commonly accompany neurological and musculoskeletal disorders. Complete system includes two-strain gauged footplates, signal conditioning circuitry, a computer monitor, printer and a stand-alone tiltable balance platform. AT-1 serves as assessment tool, treatment monitor, and rehabilitation training device. It allows clinician to document quantitatively the outcome of treatment and analyze data over time to develop outcome standards for several classifications of patients. It can evaluate specifically the effects of surgery, drug treatment, physical therapy or prosthetic devices.

  2. Balancing Eggs

    ERIC Educational Resources Information Center

    Mills, Allan

    2014-01-01

    Theory predicts that an egg-shaped body should rest in stable equilibrium when on its side, balance vertically in metastable equilibrium on its broad end and be completely unstable on its narrow end. A homogeneous solid egg made from wood, clay or plastic behaves in this way, but a real egg will not stand on either end. It is shown that this…

  3. Developing a Scorecard to Assess Global Progress in Scaling Up Diarrhea Control Tools: A Qualitative Study of Academic Leaders and Implementers

    PubMed Central

    Rosinski, Alexander Anthony; Narine, Steven; Yamey, Gavin

    2013-01-01

    Background In 2010, diarrhea caused 0.75 million child deaths, accounting for nearly 12% of all under-five mortality worldwide. Many evidence-based interventions can reduce diarrhea mortality, including oral rehydration solution (ORS), zinc, and improved sanitation. Yet global coverage levels of such interventions remain low. A new scorecard of diarrhea control, showing how different countries are performing in their control efforts, could draw greater attention to the low coverage levels of proven interventions. Methods We conducted in-depth qualitative interviews with 21 experts, purposively sampled for their relevant academic or implementation expertise, to explore their views on (a) the value of a scorecard of global diarrhea control and (b) which indicators should be included in such a scorecard. We then conducted a ranking exercise in which we compiled a list of all 49 indicators suggested by the experts, sent the list to the 21 experts, and asked them to choose 10 indicators that they would include and 10 that they would exclude from such a scorecard. Finally, we created a “prototype” scorecard based on the 9 highest-ranked indicators. Results Key themes that emerged from coding the interview transcripts were: a scorecard could facilitate country comparisons; it could help to identify best practices, set priorities, and spur donor action; and it could help with goal-setting and accountability in diarrhea control. The nine highest ranking indicators, in descending order, were ORS coverage, rotavirus vaccine coverage, zinc coverage, diarrhea-specific mortality rate, diarrhea prevalence, proportion of population with access to improved sanitation, proportion with access to improved drinking water, exclusive breastfeeding coverage, and measles vaccine coverage. Conclusion A new scorecard of global diarrhea control could help track progress, focus prevention and treatment efforts on the most effective interventions, establish transparency and accountability

  4. Disease management 360 degrees: a scorecard approach to evaluating TRICARE's programs for asthma, congestive heart failure, and diabetes.

    PubMed

    Yang, Wenya; Dall, Timothy M; Zhang, Yiduo; Hogan, Paul F; Arday, David R; Gantt, Cynthia J

    2010-08-01

    To assess the effect of TRICARE's asthma, congestive heart failure, and diabetes disease management programs using a scorecard approach. EVALUATION MEASURES: Patient healthcare utilization, financial, clinical, and humanistic outcomes. Absolute measures were translated into effect size and incorporated into a scorecard. Actual outcomes for program participants were compared with outcomes predicted in the absence of disease management. The predictive equations were established from regression models based on historical control groups (n = 39,217). Z scores were calculated for the humanistic measures obtained through a mailed survey. Administrative records containing medical claims, patient demographics and characteristics, and program participation status were linked using an encrypted patient identifier (n = 57,489). The study time frame is 1 year prior to program inception through 2 years afterward (October 2005-September 2008). A historical control group was identified with the baseline year starting October 2003 and a 1-year follow-up period starting October 2004. A survey was administered to a subset of participants 6 months after baseline assessment (39% response rate). Within the observation window--24 months for asthma and congestive heart failure, and 15 months for the diabetes program--we observed modest reductions in hospital days and healthcare cost for all 3 programs and reductions in emergency visits for 2 programs. Most clinical outcomes moved in the direction anticipated. The scorecard provided a useful tool to track performance of 3 regional contractors for each of 3 diseases and over time.

  5. A new matrix for scoring the functionality of national laboratory networks in Africa: introducing the LABNET scorecard

    PubMed Central

    Datema, Tjeerd; Keita-Sow, Mah-Sere; Ndihokubwayo, Jean-Bosco; Isadore, Jocelyn; Oskam, Linda; Nkengasong, John; Lewis, Kim

    2016-01-01

    Background Functional national laboratory networks and systems are indispensable to the achievement of global health security targets according to the International Health Regulations. The lack of indicators to measure the functionality of national laboratory network has limited the efficiency of past and current interventions to enhance laboratory capacity in resource-limited-settings. Scorecard for laboratory networks We have developed a matrix for the assessment of national laboratory network functionality and progress thereof, with support from the African Society of Laboratory Medicine and the Association of Public Health Laboratories. The laboratory network (LABNET) scorecard was designed to: (1) Measure the status of nine overarching core capabilities of laboratory network required to achieve global health security targets, as recommended by the main normative standards; (2) Complement the World Health Organization joint external evaluation tool for the assessment of health system preparedness to International Health Regulations (2005) by providing detailed information on laboratory systems; and (3) Serve as a clear roadmap to guide the stepwise implementation of laboratory capability to prevent, detect and act upon infectious threats. Conclusions The application of the LABNET scorecard under the coordination of the African Society of Laboratory Medicine and the Association of Public Health Laboratories could contribute to the design, monitoring and evaluation of upcoming Global Health Security Agenda-supported laboratory capacity building programmes in sub Saharan-Africa and other resource-limited settings, and inform the development of national laboratory policies and strategic plans. Endorsement by the World Health Organization Regional Office for Africa is foreseen. PMID:28879141

  6. Use of Balanced Indicators as a Management Tool in Nursing1

    PubMed Central

    Fugaça, Neidamar Pedrini Arias; Cubas, Marcia Regina; Carvalho, Deborah Ribeiro

    2015-01-01

    Objective: to develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. Method: a single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. Results: we identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Conclusion: although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators. PMID:26625995

  7. Food Scorecard.

    ERIC Educational Resources Information Center

    Jacobson, Michael; Wilson, Wendy

    The importance of establishing good eating habits in youth as a means for laying the foundation of health in later life is discussed. This booklet contains charts that list nutritional scores for many common foods. These scores are measures of the overall nutritional content and value of the foods. Foods receive points for protein; vitamins A, B-2…

  8. Airplane Balance

    NASA Technical Reports Server (NTRS)

    Huguet, L

    1921-01-01

    The authors argue that the center of gravity has a preponderating influence on the longitudinal stability of an airplane in flight, but that manufacturers, although aware of this influence, are still content to apply empirical rules to the balancing of their airplanes instead of conducting wind tunnel tests. The author examines the following points: 1) longitudinal stability, in flight, of a glider with coinciding centers; 2) the influence exercised on the stability of flight by the position of the axis of thrust with respect to the center of gravity and the whole of the glider; 3) the stability on the ground before taking off, and the influence of the position of the landing gear. 4) the influence of the elements of the glider on the balance, the possibility of sometimes correcting defective balance, and the valuable information given on this point by wind tunnel tests; 5) and a brief examination of the equilibrium of power in horizontal flight, where the conditions of stability peculiar to this kind of flight are added to previously existing conditions of the stability of the glider, and interfere in fixing the safety limits of certain evolutions.

  9. Shaft balancing

    DOEpatents

    Irwin, John A.

    1979-01-01

    A gas turbine engine has an internal drive shaft including one end connected to a driven load and an opposite end connected to a turbine wheel and wherein the shaft has an in situ adjustable balance system near the critical center of a bearing span for the shaft including two 360.degree. rings piloted on the outer diameter of the shaft at a point accessible through an internal engine panel; each of the rings has a small amount of material removed from its periphery whereby both of the rings are precisely unbalanced an equivalent amount; the rings are locked circumferentially together by radial serrations thereon; numbered tangs on the outside diameter of each ring identify the circumferential location of unbalance once the rings are locked together; an aft ring of the pair of rings has a spline on its inside diameter that mates with a like spline on the shaft to lock the entire assembly together.

  10. The Digital Health Scorecard: A New Health Literacy Metric for NCD Prevention and Care.

    PubMed

    Ratzan, Scott C; Weinberger, Michael B; Apfel, Franklin; Kocharian, Gary

    2013-06-01

    According to the World Health Organization, 3 out of 5 deaths worldwide are due to common, chronic conditions, such as heart and respiratory diseases, cancer, and diabetes. These noncommunicable diseases (NCDs) are linked to multiple lifestyle risk factors, including smoking, the harmful use of alcohol, and physical inactivity. They are associated with other "intermediate" risk factors, such as elevated body mass index (BMI), hypertension, hyperlipidemia, and hyperglycemia. Taking action to reduce these 7 risk factors can help people protect themselves against leading causes of death. All of these risk factors are measurable and modifiable, but globally available, cost-effective, and easy-to-use outcome metrics that can drive action on all levels do not yet exist. The Digital Health Scorecard is being proposed as a dynamic, globally available digital tool to raise public, professional, and policy maker NCD health literacy (the motivation and ability to access, understand, communicate, and use information to improve health and reduce the incidence of NCD). Its aim is to motivate and empower individuals to make the behavioral and choice changes needed to improve their health and reduce NCD risk factors by giving unprecedented access to global data intelligence, creating awareness, making links to professional and community-based support services and policies, and providing a simple way to measure and track risk changes. Moreover, it provides health care professionals, communities, institutions, workplaces, and nations with a simple metric to monitor progress toward agreed local, national, and global NCD targets. Copyright © 2013 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  11. Assessing the Value of a College Degree in Outdoor Education or Recreation: Institutional Comparisons Using the College Scorecard and Surveys of Faculty and Employers

    ERIC Educational Resources Information Center

    Seaman, Jayson; Bell, Brent J.; Trauntvein, Nate

    2017-01-01

    In this article, we report on research undertaken in 2016 to assess a number of trends influencing the current status of degree-granting outdoor programs in the United States, including factors that bear on the value of degrees. We analyze data provided by the U.S. Department of Education's College Scorecard and results of a survey comparing 59…

  12. A new matrix for scoring the functionality of national laboratory networks in Africa: introducing the LABNET scorecard.

    PubMed

    Ondoa, Pascale; Datema, Tjeerd; Keita-Sow, Mah-Sere; Ndihokubwayo, Jean-Bosco; Isadore, Jocelyn; Oskam, Linda; Nkengasong, John; Lewis, Kim

    2016-01-01

    Functional national laboratory networks and systems are indispensable to the achievement of global health security targets according to the International Health Regulations. The lack of indicators to measure the functionality of national laboratory network has limited the efficiency of past and current interventions to enhance laboratory capacity in resource-limited-settings. We have developed a matrix for the assessment of national laboratory network functionality and progress thereof, with support from the African Society of Laboratory Medicine and the Association of Public Health Laboratories. The laboratory network (LABNET) scorecard was designed to: (1) Measure the status of nine overarching core capabilities of laboratory network required to achieve global health security targets, as recommended by the main normative standards; (2) Complement the World Health Organization joint external evaluation tool for the assessment of health system preparedness to International Health Regulations (2005) by providing detailed information on laboratory systems; and (3) Serve as a clear roadmap to guide the stepwise implementation of laboratory capability to prevent, detect and act upon infectious threats. The application of the LABNET scorecard under the coordination of the African Society of Laboratory Medicine and the Association of Public Health Laboratories could contribute to the design, monitoring and evaluation of upcoming Global Health Security Agenda-supported laboratory capacity building programmes in sub Saharan-Africa and other resource-limited settings, and inform the development of national laboratory policies and strategic plans. Endorsement by the World Health Organization Regional Office for Africa is foreseen.

  13. Using the CDC's Worksite Health ScoreCard as a Framework to Examine Worksite Health Promotion and Physical Activity.

    PubMed

    Gutermuth, Leah K; Hager, Erin R; Pollack Porter, Keshia

    2018-06-21

    Worksite health promotion programs are emerging as an effective approach for addressing the adult obesity epidemic and improving the overall health of employees. We conducted a scoping review to identify articles that described a physical activity component (eg, promoted increased physical or reduced sitting time) of a worksite health promotion intervention. Our search specified full-length articles published in English from January 2000 through July 2015. We used the Centers for Disease Control and Prevention's Worksite Health ScoreCard, a validated tool, as a framework to summarize information on organizational supports strategies (18 questions) and physical activity strategies (9 questions) implemented by worksite health promotion programs. We also determined whether or not the included studies reported significant (P < .05) improvements in physical activity. We identified 18 worksite health promotion programs; 11 produced significant improvements in physical activity. Incentives, health risk assessments, health promotion committees, leadership support, marketing, and subsidies or discounts for use of exercise facilities were the most effective organizational supports strategies cited, and physical activity seminars, classes, and workshops were the most effective physical activity strategies cited. The use of the Health ScoreCard allowed for a practical interpretation of our findings, which can inform next steps for the field. Future research should explore the relationships between components of worksite health promotion programs and their outcomes to further develop best practices that can improve worker health and promote physical activity.

  14. Balance Food and Activity

    MedlinePlus

    ... eNewsletters Calendar Balance Food and Activity What is Energy Balance? Energy is another word for "calories." Your ... adults, fewer calories are needed at older ages. Energy Balance in Real Life Think of it as ...

  15. Prenatal diagnosis of de novo t(2;18;14)(q33.1;q12.2;q31.2), dup(5)(q34q34), del(7)(p21.1p21.1), and del(10)(q25.3q25.3) and a review of the prenatally ascertained de novo apparently balanced complex and multiple chromosomal rearrangements.

    PubMed

    Chen, Chih-Ping; Chern, Schu-Rern; Lee, Chen-Chi; Lin, Chyi-Chyang; Li, Yueh-Chun; Hsieh, Lie-Jiau; Chen, Wen-Lin; Wang, Wayseen

    2006-02-01

    To present the prenatal diagnosis of a de novo complex chromosomal rearrangement (CCR) associated with de novo interstitial deletions and duplication and to review the literature. Amniocentesis was performed at 18 weeks' gestation because of an increased risk for Down syndrome based on maternal serum alpha-fetoprotein and human chorionic gonadotrophin screening. Amniocentesis revealed a karyotype of 46,XY,t(2;18;14)(q33.1;q12.2;q31.2),dup(5)(q34q34),del(7)(p21.1p21.1), del(10)(q25.3q25.3). The parental karyotypes were normal. The pregnancy was terminated. The fetus manifested facial dysmorphism, clinodactyly of both hands, and hypoplasia of the left great toe. Spectral karyotyping (SKY), cytogenetic polymorphism, and polymorphic DNA markers were used to investigate the imbalances and the origin of the de novo aberrant chromosomes. SKY showed a three-way CCR. Cytogenetic polymorphism investigation of the derivative chromosome 14 of the fetus and the parental chromosomes 14 determined the maternal origin of the translocation. Polymorphic DNA marker analysis confirmed the maternal origin of the de novo interstitial deletions and duplication. No cryptic imbalance at or near the breakpoints of the CCR was detected by the molecular analysis. De novo apparently balanced CCRs may be associated with imbalances in other chromosomes. We suggest further investigation and re-evaluation of cryptic or subtle imbalances in all cases classified as de novo apparently balanced CCRs. Copyright 2006 John Wiley & Sons, Ltd.

  16. Rotor balance system

    NASA Technical Reports Server (NTRS)

    Novotny, Rudolph J. (Inventor)

    1989-01-01

    A balance ring (18) which is shrunk fit within each disk (12) of a rotor is selectively ground for detail balance. A plurality of openings (20) through the outer edge of the balance ring receive weights during the asssembly balance of the rotor. A snap ring (42) retains the weights within the openings.

  17. A Question of Balance

    ERIC Educational Resources Information Center

    Claxton, David B.; Troy, Maridy; Dupree, Sarah

    2006-01-01

    Most authorities consider balance to be a component of skill-related physical fitness. Balance, however, is directly related to health, especially for older adults. Falls are a leading cause of injury and death among the elderly. Improved balance can help reduce falls and contribute to older people remaining physically active. Balance is a…

  18. Dynamic balance improvement program

    NASA Technical Reports Server (NTRS)

    Butner, M. F.

    1983-01-01

    The reduction of residual unbalance in the space shuttle main engine (SSME) high pressure turbopump rotors was addressed. Elastic rotor response to unbalance and balancing requirements, multiplane and in housing balancing, and balance related rotor design considerations were assessed. Recommendations are made for near term improvement of the SSME balancing and for future study and development efforts.

  19. Balance in Assessment

    ERIC Educational Resources Information Center

    White, Richard

    2007-01-01

    The review by Black and Wiliam of national systems makes clear the complexity of assessment, and identifies important issues. One of these is "balance": balance between local and central responsibilities, balance between the weights given to various purposes of schooling, balance between weights for various functions of assessment, and balance…

  20. Balancing Vanguard Satellites

    NASA Technical Reports Server (NTRS)

    Simkovich, A.; Baumann, Robert C.

    1961-01-01

    The Vanguard satellites and component parts were balanced within the specified limits by using a Gisholt Type-S balancer in combination with a portable International Research and Development vibration analyzer and filter, with low-frequency pickups. Equipment and procedures used for balancing are described; and the determination of residual imbalance is accomplished by two methods: calculation, and graphical interpretation. Between-the-bearings balancing is recommended for future balancing of payloads.

  1. Development of balanced key performance indicators for emergency departments strategic dashboards following analytic hierarchical process.

    PubMed

    Safdari, Reza; Ghazisaeedi, Marjan; Mirzaee, Mahboobeh; Farzi, Jebrail; Goodini, Azadeh

    2014-01-01

    Dynamic reporting tools, such as dashboards, should be developed to measure emergency department (ED) performance. However, choosing an effective balanced set of performance measures and key performance indicators (KPIs) is a main challenge to accomplish this. The aim of this study was to develop a balanced set of KPIs for use in ED strategic dashboards following an analytic hierarchical process. The study was carried out in 2 phases: constructing ED performance measures based on balanced scorecard perspectives and incorporating them into analytic hierarchical process framework to select the final KPIs. The respondents placed most importance on ED internal processes perspective especially on measures related to timeliness and accessibility of care in ED. Some measures from financial, customer, and learning and growth perspectives were also selected as other top KPIs. Measures of care effectiveness and care safety were placed as the next priorities too. The respondents placed least importance on disease-/condition-specific "time to" measures. The methodology can be presented as a reference model for development of KPIs in various performance related areas based on a consistent and fair approach. Dashboards that are designed based on such a balanced set of KPIs will help to establish comprehensive performance measurements and fair benchmarks and comparisons.

  2. Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: qualitative evidence using the most significant change technique.

    PubMed

    Ho, Lara S; Labrecque, Guillaume; Batonon, Isatou; Salsi, Viviana; Ratnayake, Ruwan

    2015-01-01

    More than a decade of conflict has weakened the health system in the Democratic Republic of Congo and decreased its ability to respond to the needs of the population. Community scorecards have been conceived as a way to increase accountability and responsiveness of service providers, but there is limited evidence of their effects, particularly in fragile and conflict-affected contexts. This paper describes the implementation of community scorecards within a community-driven reconstruction project in two provinces of eastern Democratic Republic of Congo. Between June 2012 and November 2013, 45 stories of change in the health system were collected from village development committee, health committee, community members (20 men and 18 women) and healthcare providers (n = 7) in 25 sites using the Most Significant Change technique. Stories were analyzed qualitatively for content related to the types and mechanisms of change observed. The most salient changes were related to increased transparency and community participation in health facility management, and improved quality of care. Quality of care included increased access to services, improved patient-provider relationships, improved performance of service providers, and improved maintenance of physical infrastructure. Changes occurred through many different mechanisms including provider actions in response to information, pressure from community representatives, or supervisors; and joint action and improved collaboration by health facility committees and providers. Although it is often assumed that confrontation is a primary mechanism for citizens to change state-provided services, this study demonstrates that healthcare providers may also be motivated to change through other means. Positive experiences of community scorecards can provide a structured space for interface between community members and the health system, allowing users to voice their opinions and preferences and bridge information gaps for both

  3. Skylab water balance analysis

    NASA Technical Reports Server (NTRS)

    Leonard, J. I.

    1977-01-01

    The water balance of the Skylab crew was analyzed. Evaporative water loss using a whole body input/output balance equation, water, body tissue, and energy balance was analyzed. The approach utilizes the results of several major Skylab medical experiments. Subsystems were designed for the use of the software necessary for the analysis. A partitional water balance that graphically depicts the changes due to water intake is presented. The energy balance analysis determines the net available energy to the individual crewman during any period. The balances produce a visual description of the total change of a particular body component during the course of the mission. The information is salvaged from metabolic balance data if certain techniques are used to reduce errors inherent in the balance method.

  4. Polarization-balanced beamsplitter

    DOEpatents

    Decker, D.E.

    1998-02-17

    A beamsplitter assembly is disclosed that includes several beamsplitter cubes arranged to define a plurality of polarization-balanced light paths. Each polarization-balanced light path contains one or more balanced pairs of light paths, where each balanced pair of light paths includes either two transmission light paths with orthogonal polarization effects or two reflection light paths with orthogonal polarization effects. The orthogonal pairing of said transmission and reflection light paths cancels polarization effects otherwise caused by beamsplitting. 10 figs.

  5. 76 FR 13353 - Department of Commerce FY 2011-2016 Strategic Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... scorecard. A balanced scorecard ``balances'' or equally emphasizes programmatic and management objectives... senior leadership to develop a balanced scorecard to deploy and execute this Strategic Plan. The Secretary directed a balanced scorecard approach to establish and maintain focus on the Department's top...

  6. Coaching for Balance.

    ERIC Educational Resources Information Center

    Larson, Bonnie

    2001-01-01

    Discusses coaching for balance the integration of the whole self: physical (body), intellectual (mind), spiritual (soul), and emotional (heart). Offers four ways to identify problems and tell whether someone is out of balance and four coaching techniques for creating balance. (Contains 11 references.) (JOW)

  7. Get the Balance Right.

    ERIC Educational Resources Information Center

    Haddock, Rebecca Jaurigue

    Today work goes on 24 hours a day, 7 days a week, and is about acceleration and access. Workers need balance more than ever. In fact, recent college graduates value work/life balance as their key factor in selecting employers. This paper, written for career counselors, defines balance as encompassing emotional, spiritual, physical, and…

  8. DEL phenotype.

    PubMed

    Kwon, Dong H; Sandler, S G; Flegel, Willy A

    2017-09-01

    DEL red blood cells (RBCs) type as D- by routine serologic methods and are transfused routinely, without being identified as expressing a very weak D antigen, to D- recipients. DEL RBCs are detected only by adsorption and elution of anti-D or by molecular methods. Most DEL phenotypes have been reported in population studies conducted in East Asia, although DEL phenotypes have been detected also among Caucasian individuals. Approximately 98 percent of DEL phenotypes in East Asians are associated with the RHD*DEL1 or RHD*01EL.01 allele. The prevalence of DEL phenotypes has been reported among D- Han Chinese (30%), Japanese (28%), and Korean (17%) populations. The prevalence of DEL phenotypes is significantly lower among D- Caucasian populations (0.1%). Among the 3-5 percent of African individuals who are D-, there are no reports of the DEL phenotype. Case reports from East Asia indicate that transfusion of DEL RBCs to D- recipients has been associated with D alloimmunization. East Asian immigrants constitute 2.1 percent of the 318.9 million persons residing in the United States, and an estimated 2.8 percent are blood donors. Using these statistics, we estimate that 68-683 units of DEL RBCs from donors of East Asian ancestry are transfused as D- annually in the United States. Given the reports from East Asia of D alloimmunization attributed to transfusion of DEL RBCs, one would expect an occasional report of D alloimmunization in the United States following transfusion of DEL RBCs to a D- recipient. If such cases do occur, the most likely reason that they are not detected is the absence of active post-transfusion monitoring for formation of anti-D.

  9. Reconceptualizing Balance: Attributes associated with balance performance

    PubMed Central

    Thomas, Julia C.; Odonkor, Charles; Griffith, Laura; Holt, Nicole; Percac-Lima, Sanja; Leveille, Suzanne; Ni, Pensheng; Latham, Nancy K.; Jette, Alan M.; Bean, Jonathan F.

    2014-01-01

    Balance tests are commonly used to screen for impairments that put older adults at risk for falls. The purpose of this study was to determine the attributes that were associated with balance performance as measured by the The Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) balance test. This study was a cross-sectional secondary analysis of baseline data from a longitudinal cohort study, the Boston Rehabilitative Impairment Study of the Elderly (Boston RISE). Boston RISE was performed in an outpatient rehabilitation research center and evaluated Boston area primary care patients aged 65 to 96 (N=364) with self-reported difficulty or task-modification climbing a flight of stairs or walking ½ of a mile. The outcome measure was standing balance as measured by the FICSIT-4 balance assessment. Other measures included: self-efficacy, pain, depression, executive function, vision, sensory loss, reaction time, kyphosis, leg range of motion, trunk extensor muscle endurance, leg strength and leg velocity at peak power. Participants were 67% female, had an average age of 76.5 (± 7.0) years, an average of 4.1 (± 2.0) chronic conditions, and an average FICSIT-4 score of 6.7 (± 2.2) out of 9. After adjusting for age and gender, attributes significantly associated with balance performance were falls self-efficacy, trunk extensor muscle endurance, sensory loss, and leg velocity at peak power. FICSIT-4 balance performance is associated with a number of behavioral and physiologic attributes, many of which are amenable to rehabilitative treatment. Our findings support a consideration of balance as multidimensional activity as proposed by the current International Classification of Functioning, Disability, and Health (ICF) model. PMID:24952097

  10. Creation of a Scorecard to Predict In-Hospital Death in Patients Undergoing Operations for Acute Type A Aortic Dissection.

    PubMed

    Leontyev, Sergey; Légaré, Jean-Francois; Borger, Michael A; Buth, Karen J; Funkat, Anne K; Gerhard, Jochann; Mohr, Friedrich W

    2016-05-01

    This study evaluated preoperative predictors of in-hospital death for the surgical treatment of patients with acute type A aortic dissection (Type A) and created an easy-to-use scorecard to predict in-hospital death. We reviewed retrospectively all consecutive patients who underwent operations for acute Type A between 1996 and 2011 at 2 tertiary care institutions. A logistic regression model was created to identify independent preoperative predictors of in-hospital death. The results were used to create a scorecard predicting operative risk. Emergency operations were performed in 534 consecutive patients for acute Type A. Mean age was 61 ± 14 years and 36.3% were women. Critical preoperative state was present in 31% of patients and malperfusion of one or more end organs in 36%. Unadjusted in-hospital mortality was 18.7% and not significantly different between institutions. Independent predictors of in-hospital death were age 50 to 70 years (odds ratio [OR], 3.8; p = 0.001), age older than 70 years (OR, 2.8; p = 0.03), critical preoperative state (OR, 3.2; p < 0.001), visceral malperfusion (OR, 3.0; p = 0.003), and coronary artery disease (OR, 2.2; p = 0.006). Age younger than 50 years (OR, 0.3; p = 0.01) was protective for early survival. Using this information, we created an easily usable mortality risk score based on these variables. The patients were stratified into four risk categories predicting in-hospital death: less than 10%, 10% to 25%, 25% to 50%, and more than 50%. This represents one of the largest series of patients with Type A in which a risk model was created. Using our approach, we have shown that age, critical preoperative state, and malperfusion syndrome were strong independent risk factors for early death and could be used for the preoperative risk assessment. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Department of Defense Civilian Human Resources Strategic Plan

    DTIC Science & Technology

    2005-04-01

    the strategic plan. A balanced scorecard approach was used to build the strategic plan. The balanced scorecard is a strategic management tool that...in the balanced scorecard format. Details of how the balanced scorecard addresses the DoD Human Capital Initiative are outlined in the Office of...mission- ready civilian workforce 8 GOALS AND OBJECTIVES The balanced scorecard approach reflects the changes the Department is undergoing and

  12. Balance and flexibility.

    PubMed

    2003-12-01

    The 'work-life balance' and flexible working are currently key buzz terms in the NHS. Those looking for more information on these topics should visit Flexibility at www.flexibility.co.uk for a host of resources designed to support new ways of working, including information on flexible workers and flexible rostering, the legal balancing act for work-life balance and home working.

  13. Characteristics of 'tween' participants and non-participants in the VERB™ summer scorecard physical activity promotion program.

    PubMed

    Nickelson, Jen; Alfonso, Moya L; McDermott, Robert J; Bumpus, Elizabeth C; Bryant, Carol A; Baldwin, Julie A

    2011-04-01

    Creating community-based opportunities for youth to be physically active is challenging for many municipalities. A Lexington, Kentucky community coalition designed and piloted a physical activity program, 'VERB™ summer scorecard (VSS)', leveraging the brand equity of the national VERB™--It's What You Do! campaign. Key elements of VSS subsequently were adopted in Sarasota County, FL. This study identified characteristics of Sarasota's VSS participants and non-participants. Students in Grades 5-8 from six randomly selected public schools completed a survey assessing VSS participation, physical activity level, psychosocial variables, parental support for physical activity and demographics. Logistic regression showed that VSS participants were more likely to be from Grades 5 to 6 versus Grades 7 and 8 [odds ratio (OR) = 6.055] and perceive high versus low parental support for physical activity (OR = 4.627). Moreover, for each unit rise in self-efficacy, the odds of VSS participation rose by 1.839. Chi-squared automatic interaction detector (CHAID) analysis suggested an interaction effect between grade and school socioeconomic status (SES), with a large proportion of seventh and eighth graders from high SES schools being non-participants (76.6%). A VSS-style program can be expected to be more effective with tweens who are younger, in a middle SES school, having high self-efficacy and high parental support for physical activity.

  14. Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey.

    PubMed

    Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar

    2013-01-01

    This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data. Copyright © 2012 John Wiley & Sons, Ltd.

  15. Chemical Equation Balancing.

    ERIC Educational Resources Information Center

    Blakley, G. R.

    1982-01-01

    Reviews mathematical techniques for solving systems of homogeneous linear equations and demonstrates that the algebraic method of balancing chemical equations is a matter of solving a system of homogeneous linear equations. FORTRAN programs using this matrix method to chemical equation balancing are available from the author. (JN)

  16. Judicial Checks and Balances

    ERIC Educational Resources Information Center

    La Porta, Rafael; Lopez-de-Silanes, Florencio; Pop-Eleches, Cristian; Shleifer, Andrei

    2004-01-01

    In the Anglo-American constitutional tradition, judicial checks and balances are often seen as crucial guarantees of freedom. Hayek distinguishes two ways in which the judiciary provides such checks and balances: judicial independence and constitutional review. We create a new database of constitutional rules in 71 countries that reflect these…

  17. A Balance of Power?

    ERIC Educational Resources Information Center

    Mosey, Edward

    1991-01-01

    The booming economy of the Pacific Northwest region promotes the dilemma of balancing the need for increased electrical power with the desire to maintain that region's unspoiled natural environment. Pertinent factors discussed within the balance equation are population trends, economic considerations, industrial power requirements, and…

  18. A Smartphone Inertial Balance

    ERIC Educational Resources Information Center

    Barrera-Garrido, Azael

    2017-01-01

    In order to measure the mass of an object in the absence of gravity, one useful tool for many decades has been the inertial balance. One of the simplest forms of inertial balance is made by two mass holders or pans joined together with two stiff metal plates, which act as springs.

  19. Active balance system and vibration balanced machine

    NASA Technical Reports Server (NTRS)

    White, Maurice A. (Inventor); Qiu, Songgang (Inventor); Augenblick, John E. (Inventor); Peterson, Allen A. (Inventor)

    2005-01-01

    An active balance system is provided for counterbalancing vibrations of an axially reciprocating machine. The balance system includes a support member, a flexure assembly, a counterbalance mass, and a linear motor or an actuator. The support member is configured for attachment to the machine. The flexure assembly includes at least one flat spring having connections along a central portion and an outer peripheral portion. One of the central portion and the outer peripheral portion is fixedly mounted to the support member. The counterbalance mass is fixedly carried by the flexure assembly along another of the central portion and the outer peripheral portion. The linear motor has one of a stator and a mover fixedly mounted to the support member and another of the stator and the mover fixedly mounted to the counterbalance mass. The linear motor is operative to axially reciprocate the counterbalance mass.

  20. Load Balancing Scientific Applications

    SciTech Connect

    Pearce, Olga Tkachyshyn

    2014-12-01

    The largest supercomputers have millions of independent processors, and concurrency levels are rapidly increasing. For ideal efficiency, developers of the simulations that run on these machines must ensure that computational work is evenly balanced among processors. Assigning work evenly is challenging because many large modern parallel codes simulate behavior of physical systems that evolve over time, and their workloads change over time. Furthermore, the cost of imbalanced load increases with scale because most large-scale scientific simulations today use a Single Program Multiple Data (SPMD) parallel programming model, and an increasing number of processors will wait for the slowest one atmore » the synchronization points. To address load imbalance, many large-scale parallel applications use dynamic load balance algorithms to redistribute work evenly. The research objective of this dissertation is to develop methods to decide when and how to load balance the application, and to balance it effectively and affordably. We measure and evaluate the computational load of the application, and develop strategies to decide when and how to correct the imbalance. Depending on the simulation, a fast, local load balance algorithm may be suitable, or a more sophisticated and expensive algorithm may be required. We developed a model for comparison of load balance algorithms for a specific state of the simulation that enables the selection of a balancing algorithm that will minimize overall runtime.« less

  1. Consideration of Dynamical Balances

    NASA Technical Reports Server (NTRS)

    Errico, Ronald M.

    2015-01-01

    The quasi-balance of extra-tropical tropospheric dynamics is a fundamental aspect of nature. If an atmospheric analysis does not reflect such balance sufficiently well, the subsequent forecast will exhibit unrealistic behavior associated with spurious fast-propagating gravity waves. Even if these eventually damp, they can create poor background fields for a subsequent analysis or interact with moist physics to create spurious precipitation. The nature of this problem will be described along with the reasons for atmospheric balance and techniques for mitigating imbalances. Attention will be focused on fundamental issues rather than on recipes for various techniques.

  2. Balance Evaluation Systems

    NASA Technical Reports Server (NTRS)

    1996-01-01

    NeuroCom's Balance Master is a system to assess and then retrain patients with balance and mobility problems and is used in several medical centers. NeuroCom received assistance in research and funding from NASA, and incorporated technology from testing mechanisms for astronauts after shuttle flights. The EquiTest and Balance Master Systems are computerized posturography machines that measure patient responses to movement of a platform on which the subject is standing or sitting, then provide assessments of the patient's postural alignment and stability.

  3. Balancing Work & Family.

    ERIC Educational Resources Information Center

    Lee, Chris

    1991-01-01

    Describes the responses of some companies to increasing demands for family-work balance in terms of flexibility in working hours and leave policies, child care, and fringe benefits. Identifies some of the effects on the "bottom line." (SK)

  4. A Basic Balance.

    ERIC Educational Resources Information Center

    Science and Children, 1995

    1995-01-01

    Presents an activity for students to construct their own two-cup balances. Suggests some alternatives for rejuvenating weak bar magnets. Describes how to remove burnt carbon deposits from glass vessels. (NB)

  5. The Balanced Literacy Diet.

    ERIC Educational Resources Information Center

    Willows, Dale

    2002-01-01

    Describes professional development program in Ontario school district to improve student reading and writing skills. Program used food-pyramid concepts to help teacher learn to provide a balanced and flexible approach to literacy instruction based on student needs. (PKP)

  6. Balance Function Disorders

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Researchers at the Balance Function Laboratory and Clinic at the Minneapolis (MN) Neuroscience Institute on the Abbot Northwestern Hospital Campus are using a rotational chair (technically a "sinusoidal harmonic acceleration system") originally developed by NASA to investigate vestibular (inner ear) function in weightlessness to diagnose and treat patients with balance function disorders. Manufactured by ICS Medical Corporation, Schaumberg, IL, the chair system turns a patient and monitors his or her responses to rotational stimulation.

  7. Greenland Ice Sheet Mass Balance

    NASA Technical Reports Server (NTRS)

    Reeh, N.

    1984-01-01

    Mass balance equation for glaciers; areal distribution and ice volumes; estimates of actual mass balance; loss by calving of icebergs; hydrological budget for Greenland; and temporal variations of Greenland mass balance are examined.

  8. Watt and joule balances

    NASA Astrophysics Data System (ADS)

    Robinson, Ian A.

    2014-04-01

    The time is fast approaching when the SI unit of mass will cease to be based on a single material artefact and will instead be based upon the defined value of a fundamental constant—the Planck constant—h . This change requires that techniques exist both to determine the appropriate value to be assigned to the constant, and to measure mass in terms of the redefined unit. It is important to ensure that these techniques are accurate and reliable to allow full advantage to be taken of the stability and universality provided by the new definition and to guarantee the continuity of the world's mass measurements, which can affect the measurement of many other quantities such as energy and force. Up to now, efforts to provide the basis for such a redefinition of the kilogram were mainly concerned with resolving the discrepancies between individual implementations of the two principal techniques: the x-ray crystal density (XRCD) method [1] and the watt and joule balance methods which are the subject of this special issue. The first three papers report results from the NRC and NIST watt balance groups and the NIM joule balance group. The result from the NRC (formerly the NPL Mk II) watt balance is the first to be reported with a relative standard uncertainty below 2 × 10-8 and the NIST result has a relative standard uncertainty below 5 × 10-8. Both results are shown in figure 1 along with some previous results; the result from the NIM group is not shown on the plot but has a relative uncertainty of 8.9 × 10-6 and is consistent with all the results shown. The Consultative Committee for Mass and Related Quantities (CCM) in its meeting in 2013 produced a resolution [2] which set out the requirements for the number, type and quality of results intended to support the redefinition of the kilogram and required that there should be agreement between them. These results from NRC, NIST and the IAC may be considered to meet these requirements and are likely to be widely debated

  9. Cavendish Balance Automation

    NASA Technical Reports Server (NTRS)

    Thompson, Bryan

    2000-01-01

    This is the final report for a project carried out to modify a manual commercial Cavendish Balance for automated use in cryostat. The scope of this project was to modify an off-the-shelf manually operated Cavendish Balance to allow for automated operation for periods of hours or days in cryostat. The purpose of this modification was to allow the balance to be used in the study of effects of superconducting materials on the local gravitational field strength to determine if the strength of gravitational fields can be reduced. A Cavendish Balance was chosen because it is a fairly simple piece of equipment for measuring gravity, one the least accurately known and least understood physical constants. The principle activities that occurred under this purchase order were: (1) All the components necessary to hold and automate the Cavendish Balance in a cryostat were designed. Engineering drawings were made of custom parts to be fabricated, other off-the-shelf parts were procured; (2) Software was written in LabView to control the automation process via a stepper motor controller and stepper motor, and to collect data from the balance during testing; (3)Software was written to take the data collected from the Cavendish Balance and reduce it to give a value for the gravitational constant; (4) The components of the system were assembled and fitted to a cryostat. Also the LabView hardware including the control computer, stepper motor driver, data collection boards, and necessary cabling were assembled; and (5) The system was operated for a number of periods, data collected, and reduced to give an average value for the gravitational constant.

  10. Automatic force balance calibration system

    NASA Technical Reports Server (NTRS)

    Ferris, Alice T. (Inventor)

    1995-01-01

    A system for automatically calibrating force balances is provided. The invention uses a reference balance aligned with the balance being calibrated to provide superior accuracy while minimizing the time required to complete the calibration. The reference balance and the test balance are rigidly attached together with closely aligned moment centers. Loads placed on the system equally effect each balance, and the differences in the readings of the two balances can be used to generate the calibration matrix for the test balance. Since the accuracy of the test calibration is determined by the accuracy of the reference balance and current technology allows for reference balances to be calibrated to within +/-0.05% the entire system has an accuracy of +/-0.2%. The entire apparatus is relatively small and can be mounted on a movable base for easy transport between test locations. The system can also accept a wide variety of reference balances, thus allowing calibration under diverse load and size requirements.

  11. Automatic force balance calibration system

    NASA Technical Reports Server (NTRS)

    Ferris, Alice T. (Inventor)

    1996-01-01

    A system for automatically calibrating force balances is provided. The invention uses a reference balance aligned with the balance being calibrated to provide superior accuracy while minimizing the time required to complete the calibration. The reference balance and the test balance are rigidly attached together with closely aligned moment centers. Loads placed on the system equally effect each balance, and the differences in the readings of the two balances can be used to generate the calibration matrix for the test balance. Since the accuracy of the test calibration is determined by the accuracy of the reference balance and current technology allows for reference balances to be calibrated to within .+-.0.05%, the entire system has an accuracy of a .+-.0.2%. The entire apparatus is relatively small and can be mounted on a movable base for easy transport between test locations. The system can also accept a wide variety of reference balances, thus allowing calibration under diverse load and size requirements.

  12. Sport-specific balance.

    PubMed

    Zemková, Erika

    2014-05-01

    This review includes the latest findings based on experimental studies addressing sport-specific balance, an area of research that has grown dramatically in recent years. The main objectives of this work were to investigate the postural sway response to different forms of exercise under laboratory and sport-specific conditions, to examine how this effect can vary with expertise, and to provide examples of the association of impaired balance with sport performance and/or increasing risk of injury. In doing so, sports where body balance is one of the limiting factors of performance were analyzed. While there are no significant differences in postural stability between athletes of different specializations and physically active individuals during standing in a standard upright position (e.g., bipedal stance), they have a better ability to maintain balance in specific conditions (e.g., while standing on a narrow area of support). Differences in magnitude of balance impairment after specific exercises (rebound jumps, repeated rotations, etc.) and mainly in speed of its readjustment to baseline are also observed. Besides some evidence on an association of greater postural sway with the increasing risk of injuries, there are many myths related to the negative influence of impaired balance on sport performance. Though this may be true for shooting or archery, findings have shown that in many other sports, highly skilled athletes are able to perform successfully in spite of increased postural sway. These findings may contribute to better understanding of the postural control system under various performance requirements. It may provide useful knowledge for designing training programs for specific sports.

  13. Rotary and Magnus balances

    NASA Technical Reports Server (NTRS)

    Malcolm, G. N.

    1981-01-01

    Two wind tunnel techniques for determining part of the aerodynamic information required to describe the dynamic bahavior of various types of vehicles in flight are described. Force and moment measurements are determined with a rotary-balance apparatus in a coning motion and with a Magnus balance in a high-speed spinning motion. Coning motion is pertinent to both aircraft and missiles, and spinning is important for spin stabilized missiles. Basic principles of both techniques are described, and specific examples of each type of apparatus are presented. Typical experimental results are also discussed.

  14. Balancing Chemical Equations.

    ERIC Educational Resources Information Center

    Savoy, L. G.

    1988-01-01

    Describes a study of students' ability to balance equations. Answers to a test on this topic were analyzed to determine the level of understanding and processes used by the students. Presented is a method to teach this skill to high school chemistry students. (CW)

  15. A Balancing Act

    ERIC Educational Resources Information Center

    Lewis, Tamika; Mobley, Mary; Huttenlock, Daniel

    2013-01-01

    It's the season for the job hunt, whether one is looking for their first job or taking the next step along their career path. This article presents first-person accounts to see how teachers balance the rewards and challenges of working in different types of schools. Tamica Lewis, a third-grade teacher, states that faculty at her school is…

  16. Lives in the Balance.

    ERIC Educational Resources Information Center

    Our Children, 1997

    1997-01-01

    Changes in the workplace that would provide flexibility for working parents are slowly developing and receiving government, business, and societal attention. A sidebar, "Mother, Professional, Volunteer: One Woman's Balancing Act," presents an account of how one woman rearranged her professional life to enable her to do full-time…

  17. Multidimensional spectral load balancing

    DOEpatents

    Hendrickson, Bruce A.; Leland, Robert W.

    1996-12-24

    A method of and apparatus for graph partitioning involving the use of a plurality of eigenvectors of the Laplacian matrix of the graph of the problem for which load balancing is desired. The invention is particularly useful for optimizing parallel computer processing of a problem and for minimizing total pathway lengths of integrated circuits in the design stage.

  18. Load Balancing in Hypergraphs

    NASA Astrophysics Data System (ADS)

    Delgosha, Payam; Anantharam, Venkat

    2018-03-01

    Consider a simple locally finite hypergraph on a countable vertex set, where each edge represents one unit of load which should be distributed among the vertices defining the edge. An allocation of load is called balanced if load cannot be moved from a vertex to another that is carrying less load. We analyze the properties of balanced allocations of load. We extend the concept of balancedness from finite hypergraphs to their local weak limits in the sense of Benjamini and Schramm (Electron J Probab 6(23):13, 2001) and Aldous and Steele (in: Probability on discrete structures. Springer, Berlin, pp 1-72, 2004). To do this, we define a notion of unimodularity for hypergraphs which could be considered an extension of unimodularity in graphs. We give a variational formula for the balanced load distribution and, in particular, we characterize it in the special case of unimodular hypergraph Galton-Watson processes. Moreover, we prove the convergence of the maximum load under some conditions. Our work is an extension to hypergraphs of Anantharam and Salez (Ann Appl Probab 26(1):305-327, 2016), which considered load balancing in graphs, and is aimed at more comprehensively resolving conjectures of Hajek (IEEE Trans Inf Theory 36(6):1398-1414, 1990).

  19. Balance functions reexamined

    NASA Astrophysics Data System (ADS)

    Bialas, A.

    2011-02-01

    The idea of glue clusters, i.e., short-range correlations in the quark-gluon plasma close to freeze-out, is used to estimate the width of balance functions in momentum space. A good agreement is found with the recent measurements of the STAR Collaboration for central Au-Au collisions.

  20. Maintaining an Environmental Balance

    ERIC Educational Resources Information Center

    Environmental Science and Technology, 1976

    1976-01-01

    A recent conference of the National Environmental Development Association focused on the concepts of environment, energy and economy and underscored the necessity for balancing the critical needs embodied in these issues. Topics discussed included: nuclear energy and wastes, water pollution control, federal regulations, environmental technology…

  1. Interchangeability of the Wii Balance Board for Bipedal Balance Assessment

    PubMed Central

    Jansen, Bart; Omelina, Lubos; Rooze, Marcel; Van Sint Jan, Serge

    2015-01-01

    Background Since 2010, an increasing interest in more portable and flexible hardware for balance and posture assessment led to previously published studies determining whether or not the Wii Balance Board could be used to assess balance and posture, both scientifically and clinically. However, no previous studies aimed at comparing results from different Wii Balance Boards for clinical balance evaluation exist. Objective The objective of this crossover study is to assess the interchangeability of the Wii Balance Board. Methods A total of 6 subjects participated in the study and their balance was assessed using 4 different Wii Balance Boards. Trials were recorded simultaneously with Wii Balance Boards and with a laboratory force plate. Nine relevant clinical parameters were derived from center of pressure displacement data obtained from Wii Balance Board and force plate systems. Intraclass correlation coefficients (ICC), F tests, and Friedman tests were computed to assess the agreement between trials and to compare the Wii Balance Board and force plate results. Results Excellent correlations were found between the Wii Balance Board and force plate (mean ρ =.83). With the exception of 2 parameters, strong to excellent agreements were found for the 7 remaining parameters (ICC=.96). No significant differences were found between trials recorded with different Wii Balance Boards. Conclusions Our results indicate that for most of the parameters analyzed, balance and posture assessed with one Wii Balance Board were statistically similar to results obtained from another. Furthermore, the good correlation between the Wii Balance Board and force plate results shows that Wii Balance Boards can be reliably used for scientific assessment using most of the parameters analyzed in this study. These results also suggest that the Wii Balance Board could be used in multicenter studies and therefore, would allow for the creation of larger populations for clinical studies. Trial

  2. Linking Workplace Health Promotion Best Practices and Organizational Financial Performance: Tracking Market Performance of Companies With Highest Scores on the HERO Scorecard.

    PubMed

    Grossmeier, Jessica; Fabius, Ray; Flynn, Jennifer P; Noeldner, Steven P; Fabius, Dan; Goetzel, Ron Z; Anderson, David R

    2016-01-01

    The aim of the study was to evaluate the stock performance of publicly traded companies that received high scores on the HERO Employee Health Management Best Practices Scorecard in Collaboration with Mercer© based on their implementation of evidence-based workplace health promotion practices. A portfolio of companies that received high scores in a corporate health and wellness self-assessment was simulated based on past market performance and compared with past performance of companies represented on the Standard and Poor's (S&P) 500 Index. Stock values for a portfolio of companies that received high scores in a corporate health and wellness self-assessment appreciated by 235% compared with the S&P 500 Index appreciation of 159% over a 6-year simulation period. Robust investment in workforce health and well-being appears to be one of multiple practices pursued by high-performing, well-managed companies.

  3. Lunar Balance and Locomotion

    NASA Technical Reports Server (NTRS)

    Paloski, William H.

    2008-01-01

    Balance control and locomotor patterns were altered in Apollo crewmembers on the lunar surface, owing, presumably, to a combination of sensory-motor adaptation during transit and lunar surface operations, decreased environmental affordances associated with the reduced gravity, and restricted joint mobility as well as altered center-of-gravity caused by the EVA pressure suits. Dr. Paloski will discuss these factors, as well as the potential human and mission impacts of falls and malcoordination during planned lunar sortie and outpost missions. Learning objectives: What are the potential impacts of postural instabilities on the lunar surface? CME question: What factors affect balance control and gait stability on the moon? Answer: Sensory-motor adaptation to the lunar environment, reduced mechanical and visual affordances, and altered biomechanics caused by the EVA suit.

  4. Life Balancing -- A Better Way to Balance Large Batteries

    SciTech Connect

    Anderson, R. Dyche; Zane, Regan; Plett, Gregory

    2017-03-28

    A new cell balancing technology was developed under a Department of Energy contract which merges the DC/DC converter function into cell balancing. Instead of conventional passive cell balancing technology which bypasses current through a resistor, or active cell balancing which moves current from one cell to another, with significant cost and additional inefficiencies, this concept takes variable amount of current from each cell or small group of cells and converts it to current for the low voltage system.

  5. Balanced Atmospheric Data Assimilation

    NASA Astrophysics Data System (ADS)

    Hastermann, Gottfried; Reinhardt, Maria; Klein, Rupert; Reich, Sebastian

    2017-04-01

    The atmosphere's multi-scale structure poses several major challenges in numerical weather prediction. One of these arises in the context of data assimilation. The large-scale dynamics of the atmosphere are balanced in the sense that acoustic or rapid internal wave oscillations generally come with negligibly small amplitudes. If triggered artificially, however, through inappropriate initialization or by data assimilation, such oscillations can have a detrimental effect on forecast quality as they interact with the moist aerothermodynamics of the atmosphere. In the setting of sequential Bayesian data assimilation, we therefore investigate two different strategies to reduce these artificial oscillations induced by the analysis step. On the one hand, we develop a new modification for a local ensemble transform Kalman filter, which penalizes imbalances via a minimization problem. On the other hand, we modify the first steps of the subsequent forecast to push the ensemble members back to the slow evolution. We therefore propose the use of certain asymptotically consistent integrators that can blend between the balanced and the unbalanced evolution model seamlessly. In our work, we furthermore present numerical results and performance of the proposed methods for two nonlinear ordinary differential equation models, where we can identify the different scales clearly. The first one is a Lorenz 96 model coupled with a wave equation. In this case the balance relation is linear and the imbalances are caused only by the localization of the filter. The second one is the elastic double pendulum where the balance relation itself is already highly nonlinear. In both cases the methods perform very well and could significantly reduce the imbalances and therefore increase the forecast quality of the slow variables.

  6. Ten years of preanalytical monitoring and control: Synthetic Balanced Score Card Indicator

    PubMed Central

    López-Garrigós, Maite; Flores, Emilio; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

    2015-01-01

    Introduction Preanalytical control and monitoring continue to be an important issue for clinical laboratory professionals. The aim of the study was to evaluate a monitoring system of preanalytical errors regarding not suitable samples for analysis, based on different indicators; to compare such indicators in different phlebotomy centres; and finally to evaluate a single synthetic preanalytical indicator that may be included in the balanced scorecard management system (BSC). Materials and methods We collected individual and global preanalytical errors in haematology, coagulation, chemistry, and urine samples analysis. We also analyzed a synthetic indicator that represents the sum of all types of preanalytical errors, expressed in a sigma level. We studied the evolution of those indicators over time and compared indicator results by way of the comparison of proportions and Chi-square. Results There was a decrease in the number of errors along the years (P < 0.001). This pattern was confirmed in primary care patients, inpatients and outpatients. In blood samples, fewer errors occurred in outpatients, followed by inpatients. Conclusion We present a practical and effective methodology to monitor unsuitable sample preanalytical errors. The synthetic indicator results summarize overall preanalytical sample errors, and can be used as part of BSC management system. PMID:25672466

  7. Simple Cell Balance Circuit

    NASA Technical Reports Server (NTRS)

    Johnson, Steven D.; Byers, Jerry W.; Martin, James A.

    2012-01-01

    A method has been developed for continuous cell voltage balancing for rechargeable batteries (e.g. lithium ion batteries). A resistor divider chain is provided that generates a set of voltages representing the ideal cell voltage (the voltage of each cell should be as if the cells were perfectly balanced). An operational amplifier circuit with an added current buffer stage generates the ideal voltage with a very high degree of accuracy, using the concept of negative feedback. The ideal voltages are each connected to the corresponding cell through a current- limiting resistance. Over time, having the cell connected to the ideal voltage provides a balancing current that moves the cell voltage very close to that ideal level. In effect, it adjusts the current of each cell during charging, discharging, and standby periods to force the cell voltages to be equal to the ideal voltages generated by the resistor divider. The device also includes solid-state switches that disconnect the circuit from the battery so that it will not discharge the battery during storage. This solution requires relatively few parts and is, therefore, of lower cost and of increased reliability due to the fewer failure modes. Additionally, this design uses very little power. A preliminary model predicts a power usage of 0.18 W for an 8-cell battery. This approach is applicable to a wide range of battery capacities and voltages.

  8. Assessment of postural balance function.

    PubMed

    Kostiukow, Anna; Rostkowska, Elzbieta; Samborski, Włodzimierz

    2009-01-01

    Postural balance is defined as the ability to stand unassisted without falling. Examination of the patient's postural balance function is a difficult diagnostic task. Most of the balance tests used in medicine provide incomplete information on this coordination ability of the human body. The aim of this study was to review methods of assessment of the patient's postural balance function, including various tests used in medical diagnostics centers.

  9. More on Chemical Reaction Balancing.

    ERIC Educational Resources Information Center

    Swinehart, D. F.

    1985-01-01

    A previous article stated that only the matrix method was powerful enough to balance a particular chemical equation. Shows how this equation can be balanced without using the matrix method. The approach taken involves writing partial mathematical reactions and redox half-reactions, and combining them to yield the final balanced reaction. (JN)

  10. Lesson "Balance in Nature

    NASA Astrophysics Data System (ADS)

    Chapanova, V.

    2012-04-01

    Lesson "Balance in Nature" This simulation game-lesson (Balance in Nature) gives an opportunity for the students to show creativity, work independently, and to create models and ideas. It creates future-oriented thought connected to their experience, allowing them to propose solutions for global problems and personal responsibility for their activities. The class is divided in two teams. Each team chooses questions. 1. Question: Pollution in the environment. 2. Question: Care for nature and climate. The teams work on the chosen tasks. They make drafts, notes and formulate their solutions on small pieces of paper, explaining the impact on nature and society. They express their points of view using many different opinions. This generates alternative thoughts and results in creative solutions. With the new knowledge and positive behaviour defined, everybody realizes that they can do something positive towards nature and climate problems and the importance of individuals for solving global problems is evident. Our main goal is to recover the ecological balance, and everybody explains his or her own well-grounded opinions. In this work process the students obtain knowledge, skills and more responsible behaviour. This process, based on his or her own experience, dialogue and teamwork, helps the participant's self-development. Making the model "human↔ nature" expresses how human activities impact the natural Earth and how these impacts in turn affect society. Taking personal responsibility, we can reduce global warming and help the Earth. By helping nature we help ourselves. Teacher: Veselina Boycheva-Chapanova " Saint Patriarch Evtimii" Scholl Str. "Ivan Vazov"-19 Plovdiv Bulgaria

  11. Micromechanical Oscillating Mass Balance

    NASA Technical Reports Server (NTRS)

    Altemir, David A. (Inventor)

    1997-01-01

    A micromechanical oscillating mass balance and method adapted for measuring minute quantities of material deposited at a selected location, such as during a vapor deposition process. The invention comprises a vibratory composite beam which includes a dielectric layer sandwiched between two conductive layers. The beam is positioned in a magnetic field. An alternating current passes through one conductive layers, the beam oscillates, inducing an output current in the second conductive layer, which is analyzed to determine the resonant frequency of the beam. As material is deposited on the beam, the mass of the beam increases and the resonant frequency of the beam shifts, and the mass added is determined.

  12. Pyrometer with tracking balancing

    NASA Astrophysics Data System (ADS)

    Ponomarev, D. B.; Zakharenko, V. A.; Shkaev, A. G.

    2018-04-01

    Currently, one of the main metrological noncontact temperature measurement challenges is the emissivity uncertainty. This paper describes a pyrometer with emissivity effect diminishing through the use of a measuring scheme with tracking balancing in which the radiation receiver is a null-indicator. In this paper the results of the prototype pyrometer absolute error study in surfaces temperature measurement of aluminum and nickel samples are presented. There is absolute error calculated values comparison considering the emissivity table values with errors on the results of experimental measurements by the proposed method. The practical implementation of the proposed technical solution has allowed two times to reduce the error due to the emissivity uncertainty.

  13. Tai Chi and balance control.

    PubMed

    Wong, Alice M K; Lan, Ching

    2008-01-01

    Balance function begins to decline from middle age on, and poor balance function increases the risk of fall and injury. Suitable exercise training may improve balance function and prevent accidental falls. The coordination of visual, proprioceptive, vestibular and musculoskeletal system is important to maintain balance. Balance function can be evaluated by functional balance testing and sensory organization testing. Tai Chi Chuan (TC) is a popular conditioning exercise in the Chinese community, and recent studies substantiate that TC is effective in balance function enhancement and falls prevention. In studies utilizing functional balance testing, TC may increase the duration of one-leg standing and the distance of functional reach. In studies utilizing sensory organization testing, TC improves static and dynamic balance, especially in more challenging sensory perturbed condition. Therefore, TC may be prescribed as an alternative exercise program for elderly subjects or balance-impaired patients. Participants can choose to perform a complete set of TC or selected movements according to their needs. In conclusion, TC may improve balance function and is appropriate for implementation in the community.

  14. Interchangeability of the Wii Balance Board for Bipedal Balance Assessment.

    PubMed

    Bonnechère, Bruno; Jansen, Bart; Omelina, Lubos; Rooze, Marcel; Van Sint Jan, Serge

    2015-08-27

    Since 2010, an increasing interest in more portable and flexible hardware for balance and posture assessment led to previously published studies determining whether or not the Wii Balance Board could be used to assess balance and posture, both scientifically and clinically. However, no previous studies aimed at comparing results from different Wii Balance Boards for clinical balance evaluation exist. The objective of this crossover study is to assess the interchangeability of the Wii Balance Board. A total of 6 subjects participated in the study and their balance was assessed using 4 different Wii Balance Boards. Trials were recorded simultaneously with Wii Balance Boards and with a laboratory force plate. Nine relevant clinical parameters were derived from center of pressure displacement data obtained from Wii Balance Board and force plate systems. Intraclass correlation coefficients (ICC), F tests, and Friedman tests were computed to assess the agreement between trials and to compare the Wii Balance Board and force plate results. Excellent correlations were found between the Wii Balance Board and force plate (mean ρ =.83). With the exception of 2 parameters, strong to excellent agreements were found for the 7 remaining parameters (ICC=.96). No significant differences were found between trials recorded with different Wii Balance Boards. Our results indicate that for most of the parameters analyzed, balance and posture assessed with one Wii Balance Board were statistically similar to results obtained from another. Furthermore, the good correlation between the Wii Balance Board and force plate results shows that Wii Balance Boards can be reliably used for scientific assessment using most of the parameters analyzed in this study. These results also suggest that the Wii Balance Board could be used in multicenter studies and therefore, would allow for the creation of larger populations for clinical studies. Ethical Committee of the Erasme Hospital (CCB B406201215142

  15. Biomechanical assessment of dynamic balance: Specificity of different balance tests.

    PubMed

    Ringhof, Steffen; Stein, Thorsten

    2018-04-01

    Dynamic balance is vitally important for most sports and activities of daily living, so the assessment of dynamic stability has become an important issue. In consequence, a large number of balance tests have been developed. However, it is not yet known whether these tests (i) measure the same construct and (ii) can differentiate between athletes with different balance expertise. We therefore studied three common dynamic balance tests: one-leg jump landings, Posturomed perturbations and simulated forward falls. Participants were 24 healthy young females in regular training in either gymnastics (n = 12) or swimming (n = 12). In each of the tests, the participants were instructed to recover balance as quickly as possible. Dynamic stability was computed by time to stabilization and margin of stability, deduced from force plates and motion capture respectively. Pearson's correlations between the dynamic balance tests found no significant associations between the respective dynamic stability measures. Furthermore, independent t-tests indicated that only jump landings could properly distinguish between both groups of athletes. In essence, the different dynamic balance tests applied did not measure the same construct but rather task-specific skills, each of which depends on multifactorial internal and external constraints. Our study therefore contradicts the traditional view of considering balance as a general ability, and reinforces that dynamic balance measures are not interchangeable. This highlights the importance of selecting appropriate balance tests. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Resource Balancing Control Allocation

    NASA Technical Reports Server (NTRS)

    Frost, Susan A.; Bodson, Marc

    2010-01-01

    Next generation aircraft with a large number of actuators will require advanced control allocation methods to compute the actuator commands needed to follow desired trajectories while respecting system constraints. Previously, algorithms were proposed to minimize the l1 or l2 norms of the tracking error and of the control effort. The paper discusses the alternative choice of using the l1 norm for minimization of the tracking error and a normalized l(infinity) norm, or sup norm, for minimization of the control effort. The algorithm computes the norm of the actuator deflections scaled by the actuator limits. Minimization of the control effort then translates into the minimization of the maximum actuator deflection as a percentage of its range of motion. The paper shows how the problem can be solved effectively by converting it into a linear program and solving it using a simplex algorithm. Properties of the algorithm are investigated through examples. In particular, the min-max criterion results in a type of resource balancing, where the resources are the control surfaces and the algorithm balances these resources to achieve the desired command. A study of the sensitivity of the algorithms to the data is presented, which shows that the normalized l(infinity) algorithm has the lowest sensitivity, although high sensitivities are observed whenever the limits of performance are reached.

  17. Balance ability and athletic performance.

    PubMed

    Hrysomallis, Con

    2011-03-01

    The relationship between balance ability and sport injury risk has been established in many cases, but the relationship between balance ability and athletic performance is less clear. This review compares the balance ability of athletes from different sports, determines if there is a difference in balance ability of athletes at different levels of competition within the same sport, determines the relationship of balance ability with performance measures and examines the influence of balance training on sport performance or motor skills. Based on the available data from cross-sectional studies, gymnasts tended to have the best balance ability, followed by soccer players, swimmers, active control subjects and then basketball players. Surprisingly, no studies were found that compared the balance ability of rifle shooters with other athletes. There were some sports, such as rifle shooting, soccer and golf, where elite athletes were found to have superior balance ability compared with their less proficient counterparts, but this was not found to be the case for alpine skiing, surfing and judo. Balance ability was shown to be significantly related to rifle shooting accuracy, archery shooting accuracy, ice hockey maximum skating speed and simulated luge start speed, but not for baseball pitching accuracy or snowboarding ranking points. Prospective studies have shown that the addition of a balance training component to the activities of recreationally active subjects or physical education students has resulted in improvements in vertical jump, agility, shuttle run and downhill slalom skiing. A proposed mechanism for the enhancement in motor skills from balance training is an increase in the rate of force development. There are limited data on the influence of balance training on motor skills of elite athletes. When the effectiveness of balance training was compared with resistance training, it was found that resistance training produced superior performance results for

  18. Typical balance exercises or exergames for balance improvement?

    PubMed

    Gioftsidou, Asimenia; Vernadakis, Nikolaos; Malliou, Paraskevi; Batzios, Stavros; Sofokleous, Polina; Antoniou, Panagiotis; Kouli, Olga; Tsapralis, Kyriakos; Godolias, George

    2013-01-01

    Balance training is an effective intervention to improve static postural sway and balance. The purpose of the present study was to investigate the effectiveness of the Nintendo Wii Fit Plus exercises for improving balance ability in healthy collegiate students in comparison with a typical balance training program. Forty students were randomly divided into two groups, a traditional (T group) and a Nintendo Wii group (W group) performed an 8 week balance program. The "W group" used the interactive games as a training method, while the "T group" used an exercise program with mini trampoline and inflatable discs (BOSU). Pre and Post-training participants completed balance assessments. Two-way repeated measures analyses of variance (ANOVAs) were conducted to determine the effect of training program. Analysis of the data illustrated that both training program groups demonstrated an improvement in Total, Anterior-posterior and Medial Lateral Stability Index scores for both limbs. Only at the test performed in the balance board with anterior-posterior motion, the improvement in balance ability was greater in the "T group" than the "W group", when the assessment was performed post-training (p=0.023). Findings support the effectiveness of using the Nintendo Wii gaming console as a balance training intervention tool.

  19. Balancing Family and Career

    NASA Astrophysics Data System (ADS)

    Andam, Aba Bentil; Dawson, Silvina Ponce; Horton, K. Renee; Sandow, Barbara

    2005-10-01

    In essentially all countries, responsibilities for child care, cooking, cleaning, and other homemaking tasks fall predominantly on the wife and mother. In addition, the childbearing years come during the period when a physicist must study hard, work long hours on research, and take temporary positions, often abroad. Thus, balancing family and career has long been one of the major barriers to women's participation in science and engineering fields, including physics. While many young women believe that they must choose between having children and having a science career, the fact is that the majority of women physicists in both developing and developed countries have successfully done both. This paper summarizes some ideas and recommendations raised in discussions, especially focused on easing the challenges of having children while in temporary jobs, returning to physics after a career break, the need for "family-friendly" working conditions, and the dual-career problem facing couples where both are scientists.

  20. Energy balance climate models

    NASA Technical Reports Server (NTRS)

    North, G. R.; Cahalan, R. F.; Coakley, J. A., Jr.

    1981-01-01

    An introductory survey of the global energy balance climate models is presented with an emphasis on analytical results. A sequence of increasingly complicated models involving ice cap and radiative feedback processes are solved, and the solutions and parameter sensitivities are studied. The model parameterizations are examined critically in light of many current uncertainties. A simple seasonal model is used to study the effects of changes in orbital elements on the temperature field. A linear stability theorem and a complete nonlinear stability analysis for the models are developed. Analytical solutions are also obtained for the linearized models driven by stochastic forcing elements. In this context the relation between natural fluctuation statistics and climate sensitivity is stressed.

  1. Dynamic load balancing of applications

    DOEpatents

    Wheat, S.R.

    1997-05-13

    An application-level method for dynamically maintaining global load balance on a parallel computer, particularly on massively parallel MIMD computers is disclosed. Global load balancing is achieved by overlapping neighborhoods of processors, where each neighborhood performs local load balancing. The method supports a large class of finite element and finite difference based applications and provides an automatic element management system to which applications are easily integrated. 13 figs.

  2. Dynamic load balancing of applications

    DOEpatents

    Wheat, Stephen R.

    1997-01-01

    An application-level method for dynamically maintaining global load balance on a parallel computer, particularly on massively parallel MIMD computers. Global load balancing is achieved by overlapping neighborhoods of processors, where each neighborhood performs local load balancing. The method supports a large class of finite element and finite difference based applications and provides an automatic element management system to which applications are easily integrated.

  3. Radar channel balancing with commutation

    SciTech Connect

    Doerry, Armin Walter

    2014-02-01

    When multiple channels are employed in a pulse-Doppler radar, achieving and maintaining balance between the channels is problematic. In some circumstances the channels may be commutated to achieve adequate balance. Commutation is the switching, trading, toggling, or multiplexing of the channels between signal paths. Commutation allows modulating the imbalance energy away from the balanced energy in Doppler, where it can be mitigated with filtering.

  4. Balanced multiwavelets with interpolatory property.

    PubMed

    Li, Baobin; Peng, Lizhong

    2011-05-01

    Balanced multiwavelets with interpolatory property are discussed in this paper. This kind of multiwavelets can have a sampling property like Shannon's sampling theorem. It has been shown that the corresponding matrix-valued refinable mask has special structure, and an orthogonal multifilter bank {H(z),G(z)} can be reduced to a scalar valued conjugate quadrature filter (CQF) a(z) . But it does not mean that any scalar CQF can form a "good" multifilter bank which can generate a vector-valued refinable function with some degree of smoothness. In the context of balanced multiwavelets, we give the definition of transferring balance order, which a scalar CQF a(z) satisfies, to guarantee that the multiwavelet Ψ generated is balanced. On the basis of the parametrization of a scalar CQF with any length and conditions of transferring balance order, parametrization of multifilter banks which can generate interpolatory multiwavelet and interpolatory scaling function, is gotten. Moreover, some balanced interpolatory multiwavelets have been constructed. Interpolatory analysis-ready multiwavelets (armlets) are also discussed in this paper. It is known that conditions of armlets are easy to validate, compared with balanced multiwavelets. But it will be present that if the corresponding scaling function Φ is interpolatory, the multiwavelet Ψ is balanced of order n if and only if it is an armlet of order n. Finally, the application of balanced multiwavelets with interpolatory property in image processing is also discussed.

  5. In the Balance:

    PubMed Central

    Weaver, Lawrence T.

    2010-01-01

    Summary The nineteenth century saw the incorporation of technology, such as the stethoscope, microscope, and thermometer, into clinical medicine. An instrument that has received less attention in the history of the role of technology in medicine is the weighing balance, or scale. Although not new to nineteenth-century medicine, it played an important part in the rise of the numerical method and its application to the development and shaping of pediatrics. This article explores the origin and development of the weighing of babies. During its clinical and scientific adoption, this simple procedure was refined and applied in a number of increasingly sophisticated and far-reaching ways: as a measure of the dimensions of the fetus and newborn, as an index of the viability of the newborn, as a means of estimating milk intake, as a way of distinguishing normality from abnormality, as a summary measure of infant health, and as an instrument of mass surveillance. In so doing it changed the way in which medical care was delivered to infants. PMID:20632732

  6. A Balanced Memory Network

    PubMed Central

    Roudi, Yasser; Latham, Peter E

    2007-01-01

    A fundamental problem in neuroscience is understanding how working memory—the ability to store information at intermediate timescales, like tens of seconds—is implemented in realistic neuronal networks. The most likely candidate mechanism is the attractor network, and a great deal of effort has gone toward investigating it theoretically. Yet, despite almost a quarter century of intense work, attractor networks are not fully understood. In particular, there are still two unanswered questions. First, how is it that attractor networks exhibit irregular firing, as is observed experimentally during working memory tasks? And second, how many memories can be stored under biologically realistic conditions? Here we answer both questions by studying an attractor neural network in which inhibition and excitation balance each other. Using mean-field analysis, we derive a three-variable description of attractor networks. From this description it follows that irregular firing can exist only if the number of neurons involved in a memory is large. The same mean-field analysis also shows that the number of memories that can be stored in a network scales with the number of excitatory connections, a result that has been suggested for simple models but never shown for realistic ones. Both of these predictions are verified using simulations with large networks of spiking neurons. PMID:17845070

  7. A balanced memory network.

    PubMed

    Roudi, Yasser; Latham, Peter E

    2007-09-01

    A fundamental problem in neuroscience is understanding how working memory--the ability to store information at intermediate timescales, like tens of seconds--is implemented in realistic neuronal networks. The most likely candidate mechanism is the attractor network, and a great deal of effort has gone toward investigating it theoretically. Yet, despite almost a quarter century of intense work, attractor networks are not fully understood. In particular, there are still two unanswered questions. First, how is it that attractor networks exhibit irregular firing, as is observed experimentally during working memory tasks? And second, how many memories can be stored under biologically realistic conditions? Here we answer both questions by studying an attractor neural network in which inhibition and excitation balance each other. Using mean-field analysis, we derive a three-variable description of attractor networks. From this description it follows that irregular firing can exist only if the number of neurons involved in a memory is large. The same mean-field analysis also shows that the number of memories that can be stored in a network scales with the number of excitatory connections, a result that has been suggested for simple models but never shown for realistic ones. Both of these predictions are verified using simulations with large networks of spiking neurons.

  8. Balancing "we" and "me".

    PubMed

    Congdon, Christine; Flynn, Donna; Redman, Melanie

    2014-10-01

    The open office is the dominant form of workspace design for good reason: It fosters collaboration, promotes learning, and nurtures strong culture. But what most companies fail to realize is that collaboration has a natural rhythm that requires both interaction and private contemplation. Companies have been trying for decades to find the balance between public and private workspace that best supports collaboration. In 1980 52% of U.S. employees lacked workspaces where they could concentrate without distraction. In response, high-walled cubicles took over the corporate landscape. By the late 1990s, the tide had turned, and only 23% of employees wanted more privacy, and 50% wanted more access to other people. Ever since, firms have been beefing up spaces that support collaboration and shrinking areas for individual work. But the pendulum seems to have swung too far: Once again, people feel a pressing need for privacy, not only to do heads-down work but to cope with the intensity of work today. To address these needs, according to the authors, we have to rethink our assumptions about privacy. Traditionally defined in physical terms, privacy is now about the individual's ability to control information and stimulation. In this article, the authors examine workspace design through the new lens of privacy and offer insights on how to foster teamwork and solitude.

  9. Balancing Safety and Free Speech

    ERIC Educational Resources Information Center

    Hudson, David L., Jr.

    2004-01-01

    According to Jay Worona, general counsel for the New York State School Board Association, "Balancing safety and student constitutional rights is not easy. It has to be a careful balance. School officials must be prudent and not overreact. But one part of the equation has to be paramount. And safety should be the primary concern"…

  10. Predicting prolonged intensive care unit length of stay in patients undergoing coronary artery bypass surgery--development of an entirely preoperative scorecard.

    PubMed

    Herman, Christine; Karolak, Wojtek; Yip, Alexandra M; Buth, Karen J; Hassan, Ansar; Légaré, Jean-Francois

    2009-10-01

    We sought to develop a predictive model based exclusively on preoperative factors to identify patients at risk for PrlICULOS following coronary artery bypass grafting (CABG). Retrospective analysis was performed on patients undergoing isolated CABG at a single center between June 1998 and December 2002. PrlICULOS was defined as initial admission to ICU exceeding 72 h. A parsimonious risk-predictive model was constructed on the basis of preoperative factors, with subsequent internal validation. Of 3483 patients undergoing isolated CABG between June 1998 and December 2002, 411 (11.8%) experienced PrlICULOS. Overall in-hospital mortality was higher among these patients (14.4% vs. 1.2%, Pscorecard was developed allowing identification of these patients prior to surgery and allowing for strategies aimed at optimizing hospital resources.

  11. Process evaluation of the implementation of scorecard-based antenatal risk assessment, care pathways and interdisciplinary consultation: the Healthy Pregnancy 4 All study.

    PubMed

    Vos, A A; van Voorst, S F; Posthumus, A G; Waelput, A J M; Denktaş, S; Steegers, E A P

    2017-09-01

    To evaluate the implementation of a complex intervention in the antenatal healthcare field in 14 Dutch municipalities. The intervention consisted of the implementation of a systematic scorecard-based risk assessment in pregnancy, subsequent patient-tailored care pathways, and consultations of professionals from different medical and social disciplines. Saunders's seven-step method was used for the development of a programme implementation monitoring plan, with specific attention to the setting and context of the programme. Data were triangulated from multiple sources, and prespecified criteria were applied to examine the evidence for implementation. Six out of 11 municipalities (54%) met the implementation criteria for the entire risk assessment programme, whereas three municipalities (27%) met the criteria if the three components of implementation were analysed separately. A process evaluation of implementation of a complex intervention is possible. The results can be used to improve understanding of the associations between specific programme elements and programme outcomes on effectiveness of the intervention. Additionally, the results are important for formative purposes to assess how future implementation of antenatal risk assessment can be improved in comparable contexts. Copyright © 2017. Published by Elsevier Ltd.

  12. Scorecards and social accountability for improved maternal and newborn health services: A pilot in the Ashanti and Volta regions of Ghana.

    PubMed

    Blake, Carolyn; Annorbah-Sarpei, Nii Ankonu; Bailey, Claire; Ismaila, Yakubu; Deganus, Sylvia; Bosomprah, Samuel; Galli, Francesco; Clark, Sarah

    2016-12-01

    With the limited availability of quality emergency obstetric and newborn care (EmONC) in Ghana, and a lack of dialogue on the issue at district level, the Evidence for Action (E4A) program (2011-2015) initiated a pilot intervention using a social accountability approach in two regions of Ghana. Using scorecards to assess and improve maternal and newborn health services, the intervention study evaluated the effectiveness of engaging multiple, health and non-health sector stakeholders at district level to improve the enabling environment for quality EmONC. The quantitative study component comprised two rounds of assessments in 37 health facilities. The qualitative component is based on an independent prospective policy study. Results show a marked growth in a culture of accountability, with heightened levels of community participation, transparency, and improved clarity of lines of accountability among decision-makers. The breadth and type of quality of care improvements were dependent on the strength of community and government engagement in the process, especially in regard to more complex systemic changes. Engaging a broad network of stakeholders to support MNH services has great potential if implemented in ways that are context-appropriate and that build around full collaboration with government and civil society stakeholders. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. A balancing act: physical balance, through arousal, influences size perception.

    PubMed

    Geuss, Michael N; Stefanucci, Jeanine K; de Benedictis-Kessner, Justin; Stevens, Nicholas R

    2010-10-01

    Previous research has demonstrated that manipulating vision influences balance. Here, we question whether manipulating balance can influence vision and how it may influence vision--specifically, the perception of width. In Experiment 1, participants estimated the width of beams while balanced and unbalanced. When unbalanced, participants judged the widths to be smaller. One possible explanation is that unbalanced participants did not view the stimulus as long as when balanced because they were focused on remaining balanced. In Experiment 2, we tested this notion by limiting viewing time. Experiment 2 replicated the findings of Experiment 1, but viewing time had no effect on width judgments. In Experiment 3, participants' level of arousal was manipulated, because the balancing task likely produced arousal. While jogging, participants judged the beams to be smaller. In Experiment 4, participants completed another arousing task (counting backward by sevens) that did not involve movement. Again, participants judged the beams to be smaller when aroused. Experiment 5A raised participants' level of arousal before estimating the board widths (to control for potential dual-task effects) and showed that heightened arousal still influenced perceived width of the boards. Collectively, heightened levels of arousal, caused by multiple manipulations (including balance), influenced perceived width.

  14. Work-life balance: history, costs, and budgeting for balance.

    PubMed

    Raja, Siva; Stein, Sharon L

    2014-06-01

    The concept and difficulties of work-life balance are not unique to surgeons, but professional responsibilities make maintaining a work-life balance difficult. Consequences of being exclusively career focused include burn out, physical, and mental ailments. In addition, physician burn out may hinder optimal patient care and incur significant costs on health care in general. Assessing current uses of time, allocating goals catered to an individual surgeon, and continual self-assessment may help balance time, and ideally will help prevent burn out.

  15. Work–Life Balance: History, Costs, and Budgeting for Balance

    PubMed Central

    Raja, Siva; Stein, Sharon L.

    2014-01-01

    The concept and difficulties of work–life balance are not unique to surgeons, but professional responsibilities make maintaining a work–life balance difficult. Consequences of being exclusively career focused include burn out, physical, and mental ailments. In addition, physician burn out may hinder optimal patient care and incur significant costs on health care in general. Assessing current uses of time, allocating goals catered to an individual surgeon, and continual self-assessment may help balance time, and ideally will help prevent burn out. PMID:25067921

  16. Modern rotor balancing - Emerging technologies

    NASA Technical Reports Server (NTRS)

    Zorzi, E. S.; Von Pragenau, G. L.

    1985-01-01

    Modern balancing methods for flexible and rigid rotors are explored. Rigid rotor balancing is performed at several hundred rpm, well below the first bending mode of the shaft. High speed balancing is necessary when the nominal rotational speed is higher than the first bending mode. Both methods introduce weights which will produce rotor responses at given speeds that will be exactly out of phase with the responses of an unbalanced rotor. Modal balancing seeks to add weights which will leave other rotor modes unaffected. Also, influence coefficients can be determined by trial and error addition of weights and recording of their effects on vibration at speeds of interest. The latter method is useful for balancing rotors at other than critical speeds and for performing unified balancing beginning with the first critical speed. Finally, low-speed flexible balancing permits low-speed tests and adjustments of rotor assemblies which will not be accessible when operating in their high-speed functional configuration. The method was developed for the high pressure liquid oxygen turbopumps for the Shuttle.

  17. Acerca del moho

    EPA Pesticide Factsheets

    El moho forma parte del medio ambiente natural. Afuera del hogar, el moho juega un papel en la naturaleza al desintegrar materias organicas tales como las hojas que se han caido o los arboles muertos. El moho puede crecer adentro del hogar cuando las espor

  18. Appetite and energy balancing.

    PubMed

    Rogers, Peter J; Brunstrom, Jeffrey M

    2016-10-01

    pleasure of eating it. The latter, which is similar to food reward, is determined primarily by the state of emptiness of the gut and food liking related to the food's sensory qualities and macronutrient value and the individual's dietary history. Importantly, energy density adds value because energy dense foods are less satiating kJ for kJ and satiation limits further intake. That is, energy dense foods promote energy intake by virtue (1) of being more attractive and (2) having low satiating capacity kJ for kJ, and (1) is partly a consequence of (2). Energy storage is adapted to feast and famine and that includes unevenness over time of the costs of obtaining and ingesting food compared with engaging in other activities. However, in very low-cost food environments with energy dense foods readily available, risk of obesity is high. This risk can be and is mitigated by dietary restraint, which in its simplest form could mean missing the occasional meal. Another strategy we discuss is the energy dilution achieved by replacing some sugar in the diet with low-calorie sweeteners. Perhaps as or more significant, though, is that belief in short-term energy balancing (the energy depletion model) may undermine attempts to eat less. Therefore, correcting narratives of eating to be consistent with biological reality could also assist with weight control. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Skylab water balance error analysis

    NASA Technical Reports Server (NTRS)

    Leonard, J. I.

    1977-01-01

    Estimates of the precision of the net water balance were obtained for the entire Skylab preflight and inflight phases as well as for the first two weeks of flight. Quantitative estimates of both total sampling errors and instrumentation errors were obtained. It was shown that measurement error is minimal in comparison to biological variability and little can be gained from improvement in analytical accuracy. In addition, a propagation of error analysis demonstrated that total water balance error could be accounted for almost entirely by the errors associated with body mass changes. Errors due to interaction between terms in the water balance equation (covariances) represented less than 10% of the total error. Overall, the analysis provides evidence that daily measurements of body water changes obtained from the indirect balance technique are reasonable, precise, and relaible. The method is not biased toward net retention or loss.

  20. Cautions Concerning Electronic Analytical Balances.

    ERIC Educational Resources Information Center

    Johnson, Bruce B.; Wells, John D.

    1986-01-01

    Cautions chemists to be wary of ferromagnetic samples (especially magnetized samples), stray electromagnetic radiation, dusty environments, and changing weather conditions. These and other conditions may alter readings obtained from electronic analytical balances. (JN)

  1. Laboratory Workhorse: The Analytical Balance.

    ERIC Educational Resources Information Center

    Clark, Douglas W.

    1979-01-01

    This report explains the importance of various analytical balances in the water or wastewater laboratory. Stressed is the proper procedure for utilizing the equipment as well as the mechanics involved in its operation. (CS)

  2. Roads & loads : finding a balance.

    DOT National Transportation Integrated Search

    2006-01-01

    Striking a balance between the needs of commerce to carry heavy loads on roads and the need to preserve the significant investment in our transportation infrastructure is a challenging process. There are compelling needs from both sides of the pictur...

  3. Mass balance computation in SAGUARO

    SciTech Connect

    Baker, B.L.; Eaton, R.R.

    1986-12-01

    This report describes the development of the mass balance subroutines used with the finite-element code, SAGUARO, which models fluid flow in partially saturated porous media. Derivation of the basic mass storage and mass flux equations is included. The results of the SAGUARO mass-balance subroutine, MASS, are shown to compare favorably with the linked results of FEMTRAN. Implementation of the MASS option in SAGUARO is described. Instructions for use of the MASS option are demonstrated with the three sample cases.

  4. The Limits of Offshore Balancing

    DTIC Science & Technology

    2015-09-01

    believe, is to adopt a minimalist approach referred to as “offshore balancing.” Briefly stated, offshore balancing envisions a dramatic reduction in...behavior from allies and adversaries alike. The proper response to this situation, they believe, is to adopt a minimalist approach usually referred to as...as a minimalist , or free-hand strategy, because it asserts that America can attain that goal while also shedding obligations and resources.30 Indeed

  5. Low cost balancing unit design

    NASA Astrophysics Data System (ADS)

    Golembiovsky, Matej; Dedek, Jan; Slanina, Zdenek

    2017-06-01

    This article deals with the design of a low-cost balancing system which consist of battery balancing units, accumulator pack units and coordinator unit with interface for higher level of battery management system. This solution allows decentralized mode of operation and the aim of this work is implementation of controlling and diagnostic mechanism into an electric scooter project realized at Technical university of Ostrava. In todays world which now fully enjoys the prime of electromobility, off-grid battery systems and other, it is important to seek the optimal balance between functionality and the economy side of BMS that being electronics which deals with secondary cells of batery packs. There were numerous sophisticated, but not too practical BMS models in the past, such as centralized system or standalone balance modules of individual cells. This article aims at development of standalone balance modules which are able to communicate with the coordinator, adjust their parameters and ensure their cells safety in case of a communication failure. With the current worldwide cutting cost trend in mind, the emphasis was put on the lowest price possible for individual component. The article is divided into two major categories, the first one being desing of power electronics with emphasis on quality, safety (cooling) and also cost. The second part describes development of a communication interface with reliability and cost in mind. The article contains numerous graphs from practical measurements. The outcome of the work and its possible future is defined in the conclusion.

  6. Balancing on tightropes and slacklines

    PubMed Central

    Paoletti, P.; Mahadevan, L.

    2012-01-01

    Balancing on a tightrope or a slackline is an example of a neuromechanical task where the whole body both drives and responds to the dynamics of the external environment, often on multiple timescales. Motivated by a range of neurophysiological observations, here we formulate a minimal model for this system and use optimal control theory to design a strategy for maintaining an upright position. Our analysis of the open and closed-loop dynamics shows the existence of an optimal rope sag where balancing requires minimal effort, consistent with qualitative observations and suggestive of strategies for optimizing balancing performance while standing and walking. Our consideration of the effects of nonlinearities, potential parameter coupling and delays on the overall performance shows that although these factors change the results quantitatively, the existence of an optimal strategy persists. PMID:22513724

  7. BALANCER: A Computer Program for Balancing Chemical Equations.

    ERIC Educational Resources Information Center

    Jones, R. David; Schwab, A. Paul

    1989-01-01

    Describes the theory and operation of a computer program which was written to balance chemical equations. Software consists of a compiled file of 46K for use under MS-DOS 2.0 or later on IBM PC or compatible computers. Additional specifications of courseware and availability information are included. (Author/RT)

  8. 40 CFR 35.118 - Unexpended balances.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Unexpended balances. 35.118 Section 35... balances. Subject to any relevant provisions of law, if a recipient's Financial Status Report shows unexpended balances, the Regional Administrator will deobligate the unexpended balances and make them...

  9. 40 CFR 35.518 - Unexpended balances.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Unexpended balances. 35.518 Section 35... Unexpended balances. Subject to any relevant provisions of law, if a recipient's final Financial Status Report shows unexpended balances, the Regional Administrator will deobligate the unexpended balances and...

  10. Alternative Fuels Data Center: Lifecycle Energy Balance

    Science.gov Websites

    Energy Balance to someone by E-mail Share Alternative Fuels Data Center: Lifecycle Energy Balance on Facebook Tweet about Alternative Fuels Data Center: Lifecycle Energy Balance on Twitter Bookmark Alternative Fuels Data Center: Lifecycle Energy Balance on Google Bookmark Alternative Fuels Data Center

  11. 40 CFR 35.518 - Unexpended balances.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Unexpended balances. 35.518 Section 35... Unexpended balances. Subject to any relevant provisions of law, if a recipient's final Financial Status Report shows unexpended balances, the Regional Administrator will deobligate the unexpended balances and...

  12. 40 CFR 35.118 - Unexpended balances.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Unexpended balances. 35.118 Section 35... balances. Subject to any relevant provisions of law, if a recipient's Financial Status Report shows unexpended balances, the Regional Administrator will deobligate the unexpended balances and make them...

  13. Heider balance in human networks

    NASA Astrophysics Data System (ADS)

    Gawroński, P.; Kułakowski, K.

    2005-07-01

    Recently, a continuous dynamics was proposed to simulate dynamics of interpersonal relations in a society represented by a fully connected graph. The final state of such a society was found to be identical with the so-called Heider balance (HB), where the society is divided into two mutually hostile groups. In the continuous model, a polarization of opinions was found in HB. Here we demonstrate that the polarization occurs also in Barabási-Albert networks, where the Heider balance is not necessarily present. In the second part of this work we demonstrate the results of our formalism, when applied to reference examples: the Southern women and the Zachary club.

  14. Current balancing for battery strings

    DOEpatents

    Galloway, James H.

    1985-01-01

    A battery plant is described which features magnetic circuit means for balancing the electrical current flow through a pluraliircuitbattery strings which are connected electrically in parallel. The magnetic circuit means is associated with the battery strings such that the conductors carrying the electrical current flow through each of the battery strings pass through the magnetic circuit means in directions which cause the electromagnetic fields of at least one predetermined pair of the conductors to oppose each other. In an alternative embodiment, a low voltage converter is associated with each of the battery strings for balancing the electrical current flow through the battery strings.

  15. Dual shell pressure balanced vessel

    DOEpatents

    Fassbender, Alexander G.

    1992-01-01

    A dual-wall pressure balanced vessel for processing high viscosity slurries at high temperatures and pressures having an outer pressure vessel and an inner vessel with an annular space between the vessels pressurized at a pressure slightly less than or equivalent to the pressure within the inner vessel.

  16. A Balanced Higher Education System

    ERIC Educational Resources Information Center

    Brown, Roger

    2011-01-01

    This article explores what is meant by "a balanced higher education system". It argues that the Clarkian "triangle of coordination" (Clark, 1983) and the more recent model of Martinez and Richardson (2003) should be replaced by one that distinguishes between "self" and "collective" interests in both the…

  17. Face verification with balanced thresholds.

    PubMed

    Yan, Shuicheng; Xu, Dong; Tang, Xiaoou

    2007-01-01

    The process of face verification is guided by a pre-learned global threshold, which, however, is often inconsistent with class-specific optimal thresholds. It is, hence, beneficial to pursue a balance of the class-specific thresholds in the model-learning stage. In this paper, we present a new dimensionality reduction algorithm tailored to the verification task that ensures threshold balance. This is achieved by the following aspects. First, feasibility is guaranteed by employing an affine transformation matrix, instead of the conventional projection matrix, for dimensionality reduction, and, hence, we call the proposed algorithm threshold balanced transformation (TBT). Then, the affine transformation matrix, constrained as the product of an orthogonal matrix and a diagonal matrix, is optimized to improve the threshold balance and classification capability in an iterative manner. Unlike most algorithms for face verification which are directly transplanted from face identification literature, TBT is specifically designed for face verification and clarifies the intrinsic distinction between these two tasks. Experiments on three benchmark face databases demonstrate that TBT significantly outperforms the state-of-the-art subspace techniques for face verification.

  18. Burner balancing Salem Harbor Station

    SciTech Connect

    Sload, A.W.; Dube, R.J.

    The traditional method of burner balancing is first to determine the fuel distribution, then to measure the economizer outlet excess oxygen distribution and to adjust the burners accordingly. Fuel distribution is typically measured by clean and dirty air probing. Coal pipe flow can then be adjusted, if necessary, through the use of coal pipe orificing or by other means. Primary air flow must be adjusted to meet the design criteria of the burner. Once coal pipe flow is balanced to within the desired criteria, secondary air flow to individual burners can be changed by adjusting windbox dampers, burner registers, shroudsmore » or other devices in the secondary air stream. This paper discusses problems encountered in measuring excess O{sub 2} at the economizer outlet. It is important to recognize that O{sub 2} measurements at the economizer outlet, by themselves, can be very misleading. If measurement problems are suspected or encountered, an alternate approach similar to that described should be considered. The alternate method is not only useful for burner balancing but also can be used to help in calibrating the plant excess O{sub 2} instruments and provide an on line means of cross-checking excess air measurements. Balanced burners operate closer to their design stoichiometry, providing better NO{sub x} reduction. For Salem Harbor Station, this means a significant saving in urea consumption.« less

  19. No Such Thing as Balance

    ERIC Educational Resources Information Center

    Zigler, Ted

    2007-01-01

    The demands of the principalship today are keeping good people away. They do not want to deal with the demands on their time, the drive for great test scores, hovering parents, neglectful parents, teachers' needs, and the political hot spot that some schools have become in their communities. They do not see current principals finding balance and…

  20. The Mean as Balance Point

    ERIC Educational Resources Information Center

    O'Dell, Robin S.

    2012-01-01

    There are two primary interpretations of the mean: as a leveler of data (Uccellini 1996, pp. 113-114) and as a balance point of a data set. Typically, both interpretations of the mean are ignored in elementary school and middle school curricula. They are replaced with a rote emphasis on calculation using the standard algorithm. When students are…

  1. Learning from Balance Sheet Visualization

    ERIC Educational Resources Information Center

    Tanlamai, Uthai; Soongswang, Oranuj

    2011-01-01

    This exploratory study examines alternative visuals and their effect on the level of learning of balance sheet users. Executive and regular classes of graduate students majoring in information technology in business were asked to evaluate the extent of acceptance and enhanced capability of these alternative visuals toward their learning…

  2. Off-Balance Sheet Financing.

    ERIC Educational Resources Information Center

    Adams, Matthew C.

    1998-01-01

    Examines off-balance sheet financing, the facilities use of outsourcing for selected needs, as a means of saving operational costs and using facility assets efficiently. Examples of using outside sources for energy supply and food services, as well as partnering with business for facility expansion are provided. Concluding comments address tax…

  3. Balance functions in coalescence model

    NASA Astrophysics Data System (ADS)

    Bialas, A.

    2004-01-01

    It is shown that the quark-antiquark coalescence mechanism for pion production allows to explain the small pseudorapidity width of the balance function observed for central collisions of heavy ions, provided effects of the finite acceptance region and of the transverse flow are taken into account. In contrast, the standard hadronic cluster model is not compatible with this data.

  4. Dynamic balance in elite karateka.

    PubMed

    Zago, Matteo; Mapelli, Andrea; Shirai, Yuri Francesca; Ciprandi, Daniela; Lovecchio, Nicola; Galvani, Christel; Sforza, Chiarella

    2015-12-01

    In karate, balance control represents a key performance determinant. With the hypothesis that high-level athletes display advanced balance abilities, the purpose of the current study was to quantitatively investigate the motor strategies adopted by elite and non-elite karateka to maintain balance control in competition. The execution of traditional karate techniques (kihon) in two groups of elite Masters (n = 6, 31 ± 19 years) and non-elite Practitioners (n = 4, 25 ± 9 years) was compared assessing body center of mass (CoM) kinematics and other relevant parameters like step width and angular joint behavior. In the considered kihon sequence, normalized average CoM height was 8% lower (p < 0.05), while CoM displacement in the horizontal direction was significantly higher in Masters than in Practitioners (2.5 vs. 1.9 m, p < 0.05), as well as CoM average velocity and rms acceleration (p < 0.05). Step width was higher in Masters in more than half of the sequence steps (p < 0.05). Results suggest that elite karateka showed a refined dynamic balance control, obtained through the increase of the base of support and different maneuvers of lower limbs. The proposed method could be used to objectively detect talented karateka, to measure proficiency level and to assess training effectiveness. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Balancing Our Personal & Professional Lives.

    ERIC Educational Resources Information Center

    Amy, Chris; Smith, Becky F.

    1996-01-01

    Campus activities programmers are encouraged to balance roles by: remembering their time is valuable; accepting their own imperfection; saying "no" when necessary; taking care of themselves; learning to request help and delegate; giving best time and energy to what matters most; focusing on life's positives; developing support systems; keeping a…

  6. Walking on ballast impacts balance.

    PubMed

    Wade, Chip; Garner, John C; Redfern, Mark S; Andres, Robert O

    2014-01-01

    Railroad workers often perform daily work activities on irregular surfaces, specifically on ballast rock. Previous research and injury epidemiology have suggested a relationship between working on irregular surfaces and postural instability. The purpose of this study was to examine the impact of walking on ballast for an extended duration on standing balance. A total of 16 healthy adult males walked on a 7.62 m × 4.57 m (25 ft × 15 ft) walking surface of no ballast (NB) or covered with ballast (B) of an average rock size of about 1 inch for 4 h. Balance was evaluated using dynamic posturography with the NeuroCom(®) Equitest System(™) prior to experiencing the NB or B surface and again every 30 min during the 4 h of ballast exposure. Dependent variables were the sway velocity and root-mean-square (RMS) sway components in the medial-lateral and anterior-posterior directions. Repeated measures ANOVA revealed statistically significant differences in RMS and sway velocity between ballast surface conditions and across exposure times. Overall, the ballast surface condition induced greater sway in all of the dynamic posturography conditions. Walking on irregular surfaces for extended durations has a deleterious effect on balance compared to walking on a surface without ballast. These findings of changes in balance during ballast exposure suggest that working on an irregular surface may impact postural control.

  7. The Revenue vs. Service Balance

    ERIC Educational Resources Information Center

    Savarese, John

    2006-01-01

    Ten years ago, students at the University of Vermont (UVM) had to carry separate ID cards, meal cards, and athletic cards. Today, the single CATcard combines all of these functions, plus library privileges, an optional declining balance program called CAT$cratch, access to computer labs, use of vending machines without quarters, and even a ride on…

  8. Sustainability Education and Accounting Experience. What Motivates Higher Valuation of Environmental Performance?: A Commentary on "Rhetoric or Reality? Do Accounting Education and Experience Increase Weighting on Environmental Performance in a Balanced Scorecard?"

    ERIC Educational Resources Information Center

    Schaltegger, Stefan

    2013-01-01

    Accounting has been accused of being a cause of unsustainable management, but is also seen as being a means to support corporate sustainability and improvement. In both views the introduction of environmental and sustainability topics in accounting education is widely supported. The main finding from the study by Wynder, Wellner, and Reinhard…

  9. Work-life balancing: challenges and strategies.

    PubMed

    Chittenden, Eva H; Ritchie, Christine S

    2011-07-01

    Balancing the personal and the professional is an ongoing struggle for most professionals, and palliative care clinicians are no exception. A sustained lack of balance can lead to feelings of frustration, inadequacy, and guilt. Palliative care physicians may find this balance particularly difficult due to the nature of their work: caring for patients and families who are often suffering and in crisis. In this article, we describe challenges to work-life balancing and strategies that may promote balance, including "timeshifting," goal setting, cognitive reframing, and self-care. We argue that the search for balance is a lifelong endeavor that entails self-reflection and continuing examination of one's values and goals.

  10. Balanced pressure gerotor fuel pump

    DOEpatents

    Raney, Michael Raymond; Maier, Eugen

    2004-08-03

    A gerotor pump for pressurizing gasoline fuel is capable of developing pressures up to 2.0 MPa with good mechanical and volumetric efficiency and satisfying the durability requirements for an automotive fuel pump. The pump has been designed with optimized clearances and by including features that promote the formation of lubricating films of pressurized fuel. Features of the improved pump include the use of a shadow port in the side plate opposite the outlet port to promote balancing of high fuel pressures on the opposite sides of the rotors. Inner and outer rotors have predetermined side clearances with the clearances of the outer rotor being greater than those of the inner rotor in order to promote fuel pressure balance on the sides of the outer rotor. Support of the inner rotor and a drive shaft on a single bushing with bearing sleeves maintains concentricity. Additional features are disclosed.

  11. A balancing act for autophagin.

    PubMed

    Till, Andreas; Subramani, Suresh

    2010-07-01

    Autophagy is a tightly regulated catabolic process whereby cells degrade their constituents to dispose of unwanted cytoplasmic elements and recycle nutrients for cellular remodeling. Studies of autophagy in mammals have elicited substantial interest because it is linked to a range of physiologic and pathologic states. In this issue of the JCI, Mariño et al. uncover a role for autophagy in a balance disorder related to inner ear pathologies. Mice lacking the protease autophagy-related 4B (Atg4b, also known as autophagin-1) exhibited a systemic reduction in autophagy and showed defects in the development of otoconia, organic particles that contain calcium carbonate crystals and proteins and that are essential for balance perception (equilibrioception) in mammals. The intriguing aspect of this work is that an autophagy block impairs the secretion and assembly of otoconial proteins, emphasizing a role for autophagy in functions distinct from macromolecule degradation.

  12. Halo vest effect on balance.

    PubMed

    Richardson, J K; Ross, A D; Riley, B; Rhodes, R L

    2000-03-01

    To determine the effect of a halo vest, a cervical orthosis, on clinically relevant balance parameters. Subjects performed unipedal stance (with eyes open and closed, on both firm and soft surfaces) and functional reach, with and without the application of a halo vest. A convenience sample of 12 healthy young subjects, with an equal number of men and women. Seconds for unipedal stance (maximum 45); inches for functional reach. Both unipedal stance times and functional reach (mean +/- standard deviation) were significantly decreased with the halo vest as compared to without it (29.1+/-5.8 vs. 32.8+/-6.4 seconds, p = .002; 12.9+/-1.4 vs. 15.1+/-2.1 inches, p<.01). A halo vest causes an acute impairment in balance in the healthy young. It is likely that the impairment would be greater in older or injured patients, thus increasing their risk for a fall, which could have devastating consequences.

  13. Cyber Operations: The New Balance

    DTIC Science & Technology

    2009-01-01

    compelling evidence to suggest that enlight - enment, rather than retrenchment, is the path for cyber New Balance. The economic calamity of the Great...www.guardian.co.uk/ technology /2008/ oct/02/interviews.internet>. 16 Langevin, 11. 17 James Lewis, “Cyber Security Recommen- dations for the Next...Administration,” testimony before House Subcommittee on Emerging Threats, Cyber Security, and Science and Technology , Washington, DC, September 16

  14. Force-Balance Dynamic Display

    NASA Technical Reports Server (NTRS)

    Ferris, Alice T.; White, William C.

    1988-01-01

    Balance dynamic display unit (BDDU) is compact system conditioning six dynamic analog signals so they are monitored simultaneously in real time on single-trace oscilloscope. Typical BDDU oscilloscope display in scan mode shows each channel occupying one-sixth of total trace. System features two display modes usable with conventional, single-channel oscilloscope: multiplexed six-channel "bar-graph" format and single-channel display. Two-stage visual and audible limit alarm provided for each channel.

  15. Constrained Allocation Flux Balance Analysis

    PubMed Central

    Mori, Matteo; Hwa, Terence; Martin, Olivier C.

    2016-01-01

    New experimental results on bacterial growth inspire a novel top-down approach to study cell metabolism, combining mass balance and proteomic constraints to extend and complement Flux Balance Analysis. We introduce here Constrained Allocation Flux Balance Analysis, CAFBA, in which the biosynthetic costs associated to growth are accounted for in an effective way through a single additional genome-wide constraint. Its roots lie in the experimentally observed pattern of proteome allocation for metabolic functions, allowing to bridge regulation and metabolism in a transparent way under the principle of growth-rate maximization. We provide a simple method to solve CAFBA efficiently and propose an “ensemble averaging” procedure to account for unknown protein costs. Applying this approach to modeling E. coli metabolism, we find that, as the growth rate increases, CAFBA solutions cross over from respiratory, growth-yield maximizing states (preferred at slow growth) to fermentative states with carbon overflow (preferred at fast growth). In addition, CAFBA allows for quantitatively accurate predictions on the rate of acetate excretion and growth yield based on only 3 parameters determined by empirical growth laws. PMID:27355325

  16. Efficacy of virtual reality-based balance training versus the Biodex balance system training on the body balance of adults

    PubMed Central

    Ibrahim, Manal S.; Mattar, Ayman G.; Elhafez, Salam M.

    2016-01-01

    [Purpose] This study investigated efficacy of virtual reality (VR)-based balance training on enhancing balance and postural reactions of adults as a low-cost new modality compared to the established Biodex Balance System (BBS). [Subjects] Thirty normal adults of both genders were divided randomly into two equal-sized experimental groups of 15: BBS balance training and VR balance training. [Methods] The training programmes were conducted in 12 sessions, three 15-min sessions per week. The Nintendo® Wii Fit Plus (NWFP) and its balance board were used to train of the VR group. Each participant answered a questionnaire concerning usability, enjoyment, balance improvement, and fatigue at the end of the training programs. [Results] The study found a significant increase the measure of mean overall balance (OLB) in both groups. No significant difference was found between the groups, but a significant decrease in the mean balance-test time was found for both groups, with no significant difference between the two training methods. The VR programme was rated highly enjoyable by 81.8% of the group. [Conclusion] The Wii Fit Plus system with the balance board as a new VR balance-training technique, can be considered an effective and enjoyable tool for the training of adults’ body balance. PMID:26957722

  17. Towards balanced development in Pakistan.

    PubMed

    Pyatt, G

    1992-01-01

    Pakistan is a country whose economic growth is surprising in light of its social indicators. The aim of this article is to examine why conditions are such and to develop a framework for understanding the issues as an aid to redesigning policies. 5 sections are devoted to a summary of the main findings, the diagnosis of development and the impact on social sectors, a proposal for balanced development, and implications for policy changes. A sound macro economic context is needed with reforms economically in price and incentive systems, institutionally, and in the law and order sector. Public administration needs to be improved and individual opportunities need to be expanded. Internal security needs to be secured, so that law and order are restored. Economic growth has been high between 1960 and 1988, due to exploitation of natural resources and cheap unskilled labor, expansion of irrigated land, and growth of the unregulated informal sector. The major constraints on economic growth will come from a lack of fiscal discipline. 40% of government revenues are consumed by the military and 20% for servicing debt. Other constraints are the population growth rate in excess of 3%/year, an urban bias in allocation of resources, neglected primary education, and gender bias in education. There has been little incentive for provincial governments to balance budgets, and civil service has become disorganized. Balanced development entails recognizing human capital, natural resources, and infrastructure; accepting the status quo; and creating and maintaining an institutional framework to correct market failures and promote individual opportunities. The environmental polluter must pay. Income must be increased through higher wages, increasing the demand for labor, and transfers to households in the form of food rations, schooling, and medical care. Investment in women will increase household earnings, and improve living conditions and the health of themselves and their children

  18. [Striking the work-life balance].

    PubMed

    Dumas, Marc

    2014-11-01

    Solutions for finding a satisfactory balance between home life and work lie in the organisation of work and the work environment. Line managers in particular have a key role to play in helping their staff maintain this balance.

  19. The balance principle in scientific research.

    PubMed

    Hu, Liang-ping; Bao, Xiao-lei; Wang, Qi

    2012-05-01

    The principles of balance, randomization, control and repetition, which are closely related, constitute the four principles of scientific research. The balance principle is the kernel of the four principles which runs through the other three. However, in scientific research, the balance principle is always overlooked. If the balance principle is not well performed, the research conclusion is easy to be denied, which may lead to the failure of the whole research. Therefore, it is essential to have a good command of the balance principle in scientific research. This article stresses the definition and function of the balance principle, the strategies and detailed measures to improve balance in scientific research, and the analysis of the common mistakes involving the use of the balance principle in scientific research.

  20. Carbon balance of the Alaskan boreal forest

    Treesearch

    John Yarie; Tim Hammond

    1996-01-01

    Determination of the carbon balance in a broad forest region like the Alaskan boreal forest requires the development of a number of important environmental (state factors) classes to allow for the development of carbon balance estimates.

  1. State of balance of the cryosphere

    NASA Technical Reports Server (NTRS)

    Van Der Veen, C. J.

    1991-01-01

    Available observations and mass balance estimates of the cryosphere are summarized. Problems discussed include mountain glaciers, the Greenland ice sheet, the Antarctic ice sheet, conventional glacier measurement techniques, and satellite applications in glacier mass balance studies. It is concluded that the interior part of the Greenland ice sheet is thickening or in near equilibrium. Estimates of the mass balance of the Antarctic ice sheet suggest that it is positive, although the error limits allow for a slightly negative balance.

  2. Leadership and Work-Life Balance.

    PubMed

    Mattock, Sarah L

    2015-01-01

    Simply stated, work-life balance is something that is both difficult to define and difficult to achieve. Leaders, throughout the continuum of trauma care, need to have a sound understanding of what work-life balance means and set an example of a healthy work-life balance for those they lead. This article offers strategies for enhancing work-life balance and challenges individuals to use self-reflection as a means to furthering their personal and professional growth.

  3. 14 CFR 23.659 - Mass balance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Mass balance. 23.659 Section 23.659 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... Surfaces § 23.659 Mass balance. The supporting structure and the attachment of concentrated mass balance...

  4. 14 CFR 29.659 - Mass balance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Mass balance. 29.659 Section 29.659... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor... flutter at any speed up to the maximum forward speed. (b) The structural integrity of the mass balance...

  5. 14 CFR 27.659 - Mass balance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Mass balance. 27.659 Section 27.659... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors... flutter at any speed up to the maximum forward speed. (b) The structural integrity of the mass balance...

  6. 14 CFR 27.659 - Mass balance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Mass balance. 27.659 Section 27.659... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors... flutter at any speed up to the maximum forward speed. (b) The structural integrity of the mass balance...

  7. 14 CFR 23.659 - Mass balance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Mass balance. 23.659 Section 23.659 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... Surfaces § 23.659 Mass balance. The supporting structure and the attachment of concentrated mass balance...

  8. 14 CFR 29.659 - Mass balance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Mass balance. 29.659 Section 29.659... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor... flutter at any speed up to the maximum forward speed. (b) The structural integrity of the mass balance...

  9. 14 CFR 29.659 - Mass balance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Mass balance. 29.659 Section 29.659...

  10. 14 CFR 27.659 - Mass balance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Mass balance. 27.659 Section 27.659...

  11. 14 CFR 29.659 - Mass balance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Mass balance. 29.659 Section 29.659...

  12. 14 CFR 27.659 - Mass balance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Mass balance. 27.659 Section 27.659...

  13. 14 CFR 27.659 - Mass balance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.659 Mass balance. (a) The rotors and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Mass balance. 27.659 Section 27.659...

  14. 14 CFR 29.659 - Mass balance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.659 Mass balance. (a) The rotor and blades must be mass balanced as necessary to— (1) Prevent excessive vibration; and (2) Prevent... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Mass balance. 29.659 Section 29.659...

  15. Espectroscopia del Cometa Halley

    NASA Astrophysics Data System (ADS)

    Naranjo, O.; Fuenmayor, F.; Ferrin, L.; Bulka, P.; Mendoza, C.

    1987-05-01

    Se reportan observaciones espectroscópicas del cometa Halley. Los espectros fueron tomados usando el espectrógrafo del telescopio reflector de 1 metro del Observatorio Nacional de Venezuela. Se utilizó óptica azul, con una red de difracción de 600 lineas/min, obteniéndose una dispersión de 74.2 A/mm y una resolución de 2.5 A, en el rango espectral de 3500 a 6500 A. Seis placas fueron tomadas con emulsión IIa-O y dos con IIa-D. Los tiempos de exposición fueron entre 10 y 150 minutos. El cometa se encontraba entre 0.70 y 1.04 UA del Sol, y entre 1.28 y 0.73 UA de la Tierra. Las emisiones más prominentes en el espectro, son las del CN, C2, y C3. Otras emisiones detectadas corresponden a CH, NH2 y Na. Los espectros muestran un fuerte continuo, indicando un contenido significativo de polvo. Se detectó mayor intensidad del contínuo, en la dirección anti solar, lo cual es evidencia de la cola de polvo.

  16. Hatha yoga on body balance

    PubMed Central

    Prado, Erick Tadeu; Raso, Vagner; Scharlach, Renata Coelho; Kasse, Cristiane Akemi

    2014-01-01

    Background: A good body balance requires a proper function of vestibular, visual, and somatosensory systems which can be reach with exercise practice and/or yoga. Aim: To determine the effects of a 5-month hatha yoga training program on body balance in young adults. Materials and Methods: This study used a controlled, nonrandomized design, where the experimental group underwent a 5-month training program and were then compared with the control group that had a sedentary lifestyle. A convenience sample of 34 out of 40 men aged 25-55 years old (34.0 ± 0.9) were deemed eligible for this study. They were randomly divided into two groups: Experimental and control groups. Subjects in the experimental group were engaged in 60 min sessions of hatha yoga three times a week for 5 months. We evaluated postural control by measuring the limit of stability and velocity of oscillation (VOS) in three conditions of the balance rehabilitation unit (BRU) and through field procedures (four position, plane, flamingo, hopscotch, and dynamic test). Results: We observed differences (P < 0.05) in postintervention scores between the groups regardless of BRU parameters and field procedures (except for flamingo) even after adjusting for preintervention scores, suggesting that these changes were induced by hatha yoga training. The partial eta squared on BRU parameters ranged from 0.78 (VOS1)-0.97 (COP2), and from 0.00 (flamingo)-0.94 (four position) for the field procedures. Conclusions: Our results provide substantial evidence that postural control in healthy young adults can be improved through practicing hatha yoga. PMID:25035623

  17. Calcium Balance in Chronic Kidney Disease.

    PubMed

    Hill Gallant, Kathleen M; Spiegel, David M

    2017-06-01

    The kidneys play a critical role in the balance between the internal milieu and external environment. Kidney failure is known to disrupt a number of homeostatic mechanisms that control serum calcium and normal bone metabolism. However, our understanding of calcium balance throughout the stages of chronic kidney disease is limited and the concept of balance itself, especially with a cation as complex as calcium, is often misunderstood. Both negative and positive calcium balance have important implications in patients with chronic kidney disease, where negative balance may increase risk of osteoporosis and fracture and positive balance may increase risk of vascular calcification and cardiovascular events. Here, we examine the state of current knowledge about calcium balance in adults throughout the stages of chronic kidney disease and discuss recommendations for clinical strategies to maintain balance as well as future research needs in this area. Recent calcium balance studies in adult patients with chronic kidney disease show that neutral calcium balance is achieved with calcium intake near the recommended daily allowance. Increases in calcium through diet or supplements cause high positive calcium balance, which may put patients at risk for vascular calcification. However, heterogeneity in calcium balance exists among these patients. Given the available calcium balance data in this population, it appears clinically prudent to aim for recommended calcium intakes around 1000 mg/day to achieve neutral calcium balance and avoid adverse effects of either negative or positive calcium balance. Assessment of patients' dietary calcium intake could further equip clinicians to make individualized recommendations for meeting recommended intakes.

  18. Skylight energy balance analysis procedure

    SciTech Connect

    Dietz, P.S.; Murdoch, J.B.; Pokoski, J.L.

    1981-10-01

    This paper provides a systematic method for calculating the total, net differential energy balance observed when sections of the roof of a building are replaced with skylights. Among the topics discussed are the effect of solar gains, dome and curb conduction heat transfers, equivalent roof area heat transfers, infiltration heat transfers, artificial lighting energy requirements, and illumination savings from skylights. The paper also provides much of the supplementary information needed to complete these energy calculations. This information appears in the form of appendices, tables, and graphs. 9 refs.

  19. Energy landscape of social balance.

    PubMed

    Marvel, Seth A; Strogatz, Steven H; Kleinberg, Jon M

    2009-11-06

    We model a close-knit community of friends and enemies as a fully connected network with positive and negative signs on its edges. Theories from social psychology suggest that certain sign patterns are more stable than others. This notion of social "balance" allows us to define an energy landscape for such networks. Its structure is complex: numerical experiments reveal a landscape dimpled with local minima of widely varying energy levels. We derive rigorous bounds on the energies of these local minima and prove that they have a modular structure that can be used to classify them.

  20. On the balanced quantum hashing

    NASA Astrophysics Data System (ADS)

    Ablayev, F.; Ablayev, M.; Vasiliev, A.

    2016-02-01

    In the paper we define a notion of a resistant quantum hash function which combines a notion of pre-image (one-way) resistance and the notion of collision resistance. In the quantum setting one-way resistance property and collision resistance property are correlated: the “more” a quantum function is one-way resistant the “less” it is collision resistant and vice versa. We present an explicit quantum hash function which is “balanced” one-way resistant and collision resistant and demonstrate how to build a large family of balanced quantum hash functions.

  1. 26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Effect of prefunding balance and funding standard carryover balance. 1.430(f)-1 Section 1.430(f)-1 Internal Revenue INTERNAL REVENUE SERVICE... § 1.430(f)-1 Effect of prefunding balance and funding standard carryover balance. (a) In general—(1...

  2. 26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Effect of prefunding balance and funding standard carryover balance. 1.430(f)-1 Section 1.430(f)-1 Internal Revenue INTERNAL REVENUE SERVICE... Effect of prefunding balance and funding standard carryover balance. (a) In general—(1) Overview. This...

  3. Effect of Selected Balance Exercises on the Dynamic Balance of Children with Visual Impairments

    ERIC Educational Resources Information Center

    Jazi, Shirin Davarpanah; Purrajabi, Fatemeh; Movahedi, Ahmadreza; Jalali, Shahin

    2012-01-01

    Introduction: Maintaining balance while walking is of utmost importance for individuals with visual impairments because deficits in dynamic balance have been associated with a high risk of falling. Thus, the primary aim of the study presented here was to determine whether balance training effects the dynamic balance of children with visual…

  4. Engine balance apparatus and accessory drive device

    NASA Technical Reports Server (NTRS)

    Brogdon, James William (Inventor); Gill, David Keith (Inventor)

    2000-01-01

    A balancing mechanism for an engine that has a rotating crankshaft and reciprocating pistons such as those engines used in automobiles, aircrafts, boats, piston-driven compressors, piston-driven slider crank mechanisms, etc. The present balancing mechanism may comprise a first balance mass non-rotatably affixed to the crankshaft and a second balance mass rotatably supported on the crankshaft. A driver assembly is affixed to crankshaft to cause the second balance mass to rotate in a direction that is opposite to the direction in which the crank shaft is rotating. The driver assembly may include auxiliary gears configured to transport rotary power to auxiliary components.

  5. Rotary balances: A selected, annotated bibliography

    NASA Technical Reports Server (NTRS)

    Tuttle, Marie H.; Kilgore, Robert A.; Sych, Karen L.

    1989-01-01

    This bibliography on rotary balances contains 102 entries. It is part of NASA's support of the AGARD Fluid Dynamics Panel Working Group 11 on Rotary Balances. This bibliography includes works that might be useful to anyone interested in building or using rotor balances. Emphasis is on the rotary balance rigs and testing techniques rather than the aerodynamic data. Also included are some publications of historical interest which relate to key events in the development and use of rotary balances. The arrangement is chronological by date of publication in the case of reports and by presentation in the case of papers.

  6. The Six-Component Wind Balance

    NASA Technical Reports Server (NTRS)

    Zahm, A F

    1923-01-01

    Dr. Zahm's report is a description of the six-component wind-tunnel balance in use at the Aerodynamic Laboratory, Washington Navy Yard. The description of the balance gives the mechanical details and the method of operation, and is accompanied by line drawings showing the construction of the balance. The balance is of particular interest, as it allows the model to be set up quickly and accurately in roll, pitch, and yaw, without stopping the wind. It is possible to measure automatically, directly, and independently the drag, cross-wind force, and lift; also the rolling, pitching, and yawing moments. It is also possible to make the balance self-recording.

  7. Field balancing in the real world

    SciTech Connect

    Bracher, B.

    Field balancing can achieve significant results when other problems are present in the frequency spectrum and multiple vibrations are evident in the waveform. Many references suggest eliminating other problems before attempting to balance. That`s great - if you can do it. There are valid reasons for this approach, and it would be much easier to balance machinery when other problems have been corrected. It is the theoretical ideal in field balancing. However, in the real world of machinery maintained for years by reacting to immediate problems, the classic vibration signature for unbalance is rarely seen. Maintenance personnel make most ofmore » their decisions with limited information. The decision to balance or not to balance is usually made the same way. This paper will demonstrate significant results of field balancing in the presence of multiple problems. By examining the data available and analyzing the probabilities, a reasonable chance for success can be assured.« less

  8. Control Allocation with Load Balancing

    NASA Technical Reports Server (NTRS)

    Bodson, Marc; Frost, Susan A.

    2009-01-01

    Next generation aircraft with a large number of actuators will require advanced control allocation methods to compute the actuator commands needed to follow desired trajectories while respecting system constraints. Previously, algorithms were proposed to minimize the l1 or l2 norms of the tracking error and of the actuator deflections. The paper discusses the alternative choice of the l(infinity) norm, or sup norm. Minimization of the control effort translates into the minimization of the maximum actuator deflection (min-max optimization). The paper shows how the problem can be solved effectively by converting it into a linear program and solving it using a simplex algorithm. Properties of the algorithm are also investigated through examples. In particular, the min-max criterion results in a type of load balancing, where the load is th desired command and the algorithm balances this load among various actuators. The solution using the l(infinity) norm also results in better robustness to failures and to lower sensitivity to nonlinearities in illustrative examples.

  9. Balanced branching in transcription termination.

    PubMed

    Harrington, K J; Laughlin, R B; Liang, S

    2001-04-24

    The theory of stochastic transcription termination based on free-energy competition [von Hippel, P. H. & Yager, T. D. (1992) Science 255, 809-812 and von Hippel, P. H. & Yager, T. D. (1991) Proc. Natl. Acad. Sci. USA 88, 2307-2311] requires two or more reaction rates to be delicately balanced over a wide range of physical conditions. A large body of work on glasses and large molecules suggests that this balancing should be impossible in such a large system in the absence of a new organizing principle of matter. We review the experimental literature of termination and find no evidence for such a principle, but do find many troubling inconsistencies, most notably, anomalous memory effects. These effects suggest that termination has a deterministic component and may conceivably not be stochastic at all. We find that a key experiment by Wilson and von Hippel [Wilson, K. S. & von Hippel, P. H. (1994) J. Mol. Biol. 244, 36-51] thought to demonstrate stochastic termination was an incorrectly analyzed regulatory effect of Mg(2+) binding.

  10. Mass balance assessment using GPS

    NASA Technical Reports Server (NTRS)

    Hulbe, Christina L.

    1993-01-01

    Mass balance is an integral part of any comprehensive glaciological investigation. Unfortunately, it is hard to determine at remote locations where there is no fixed reference. The Global Positioning System (GPS) offers a solution. Simultaneous GPS observations at a known location and the remote field site, processed differentially, will accurately position the camp site. From there, a monument planted in the firn atop the ice can also be accurately positioned. Change in the monument's vertical position is a direct indicator of ice thickness change. Because the monument is not connected to the ice, its motion is due to both mass balance change and to the settling of firn as it densifies into ice. Observations of relative position change between the monument and anchors at various depths within the firn are used to remove the settling effect. An experiment to test this method has begun at Byrd Station on the West Antarctic Ice Sheet and the first epoch of observations was made. Analysis indicates that positioning errors will be very small. It appears likely that the largest errors involved with this technique will arise from ancillary data needed to determine firn settling.

  11. Differential force balances during levitation

    NASA Astrophysics Data System (ADS)

    Todd, Paul

    The simplest arithmetic of inertial, buoyant, magnetic and electrokinetic levitation is explored in the context of a model living system with “acceleration-sensitive structures” in which motion, if allowed, produces a biological effect. The simple model is a finite-sized object enclosed within another finite-sized object suspended in an outer fluid (liquid or vapor) medium. The inner object has density and electrical and magnetic properties quantitatively different from those of the outer object and the medium. In inertial levitation (“weightlessness”) inertial accelerations are balanced, and the forces due to them are canceled in accordance with Newton’s third law. In the presence of inertial acceleration (gravity, centrifugal) motionlessness depends on a balance between the levitating force and the inertial force. If the inner and outer objects differ in density one or the other will be subjected to an unbalanced force when one object is levitated by any other force (buoyant, magnetic, electrokinetic). The requirements for motionlessness of the internal object in the presence of a levitating force are equality of density in the case of buoyant levitation, equality of magnetic susceptibility in the case of magnetic levitation, and equality of zeta potential and dielectric constant in the case of electrokinetic levitation. Examples of internal “acceleration-sensitive structures” are cellular organelles and the organs of advanced plants and animals. For these structures fundamental physical data are important in the interpretation of the effects of forces used for levitation.

  12. Differential Sensitivity Between a Virtual Reality Balance Module and Clinically Used Concussion Balance Modalities.

    PubMed

    Teel, Elizabeth F; Gay, Michael R; Arnett, Peter A; Slobounov, Semyon M

    2016-03-01

    Balance assessments are part of the recommended clinical concussion evaluation, along with computerized neuropsychological testing and self-reported symptoms checklists. New technology has allowed for the creation of virtual reality (VR) balance assessments to be used in concussion care, but there is little information on the sensitivity and specificity of these evaluations. The purpose of this study is to establish the sensitivity and specificity of a VR balance module for detecting lingering balance deficits clinical concussion care. Retrospective case-control study. Institutional research laboratory. Normal controls (n = 94) and concussed participants (n = 27). All participants completed a VR balance assessment paradigm. Concussed participants were diagnosed by a Certified Athletic Trainer or physician (with 48 hours postinjury) and tested in the laboratory between 7 and 10 days postinjury. Receiver operating characteristic curves were performed to establish the VR module's sensitivity and specificity for detecting lingering balance deficits. Final balance score. For the VR balance module, a cutoff score of 8.25 was established to maximize sensitivity at 85.7% and specificity at 87.8%. The VR balance module has high sensitivity and specificity for detecting subacute balance deficits after concussive injury. The VR balance has a high subacute sensitivity and specificity as a stand-alone balance assessment tool and may detect ongoing balance deficits not readily detectable by the Balance Error Scoring System or Sensory Organization Test. Virtual reality balance modules may be a beneficial addition to the current clinical concussion diagnostic battery.

  13. Cell phone based balance trainer

    PubMed Central

    2012-01-01

    Background In their current laboratory-based form, existing vibrotactile sensory augmentation technologies that provide cues of body motion are impractical for home-based rehabilitation use due to their size, weight, complexity, calibration procedures, cost, and fragility. Methods We have designed and developed a cell phone based vibrotactile feedback system for potential use in balance rehabilitation training in clinical and home environments. It comprises an iPhone with an embedded tri-axial linear accelerometer, custom software to estimate body tilt, a "tactor bud" accessory that plugs into the headphone jack to provide vibrotactile cues of body tilt, and a battery. Five young healthy subjects (24 ± 2.8 yrs, 3 females and 2 males) and four subjects with vestibular deficits (42.25 ± 13.5 yrs, 2 females and 2 males) participated in a proof-of-concept study to evaluate the effectiveness of the system. Healthy subjects used the system with eyes closed during Romberg, semi-tandem Romberg, and tandem Romberg stances. Subjects with vestibular deficits used the system with both eyes-open and eyes-closed conditions during semi-tandem Romberg stance. Vibrotactile feedback was provided when the subject exceeded either an anterior-posterior (A/P) or a medial-lateral (M/L) body tilt threshold. Subjects were instructed to move away from the vibration. Results The system was capable of providing real-time vibrotactile cues that informed corrective postural responses. When feedback was available, both healthy subjects and those with vestibular deficits significantly reduced their A/P or M/L RMS sway (depending on the direction of feedback), had significantly smaller elliptical area fits to their sway trajectory, spent a significantly greater mean percentage time within the no feedback zone, and showed a significantly greater A/P or M/L mean power frequency. Conclusion The results suggest that the real-time feedback provided by this system can be used to reduce body sway. Its

  14. Cell phone based balance trainer.

    PubMed

    Lee, Beom-Chan; Kim, Jeonghee; Chen, Shu; Sienko, Kathleen H

    2012-02-08

    In their current laboratory-based form, existing vibrotactile sensory augmentation technologies that provide cues of body motion are impractical for home-based rehabilitation use due to their size, weight, complexity, calibration procedures, cost, and fragility. We have designed and developed a cell phone based vibrotactile feedback system for potential use in balance rehabilitation training in clinical and home environments. It comprises an iPhone with an embedded tri-axial linear accelerometer, custom software to estimate body tilt, a "tactor bud" accessory that plugs into the headphone jack to provide vibrotactile cues of body tilt, and a battery. Five young healthy subjects (24 ± 2.8 yrs, 3 females and 2 males) and four subjects with vestibular deficits (42.25 ± 13.5 yrs, 2 females and 2 males) participated in a proof-of-concept study to evaluate the effectiveness of the system. Healthy subjects used the system with eyes closed during Romberg, semi-tandem Romberg, and tandem Romberg stances. Subjects with vestibular deficits used the system with both eyes-open and eyes-closed conditions during semi-tandem Romberg stance. Vibrotactile feedback was provided when the subject exceeded either an anterior-posterior (A/P) or a medial-lateral (M/L) body tilt threshold. Subjects were instructed to move away from the vibration. The system was capable of providing real-time vibrotactile cues that informed corrective postural responses. When feedback was available, both healthy subjects and those with vestibular deficits significantly reduced their A/P or M/L RMS sway (depending on the direction of feedback), had significantly smaller elliptical area fits to their sway trajectory, spent a significantly greater mean percentage time within the no feedback zone, and showed a significantly greater A/P or M/L mean power frequency. The results suggest that the real-time feedback provided by this system can be used to reduce body sway. Its advantages over more complex

  15. Occupational balance in health professionals in Sweden.

    PubMed

    Wagman, Petra; Lindmark, Ulrika; Rolander, Bo; Wåhlin, Charlotte; Håkansson, Carita

    2017-01-01

    Health care employees are often women, a group that has high degrees of sick leave and perhaps problems attaining occupational balance. However, people think differently about their everyday activities and it is therefore important to take their perceptions into account but occupational balance has not yet been measured in health professionals. The aim was to describe occupational balance in three different samples of health professionals in Sweden. A further aim was to investigate whether occupational therapists (OTs) rate their occupational balance differently from other health professionals. Four hundred and eighty-two health professionals, employees in public dentistry, mental health care and OTs, aged 21-70 years participated. The participants' occupational balance was measured using the occupational balance questionnaire (OBQ). The ratings of occupational balance were similar to earlier studies and did not differ significantly between the samples. The OTs' occupational balance was also similar to that of the other health professionals. The similarities in occupational balance indicate the same difficulties in attaining it. The result highlights the possibility that working people face similar difficulties in achieving occupational balance. Further research is warranted about how to attain it.

  16. Balancing the quality of consent.

    PubMed Central

    Hansson, M O

    1998-01-01

    The rule that one must obtain informed consent is well established in medical ethics and an intrinsic part of clinical practice and of research in biomedicine. However, there is a tendency that the rule today is being applied too rigidly and with too little sensitivity to the values that are at stake in connection with different kinds of research protocols. It is here argued that the quality of consent needs to be balanced against variables such as degree of confidentiality and importance of values at stake, in order to be ethically acceptable. Appropriate information and consent procedures should be adjusted accordingly. Three levels are suggested, ranging from extensively informed consent with both written and oral information, through informed refusal with only a limited amount of information given to, at the other end of the scale, just making relevant information available. PMID:9650113

  17. Balanced Branching in Transcription Termination

    NASA Technical Reports Server (NTRS)

    Harrington, K. J.; Laughlin, R. B.; Liang, S.

    2001-01-01

    The theory of stochastic transcription termination based on free-energy competition requires two or more reaction rates to be delicately balanced over a wide range of physical conditions. A large body of work on glasses and large molecules suggests that this should be impossible in such a large system in the absence of a new organizing principle of matter. We review the experimental literature of termination and find no evidence for such a principle but many troubling inconsistencies, most notably anomalous memory effects. These suggest that termination has a deterministic component and may conceivably be not stochastic at all. We find that a key experiment by Wilson and von Hippel allegedly refuting deterministic termination was an incorrectly analyzed regulatory effect of Mg(2+) binding.

  18. Device for balancing parallel strings

    DOEpatents

    Mashikian, Matthew S.

    1985-01-01

    A battery plant is described which features magnetic circuit means in association with each of the battery strings in the battery plant for balancing the electrical current flow through the battery strings by equalizing the voltage across each of the battery strings. Each of the magnetic circuit means generally comprises means for sensing the electrical current flow through one of the battery strings, and a saturable reactor having a main winding connected electrically in series with the battery string, a bias winding connected to a source of alternating current and a control winding connected to a variable source of direct current controlled by the sensing means. Each of the battery strings is formed by a plurality of batteries connected electrically in series, and these battery strings are connected electrically in parallel across common bus conductors.

  19. Improve SSME power balance model

    NASA Technical Reports Server (NTRS)

    Karr, Gerald R.

    1992-01-01

    Effort was dedicated to development and testing of a formal strategy for reconciling uncertain test data with physically limited computational prediction. Specific weaknesses in the logical structure of the current Power Balance Model (PBM) version are described with emphasis given to the main routing subroutines BAL and DATRED. Selected results from a variational analysis of PBM predictions are compared to Technology Test Bed (TTB) variational study results to assess PBM predictive capability. The motivation for systematic integration of uncertain test data with computational predictions based on limited physical models is provided. The theoretical foundation for the reconciliation strategy developed in this effort is presented, and results of a reconciliation analysis of the Space Shuttle Main Engine (SSME) high pressure fuel side turbopump subsystem are examined.

  20. Energy-balance climate models

    NASA Technical Reports Server (NTRS)

    North, G. R.; Cahalan, R. F.; Coakley, J. A., Jr.

    1980-01-01

    An introductory survey of the global energy balance climate models is presented with an emphasis on analytical results. A sequence of increasingly complicated models involving ice cap and radiative feedback processes are solved and the solutions and parameter sensitivities are studied. The model parameterizations are examined critically in light of many current uncertainties. A simple seasonal model is used to study the effects of changes in orbital elements on the temperature field. A linear stability theorem and a complete nonlinear stability analysis for the models are developed. Analytical solutions are also obtained for the linearized models driven by stochastic forcing elements. In this context the relation between natural fluctuation statistics and climate sensitivity is stressed.

  1. Balancing Teacher Quality and Quantity

    NASA Astrophysics Data System (ADS)

    Bond, Helen

    The world is facing a shortage of trained teachers. According to the 2010 Global Monitoring Report approximately 10.3 million teachers will be needed globally to staff classrooms from Bangkok to Canada. The situation is worse in Sub-Saharan Africa. Estimates suggest that approximately 1.2 million new teachers will be needed in Sub-Saharan Africa alone to achieve universal primary education goals by 2015. Increases in primary school enrollments, drought, and HIV-AIDS have exacerbated the need for well trained teachers. Despite the need, the focus is on balancing quality with quantity. An effective teacher is deemed a critical element, although not the only one, in a student's success in the classroom. This paper focuses on the dilemma of meeting universal primary education goals in Sub-Saharan Africa, while maintaining teacher quality in fragile contexts.

  2. Statistical physics of balance theory

    PubMed Central

    Belaza, Andres M.; Hoefman, Kevin; Bramson, Aaron; van den Heuvel, Milan; Schoors, Koen

    2017-01-01

    Triadic relationships are accepted to play a key role in the dynamics of social and political networks. Building on insights gleaned from balance theory in social network studies and from Boltzmann-Gibbs statistical physics, we propose a model to quantitatively capture the dynamics of the four types of triadic relationships in a network. Central to our model are the triads’ incidence rates and the idea that those can be modeled by assigning a specific triadic energy to each type of triadic relation. We emphasize the role of the degeneracy of the different triads and how it impacts the degree of frustration in the political network. In order to account for a persistent form of disorder in the formation of the triadic relationships, we introduce the systemic variable temperature. In order to learn about the dynamics and motives, we propose a generic Hamiltonian with three terms to model the triadic energies. One term is connected with a three-body interaction that captures balance theory. The other terms take into account the impact of heterogeneity and of negative edges in the triads. The validity of our model is tested on four datasets including the time series of triadic relationships for the standings between two classes of alliances in a massively multiplayer online game (MMOG). We also analyze real-world data for the relationships between the “agents” involved in the Syrian civil war, and in the relations between countries during the Cold War era. We find emerging properties in the triadic relationships in a political network, for example reflecting itself in a persistent hierarchy between the four triadic energies, and in the consistency of the extracted parameters from comparing the model Hamiltonian to the data. PMID:28846726

  3. Statistical physics of balance theory.

    PubMed

    Belaza, Andres M; Hoefman, Kevin; Ryckebusch, Jan; Bramson, Aaron; van den Heuvel, Milan; Schoors, Koen

    2017-01-01

    Triadic relationships are accepted to play a key role in the dynamics of social and political networks. Building on insights gleaned from balance theory in social network studies and from Boltzmann-Gibbs statistical physics, we propose a model to quantitatively capture the dynamics of the four types of triadic relationships in a network. Central to our model are the triads' incidence rates and the idea that those can be modeled by assigning a specific triadic energy to each type of triadic relation. We emphasize the role of the degeneracy of the different triads and how it impacts the degree of frustration in the political network. In order to account for a persistent form of disorder in the formation of the triadic relationships, we introduce the systemic variable temperature. In order to learn about the dynamics and motives, we propose a generic Hamiltonian with three terms to model the triadic energies. One term is connected with a three-body interaction that captures balance theory. The other terms take into account the impact of heterogeneity and of negative edges in the triads. The validity of our model is tested on four datasets including the time series of triadic relationships for the standings between two classes of alliances in a massively multiplayer online game (MMOG). We also analyze real-world data for the relationships between the "agents" involved in the Syrian civil war, and in the relations between countries during the Cold War era. We find emerging properties in the triadic relationships in a political network, for example reflecting itself in a persistent hierarchy between the four triadic energies, and in the consistency of the extracted parameters from comparing the model Hamiltonian to the data.

  4. Charter School Laws: Ranking Scorecard.

    ERIC Educational Resources Information Center

    Center for Education Reform, Washington, DC.

    This is the fifth report prepared by the Center for Education Reform (CER) evaluating the capacity and flexibility of state laws promoting charter schools. Three primary factors were evaluated in preparing charter-school quality rankings by state. The center finds that the establishment of multiple sponsoring authorities, in addition to local…

  5. Engineering redox balance through cofactor systems.

    PubMed

    Chen, Xiulai; Li, Shubo; Liu, Liming

    2014-06-01

    Redox balance plays an important role in the production of enzymes, pharmaceuticals, and chemicals. To meet the demands of industrial production, it is desirable that microbes maintain a maximal carbon flux towards target metabolites with no fluctuations in redox. This requires functional cofactor systems that support dynamic homeostasis between different redox states or functional stability in a given redox state. Redox balance can be achieved by improving the self-balance of a cofactor system, regulating the substrate balance of a cofactor system, and engineering the synthetic balance of a cofactor system. This review summarizes how cofactor systems can be manipulated to improve redox balance in microbes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Water balance model for Kings Creek

    NASA Technical Reports Server (NTRS)

    Wood, Eric F.

    1990-01-01

    Particular attention is given to the spatial variability that affects the representation of water balance at the catchment scale in the context of macroscale water-balance modeling. Remotely sensed data are employed for parameterization, and the resulting model is developed so that subgrid spatial variability is preserved and therefore influences the grid-scale fluxes of the model. The model permits the quantitative evaluation of the surface-atmospheric interactions related to the large-scale hydrologic water balance.

  7. Reframing Our Pursuit of Life Balance

    PubMed Central

    Ogden, Rachel R.; Ryan-Haddad, Ann; Strang, Aimee F.

    2015-01-01

    During our time in the 2013 Academic Leadership Fellows Program, we explored what it takes to achieve life balance through a framework presented in a Harvard Business Review article. In this Statement, we describe 5 different areas from the article that provide infrastructure for reflecting on how we have learned to approach life balance in academia. We also provide brief messages based on this reading and others to help academics’ pursuit of life balance. PMID:25995509

  8. Reframing our pursuit of life balance.

    PubMed

    Fuentes, David G; Ogden, Rachel R; Ryan-Haddad, Ann; Strang, Aimee F

    2015-04-25

    During our time in the 2013 Academic Leadership Fellows Program, we explored what it takes to achieve life balance through a framework presented in a Harvard Business Review article. In this Statement, we describe 5 different areas from the article that provide infrastructure for reflecting on how we have learned to approach life balance in academia. We also provide brief messages based on this reading and others to help academics' pursuit of life balance.

  9. AN INITIAL EVALUATION OF THE BTRACKS BALANCE PLATE AND SPORTS BALANCE SOFTWARE FOR CONCUSSION DIAGNOSIS

    PubMed Central

    Manyak, Kristin A.; Abdenour, Thomas E.; Rauh, Mitchell J.; Baweja, Harsimran S.

    2016-01-01

    Background As recently dictated by the American Medical Society, balance testing is an important component in the clinical evaluation of concussion. Despite this, previous research on the efficacy of balance testing for concussion diagnosis suggests low sensitivity (∼30%), based primarily on the popular Balance Error Scoring System (BESS). The Balance Tracking System (BTrackS, Balance Tracking Systems Inc., San Diego, CA, USA) consists of a force plate (BTrackS Balance Plate) and software (BTrackS Sport Balance) which can quickly (<2 min) perform concussion balance testing with gold standard accuracy. Purpose The present study aimed to determine the sensitivity of the BTrackS Balance Plate and Sports Balance Software for concussion diagnosis. Study Design Cross-Sectional Study Methods Preseason baseline balance testing of 519 healthy Division I college athletes playing sports with a relatively high risk for concussions was performed with the BTrackS Balance Test. Testing was administered by certified athletic training staff using the BTrackS Balance Plate and Sport Balance software. Of the baselined athletes, 25 later experienced a concussion during the ensuing sport season. Post-injury balance testing was performed on these concussed athletes within 48 of injury and the sensitivity of the BTrackS Balance Plate and Sport Balance software was estimated based on the number of athletes showing a balance decline according to the criteria specified in the Sport Balance software. This criteria is based on the minimal detectable change statistic with a 90% confidence level (i.e. 90% specificity). Results Of 25 athletes who experienced concussions, 16 had balance declines relative to baseline testing results according to the BTrackS Sport Balance software criteria. This corresponds to an estimated concussion sensitivity of 64%, which is twice as great as that reported previously for the BESS. Conclusions The BTrackS Balance Plate and Sport Balance software has the

  10. Mass balancing of hollow fan blades

    NASA Technical Reports Server (NTRS)

    Kielb, R. E.

    1986-01-01

    A typical section model is used to analytically investigate the effect of mass balancing as applied to hollow, supersonic fan blades. A procedure to determine the best configuration of an internal balancing mass to provide flutter alleviation is developed. This procedure is applied to a typical supersonic shroudless fan blade which is unstable in both the solid configuration and when it is hollow with no balancing mass. The addition of an optimized balancing mass is shown to stabilize the blade at the design condition.

  11. Balance Velocities of the Greenland Ice Sheet

    NASA Technical Reports Server (NTRS)

    Joughin, Ian; Fahnestock, Mark; Ekholm, Simon; Kwok, Ron

    1997-01-01

    We present a map of balance velocities for the Greenland ice sheet. The resolution of the underlying DEM, which was derived primarily from radar altimetry data, yields far greater detail than earlier balance velocity estimates for Greenland. The velocity contours reveal in striking detail the location of an ice stream in northeastern Greenland, which was only recently discovered using satellite imagery. Enhanced flow associated with all of the major outlets is clearly visible, although small errors in the source data result in less accurate estimates of the absolute flow speeds. Nevertheless, the balance map is useful for ice-sheet modelling, mass balance studies, and field planning.

  12. Balance impairment in individuals with Wolfram syndrome

    PubMed Central

    Pickett, Kristen A.; Duncan, Ryan P.; Paciorkowski, Alex R.; Permutt, Alan; Marshall, Bess; Hershey, Tamara; Earhart, Gammon M.

    2012-01-01

    AIM Wolfram syndrome (WFS), a rare neurodegenerative disorder, is characterized by early onset insulin-dependent diabetes mellitus, optic atrophy, deafness, diabetes insipidus, and neurological abnormalities. Although previously unreported, we hypothesized that neurological complications may be detectable in relatively early stages of the disease. As the cerebellum and brainstem seem particularly vulnerable in WFS, we focused on balance functions critically dependent on these regions. The primary goal of this investigation was to compare balance in young individuals with WFS, in relatively early stages of the disease, to an age-matched cohort using a clinically applicable test. METHOD Balance was assessed via the mini-BESTest in 13 children, adolescents and young adults with WFS and 30 typically developing age-matched individuals. RESULTS A significant difference was observed between groups in balance as well as in three of four subcomponents of the mini-BESTest and in two timed tasks related to balance. Mini-BESTest scores were correlated with age (p < 0.001, rs = 0.59) among typically developing individuals. In the WFS group, mini-BESTest scores were related to overall motor dysfunction, but not age. INTERPRETATION Impairments in balance in WFS may occur earlier in the disease process than previously recognized and appear to be related to overall neurological progression rather than chronological age. Recognizing balance impairments and understanding which balance systems contribute to balance deficits in those with WFS may allow for development of effective patient-centered treatment paradigms. PMID:22771154

  13. Cryogenic balances for the US NTF

    NASA Technical Reports Server (NTRS)

    Ferris, Alice T.

    1989-01-01

    Force balances were used to obtain aerodynamic data in the National Transonic Facility (NTF) wind tunnel since it became operational in 1983. These balances were designed, fabricated, gaged, and calibrated to Langley Research Center's specifications to operate over the temperature range of -320 F to +140 F without thermal control. Some of the materials and procedures developed to obtain a balance that would perform in this environment are reviewed. The degree of success in using these balances thus far is reported. Some of the problem areas that need additional work are specified and some of the progress addressing these problems is described.

  14. Balance confidence is related to features of balance and gait in individuals with chronic stroke

    PubMed Central

    Schinkel-Ivy, Alison; Wong, Jennifer S.; Mansfield, Avril

    2016-01-01

    Reduced balance confidence is associated with impairments in features of balance and gait in individuals with sub-acute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke. Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months post-discharge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable and quiet standing, walking, and reactive stepping outcome measures as the dependent variables. Walking velocity was positively correlated with balance confidence, while medio-lateral centre of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence. This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs. PMID:27955809

  15. Mentorship, learning curves, and balance.

    PubMed

    Cohen, Meryl S; Jacobs, Jeffrey P; Quintessenza, James A; Chai, Paul J; Lindberg, Harald L; Dickey, Jamie; Ungerleider, Ross M

    2007-09-01

    Professionals working in the arena of health care face a variety of challenges as their careers evolve and develop. In this review, we analyze the role of mentorship, learning curves, and balance in overcoming challenges that all such professionals are likely to encounter. These challenges can exist both in professional and personal life. As any professional involved in health care matures, complex professional skills must be mastered, and new professional skills must be acquired. These skills are both technical and judgmental. In most circumstances, these skills must be learned. In 2007, despite the continued need for obtaining new knowledge and learning new skills, the professional and public tolerance for a "learning curve" is much less than in previous decades. Mentorship is the key to success in these endeavours. The success of mentorship is two-sided, with responsibilities for both the mentor and the mentee. The benefits of this relationship must be bidirectional. It is the responsibility of both the student and the mentor to assure this bidirectional exchange of benefit. This relationship requires time, patience, dedication, and to some degree selflessness. This mentorship will ultimately be the best tool for mastering complex professional skills and maturing through various learning curves. Professional mentorship also requires that mentors identify and explicitly teach their mentees the relational skills and abilities inherent in learning the management of the triad of self, relationships with others, and professional responsibilities.Up to two decades ago, a learning curve was tolerated, and even expected, while professionals involved in healthcare developed the techniques that allowed for the treatment of previously untreatable diseases. Outcomes have now improved to the point that this type of learning curve is no longer acceptable to the public. Still, professionals must learn to perform and develop independence and confidence. The responsibility to

  16. Estudio del CH interestelar

    NASA Astrophysics Data System (ADS)

    Olano, C.; Lemarchand, G.; Sanz, A. J.; Bava, J. A.

    El objetivo principal de este proyecto consiste en el estudio de la distribución y abundancia del CH en nubes interestelares a través de la observación de las líneas hiperfinas del CH en 3,3 GHz. El CH es una molécula de amplia distribución en el espacio interestelar y una de las pocas especies que han sido observadas tanto con técnicas de radio como ópticas. Desde el punto de vista tecnológico se ha desarrollado un cabezal de receptor que permitirá la realización de observaciones polarimétricas en la frecuencia de 3,3 GHz, con una temperatura del sistema de 60 K y un ancho de banda de 140 MHz, y que será instalado en el foco primario de la antena parabólica del IAR. El cabezal del receptor es capaz de detectar señales polarizadas, separando las componentes de polarización circular derecha e izquierda. Para tal fin el cabezal consta de dos ramas receptoras que amplificarán la señal y la trasladarán a una frecuencia más baja (frecuencia intermedia), permitiendo de esa forma un mejor transporte de la señal a la sala de control para su posterior procesamiento. El receptor además de tener características polarimétricas, podrá ser usado en el continuo y en la línea, utilizando las ventajas observacionales y de procesamiento de señal que actualmente posee el IAR.

  17. Balancing the professional and personal.

    PubMed

    Armstrong, Alicia Y; Alvero, Ruben J; Dunlow, Susan; Nace, Mary Catherine; Baker, Valerie; Stewart, Elizabeth A

    2009-01-01

    To review the common roles that physicians pursue away from work and identify related challenges and potential solutions, so that individuals can develop a personalized plan for success in each of the areas. Literature review. University-based and university-affiliated medical centers. No subjects were involved in this literature review. Literature searches in Entrez PubMed and the following Websites: http://www.apgo.org, http://www.psychiatrictimes.com, as well as other data sources. Results of physician surveys and summaries of strategies for achieving work-personal life balance. According to surveys of physicians in various specialties, a majority of physicians have high levels of job, marital, and parental satisfaction. However, professional and personal challenges faced by physicians include struggle with time management, lack of mentorship, and difficulty maintaining intimate relationships. Multiple potentially effective strategies have been described in the literature, including exerting control over hours worked, taking a long view of life that acknowledges the need for changing priorities over time, developing communication skills, seeking counseling services if needed that focus on physician relationships, and simplifying home life whenever possible. Although there are unique challenges in being a physician, partner, and parent, many of the professional challenges faced by physicians are common to many adults in the United States. Self-assessment may help individuals to clarify priorities and develop strategies that can lead to improved personal satisfaction.

  18. The Copper Balance of Cities

    PubMed Central

    Kral, Ulrich; Lin, Chih-Yi; Kellner, Katharina; Ma, Hwong-wen; Brunner, Paul H

    2014-01-01

    Material management faces a dual challenge: on the one hand satisfying large and increasing demands for goods and on the other hand accommodating wastes and emissions in sinks. Hence, the characterization of material flows and stocks is relevant for both improving resource efficiency and environmental protection. This article focuses on the urban scale, a dimension rarely investigated in past metal flow studies. We compare the copper (Cu) metabolism of two cities in different economic states, namely, Vienna (Europe) and Taipei (Asia). Substance flow analysis is used to calculate urban Cu balances in a comprehensive and transparent form. The main difference between Cu in the two cities appears to be the stock: Vienna seems close to saturation with 180 kilograms per capita (kg/cap) and a growth rate of 2% per year. In contrast, the Taipei stock of 30 kg/cap grows rapidly by 26% per year. Even though most Cu is recycled in both cities, bottom ash from municipal solid waste incineration represents an unused Cu potential accounting for 1% to 5% of annual demand. Nonpoint emissions are predominant; up to 50% of the loadings into the sewer system are from nonpoint sources. The results of this research are instrumental for the design of the Cu metabolism in each city. The outcomes serve as a base for identification and recovery of recyclables as well as for directing nonrecyclables to appropriate sinks, avoiding sensitive environmental pathways. The methodology applied is well suited for city benchmarking if sufficient data are available. PMID:25866460

  19. Sodium balance in hemodialysis therapy.

    PubMed

    Kooman, Jeroen P; van der Sande, Frank; Leunissen, Karel; Locatelli, Francesco

    2003-01-01

    Water and sodium overload is the predominant factor in the pathogenesis of hypertension in dialysis patients. In many dialysis patients, dry weight is not reached because of an imbalance between the interdialytic accumulation of water and sodium and the brief and discontinuous nature of routine dialysis therapy. During dialysis, sodium is removed by convection and to a lesser degree by diffusion. However, with supraphysiologic dialysate sodium concentrations, diffusive influx from dialysate may occur, especially in patients with low predialytic plasma sodium concentrations. Measuring sodium removal during dialysis is difficult and hampered by the variability in conventional sodium measurements. Ionic mass removal by continuous measurement of conductivity in the dialysate ports appears to be a promising tool for the approximation of sodium removal during dialysis. While the beneficial effects of concomitant water and sodium removal on blood pressure control in dialysis patients are undisputed, it is less well known whether a change in hydrosodium balance solely by reducing dialysate sodium is beneficial. Considering the inherent dangers of such an approach (intradialytic hemodynamic instability), the beneficial effects of strict dietary sodium restriction appear to be of much larger clinical benefit. It has become possible to individualize dialysate sodium concentration by means of online measurements of plasma conductivity and adjustment of dialysate conductivity by feedback technologies. The clinical benefits of this approach deserve further study. Still, reducing dietary sodium intake remains the most important tool in improving blood control in dialysis patients.

  20. Protein kinase C: perfectly balanced.

    PubMed

    Newton, Alexandra C

    2018-04-01

    Protein kinase C (PKC) isozymes belong to a family of Ser/Thr kinases whose activity is governed by reversible release of an autoinhibitory pseudosubstrate. For conventional and novel isozymes, this is effected by binding the lipid second messenger, diacylglycerol, but for atypical PKC isozymes, this is effected by binding protein scaffolds. PKC shot into the limelight following the discovery in the 1980s that the diacylglycerol-sensitive isozymes are "receptors" for the potent tumor-promoting phorbol esters. This set in place a concept that PKC isozymes are oncoproteins. Yet three decades of cancer clinical trials targeting PKC with inhibitors failed and, in some cases, worsened patient outcome. Emerging evidence from cancer-associated mutations and protein expression levels provide a reason: PKC isozymes generally function as tumor suppressors and their activity should be restored, not inhibited, in cancer therapies. And whereas not enough activity is associated with cancer, variants with enhanced activity are associated with degenerative diseases such as Alzheimer's disease. This review describes the tightly controlled mechanisms that ensure PKC activity is perfectly balanced and what happens when these controls are deregulated. PKC isozymes serve as a paradigm for the wisdom of Confucius: "to go beyond is as wrong as to fall short."

  1. Student Understanding of Chemical Equation Balancing.

    ERIC Educational Resources Information Center

    Yarroch, W. L.

    1985-01-01

    Results of interviews with high school chemistry students (N=14) during equation-solving sessions indicate that those who were able to construct diagrams consistent with notation of their balanced equation possessed good concepts of subscript and the balancing rule. Implications for chemistry teaching are discussed. (DH)

  2. How Should Equation Balancing Be Taught?

    ERIC Educational Resources Information Center

    Porter, Spencer K.

    1985-01-01

    Matrix methods and oxidation-number methods are currently advocated and used for balancing equations. This article shows how balancing equations can be introduced by a third method which is related to a fundamental principle, is easy to learn, and is powerful in its application. (JN)

  3. Gait and balance disorders in older adults.

    PubMed

    Salzman, Brooke

    2010-07-01

    Gait and balance disorders are common in older adults and are a major cause of falls in this population. They are associated with increased morbidity and mortality, as well as reduced level of function. Common causes include arthritis and orthostatic hypotension; however, most gait and balance disorders involve multiple contributing factors. Most changes in gait are related to underlying medical conditions and should not be considered an inevitable consequence of aging. Physicians caring for older patients should ask at least annually about falls, and should ask about or examine for difficulties with gait and balance at least once. For older adults who report a fall, physicians should ask about difficulties with gait and balance, and should observe for any gait or balance dysfunctions. The Timed Up and Go test is a fast and reliable diagnostic tool. Persons who have difficulty or demonstrate unsteadiness performing the Timed Up and Go test require further assessment, usually with a physical therapist, to help elucidate gait impairments and related functional limitations. The most effective strategy for falls prevention involves a multifactorial evaluation followed by targeted interventions for identified contributing factors. Evidence on the effectiveness of interventions for gait and balance disorders is limited because of the lack of standardized outcome measures determining gait and balance abilities. However, effective options for patients with gait and balance disorders include exercise and physical therapy. (c) 2010 American Academy of Family Physicians.

  4. Course Budgeting: Balancing Rewards and Risks.

    ERIC Educational Resources Information Center

    Matkin, Gary W.

    Continuing education programmers must be risk takers; however, they should not be gamblers. The most successful of them are able to estimate a balance between potential rewards and risks, taking chances when the odds are favorable. Although it is essential that course planners balance potential financial rewards and risks, it is important to bear…

  5. Astronaut Scott Carpenter tests balance mechanism performance

    NASA Technical Reports Server (NTRS)

    1961-01-01

    Astronaut M. Scott Carpenter's balance mechanism performance is tested by his walking on a narrow board in his bare feet. He is performing this test at the School of Aviation Medicine, Pensicola, Florida (04570); Carpenter walks a straight line by putting one foot directly in front of the other to test his balance (04571).

  6. Attentional Focus Effects in Balance Acrobats

    ERIC Educational Resources Information Center

    Wulf, Gabriele

    2008-01-01

    Performing and learning motor skills has been shown to be enhanced if the performer adopts an external relative to internal focus (or no focus) of attention (Wulf, 2007). The present study examined the generalizability of this effect to top-level performers (balance acrobats). Participants performed a balance task (standing on an inflated rubber…

  7. Newton's Third Law on a Scale Balance

    ERIC Educational Resources Information Center

    Nopparatjamjomras, Suchai; Panijpan, Bhinyo; Huntula, Jiradawan

    2009-01-01

    We propose a series of experiments involving balance readings of an object naturally floating or forced to be partially or fully immersed in water contained in a beaker sitting on an electronic scale balance. Students were asked to predict, observe and explain each case. The teacher facilitated the learning by asking probing questions, giving…

  8. Student Life Balance: Myth or Reality?

    ERIC Educational Resources Information Center

    Doble, Niharika; Supriya, M. V.

    2011-01-01

    Purpose: Student life stress, student family conflict and student life balance are issues that are scarcely researched. This paper aims to develop a scale for assessing the concept of student life balance. Design/methodology/approach: The study evaluated a 54-item scale for assessing the construct. The data are obtained from 612 Indian students.…

  9. Dimensions of Balance in an Administrator's Life.

    ERIC Educational Resources Information Center

    Creswell, John W.; And Others

    1991-01-01

    This article presents a new model for viewing and implementing balance in the lives of higher education administrators derived from a review of the educational, psychological, and management literature. Rejecting the traditional, two dimensional model for balancing work with the rest of life, the new model envisions four concentric circles of…

  10. Microprocessor-Controlled Laser Balancing System

    NASA Technical Reports Server (NTRS)

    Demuth, R. S.

    1985-01-01

    Material removed by laser action as part tested for balance. Directed by microprocessor, laser fires appropriate amount of pulses in correct locations to remove necessary amount of material. Operator and microprocessor software interact through video screen and keypad; no programing skills or unprompted system-control decisions required. System provides complete and accurate balancing in single load-and-spinup cycle.

  11. 26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Effect of prefunding balance and funding... § 1.430(f)-1 Effect of prefunding balance and funding standard carryover balance. (a) In general—(1... funding standard account under section 412(b) (as in effect prior to amendment by the Pension Protection...

  12. 26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Effect of prefunding balance and funding standard...(f)-1 Effect of prefunding balance and funding standard carryover balance. (a) In general—(1... funding standard account under section 412(b) (as in effect prior to amendment by the Pension Protection...

  13. 26 CFR 1.430(f)-1 - Effect of prefunding balance and funding standard carryover balance.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 5 2014-04-01 2014-04-01 false Effect of prefunding balance and funding... § 1.430(f)-1 Effect of prefunding balance and funding standard carryover balance. (a) In general—(1... funding standard account under section 412(b) (as in effect prior to amendment by the Pension Protection...

  14. Balance and Self-Efficacy of Balance in Children with CHARGE Syndrome

    ERIC Educational Resources Information Center

    Haibach, Pamela S.; Lieberman, Lauren J.

    2013-01-01

    Introduction: Balance is a critical component of daily living, because it affects all movements and the ability to function independently. Children with CHARGE syndrome have sensory and motor impairments that could negatively affect their balance and postural control. The purpose of the study presented in this article was to assess the balance and…

  15. Energy balance and stability. [in stellar coronae

    NASA Technical Reports Server (NTRS)

    Hammer, R.

    1982-01-01

    The energy balance of the outer atmospheres of solarlike stars is discussed. The energy balance of open coronal regions is considered, discussing the construction and characteristics of models of such regions in some detail. In particular, the temperature as a function of height is considered, as are the damping length dependence of the global energy balance in the region between the base of the transition region and the critical point, and the effects of changing the amount of coronal heating, the stellar mass, and the stellar radius. Models of coronal loops are more briefly discussed. The chromosphere is then included in the discussion of the energy balance, and the connection between global energy balance and global thermal stability is addressed. The observed positive correlations between the chromospheric and coronal energy losses and the pressure of the transition region is qualitatively explained.

  16. Engine balance apparatus and accessory drive device

    NASA Technical Reports Server (NTRS)

    Egleston, Robert W. (Inventor)

    2002-01-01

    A balancing mechanism for an engine that has a rotating crankshaft and reciprocating pistons. The balancing mechanism comprises a primary balance mass assembly non-rotatably and removably affixed to the crankshaft. The primary mass assembly comprises a primary mass affixed to a primary hub portion and a primary cap portion removably affixed to the primary hub portion to clamp a portion of the crankshaft therebetween. A secondary balance mass assembly may be rotatably and removably supported on the crankshaft. A driver assembly is affixed to the crankshaft to cause the secondary balance mass to rotate in a direction that is opposite to the direction in which the crank shaft is rotating. The driver assembly may include auxiliary gears configured to transport rotary power to auxiliary components. The gears are readily detachable from the apparatus to facilitate inspection and repair operations.

  17. Balanced Flow Meters without Moving Parts

    NASA Technical Reports Server (NTRS)

    Kelley, Anthony R.; VanBuskirk, Paul

    2008-01-01

    Balanced flow meters are recent additions to an established class of simple, rugged flow meters that contain no moving parts in contact with flow and are based on measurement of pressure drops across objects placed in flow paths. These flow meters are highly accurate, minimally intrusive, easily manufacturable, and reliable. A balanced flow meter can be easily mounted in a flow path by bolting it between conventional pipe flanges. A balanced flow meter can be used to measure the flow of any of a variety of liquids or gases, provided that it has been properly calibrated. Relative to the standard orifice-plate flow meter, the balanced flow meter introduces less turbulence and two times less permanent pressure loss and is therefore capable of offering 10 times greater accuracy and repeatability with less dissipation of energy. A secondary benefit of the reduction of turbulence is the reduction of vibration and up to 15 times less acoustic noise generation. Both the balanced flow meter and the standard orifice-plate flow meter are basically disks that contain holes and are instrumented with pressure transducers on their upstream and downstream faces. The most obvious difference between them is that the standard orifice plate contains a single, central hole while the balanced flow meter contains multiple holes. The term 'balanced' signifies that in designing the meter, the sizes and locations of the holes are determined in an optimization procedure that involves balancing of numerous factors, including volumetric flow, mass flow, dynamic pressure, kinetic energy, all in an effort to minimize such undesired effects as turbulence, pressure loss, dissipation of kinetic energy, and non-repeatability and nonlinearity of response over the anticipated range of flow conditions. Due to proper balancing of these factors, recent testing demonstrated that the balanced flow-meter performance was similar to a Venturi tube in both accuracy and pressure recovery, but featured reduced

  18. Revisit, revamp, and revitalize your business plan: part 3.

    PubMed

    Waldron, David

    2011-01-01

    Managing with financial statements is discussed, including fundamental definitions and conventions related to this process such as an income statement and a balance sheet. Balanced scorecards and dashboards can be used to measure progress and to communicate achievements. Steps taken to defining data using KPIs, sourcing data, and structuring the scorecard are outlined. A core part of managing with financial statements is understanding how to drive the business and engage the staff using balanced scorecards.

  19. Dynamic balance in turbulent reconnection

    NASA Astrophysics Data System (ADS)

    Yokoi, N.; Higashimori, K.; Hoshino, M.

    2012-12-01

    Dynamic balance between the enhancement and suppression of transports due to turbulence in magnetic reconnection is discussed analytically and numerically by considering the interaction of the large-scale field structures with the small-scale turbulence in a consistent manner. Turbulence is expected to play an important role in bridging small and large scales related to magnetic reconnection. The configurations of the mean-field structure are determined by turbulence through the effective transport. At the same time, statistical properties of turbulence are determined by the mean-field structure through the production mechanisms of turbulence. This suggests that turbulence and mean fields should be considered simultaneously in a self-consistent manner. Following the theoretical prediction on the interaction between the mean-fields and turbulence in magnetic reconnection presented by Yokoi and Hoshino (2011), a self-consistent model for the turbulent reconnection is constructed. In the model, the mean-field equations for compressible magnetohydrodynamics are treated with the turbulence effects incorporated through the turbulence correlation such as the Reynolds stress and turbulent electromotive force. Transport coefficients appearing in the expression for these correlations are not adjustable parameters but are determined through the transport equations of the turbulent statistical quantities such as the turbulent MHD energy, the turbulent cross helicity. One of the prominent features of this reconnection model lies in the point that turbulence is not implemented as a prescribed one, but the generation and sustainment of turbulence through the mean-field inhomogeneities are treated. The theoretical predictions are confirmed by the numerical simulation of the model equations. These predictions include the quadrupole cross helicity distribution around the reconnection region, enhancement of reconnection rate due to turbulence, localization of the reconnection region

  20. Thermal balance of Nellore cattle

    NASA Astrophysics Data System (ADS)

    de Melo Costa, Cíntia Carol; Maia, Alex Sandro Campos; Nascimento, Sheila Tavares; Nascimento, Carolina Cardoso Nagib; Neto, Marcos Chiquitelli; de França Carvalho Fonsêca, Vinícius

    2018-05-01

    This work aimed at characterizing the thermal balance of Nellore cattle from the system of indirect calorimetry using a facial mask. The study was conducted at the Animal Biometeorology Laboratory of the São Paulo State University, Jaboticabal, Brazil. Five male Nellore weighing 750 ± 62 kg, at similar ages and body conditions were distributed in four 5 × 5 Latin squares (5 days of records and five schedules) during 20 days. Physiological and environmental measurements were obtained from the indirect calorimetry system using a facial mask. Respiratory parameters, hair coat, skin, and rectal temperature were continuously recorded. From this, metabolic heat production, sensible and latent ways of heat transfer were calculated. Metabolic heat production had an average value of 146.7 ± 0.49 W m-2 and did not change ( P > 0.05) over the range of air temperature (24 to 35 °C). Sensible heat flow reached 60.08 ± 0.81 W m-2 when air temperature ranged from 24 to 25 °C, being negligible in conditions of temperature above 33 °C. Most of the heat produced by metabolism was dissipated by cutaneous evaporation when air temperature was greater than 30 °C. Respiratory parameters like respiratory rate and ventilation remained stable ( P > 0.05) in the range of temperature studied. Under shade conditions and air temperature range from 24 to 35 °C, metabolic heat production, respiratory rate, and ventilation of mature Nellore cattle remain stable, which is indicative of low energetic cost to the thermoregulation.

  1. Nevado del Huila, Columbia

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Nevado del Huila Volcano in Colombia is actually a volcanic chain running north to south, capped by a glacier. With peaks ranging in height from 2,600 to 5,780 meters (8,530 to 18,960 feet), Nevado del Huila is a stratovolcano composed of alternating layers of hardened lava, solidified ash, and volcanic rocks. Its first recorded eruption occurred in the mid-sixteenth century. The long-dormant volcano erupted again in mid-April 2007. A few months before the eruption, the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite captured this image of Nevado del Huila, on February 23, 2007. In this image, the bright white area just east of the central summit is ice. Immediately west of the summit are bare rocks, appearing as blue-gray. West of those rocks, white reappears, but this patch of white results from clouds hovering in the nearby valley. In the east, the colors turn to brown (indicating bare rock) and bright green (indicating vegetation). ASTER photographed Nevado del Huila near the end of a long phase of quietude. On April 17, 2007, local authorities recorded seismic activity associated with rock fracturing on the volcano's central summit, according to the ReliefWeb Website. Activity intensified the following day with an eruption and mudflows, forcing thousands of nearby residents to evacuate. As the Associated Press reported, the eruption caused avalanches and floods that wiped away both houses and bridges. It marked the volcano's first recorded eruption since the Spanish colonized the area five centuries earlier. NASA image created by Jesse Allen, using data provided courtesy of the NASA/GSFC/MITI/ERSDAC/JAROS, and U.S./Japan ASTER Science Team.

  2. Balanced Identity in the Minimal Groups Paradigm

    PubMed Central

    Dunham, Yarrow

    2013-01-01

    Balanced Identity Theory [1] formalizes a set of relationships between group attitude, group identification, and self-esteem. While these relationships have been demonstrated for familiar and highly salient social categories, questions remain regarding the generality of the balance phenomenon and its causal versus descriptive status. Supporting the generality and rapidity of cognitive balance, four studies demonstrate that the central predictions of balance are supported even for previously unfamiliar “minimal” social groups to which participants have just been randomly assigned. Further, supporting a causal as opposed to merely descriptive interpretation, manipulating any one component of the balance model (group attitude, group identification, or self-esteem) affects at least one of the related components. Interestingly, the broader pattern of cognitive balance was preserved across such manipulations only when the manipulation strengthens as opposes to weakens the manipulated construct. Taken together, these findings indicate that Balanced Identity Theory has promise as a general theory of intergroup attitudes, and that it may be able to shed light on prior inconsistencies concerning the relationship between self-esteem and intergroup bias. PMID:24391912

  3. Balanced identity in the minimal groups paradigm.

    PubMed

    Dunham, Yarrow

    2013-01-01

    Balanced Identity Theory [1] formalizes a set of relationships between group attitude, group identification, and self-esteem. While these relationships have been demonstrated for familiar and highly salient social categories, questions remain regarding the generality of the balance phenomenon and its causal versus descriptive status. Supporting the generality and rapidity of cognitive balance, four studies demonstrate that the central predictions of balance are supported even for previously unfamiliar "minimal" social groups to which participants have just been randomly assigned. Further, supporting a causal as opposed to merely descriptive interpretation, manipulating any one component of the balance model (group attitude, group identification, or self-esteem) affects at least one of the related components. Interestingly, the broader pattern of cognitive balance was preserved across such manipulations only when the manipulation strengthens as opposes to weakens the manipulated construct. Taken together, these findings indicate that Balanced Identity Theory has promise as a general theory of intergroup attitudes, and that it may be able to shed light on prior inconsistencies concerning the relationship between self-esteem and intergroup bias.

  4. Power balance on a multibeam laser

    NASA Astrophysics Data System (ADS)

    Sampat, S.; Kelly, J. H.; Kosc, T. Z.; Rigatti, A. L.; Kwiatkowski, J.; Donaldson, W. R.; Romanofsky, M. H.; Waxer, L. J.; Dean, R.; Moshier, R.

    2018-02-01

    Inertial confinement fusion (ICF) cryogenic experiments on the 60-beam OMEGA laser have strict requirements for the laser energy delivered on target to be power balanced in order to maximize target-irradiation uniformity. For OMEGA, this quantity (power balance) is inferred from measurements of the time-integrated energy and time-resolved, spatially integrated temporal profile of each of the 60 beams at the output of the laser. The work presented here proposes a general definition of power balance as measured at the laser output and discusses the conditions that are fundamental to achieving laser power balance. Power balance necessitates equal gain across all stages of amplification, equal net losses across each amplifier stage, equal frequency conversion (from 1053 nm to 351 nm) of all 60 beams, and equal beam path lengths (beam timing). Typical OMEGA ICF laser pulse shapes consist of one or more short (100-ps) "pickets" followed by a shaped "drive" pulse of 1 to 2 ns. For these experiments, power balance is assessed for the pickets and the drive independently, with the ultimate goal of achieving root-mean-square (rms) imbalance across all 60 beams of less than 2% rms on both. This work presents a comprehensive summary of laser shot campaigns conducted to significantly improve laser power balance from typical rms values of 4.7% and 5.2%, respectively, to the 3% level for both features along with a discussion of future work required to further reduce the rms power imbalance of the laser system.

  5. Creating a Sustainability Scorecard as a predictive tool for measuring the complex social, economic and environmental impacts of industries, a case study: assessing the viability and sustainability of the dairy industry.

    PubMed

    Buys, L; Mengersen, K; Johnson, S; van Buuren, N; Chauvin, A

    2014-01-15

    Sustainability is a key driver for decisions in the management and future development of industries. The World Commission on Environment and Development (WCED, 1987) outlined imperatives which need to be met for environmental, economic and social sustainability. Development of strategies for measuring and improving sustainability in and across these domains, however, has been hindered by intense debate between advocates for one approach fearing that efforts by those who advocate for another could have unintended adverse impacts. Studies attempting to compare the sustainability performance of countries and industries have also found ratings of performance quite variable depending on the sustainability indices used. Quantifying and comparing the sustainability of industries across the triple bottom line of economy, environment and social impact continues to be problematic. Using the Australian dairy industry as a case study, a Sustainability Scorecard, developed as a Bayesian network model, is proposed as an adaptable tool to enable informed assessment, dialogue and negotiation of strategies at a global level as well as being suitable for developing local solutions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Force balancing in mammographic compression

    SciTech Connect

    Branderhorst, W., E-mail: w.branderhorst@amc.nl; Groot, J. E. de; Lier, M. G. J. T. B. van

    Purpose: In mammography, the height of the image receptor is adjusted to the patient before compressing the breast. An inadequate height setting can result in an imbalance between the forces applied by the image receptor and the paddle, causing the clamped breast to be pushed up or down relative to the body during compression. This leads to unnecessary stretching of the skin and other tissues around the breast, which can make the imaging procedure more painful for the patient. The goal of this study was to implement a method to measure and minimize the force imbalance, and to assess itsmore » feasibility as an objective and reproducible method of setting the image receptor height. Methods: A trial was conducted consisting of 13 craniocaudal mammographic compressions on a silicone breast phantom, each with the image receptor positioned at a different height. The image receptor height was varied over a range of 12 cm. In each compression, the force exerted by the compression paddle was increased up to 140 N in steps of 10 N. In addition to the paddle force, the authors measured the force exerted by the image receptor and the reaction force exerted on the patient body by the ground. The trial was repeated 8 times, with the phantom remounted at a slightly different orientation and position between the trials. Results: For a given paddle force, the obtained results showed that there is always exactly one image receptor height that leads to a balance of the forces on the breast. For the breast phantom, deviating from this specific height increased the force imbalance by 9.4 ± 1.9 N/cm (6.7%) for 140 N paddle force, and by 7.1 ± 1.6 N/cm (17.8%) for 40 N paddle force. The results also show that in situations where the force exerted by the image receptor is not measured, the craniocaudal force imbalance can still be determined by positioning the patient on a weighing scale and observing the changes in displayed weight during the procedure. Conclusions: In mammographic

  7. Method of Calibrating a Force Balance

    NASA Technical Reports Server (NTRS)

    Parker, Peter A. (Inventor); Rhew, Ray D. (Inventor); Johnson, Thomas H. (Inventor); Landman, Drew (Inventor)

    2015-01-01

    A calibration system and method utilizes acceleration of a mass to generate a force on the mass. An expected value of the force is calculated based on the magnitude and acceleration of the mass. A fixture is utilized to mount the mass to a force balance, and the force balance is calibrated to provide a reading consistent with the expected force determined for a given acceleration. The acceleration can be varied to provide different expected forces, and the force balance can be calibrated for different applied forces. The acceleration may result from linear acceleration of the mass or rotational movement of the mass.

  8. Surface Energy Balance System (SEBS) Handbook

    SciTech Connect

    Cook, DR

    2011-02-14

    A Surface Energy Balance System (SEBS) has been installed collocated with each deployed ECOR system at the Southern Great Plains (SGP), North Slope of Alaska (NSA), Tropical Western Pacific (TWP), ARM Mobile Facility 1 (AMF1), and ARM Mobile Facility 2 (AMF2). The surface energy balance system consists of upwelling and downwelling solar and infrared radiometers within one net radiometer, a wetness sensor, and soil measurements. The SEBS measurements allow the comparison of ECOR sensible and latent heat fluxes with the energy balance determined from the SEBS and provide information on wetting of the sensors for data quality purposes.

  9. Radiation balances and the solar constant

    NASA Technical Reports Server (NTRS)

    Crommelynck, D.

    1981-01-01

    The radiometric concepts are defined in order to consider various types of radiation balances and relate them to the diabetic form of the energy balance. Variability in space and time of the components of the radiation field are presented. A specific concept for sweeping which is tailored to the requirements is proposed. Finally, after establishing the truncated character of the present knowledge of the radiation balance. The results of the last observations of the solar constant are given. Ground and satellite measurement techniques are discussed.

  10. Balance Contrast Enhancement using piecewise linear stretching

    NASA Astrophysics Data System (ADS)

    Rahavan, R. V.; Govil, R. C.

    1993-04-01

    Balance Contrast Enhancement is one of the techniques employed to produce color composites with increased color contrast. It equalizes the three images used for color composition in range and mean. This results in a color composite with large variation in hue. Here, it is shown that piecewise linear stretching can be used for performing the Balance Contrast Enhancement. In comparison with the Balance Contrast Enhancement Technique using parabolic segment as transfer function (BCETP), the method presented here is algorithmically simple, constraint-free and produces comparable results.

  11. Towards an Understanding of Atmospheric Balance

    NASA Technical Reports Server (NTRS)

    Errico, Ronald M.

    2015-01-01

    During a 35 year period I published 30+ pear-reviewed papers and technical reports concerning, in part or whole, the topic of atmospheric balance. Most used normal modes, either implicitly or explicitly, as the appropriate diagnostic tool. This included examination of nonlinear balance in several different global and regional models using a variety of novel metrics as well as development of nonlinear normal mode initialization schemes for particular global and regional models. Recent studies also included the use of adjoint models and OSSEs to answer some questions regarding balance. lwill summarize what I learned through those many works, but also present what l see as remaining issues to be considered or investigated.

  12. 46 CFR 232.4 - Balance sheet accounts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Balance sheet accounts. 232.4 Section 232.4 Shipping... ACTIVITIES UNIFORM FINANCIAL REPORTING REQUIREMENTS Balance Sheet § 232.4 Balance sheet accounts. (a.... (b) Purpose of balance sheet accounts. The balance sheet accounts are intended to disclose the...

  13. 46 CFR 232.4 - Balance sheet accounts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Balance sheet accounts. 232.4 Section 232.4 Shipping... ACTIVITIES UNIFORM FINANCIAL REPORTING REQUIREMENTS Balance Sheet § 232.4 Balance sheet accounts. (a.... (b) Purpose of balance sheet accounts. The balance sheet accounts are intended to disclose the...

  14. Balance Calibration – A Method for Assigning a Direct-Reading Uncertainty to an Electronic Balance.

    SciTech Connect

    Mike Stears

    2010-07-01

    Paper Title: Balance Calibration – A method for assigning a direct-reading uncertainty to an electronic balance. Intended Audience: Those who calibrate or use electronic balances. Abstract: As a calibration facility, we provide on-site (at the customer’s location) calibrations of electronic balances for customers within our company. In our experience, most of our customers are not using their balance as a comparator, but simply putting an unknown quantity on the balance and reading the displayed mass value. Manufacturer’s specifications for balances typically include specifications such as readability, repeatability, linearity, and sensitivity temperature drift, but what does this all mean when themore » balance user simply reads the displayed mass value and accepts the reading as the true value? This paper discusses a method for assigning a direct-reading uncertainty to a balance based upon the observed calibration data and the environment where the balance is being used. The method requires input from the customer regarding the environment where the balance is used and encourages discussion with the customer regarding sources of uncertainty and possible means for improvement; the calibration process becomes an educational opportunity for the balance user as well as calibration personnel. This paper will cover the uncertainty analysis applied to the calibration weights used for the field calibration of balances; the uncertainty is calculated over the range of environmental conditions typically encountered in the field and the resulting range of air density. The temperature stability in the area of the balance is discussed with the customer and the temperature range over which the balance calibration is valid is decided upon; the decision is based upon the uncertainty needs of the customer and the desired rigor in monitoring by the customer. Once the environmental limitations are decided, the calibration is performed and the measurement data is entered into

  15. Surface Mass Balance of the Columbia Glacier, Alaska, 1978 and 2010 Balance Years

    USGS Publications Warehouse

    O'Neel, Shad

    2012-01-01

    Although Columbia Glacier is one of the largest sources of glacier mass loss in Alaska, surface mass balance measurements are sparse, with only a single data set available from 1978. The dearth of surface mass-balance data prohibits partitioning of the total mass losses between dynamics and surface forcing; however, the accurate inclusion of calving glaciers into predictive models requires both dynamic and climatic forcing of total mass balance. During 2010, the U.S. Geological Survey collected surface balance data at several locations distributed over the surface of Columbia Glacier to estimate the glacier-wide annual balance for balance year 2010 using the 2007 area-altitude distribution. This report also summarizes data collected in 1978, calculates the 1978 annual surface balance, and uses these observations to constrain the 2010 values, particularly the shape of the balance profile. Both years exhibit balances indicative of near-equilibrium surface mass-balance conditions, and demonstrate the importance of dynamic processes during the rapid retreat.

  16. Differential sensitivity between a virtual reality (VR) balance module and clinically used concussion balance modalities

    PubMed Central

    Teel, Elizabeth F; Gay, Michael R; Arnett, Peter A; Slobounov, Semyon M

    2015-01-01

    Objective Balance assessments are part of the recommended clinical concussion evaluation, along with computerized neuropsychological testing and self-reported symptoms checklists. New technology has allowed for the creation of virtual reality (VR) balance assessments to be used in concussion care, but there is little information on the sensitivity and specificity of these evaluations. The purpose of this study is to establish the sensitivity and specificity of a VR balance module for detecting lingering balance deficits clinical concussion care. Design Retrospective, case-control study Setting Institutional research laboratory Participants Normal controls (n=94) and concussed participants (n=27) Interventions All participants completed a VR balance assessment paradigm. Concussed participants were diagnosed by a Certified Athletic Trainer or physician (with 48 hours post-injury) and tested in the lab between 7-10 days post-injury. ROC curves were performed in order to establish the VR module’s sensitivity and specificity for detecting lingering balance deficits. Main Outcome Measures Final balance score Results For the VR balance module, a cutoff score of 8.25 was established to maximize sensitivity at 85.7% and specificity at 87.8%. Conclusions The VR balance module has high sensitivity and specificity for detecting sub-acute balance deficits after concussive injury. PMID:26505696

  17. [Balance trainability using the Nintendo Wii balance board in sportive people].

    PubMed

    Paukowits, S; Stöggl, T

    2014-03-01

    A multivariable training has a positive impact on balance skills and risk of injury. To date the effect of this training using the Nintendo Wii balance board in sportive people has not yet been investigated. The aim of this study was to investigate whether training with the Nintendo Wii balance board can improve balance skills. 20 people were randomized into a control and an intervention group each with 10 people who performed a unilateral stance test with eyes open and closed as well as the star excursion balance test before and after the intervention. The control group completed their usual sports and the intervention group an adjunct training with the Nintendo Wii balance board for 4 weeks. Adjunct Training using the Nintendo Wii Balance Board did not improve sportive people's balance skills significantly. The intervention group, however, attained better results in the star excursion balance test, whereas the control group did not show any changes. The unilateral stance tests did not provide significant differences before and after training within both groups. The use of the Nintendo Wii balance board should be further investigated by employing individual difficulty levels. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Effects of circular gait training on balance, balance confidence in patients with stroke: a pilot study.

    PubMed

    Park, Shin-Kyu; Kim, Sung-Jin; Yoon, Tak Yong; Lee, Suk-Min

    2018-05-01

    [Purpose] This study aimed to investigate the effects of circular gait training on balance and balance confidence in patients with stroke. [Subjects and Methods] Fifteen patients with stroke were randomly divided into either the circular gait training (CGT) group (n=8) or the straight gait training (SGT) group (n=7). Both groups had conventional therapy that adhered to the neurodevelopmental treatment (NDT) approach, for 30 min. In addition, the CGT group performed circular gait training, and the SGT group practiced straight gait training for 30 min. Each intervention was applied for 1 h, 5 days a week, for 2 weeks. Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Activities-specific Balance Confidence (ABC) scale were used to test balance and balance confidence. [Results] After the intervention, both groups showed significant increases in balance and balance confidence. Significant improvements in the balance of the CGT group compared with the SGT group were observed at post-assessment. [Conclusion] This study showed that circular gait training significantly improves balance in patients with stroke.

  19. A Multipurpose Experiment with an Electronic Balance

    ERIC Educational Resources Information Center

    Ganci, S.

    2008-01-01

    This short article describes some useful and quick applications of a cooking electronic balance. Newton's third law, Archimedes buoyancy and an estimate of relative density are accomplished in a very simple way. (Contains 1 figure.)

  20. Background-free balanced optical cross correlator

    DOEpatents

    Nejadmalayeri, Amir Hossein; Kaertner, Franz X

    2014-12-23

    A balanced optical cross correlator includes an optical waveguide, a first photodiode including a first n-type semiconductor and a first p-type semiconductor positioned about the optical waveguide on a first side of the optical waveguide's point of symmetry, and a second photodiode including a second n-type semiconductor and a second p-type semiconductor positioned about the optical waveguide on a second side of the optical waveguide's point of symmetry. A balanced receiver including first and second inputs is configured to produce an output current or voltage that reflects a difference in currents or voltages, originating from the first and the second photodiodes of the balanced cross correlator and fed to the first input and to the second input of the balanced receiver.

  1. Remote balance weighs accurately amid high radiation

    NASA Technical Reports Server (NTRS)

    Eggenberger, D. N.; Shuck, A. B.

    1969-01-01

    Commercial beam-type balance, modified and outfitted with electronic controls and digital readout, can be remotely controlled for use in high radiation environments. This allows accurate weighing of breeder-reactor fuel pieces when they are radioactively hot.

  2. Jet Exit Rig Six Component Force Balance

    NASA Technical Reports Server (NTRS)

    Castner, Raymond; Wolter, John; Woike, Mark; Booth, Dennis

    2012-01-01

    A new six axis air balance was delivered to the NASA Glenn Research Center. This air balance has an axial force capability of 800 pounds, primary airflow of 10 pounds per second, and a secondary airflow of 3 pounds per second. Its primary use was for the NASA Glenn Jet Exit Rig, a wind tunnel model used to test both low-speed, and high-speed nozzle concepts in a wind tunnel. This report outlines the installation of the balance in the Jet Exit Rig, and the results from an ASME calibration nozzle with an exit area of 8 square-inches. The results demonstrated the stability of the force balance for axial measurements and the repeatability of measurements better than 0.20 percent.

  3. The value of balanced growth for transportation.

    DOT National Transportation Integrated Search

    2014-12-01

    The Ohio Balanced Growth Program is a voluntary, locally-driven, incentive-driven program which aims to encourage : compact, nodal development patterns. The Ohio Department of Transportation provided support for this research to evaluate : potential ...

  4. Determination of nitrogen balance in agroecosystems

    USDA-ARS?s Scientific Manuscript database

    Nitrogen balance in agroecosystems provides a quantitative framework of N inputs and outputs and retention in the soil that examine sustainability of agricultural productivity and soil and environmental quality. Nitrogen inputs include N additions from manures and fertilizers, atmospheric deposition...

  5. Quantum load balancing in ad hoc networks

    NASA Astrophysics Data System (ADS)

    Hasanpour, M.; Shariat, S.; Barnaghi, P.; Hoseinitabatabaei, S. A.; Vahid, S.; Tafazolli, R.

    2017-06-01

    This paper presents a novel approach in targeting load balancing in ad hoc networks utilizing the properties of quantum game theory. This approach benefits from the instantaneous and information-less capability of entangled particles to synchronize the load balancing strategies in ad hoc networks. The quantum load balancing (QLB) algorithm proposed by this work is implemented on top of OLSR as the baseline routing protocol; its performance is analyzed against the baseline OLSR, and considerable gain is reported regarding some of the main QoS metrics such as delay and jitter. Furthermore, it is shown that QLB algorithm supports a solid stability gain in terms of throughput which stands a proof of concept for the load balancing properties of the proposed theory.

  6. Work-life balance and welfare.

    PubMed

    Evans, Lois; Young, Greg

    2017-04-01

    An online survey and focus groups were conducted, providing qualitative information on the work-life balance of psychiatrists and trainees in Australasia. An invitation to participate in an anonymous online welfare survey was emailed to all the Royal Australian and New Zealand College of Psychiatrists trainees, Fellows, and Affiliates. Following this, nine focus groups were held across Australia and New Zealand. Responses received were thematically analysed. The emergent patterns are presented in this report. Our research suggests that work-life balance can be subjectively and objectively measured. There are phases of good and bad work-life balance, depending on stage of career and other commitments. Work-life balance may be an indicator of the health of individuals and organisations. Due to its complexity, with intrinsic and extrinsic factors involved, solutions are unlikely to be simple. Further studies are needed to substantiate our findings.

  7. Astronaut John Glenn tests balance mechanism performance

    NASA Image and Video Library

    1962-02-01

    S64-14849 (1962) --- Astronaut John H. Glenn Jr.'s balance mechanism (semi-circular-canals) is tested by running cool water into his ear and measuring effect on eye motions (nystagmus). Photo credit: NASA

  8. Improving Current Balance In Parallel MOSFET's

    NASA Technical Reports Server (NTRS)

    Niedra, Janis M.

    1992-01-01

    Simple circuit makes currents more nearly equal. Addition of diodes and adjustable-tap resistor increases operating range over which drain currents in two unmatched power MOSFET's brought more nearly into balance.

  9. Surface melt dominates Alaska glacier mass balance

    USGS Publications Warehouse

    Larsen Chris F,; Burgess, E; Arendt, A.A.; O'Neel, Shad; Johnson, A.J.; Kienholz, C.

    2015-01-01

    Mountain glaciers comprise a small and widely distributed fraction of the world's terrestrial ice, yet their rapid losses presently drive a large percentage of the cryosphere's contribution to sea level rise. Regional mass balance assessments are challenging over large glacier populations due to remote and rugged geography, variable response of individual glaciers to climate change, and episodic calving losses from tidewater glaciers. In Alaska, we use airborne altimetry from 116 glaciers to estimate a regional mass balance of −75 ± 11 Gt yr−1 (1994–2013). Our glacier sample is spatially well distributed, yet pervasive variability in mass balances obscures geospatial and climatic relationships. However, for the first time, these data allow the partitioning of regional mass balance by glacier type. We find that tidewater glaciers are losing mass at substantially slower rates than other glaciers in Alaska and collectively contribute to only 6% of the regional mass loss.

  10. Dynamical balance in the Indonesian Seas circulation

    NASA Astrophysics Data System (ADS)

    Burnett, William H.; Kamenkovich, Vladimir M.; Jaffe, David A.; Gordon, Arnold L.; Mellor, George L.

    2000-09-01

    A high resolution, four-open port, non-linear, barotropic ocean model (2D POM) is used to analyze the Indonesian Seas circulation. Both local and overall momentum balances are studied. It is shown that geostrophy holds over most of the area and that the Pacific-Indian Ocean pressure difference is essentially balanced by the resultant of pressure forces acting on the bottom.

  11. DNS load balancing in the CERN cloud

    NASA Astrophysics Data System (ADS)

    Reguero Naredo, Ignacio; Lobato Pardavila, Lorena

    2017-10-01

    Load Balancing is one of the technologies enabling deployment of large-scale applications on cloud resources. A DNS Load Balancer Daemon (LBD) has been developed at CERN as a cost-effective way to balance applications accepting DNS timing dynamics and not requiring persistence. It currently serves over 450 load-balanced aliases with two small VMs acting as master and slave. The aliases are mapped to DNS subdomains. These subdomains are managed with DDNS according to a load metric, which is collected from the alias member nodes with SNMP. During the last years, several improvements were brought to the software, for instance: support for IPv6, parallelization of the status requests, implementing the client in Python to allow for multiple aliases with differentiated states on the same machine or support for application state. The configuration of the Load Balancer is currently managed by a Puppet type. It discovers the alias member nodes and gets the alias definitions from the Ermis REST service. The Aiermis self-service GUI for the management of the LB aliases has been produced and is based on the Ermis service above that implements a form of Load Balancing as a Service (LBaaS). The Ermis REST API has authorisation based in Foreman hostgroups. The CERN DNS LBD is Open Software with Apache 2 license.

  12. Exploring occupational balance in adults in Sweden.

    PubMed

    Wagman, Petra; Håkansson, Carita

    2014-11-01

    The aim of this study was to describe the relationship between occupational balance (measured by the occupational balance questionnaire [OBQ]) and self-rated health and life satisfaction. A secondary aim was to explore differences in occupational balance among adults in Sweden. The 153 participants (63% women), recruited using convenience sampling, answered a questionnaire comprising demographic questions, the OBQ, one item about self-rated health, and one about life satisfaction. The OBQ was analysed for correlation with subjective health and life satisfaction. The OBQ and its individual items were also analysed for correlations with age and for differences between men and women and participants living with children younger than 18 years versus not. The OBQ was significantly positively correlated to self-rated health and life satisfaction, supporting the relationship between occupational balance and health. No significant correlation between age and the total OBQ was identified but some differences in occupational balance, related to whether the participant was living with or without children at home, were revealed. The results should be interpreted with caution due to the nature of the sample and data but they can serve as a point of departure for further studies and hypotheses regarding occupational balance in different populations.

  13. Dynamic power balance analysis in JET

    NASA Astrophysics Data System (ADS)

    Matthews, G. F.; Silburn, S. A.; Challis, C. D.; Eich, T.; Iglesias, D.; King, D.; Sieglin, B.; Contributors, JET

    2017-12-01

    The full scale realisation of nuclear fusion as an energy source requires a detailed understanding of power and energy balance in current experimental devices. In this we explore whether a global power balance model in which some of the calibration factors applied to the source or sink terms are fitted to the data can provide insight into possible causes of any discrepancies in power and energy balance seen in the JET tokamak. We show that the dynamics in the power balance can only be properly reproduced by including the changes in the thermal stored energy which therefore provides an additional opportunity to cross calibrate other terms in the power balance equation. Although the results are inconclusive with respect to the original goal of identifying the source of the discrepancies in the energy balance, we do find that with optimised parameters an extremely good prediction of the total power measured at the outer divertor target can be obtained over a wide range of pulses with time resolution up to ∼25 ms.

  14. Measurement in Service Businesses: Challenges and Future Directions

    NASA Astrophysics Data System (ADS)

    Tyagi, Rajesh Kumar

    This chapter presents challenges faced by service businesses while implementing a measurement system. A review of existing frameworks is presented and a new framework, the Service Scorecard, is introduced. The Service Scorecard is an adaptation of the Six Sigma Business Scorecard for the service sector. The framework has also been influenced by existing frameworks such as the Malcom Baldrige award criteria, the Balanced Scorecard, the European Quality award and the Service Profit Chain model. The seven elements of the Service Scorecard are Growth, Leadership, Acceleration, Collaboration, Innovation, Execution, and Retention. The examples of measurement systems are presented with concrete real-world case examples. Final thoughts and the challenges faced are also presented.

  15. Validity and reliability of balance assessment software using the Nintendo Wii balance board: usability and validation

    PubMed Central

    2014-01-01

    Background A balance test provides important information such as the standard to judge an individual’s functional recovery or make the prediction of falls. The development of a tool for a balance test that is inexpensive and widely available is needed, especially in clinical settings. The Wii Balance Board (WBB) is designed to test balance, but there is little software used in balance tests, and there are few studies on reliability and validity. Thus, we developed a balance assessment software using the Nintendo Wii Balance Board, investigated its reliability and validity, and compared it with a laboratory-grade force platform. Methods Twenty healthy adults participated in our study. The participants participated in the test for inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with balance assessment software using the Nintendo Wii balance board and a laboratory-grade force platform. Data such as Center of Pressure (COP) path length and COP velocity were acquired from the assessment systems. The inter-rater reliability, the intra-rater reliability, and concurrent validity were analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement (SEM). Results The inter-rater reliability (ICC: 0.89-0.79, SEM in path length: 7.14-1.90, SEM in velocity: 0.74-0.07), intra-rater reliability (ICC: 0.92-0.70, SEM in path length: 7.59-2.04, SEM in velocity: 0.80-0.07), and concurrent validity (ICC: 0.87-0.73, SEM in path length: 5.94-0.32, SEM in velocity: 0.62-0.08) were high in terms of COP path length and COP velocity. Conclusion The balance assessment software incorporating the Nintendo Wii balance board was used in our study and was found to be a reliable assessment device. In clinical settings, the device can be remarkably inexpensive, portable, and convenient for the balance assessment. PMID:24912769

  16. Validity and reliability of balance assessment software using the Nintendo Wii balance board: usability and validation.

    PubMed

    Park, Dae-Sung; Lee, GyuChang

    2014-06-10

    A balance test provides important information such as the standard to judge an individual's functional recovery or make the prediction of falls. The development of a tool for a balance test that is inexpensive and widely available is needed, especially in clinical settings. The Wii Balance Board (WBB) is designed to test balance, but there is little software used in balance tests, and there are few studies on reliability and validity. Thus, we developed a balance assessment software using the Nintendo Wii Balance Board, investigated its reliability and validity, and compared it with a laboratory-grade force platform. Twenty healthy adults participated in our study. The participants participated in the test for inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with balance assessment software using the Nintendo Wii balance board and a laboratory-grade force platform. Data such as Center of Pressure (COP) path length and COP velocity were acquired from the assessment systems. The inter-rater reliability, the intra-rater reliability, and concurrent validity were analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement (SEM). The inter-rater reliability (ICC: 0.89-0.79, SEM in path length: 7.14-1.90, SEM in velocity: 0.74-0.07), intra-rater reliability (ICC: 0.92-0.70, SEM in path length: 7.59-2.04, SEM in velocity: 0.80-0.07), and concurrent validity (ICC: 0.87-0.73, SEM in path length: 5.94-0.32, SEM in velocity: 0.62-0.08) were high in terms of COP path length and COP velocity. The balance assessment software incorporating the Nintendo Wii balance board was used in our study and was found to be a reliable assessment device. In clinical settings, the device can be remarkably inexpensive, portable, and convenient for the balance assessment.

  17. Balance Assessment Practices and Use of Standardized Balance Measures Among Ontario Physical Therapists

    PubMed Central

    Sibley, Kathryn M.; Straus, Sharon E.; Inness, Elizabeth L.; Salbach, Nancy M.

    2011-01-01

    Background Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. Objective The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. Design This was a cross-sectional study. Methods A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. Results Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed “Up & Go” Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. Limitations The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. Conclusions Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall. PMID:21868613

  18. Covariant balance laws in continua with microstructure

    NASA Astrophysics Data System (ADS)

    Yavari, Arash; Marsden, Jerrold E.

    2009-02-01

    The purpose of this paper is to extend the Green-Naghdi-Rivlin balance of energy method to continua with microstructure. The key idea is to replace the group of Galilean transformations with the group of diffeomorphisms of the ambient space. A key advantage is that one obtains in a natural way all the needed balance laws on both the macro and micro levels along with two Doyle-Erickson formulas. We model a structured continuum as a triplet of Riemannian manifolds: a material manifold, the ambient space manifold of material particles and a director field manifold. The Green-Naghdi-Rivlin theorem and its extensions for structured continua are critically reviewed. We show that when the ambient space is Euclidean and when the microstructure manifold is the tangent space of the ambient space manifold, postulating a single balance of energy law and its invariance under time-dependent isometries of the ambient space, one obtains conservation of mass, balances of linear and angular momenta but not a separate balance of linear momentum. We develop a covariant elasticity theory for structured continua by postulating that energy balance is invariant under time-dependent spatial diffeomorphisms of the ambient space, which in this case is the product of two Riemannian manifolds. We then introduce two types of constrained continua in which microstructure manifold is linked to the reference and ambient space manifolds. In the case when at every material point, the microstructure manifold is the tangent space of the ambient space manifold at the image of the material point, we show that the assumption of covariance leads to balances of linear and angular momenta with contributions from both forces and micro-forces along with two Doyle-Ericksen formulas. We show that generalized covariance leads to two balances of linear momentum and a single coupled balance of angular momentum. Using this theory, we covariantly obtain the balance laws for two specific examples, namely elastic

  19. Medical Devices Assess, Treat Balance Disorders

    NASA Technical Reports Server (NTRS)

    2009-01-01

    You may have heard the phrase as difficult as walking and chewing gum as a joking way of referring to something that is not difficult at all. Just walking, however, is not all that simple physiologically speaking. Even standing upright is an undertaking requiring the complex cooperation of multiple motor and sensory systems including vision, the inner ear, somatosensation (sensation from the skin), and proprioception (the sense of the body s parts in relation to each other). The compromised performance of any of these elements can lead to a balance disorder, which in some form affects nearly half of Americans at least once in their lifetimes, from the elderly, to those with neurological or vestibular (inner ear) dysfunction, to athletes with musculoskeletal injuries, to astronauts returning from space. Readjusting to Earth s gravity has a significant impact on an astronaut s ability to balance, a result of the brain switching to a different "model" for interpreting sensory input in normal gravity versus weightlessness. While acclimating, astronauts can experience headaches, motion sickness, and problems with perception. To help ease the transition and study the effects of weightlessness on the body, NASA has conducted many investigations into post-flight balance control, realizing this research can help treat patients with balance disorders on Earth as well. In the 1960s, the NASA-sponsored Man Vehicle Laboratory at the Massachusetts Institute of Technology (MIT) studied the effects of prolonged space flight on astronauts. The lab s work intrigued MIT doctoral candidate Lewis Nashner, who began conducting NASA-funded research on human movement and balance under the supervision of Dr. Larry Young in the MIT Department of Aeronautics and Astronautics. In 1982, Nashner s work resulted in a noninvasive clinical technique for assessing the cooperative systems that allow the body to balance, commonly referred to as computerized dynamic posturography (CDP). CDP employs a

  20. Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson's Disease

    PubMed Central

    Giardini, Marica; Nardone, Antonio; Guglielmetti, Simone; Arcolin, Ilaria; Pisano, Fabrizio

    2018-01-01

    We hypothesised that rehabilitation specifically addressing balance in Parkinson's disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises) were assessed by assigning patients to two groups (Platform, n = 15, and Exercises, n = 17). The platform moved periodically in the anteroposterior, laterolateral, and oblique direction, with and without vision in different trials. Balance exercises were based on the Otago Exercise Program. Both platform and exercise sessions were administered from easy to difficult. Outcome measures were (a) balancing behaviour, assessed by both Index of Stability (IS) on platform and Mini-BESTest, and (b) gait, assessed by both baropodometry and Timed Up and Go (TUG) test. Falls Efficacy Scale-International (FES-I) and Parkinson's Disease Questionnaire (PDQ-8) were administered. Both groups exhibited better balance control, as assessed both by IS and by Mini-BESTest. Gait speed at baropodometry also improved in both groups, while TUG was less sensitive to improvement. Scores of FES-I and PDQ-8 showed a marginal improvement. A four-week treatment featuring no gait training but focused on challenging balance tasks produces considerable gait enhancement in mildly to moderately affected patients. Walking problems in PD depend on postural instability and are successfully relieved by appropriate balance rehabilitation. This trial is registered with ClinicalTrials.gov NCT03314597. PMID:29706993