The spatial distribution of behavior under varying frequencies of temporally scheduled water delivery.

PubMed Central

Ribes-Iñesta, E; Torres, C

2000-01-01

Two studies evaluated the effects of response-independent water deliveries on the location (on the floor of the experimental chamber) and position (height) of rats' behavior. In both experiments, fixed-time schedules delivered water in two dispensers that were located at opposite ends of the chamber. In Experiment 1, the two schedules provided complementary frequencies of water deliveries while the overall number of deliveries stayed constant. In Experiment 2, one of the schedules delivered water twice as frequently as the other; this proportion was kept constant while the overall density of water deliveries changed systematically. In both experiments, a single position (height) of behavior was dominant. Also, the percentage of time allocated to each dispenser was roughly proportional to the percentage of water deliveries associated with the dispensers. These data and additional considerations support the importance of examining the spatial properties and patterning of behavior. PMID:10784009

Accelerating change: Fostering innovation in healthcare delivery at academic medical centers.

PubMed

Ostrovsky, Andrey; Barnett, Michael

2014-03-01

Academic medical centers (AMCs) have the potential to be leaders in the era of healthcare delivery reform, but most have yet to display a commitment to delivery innovation on par with their commitment to basic research. Several institutional factors impede delivery innovation including the paucity of adequate training in design and implementation of new delivery models and the lack of established pathways for academic career advancement outside of research. This paper proposes two initiatives to jumpstart disruptive innovation at AMCs: an institutional "innovation incubator" program and a clinician-innovator career track coupled with innovation training programs. Copyright © 2013 Elsevier Inc. All rights reserved.

Mode of Delivery among HIV-Infected Pregnant Women in Philadelphia, 2005-2013

PubMed Central

Adams, Joëlla W.; Anderson, Emily A.

2015-01-01

Objective Current guidelines call for HIV-infected women to deliver via scheduled Caesarean when the maternal HIV viral load (VL) is >1,000 copies/ml. We describe the mode of delivery among HIV-infected women and evaluate adherence to relevant recommendations. Study Design We performed a population-based surveillance analysis of HIV-infected pregnant women in Philadelphia from 2005 to 2013, comparing mode of delivery (vaginal, scheduled Caesarean, or emergent Caesarean) by VL during pregnancy, closest to the time of delivery (≤1,000 copies/ml versus an unknown VL or VL >1,000 copies/ml) and associated factors in multivariable analysis. Results Our cohort included 824 deliveries from 648 HIV-infected women, of whom 69.4% had a VL ≤1,000 copies/ml and 30.6% lacked a VL or had a VL >1,000 copies/ml during pregnancy, closest to the time of delivery. Mode of delivery varied by VL: 56.6% of births were vaginal, 30.1% scheduled Caesarean, and 13.3% emergent Caesarean when the VL was ≤1,000 copies/ml; when the VL was unknown or >1,000 copies/ml, 32.9% of births were vaginal, 49.9% scheduled Caesarean and 17.5% emergent Caesarean. In multivariable analyses, Hispanic women (adjusted odds ratio (AOR) 0.17, 95% Confidence Interval (CI) 0.04–0.76) and non-Hispanic black women (AOR 0.27, 95% CI 0.10–0.77) were less to likely to deliver via scheduled Caesarean compared to non-Hispanic white women. Women who delivered prior to 38 weeks’ gestation (AOR 0.37, 95% CI 0.18–0.76) were also less likely to deliver via scheduled Caesarean compared to women who delivered after 38 weeks’ gestation. An interaction term for race and gestational age at delivery was significant in multivariable analysis. Non-Hispanic black (AOR 0.06, 95% CI 0.01–0.36) and Hispanic women (AOR 0.03, 95% CI 0.00–0.59) were more likely to deliver prematurely and less likely to deliver via scheduled C-section compared to non-Hispanic white women. Having a previous Caesarean (AOR 27.77, 95% CI 8.94–86.18) increased the odds of scheduled Caesarean delivery. Conclusions Only half of deliveries for women with an unknown VL or VL >1,000 copies/ml occurred via scheduled Caesarean. Delivery prior to 38 weeks, particularly among minority women, resulted in a missed opportunity to receive a scheduled Caesarean. However, even when delivering at or after 38 weeks’ gestation, a significant proportion of women did not get a scheduled Caesarean when indicated, suggesting a need for focused public health interventions to increase the proportion of women achieving viral suppression during pregnancy and delivering via scheduled Caesarean when indicated. PMID:26657902

Patient Perceptions of Treatment Delivery Platforms for Cognitive Behavioral Therapy for Insomnia.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Laba, Tracey-Lea; Saini, Bandana

2017-03-21

Stepped care has given rise to the proliferation of abbreviated CBT-I programs and delivery formats. This includes interventions delivered by allied health professionals and those delivered electronically through the Internet. This article aims to explore patient perceptions between electronic and face-to-face (FTF) delivery platforms for (abbreviated) CBT-I. Patients with insomnia from specialist sleep or psychology clinics and those from the general community in Sydney, Australia. Semistructured interviews were conducted with patients with insomnia, guided by a schedule of questions and a choice task to explore patient perceptions of the different CBT-I treatment delivery platforms (e.g., perceived advantages and disadvantages or willingness to engage with either platform). Interviews were transcribed verbatim and analyzed using Framework Analysis. Participants also completed a battery of clinical mood and insomnia measures. Fifty-one interviews were conducted with patients with insomnia from specialist sleep or psychology clinics (n = 22) and the general community (n = 29). Synthesis of the qualitative data set revealed three themes pertinent to the patients' perspective toward electronic and FTF CBT-I delivery: Concepts of Efficacy, Concerns About Treatment, and Treatment on My Terms. Participants' choice to engage with either platform was also informed by diverse factors including perceived efficacy of treatment, personal commitments, lifestyle, and beliefs about sleep and insomnia. Clarifying patient treatment priorities and allaying potential concerns about engaging with an electronic treatment platform represent important steps for disseminating eCBT-I into mainstream practice.

75 FR 14223 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

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75 FR 54937 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

.... This schedule is known as the DMM Capital Commitment Schedule (``CCS'').\\10\\ CCS provides the Display... and inside the Exchange Best Bid or Best Offer (``BBO''). CCS interest is separate and distinct from...

78 FR 38766 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

.... This schedule is known as the DMM Capital Commitment Schedule (``CCS'').\\11\\ CCS provides the Display..., at and inside the Exchange Best Bid or Best Offer (``BBO''). CCS interest is separate and distinct...

76 FR 82340 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

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Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

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78 FR 1288 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

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77 FR 45406 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-31

.... This schedule is known as the DMM Capital Commitment Schedule (``CCS'').\\11\\ CCS provides the Display..., at and inside the Exchange Best Bid or Best Offer (``BBO''). CCS interest is separate and distinct...

Optimizing Hydropower Day-Ahead Scheduling for the Oroville-Thermalito Project

NASA Astrophysics Data System (ADS)

Veselka, T. D.; Mahalik, M.

2012-12-01

Under an award from the U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy, Water Power Program, a team of national laboratories is developing and demonstrating a suite of advanced, integrated analytical tools to assist managers and planners increase hydropower resources while enhancing the environment. As part of the project, Argonne National Laboratory is developing the Conventional Hydropower Energy and Environmental Systems (CHEERS) model to optimize day-ahead scheduling and real-time operations. We will present the application of CHEERS to the Oroville-Thermalito Project located in Northern California. CHEERS will aid California Department of Water Resources (CDWR) schedulers in making decisions about unit commitments and turbine-level operating points using a system-wide approach to increase hydropower efficiency and the value of power generation and ancillary services. The model determines schedules and operations that are constrained by physical limitations, characteristics of plant components, operational preferences, reliability, and environmental considerations. The optimization considers forebay and afterbay implications, interactions between cascaded power plants, turbine efficiency curves and rough zones, and operator preferences. CHEERS simultaneously considers over time the interactions among all CDWR power and water resources, hydropower economics, reservoir storage limitations, and a set of complex environmental constraints for the Thermalito Afterbay and Feather River habitats. Power marketers, day-ahead schedulers, and plant operators provide system configuration and detailed operational data, along with feedback on model design and performance. CHEERS is integrated with CDWR data systems to obtain historic and initial conditions of the system as the basis from which future operations are then optimized. Model results suggest alternative operational regimes that improve the value of CDWR resources to the grid while enhancing the environment and complying with water delivery obligations for non-power uses.

The Effects of Varying Schedules of Incentive Delivery on Technical Training.

ERIC Educational Resources Information Center

Pritchard, Robert D.; And Others

The research reported here was initiated and designed to assess the impact of various schedules of incentive delivery (schedules of reinforcement) on performance and attitudes in an Air Force-related setting. Civilian subjects matching the characteristics of Air Force trainees were hired to work for four weeks, one week under each of four…

Assessment of Delivery Accuracy in an Operational-Like Environment

NASA Technical Reports Server (NTRS)

Sharma, Shivanjli; Wynnyk, Mitch

2016-01-01

In order to enable arrival management concepts and solutions in a Next Generation Air Transportation System (NextGen) environment, ground-based sequencing and scheduling functions were developed to support metering operations in the National Airspace System. These sequencing and scheduling tools are designed to assist air traffic controllers in developing an overall arrival strategy, from enroute down to the terminal area boundary. NASA developed a ground system concept and protoype capability called Terminal Sequencing and Spacing (TSAS) to extend metering operations into the terminal area to the runway. To demonstrate the use of these scheduling and spacing tools in an operational-like environment, the FAA, NASA, and MITRE conducted an Operational Integration Assessment (OIA) of a prototype TSAS system at the FAA's William J. Hughes Technical Center (WJHTC). This paper presents an analysis of the arrival management strategies utilized and delivery accuracy achieved during the OIA. The analysis demonstrates how en route preconditioning, in various forms, and schedule disruptions impact delivery accuracy. As the simulation spanned both enroute and terminal airspace, the use of Ground Interval Management - Spacing (GIM-S) enroute speed advisories was investigated. Delivery accuracy was measured as the difference between the Scheduled Time of Arrival (STA) and the Actual Time of Arrival (ATA). The delivery accuracy was computed across all runs conducted during the OIA, which included deviations from nominal operations which are known to commonly occur in real operations, such as schedule changes and missed approaches. Overall, 83% of all flights were delivered into the terminal airspace within +/- 30 seconds of their STA and 94% of flights were delivered within +/- 60 seconds. The meter fix delivery accuracy standard deviation was found to be between 36 and 55 seconds across all arrival procedures. The data also showed when schedule disruptions were excluded, the percentage of aircraft delivered within +/- 30 seconds was between 85 and 90% across the various arrival procedures at the meter fix. This paper illustrates the ability to meet new delivery accuracy requirements in an operational-like environment using operational systems and NATCA controller participants, while also including common events that might cause disruptions to the schedule and overall system.

Effects of Management Communication, Opportunity for Learning, and Work Schedule Flexibility on Organizational Commitment

ERIC Educational Resources Information Center

Ng, Thomas W. H.; Butts, Marcus M.; Vandenberg, Robert J.; DeJoy, David M.; Wilson, Mark G.

2006-01-01

In the current career climate characterized by change and turbulence, employees may demonstrate limited organizational commitment to their employers. Rousseau (1998) suggests that two key ways to elicit loyalty from employees today are to reinforce perceptions of organizational membership and demonstrate organizational care and support for…

Evaluation of a New Thrust in the Delivery of Mental Health Services: Outpatient Commitment.

ERIC Educational Resources Information Center

Hiday, Virginia Aldige'; Scheid-Cook, Teresa L.

The North Carolina State Legislature made outpatient commitment (OPC) criteria less restrictive than involuntary hospitalization criteria, provided an enforcement mechanism, gave facilities and staff immunity from liability, and allocated funds for OPC patients. Data collected in a state-wide study of civil commitment respondents in North Carolina…

Incentive contracts for development projects

NASA Astrophysics Data System (ADS)

Finley, David T.; Smith, Byron; DeGroff, B.

2012-09-01

Finding a contract vehicle that balances the concerns of the customer and the contractor in a development project can be difficult. The customer wants a low price and an early delivery, with as few surprises as possible as the project progresses. The contractor wants sufficient cost and schedule to cover risk. Both want to clearly define what each party will provide. Many program offices do not want to award cost plus contracts because their funding sources will not allow it, their boards do not want an open ended commitment, and they feel like they lose financial control of the project. A fixed price incentive contract, with a mutually agreed upon target cost, provides the owner with visibility into the project and input into the execution of the project, encourages both parties to save costs, and stimulates a collaborative atmosphere by aligning the respective interests of customers and contractors.

COTSAT Small Spacecraft Cost Optimization for Government and Commercial Use

NASA Technical Reports Server (NTRS)

Swank, Aaron J.; Bui, David; Dallara, Christopher; Ghassemieh, Shakib; Hanratty, James; Jackson, Evan; Klupar, Pete; Lindsay, Michael; Ling, Kuok; Mattei, Nicholas;

Spiking neural network simulation: memory-optimal synaptic event scheduling.

PubMed

Stewart, Robert D; Gurney, Kevin N

2011-06-01

Spiking neural network simulations incorporating variable transmission delays require synaptic events to be scheduled prior to delivery. Conventional methods have memory requirements that scale with the total number of synapses in a network. We introduce novel scheduling algorithms for both discrete and continuous event delivery, where the memory requirement scales instead with the number of neurons. Superior algorithmic performance is demonstrated using large-scale, benchmarking network simulations.

A comparative evaluation of the effect of Internet-based CME delivery format on satisfaction, knowledge and confidence.

PubMed

Curran, Vernon R; Fleet, Lisa J; Kirby, Fran

2010-01-29

Internet-based instruction in continuing medical education (CME) has been associated with favorable outcomes. However, more direct comparative studies of different Internet-based interventions, instructional methods, presentation formats, and approaches to implementation are needed. The purpose of this study was to conduct a comparative evaluation of two Internet-based CME delivery formats and the effect on satisfaction, knowledge and confidence outcomes. Evaluative outcomes of two differing formats of an Internet-based CME course with identical subject matter were compared. A Scheduled Group Learning format involved case-based asynchronous discussions with peers and a facilitator over a scheduled 3-week delivery period. An eCME On Demand format did not include facilitated discussion and was not based on a schedule; participants could start and finish at any time. A retrospective, pre-post evaluation study design comparing identical satisfaction, knowledge and confidence outcome measures was conducted. Participants in the Scheduled Group Learning format reported significantly higher mean satisfaction ratings in some areas, performed significantly higher on a post-knowledge assessment and reported significantly higher post-confidence scores than participants in the eCME On Demand format that was not scheduled and did not include facilitated discussion activity. The findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME.

Periodic Heterogeneous Vehicle Routing Problem With Driver Scheduling

NASA Astrophysics Data System (ADS)

Mardiana Panggabean, Ellis; Mawengkang, Herman; Azis, Zainal; Filia Sari, Rina

2018-01-01

The paper develops a model for the optimal management of logistic delivery of a given commodity. The company has different type of vehicles with different capacity to deliver the commodity for customers. The problem is then called Periodic Heterogeneous Vehicle Routing Problem (PHVRP). The goal is to schedule the deliveries according to feasible combinations of delivery days and to determine the scheduling of fleet and driver and routing policies of the vehicles. The objective is to minimize the sum of the costs of all routes over the planning horizon. We propose a combined approach of heuristic algorithm and exact method to solve the problem.

Sustainable water deliveries from the Colorado River in a changing climate.

PubMed

Barnett, Tim P; Pierce, David W

2009-05-05

The Colorado River supplies water to 27 million users in 7 states and 2 countries and irrigates over 3 million acres of farmland. Global climate models almost unanimously project that human-induced climate change will reduce runoff in this region by 10-30%. This work explores whether currently scheduled future water deliveries from the Colorado River system are sustainable under different climate-change scenarios. If climate change reduces runoff by 10%, scheduled deliveries will be missed approximately 58% of the time by 2050. If runoff reduces 20%, they will be missed approximately 88% of the time. The mean shortfall when full deliveries cannot be met increases from approximately 0.5-0.7 billion cubic meters per year (bcm/yr) in 2025 to approximately 1.2-1.9 bcm/yr by 2050 out of a request of approximately 17.3 bcm/yr. Such values are small enough to be manageable. The chance of a year with deliveries <14.5 bcm/yr increases to 21% by midcentury if runoff reduces 20%, but such low deliveries could be largely avoided by reducing scheduled deliveries. These results are computed by using estimates of Colorado River flow from the 20th century, which was unusually wet; if the river reverts to its long-term mean, shortfalls increase another 1-1.5 bcm/yr. With either climate-change or long-term mean flows, currently scheduled future water deliveries from the Colorado River are not sustainable. However, the ability of the system to mitigate droughts can be maintained if the various users of the river find a way to reduce average deliveries.

Accelerated bridge construction and structural move : workshop.

DOT National Transportation Integrated Search

2014-03-01

The Michigan Department of Transportation (MDOT) is committed to provide the highest level of safety and : mobility during each step of a projects development and delivery. To fulfil the above commitment, MDOT : embraces technology and uses innova...

Variations in schools' commitment to health and implementation of health improvement activities: a cross-sectional study of secondary schools in Wales.

PubMed

Moore, Graham F; Littlecott, Hannah J; Fletcher, Adam; Hewitt, Gillian; Murphy, Simon

2016-02-10

Interventions to improve young people's health are most commonly delivered via schools. While young people attending the lowest socioeconomic status (SES) schools report poorer health profiles, no previous studies have examined whether there is an 'inverse care law' in school health improvement activity (i.e., whether schools in more affluent areas deliver more health improvement). Nor have other factors that may explain variations, such as leadership of health improvement activities, been examined at a population level. This paper examines variability in delivery of health improvement actions among secondary schools in Wales, and whether variability is linked to organisational commitment to health, socioeconomic status and school size. Of the 82 schools participating in the 2013/14 Health Behaviour in School-aged Children (HBSC) survey in Wales, 67 completed a questionnaire on school health improvement delivery structures and health improvement actions within their school. Correlational analyses explore associations of delivery of health improvement activity among schools in Wales with organisational commitment to health, socioeconomic context and school size. There is substantial variability among schools in organisational commitment to health, with pupil emotional health identified as a priority by 52 % of schools, and physical health by 43 %. Approximately half (49 %) report written action plans for pupil health. Based on composite measures, the quantity of school health improvement activity was greater in less affluent schools and schools reporting greater commitment to health. There was a consistent though non-significant trend toward more health improvement activity in larger schools. In multivariate analysis deprivation (OR = 1.06; 95 % CI = 1.01 to 1.12) and organisational commitment to health were significant independent predictors of the quantity of health improvement (OR = 1.60; 95 % CI = 1.15 to 2.22). There is no evidence of an 'inverse care law' in school health, with some evidence of more comprehensive, multi-level health improvement activity in more deprived schools. This large-scale, quantitative analysis supports previous smaller scale, qualitative studies/process evaluations that suggest that senior management team commitment to delivering health improvement, and formulating and reviewing progress against written action plans, are important for facilitating the delivery of comprehensive interventions.

Women's autonomy and scheduled cesarean sections in Brazil: a cautionary tale.

PubMed

Potter, Joseph E; Hopkins, Kristine; Faúndes, Anibal; Perpétuo, Ignez

2008-03-01

In Brazil, one-fourth of all women deliver in the private sector, where the rate of cesarean deliveries is extremely high (70%). Most (64%) private sector cesareans are scheduled, although many women would have preferred a vaginal delivery. The question this study addresses is whether childbearing women were induced to accept the procedure by their physicians, and if so, how? Three face-to-face structured interviews were conducted with 1,612 women (519 private sector and 1,093 public sector) early in pregnancy, approximately 1 month before their due date, and approximately 1 month postpartum. For all private sector patients having a scheduled cesarean section, women's self-reported reasons given for programming surgical delivery were classified into three groups according to obstetrical justification. After loss to follow-up (19.2% of private sector and 34.4% of public sector), our final sample included 1,136 women (419 private sector and 717 public sector). Compared with public sector participants in the final sample, on average, private sector participants were older by 3.4 years (28.7 vs 25.3 yr), had 0.4 fewer previous deliveries (0.6 vs 1.0), and had 3.4 more years of education (11.0 vs 7.6 yr). The final samples also differed slightly with respect to preference for vaginal delivery: 72.3 percent among those in the private sector and 79.6 percent in public sector. The cesarean section rate was 72 percent in the private sector and 31 percent in the public sector. Of the women with reports about the timing of the cesarean decision, 64.4 percent had a scheduled cesarean delivery in the private sector compared with 23.7 percent in the public sector. Many cesarean sections were scheduled for an "unjustified" medical reason, especially among women who, during pregnancy, had declared a preference for a vaginal delivery. Among 96 women in this latter group, the reason reported for the procedure was unjustified in 33 cases. On the other hand, more cesarean deliveries were scheduled for "no medical justification," including physician's or the woman's convenience, among women who preferred to deliver by cesarean (35/65). The incidence of real medical reasons for a scheduled cesarean section diagnosed before the onset of labor among private sector patients who had no previous cesarean birth and who wanted a vaginal delivery was 13 percent (31/243). The data suggest that doctors frequently persuaded their patients to accept a scheduled cesarean section for conditions that either did not exist or did not justify this procedure. The problem identified in this paper may extend well beyond Brazil and should be of concern to those with responsibility for ethical behavior in obstetrics.

Do Conditional Reinforcers Count?

ERIC Educational Resources Information Center

Davison, Michael; Baum, William M.

2006-01-01

Six pigeons were trained on a procedure in which seven components arranged different food-delivery ratios on concurrent variable-interval schedules each session. The components were unsignaled, lasted for 10 food deliveries, and occurred in random order with a 60-s blackout between components. The schedules were arranged using a switching-key…

48 CFR 38.101 - General.

Code of Federal Regulations, 2011 CFR

2011-10-01

... authorize other agencies to award schedule contracts and publish schedules. For example, the Department of... CONTRACTING FEDERAL SUPPLY SCHEDULE CONTRACTING Federal Supply Schedule Program 38.101 General. (a) The... discounts. Indefinite-delivery contracts are awarded using competitive procedures to firms. The firms...

Developing optimal nurses work schedule using integer programming

NASA Astrophysics Data System (ADS)

Shahidin, Ainon Mardhiyah; Said, Mohd Syazwan Md; Said, Noor Hizwan Mohamad; Sazali, Noor Izatie Amaliena

2017-08-01

Time management is the art of arranging, organizing and scheduling one's time for the purpose of generating more effective work and productivity. Scheduling is the process of deciding how to commit resources between varieties of possible tasks. Thus, it is crucial for every organization to have a good work schedule for their staffs. The job of Ward nurses at hospitals runs for 24 hours every day. Therefore, nurses will be working using shift scheduling. This study is aimed to solve the nurse scheduling problem at an emergency ward of a private hospital. A 7-day work schedule for 7 consecutive weeks satisfying all the constraints set by the hospital will be developed using Integer Programming. The work schedule for the nurses obtained gives an optimal solution where all the constraints are being satisfied successfully.

A comparative evaluation of the effect of internet-based CME delivery format on satisfaction, knowledge and confidence

PubMed Central

2010-01-01

Background Internet-based instruction in continuing medical education (CME) has been associated with favorable outcomes. However, more direct comparative studies of different Internet-based interventions, instructional methods, presentation formats, and approaches to implementation are needed. The purpose of this study was to conduct a comparative evaluation of two Internet-based CME delivery formats and the effect on satisfaction, knowledge and confidence outcomes. Methods Evaluative outcomes of two differing formats of an Internet-based CME course with identical subject matter were compared. A Scheduled Group Learning format involved case-based asynchronous discussions with peers and a facilitator over a scheduled 3-week delivery period. An eCME On Demand format did not include facilitated discussion and was not based on a schedule; participants could start and finish at any time. A retrospective, pre-post evaluation study design comparing identical satisfaction, knowledge and confidence outcome measures was conducted. Results Participants in the Scheduled Group Learning format reported significantly higher mean satisfaction ratings in some areas, performed significantly higher on a post-knowledge assessment and reported significantly higher post-confidence scores than participants in the eCME On Demand format that was not scheduled and did not include facilitated discussion activity. Conclusions The findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME. PMID:20113493

Rethinking the Clockwork of Work: Why Schedule Control May Pay Off at Work and at Home.

PubMed

Kelly, Erin L; Moen, Phyllis

2007-11-01

Many employees face work-life conflicts and time deficits that negatively affect their health, well-being, effectiveness on the job, and organizational commitment. Many organizations have adopted flexible work arrangements but not all of them increase schedule control, that is, employees' control over when, where, and how much they work. This article describes some limitations of flexible work policies, proposes a conceptual model of how schedule control impacts work-life conflicts, and describes specific ways to increase employees' schedule control, including best practices for implementing common flexible work policies and Best Buy's innovative approach to creating a culture of schedule control.

17 CFR 301.300a - Form 300-A, for summary of buy-ins or sell-outs of all open contractual commitments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form 300-A, for summary of buy... Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) Schedule A to Part 285 FORMS, SECURITIES INVESTOR PROTECTION CORPORATION Forms for Closeout Or Completion of Open Contractual Commitments § 301.300a...

Management commitments and primary care: another lesson from Costa Rica for the world?

PubMed

Soors, Werner; De Paepe, Pierre; Unger, Jean-Pierre

2014-01-01

Maintained dedication to primary care has fostered a public health delivery system with exceptional outcomes in Costa Rica. For more than a decade, management commitments have been part of Costa Rican health reform. We assessed the effect of the Costa Rican management commitments on access and quality of care and on compliance with their intended objectives. We constructed seven hypotheses on opinions of primary care providers. Through a mixed qualitative and quantitative approach, we tested these hypotheses and interpreted the research findings. Management commitments consume an excessive proportion of consultation time, inflate recordkeeping, reduce comprehensiveness in primary care consultations, and induce a disproportionate consumption of hospital emergency services. Their formulation relies on norms in need of optimization, their control on unreliable sources. They also affect professionalism. In Costa Rica, management commitments negatively affect access and quality of care and pose a threat to the public service delivery system. The failures of this pay-for-performance-like initiative in an otherwise well-performing health system cast doubts on the appropriateness of pay-for-performance for health systems strengthening in less advanced environments.

Sustainable water deliveries from the Colorado River in a changing climate

PubMed Central

Barnett, Tim P.; Pierce, David W.

2009-01-01

The Colorado River supplies water to 27 million users in 7 states and 2 countries and irrigates over 3 million acres of farmland. Global climate models almost unanimously project that human-induced climate change will reduce runoff in this region by 10–30%. This work explores whether currently scheduled future water deliveries from the Colorado River system are sustainable under different climate-change scenarios. If climate change reduces runoff by 10%, scheduled deliveries will be missed ≈58% of the time by 2050. If runoff reduces 20%, they will be missed ≈88% of the time. The mean shortfall when full deliveries cannot be met increases from ≈0.5–0.7 billion cubic meters per year (bcm/yr) in 2025 to ≈1.2–1.9 bcm/yr by 2050 out of a request of ≈17.3 bcm/yr. Such values are small enough to be manageable. The chance of a year with deliveries <14.5 bcm/yr increases to 21% by midcentury if runoff reduces 20%, but such low deliveries could be largely avoided by reducing scheduled deliveries. These results are computed by using estimates of Colorado River flow from the 20th century, which was unusually wet; if the river reverts to its long-term mean, shortfalls increase another 1–1.5 bcm/yr. With either climate-change or long-term mean flows, currently scheduled future water deliveries from the Colorado River are not sustainable. However, the ability of the system to mitigate droughts can be maintained if the various users of the river find a way to reduce average deliveries. PMID:19380718

77 FR 44674 - Solicitation for a Cooperative Agreement-National Institute of Corrections Inaugural Virtual...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

..., scheduling, promotion, production, and delivery of an NIC Virtual Conference entitled ``Handcuff Key to Door... conference through design, scheduling, promotion, and delivery; (2) In-studio and/or onsite production staff... in a project plan a detailed chart and description of a project management structure and team roles...

ADP SYSTEMS ANALYSIS - COMMITTED VS. AVAILABLE MILITARY TRANSPORTATION (LMI T1).

DTIC Science & Technology

LOGISTICS , * MANAGEMENT ENGINEERING), (*DATA PROCESSING, LOGISTICS), INFORMATION RETRIEVAL, SYSTEMS ENGINEERING, MILITARY TRANSPORTATION, CARGO VEHICLES, SCHEDULING, COMPUTER PROGRAMMING, MANAGEMENT PLANNING AND CONTROL

A scalable delivery framework and a pricing model for streaming media with advertisements

NASA Astrophysics Data System (ADS)

Al-Hadrusi, Musab; Sarhan, Nabil J.

2008-01-01

This paper presents a delivery framework for streaming media with advertisements and an associated pricing model. The delivery model combines the benefits of periodic broadcasting and stream merging. The advertisements' revenues are used to subsidize the price of the media content. The pricing is determined based on the total ads' viewing time. Moreover, this paper presents an efficient ad allocation scheme and three modified scheduling policies that are well suited to the proposed delivery framework. Furthermore, we study the effectiveness of the delivery framework and various scheduling polices through extensive simulation in terms of numerous metrics, including customer defection probability, average number of ads viewed per client, price, arrival rate, profit, and revenue.

Accidental fetal lacerations during cesarean delivery: experience in an Italian level III university hospital.

PubMed

Dessole, Salvatore; Cosmi, Erich; Balata, Antonio; Uras, Luisa; Caserta, Donatella; Capobianco, Giampiero; Ambrosini, Guido

2004-11-01

The purpose of this study was to investigate the incidence, type, location, and risk factors of accidental fetal lacerations during cesarean delivery. Total deliveries, cesarean deliveries, and neonatal records for documented accidental fetal lacerations were reviewed retrospectively in our level III university hospital. The gestational age, the presenting part of the fetus, the cesarean delivery indication, the type of incision, and the surgeon who performed the procedure were recorded. Cesarean deliveries were divided into scheduled, unscheduled, and emergency procedures. Fetal lacerations were divided into mild, moderate, and severe. Neonatal follow-up examinations regarding laceration sequelae were available for 6 months. Of 14926 deliveries, 3108 women were delivered by cesarean birth (20.82%). Neonatal records documented 97 accidental fetal lacerations. Of these accidental lacerations, 94 were mild; 2 were moderate, and 1 was severe. The overall rate of accidental fetal laceration per cesarean delivery was 3.12%; the accidental laceration rate in the cohort of fetuses was 2.46%. The crude odds ratios were 0.34 for scheduled procedures, 0.57 for unscheduled procedures, and 1.7 for emergency procedures. The risk for fetal accidental lacerations was higher in fetuses who underwent emergency cesarean birth and lower for unscheduled and scheduled cesarean births (P < .001). Fetal accidental laceration may occur during cesarean delivery; the incidence is significantly higher during emergency cesarean delivery compared with elective procedures. The patient should be counseled about the occurrence of fetal laceration during cesarean delivery to avoid litigation.

Acceptability and non-compliance in a family-led weight-management programme for obese Pacific children.

PubMed

Teevale, Tasileta; Taufa, Seini; Percival, Teuila

2015-10-01

To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children. Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme. New Zealand. Forty-two parents/primary caregivers of obese children who were randomised in the intervention weight-management programme. Programmatic factors that enhanced retention included: simultaneous delivery to both children and parents as participants; delivery of the programme in small group settings at local community venues; enabling trustworthy and accountable relationships; providing resources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals; and day and time scheduling. Suggested programme improvements included having ethnic-specific Island-language delivery and practical sessions like cooking classes and shopping expeditions at local food stores. The research found that unpredictable external life crises like extended family deaths, a change in job shift, family illnesses (both acute and those requiring chronic management) and long-term family visitations affected participation and momentum. A loss of momentum through managing life crises was often difficult to overcome for participants, leading them to drop out of the weight-management programme. Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time. In order for weight-management programmes to be effective, participants must be able to complete them. Identifying factors that predict participation and attrition may serve as a basis for programme improvement.

76 FR 617 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... orders in the Exchange's system. This schedule is known as the DMM Capital Commitment Schedule (``CCS'').\\9\\ CCS provides the Display Book [supreg] \\10\\ with the amount of shares that the DMM is willing to trade at price points outside, at and inside the Exchange Best Bid or Best Offer (``BBO''). CCS interest...

75 FR 14221 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... in the Exchange's system. This schedule is known as the DMM Capital Commitment Schedule (``CCS'').\\10\\ CCS provides the Display Book[reg] \\11\\ with the amount of shares that the DMM is willing to trade at price points outside, at and inside the Exchange BBO. CCS interest is separate and distinct from other...

Rethinking the Clockwork of Work: Why Schedule Control May Pay Off at Work and at Home

PubMed Central

Kelly, Erin L.; Moen, Phyllis

2014-01-01

The problem and the solution Many employees face work–life conflicts and time deficits that negatively affect their health, well-being, effectiveness on the job, and organizational commitment. Many organizations have adopted flexible work arrangements but not all of them increase schedule control, that is, employees’ control over when, where, and how much they work. This article describes some limitations of flexible work policies, proposes a conceptual model of how schedule control impacts work–life conflicts, and describes specific ways to increase employees’ schedule control, including best practices for implementing common flexible work policies and Best Buy’s innovative approach to creating a culture of schedule control. PMID:25598711

Emotional display rules and emotional labor: the moderating role of commitment.

PubMed

Gosserand, Robin H; Diefendorff, James M

2005-11-01

The authors examined whether commitment to emotional display rules is a necessary condition for emotional display rules to affect behavior at work. Results using structural equation modeling revealed that display rule commitment moderated the relationships of emotional display rule perceptions with surface acting, deep acting, and positive affective delivery at work, such that the relationships were strong and positive when commitment to display rules was high and weak when commitment to display rules was low. These findings suggest that motivation plays a role in the emotional labor process in that individuals must be committed to display rules for these rules to affect behavior. ((c) 2005 APA, all rights reserved).

48 CFR 1436.270-2 - Part I-The Schedule.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Construction 1436.270-2 Part I—The Schedule. The CO shall prepare the Schedule as follows: (a) Section A... reliability requirements (See FAR Part 46). (f) Section F, Deliveries or performance. Include Suspension of...

48 CFR 1436.270-2 - Part I-The Schedule.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Construction 1436.270-2 Part I—The Schedule. The CO shall prepare the Schedule as follows: (a) Section A... reliability requirements (See FAR Part 46). (f) Section F, Deliveries or performance. Include Suspension of...

Amniocentesis compared with antenatal corticosteroids prior to early term scheduled cesarean delivery.

PubMed

Zafman, Kelly B; Fox, Nathan S

2018-05-06

There are a variety of maternal or fetal conditions that require late preterm or early term delivery. In cases where early delivery is indicated, optimal management is not always clear. Historically, obstetricians used amniocentesis to document fetal lung maturity, but recently, many have transitioned to administration of antenatal corticosteroids (ACS). The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving ACS prior to scheduled cesarean delivery (CD) less than 39 weeks. This was a retrospective cohort study of women undergoing scheduled CD by one maternal-fetal medicine practice between 36 and 38 6/7 weeks, from 2005 to 2017. We identified women who underwent amniocentesis or received ACS within 2 weeks prior to delivery. Neonatal outcomes were compared between the two groups, with the primary outcome being neonatal intensive care unit (NICU) admission. A total of 502 women were included, of whom 313 (62.4%) underwent amniocentesis and 189 (37.6%) received ACS. Overall, 55 (11.0%) of neonates were admitted to the NICU. NICU admission was not significantly different between groups (11.8 versus 9.5%, p=.46). This held true after adjusting for gestational age and other differences in baseline characteristics. There were no significant differences between groups for all other neonatal outcomes, including NICU admission for respiratory indications, respiratory support, neonatal greater than maternal length of stay, low Apgar scores, and neonatal death. Rates of hypoglycemia were low and not significantly different between groups (2.2% in the amniocentesis group versus 0.5% in the ACS group, p=.27). Diabetes was the only covariate significantly associated with NICU admission (aOR 3.19, 95% CI 1.35, 7.54). In women undergoing scheduled CD between 36 and 38 6/7 weeks, administration of ACS is associated with similar neonatal outcomes compared to amniocentesis. This supports the current notion that outcomes are similar with ACS compared to amniocentesis for late preterm and early term deliveries. Brief rationale: The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving antenatal corticosteroids (ACS) prior to scheduled cesarean delivery (CD) less than 39 weeks. We found that in women undergoing scheduled cesarean delivery between 36 and 38 6/7 weeks, administration of antenatal corticosteroids is associated with similar neonatal outcomes compared to amniocentesis.

28 CFR 21.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., hearings and conferences before a committing court, magistrate, or commission, grand jury proceedings, pre... trial, hearing or grand jury proceeding has been scheduled but prior to the witness' actual appearance...

No Project Exists In A Vacuum: Organizational Effects In Enterprise Information System Development

DTIC Science & Technology

2014-06-01

development projects may take too much time, or even fail, if [senior management] commitment is erratic” ( Newman & Sabherwal, 1996, p. 24) and...commitment is clearly important to the success of IS development projects” ( Newman & Sabherwal, 1996, p. 23). Not only should decision makers establish...another example, functionality in the parent program could be curtailed due to funding priorities, affecting schedule and functionality in

Keeping Promises

NASA Technical Reports Server (NTRS)

Howell, Gregory A.

2005-01-01

Commitments are between people, not schedules. Project management as practiced today creates a "commitment-free zone," because it assumes that people will commit to centrally managed schedules without providing a mechanism to ensure their work can be done. So they give it their best, but something always seems to come up ..."I tried, but you know how it is." This form of project management does not provide a mechanism to ensure that what should be done, can in fact be done at the required moment. Too often, promises reliable promise. made in coordination meetings are conditional and unreliable. It has been my experience that at times trust can be low and hard to build in this environment. The absence of reliable promises explains why on well-run projects, people are often only completing 30-50 percent of the deliverables they d promised for the week. We all know what a promise is; we have plenty of experience making them and receiving them from others. So what s the problem? The sad fact is that the project environment-like many other work environments- is often so filled with systemic dishonesty, that we don t expect promises that are reliable. Project managers excel when they manage their projects as networks of commitments and help their people learn to elicit and make reliable promises.

Job shop scheduling model for non-identic machine with fixed delivery time to minimize tardiness

NASA Astrophysics Data System (ADS)

Kusuma, K. K.; Maruf, A.

2016-02-01

Scheduling non-identic machines problem with low utilization characteristic and fixed delivery time are frequent in manufacture industry. This paper propose a mathematical model to minimize total tardiness for non-identic machines in job shop environment. This model will be categorized as an integer linier programming model and using branch and bound algorithm as the solver method. We will use fixed delivery time as main constraint and different processing time to process a job. The result of this proposed model shows that the utilization of production machines can be increase with minimal tardiness using fixed delivery time as constraint.

The delivery of clinical preventive services: acute care intervention.

PubMed

Hahn, D L

1999-10-01

. Evidence-based clinical preventive services are underutilized. We explored the major factors associated with delivery of these services in a large physician-owned community-based group practice that provided care for both fee-for-service (FFS) and health maintenance organization (HMO) patient populations. We performed a cross-sectional audit of the computerized billing data of all adult outpatients seen at least once by any primary care provider in 1995 (N = 75,621). Delivery of preventive services was stratified by age, sex, visit frequency, insurance status (FFS or HMO), and visit type (acute care only or scheduled preventive visit). Insurance status and visit type were the strongest predictors of clinical preventive service delivery. Patients with FFS coverage received 6% to 13% (absolute difference) fewer of these services than HMO patients. Acute-care-only patients received 9% to 45% fewer services than patients who scheduled preventive visits. The combination of these factors was associated with profound differences. Having insurance to pay for preventive services is an important factor in the delivery of such care. Encouraging all patients to schedule preventive visits has been suggested as a strategy for increasing delivery, but that is not practical in this setting. Assessing the need for preventive services and offering them during acute care visits has equal potential for increasing delivery.

Further Evaluation of Response-Independent Delivery of Preferred Stimuli and Child Compliance

ERIC Educational Resources Information Center

Normand, Matthew P.; Beaulieu, Lauren

2011-01-01

The effect of a fixed-time (FT) schedule involving the delivery of preferred stimuli prior to the issuance of a low-probability instruction was evaluated with 2 young children with autism. The FT schedule was introduced according to a reversal design with 3 target instructions, 1 for the first child and 2 for the second child. Compliance increased…

Building Customer Relationships: A Model for Vocational Education and Training Delivery.

ERIC Educational Resources Information Center

Jarratt, Denise G.; Murphy, Tom; Lowry, Diannah

1997-01-01

Review of the theory of relational marketing and interviews with training providers identified a training delivery model that includes elements of trust and commitment, investment by relationship partners, and knowledge exchange, supporting relationship longevity. (SK)

Transgender Day of Remembrance and a Prospective Student Open House: How One Student Inspired a School to Do Both

ERIC Educational Resources Information Center

Fusarelli, Bonnie C.; Eaton, Lucy E.

2011-01-01

This case study explores the challenges a school leader faced when her commitment to diversity was tested by a scheduling conflict. The school principal approved a Transgender Day of Remembrance but then realized that it was scheduled for the same night as the school's Open House to recruit prospective students. The case study provides an…

Nuclear Weapons: NNSA Has a New Approach to Managing the B61-12 Life Extension, but a Constrained Schedule and Other Risks Remain

DTIC Science & Technology

2016-02-01

components. In 2010, they began an LEP to consolidate four versions of a legacy nuclear weapon, the B61 bomb , into a bomb called the B61-12 (see...Force Integrated Master Schedule BIMS Boeing Integrated Master Schedule B61 bomb B61 legacy bomb CD critical decision Cost Guide GAO Cost...are versions of the B61 bomb , an aircraft-delivered weapon that is a key component of the United States’ commitments to the North Atlantic Treaty

Exploring the potential for off peak delivery in Metropolitan Chicago : research findings and conclusions.

DOT National Transportation Integrated Search

2016-08-15

Businesses generally want to receive deliveries during their normal work hours. Truckers need to schedule deliveries to meet those demands. As a result, most truck deliveries occur during the most congested daytime traffic periods. : If more business...

Potential for off-peak freight deliveries to commercial areas : implementation plan

DOT National Transportation Integrated Search

2007-12-21

This document discusses three groups of policies to foster off-peak deliveries. The first group, Industry wide policies, considers policies that target specific industry segments, e.g., tax incentives to restaurants in exchange for their commitment t...

40 CFR 144.53 - Schedule of compliance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... permittee may cease conducting regulated activities (by plugging and abandonment) rather than continue to... public commitment satisfactory to the Director, such as a resolution of the board of directors of a...

40 CFR 144.53 - Schedule of compliance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... permittee may cease conducting regulated activities (by plugging and abandonment) rather than continue to... public commitment satisfactory to the Director, such as a resolution of the board of directors of a...

40 CFR 144.53 - Schedule of compliance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... permittee may cease conducting regulated activities (by plugging and abandonment) rather than continue to... public commitment satisfactory to the Director, such as a resolution of the board of directors of a...

40 CFR 144.53 - Schedule of compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... permittee may cease conducting regulated activities (by plugging and abandonment) rather than continue to... public commitment satisfactory to the Director, such as a resolution of the board of directors of a...

40 CFR 144.53 - Schedule of compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... permittee may cease conducting regulated activities (by plugging and abandonment) rather than continue to... public commitment satisfactory to the Director, such as a resolution of the board of directors of a...

29 CFR 4000.26 - What if I use a commercial delivery service?

Code of Federal Regulations, 2011 CFR

2011-07-01

... for the type of delivery you use (such as two-day delivery or overnight delivery). If you deposit it... will arrive at the proper address by 5 p.m. on the second business day after the next scheduled... designated delivery services. You should make sure that both the provider and the particular type of delivery...

Availability Based Tariff and its impact On different Industry Players-A Review

NASA Astrophysics Data System (ADS)

Holmukhe, R. M.; Pawar, Yogini; Desai, R. S.; Hasarmani, T. S.

2010-10-01

ABT is a performance-based tariff for the supply of electricity by generators owned and controlled by the central government. It is also a new system of scheduling and dispatch, which requires both generators and beneficiaries to commit to day-ahead schedules. It is a system of rewards and penalties seeking to enforce day ahead pre-committed schedules, though variations are permitted if notified One and one half hours in advance. The order emphasizes prompt payment of dues. ABT (Availability Based Tariff) along with the Electricity Act of 2003 is perhaps the most significant and definitive step taken in the Indian power sector so far to bring more efficiency and focus to this vital infrastructure. The ABT mechanism is based on financial principles. ABT scheme is for unscheduled interchange of power. The paper reviews ABT issues, its components, clauses, mechanism, benefits and the impact of grid on different players like generation utilities, grid operator, consumers involved in power generation, transmission and distribution. While the proposed tariff structure has wide implications for each player, this deals exclusively with the technology challenges/opportunities thrown up by ABT.

An Optimizing Space Data-Communications Scheduling Method and Algorithm with Interference Mitigation, Generalized for a Broad Class of Optimization Problems

NASA Technical Reports Server (NTRS)

Rash, James

2014-01-01

NASA's space data-communications infrastructure-the Space Network and the Ground Network-provide scheduled (as well as some limited types of unscheduled) data-communications services to user spacecraft. The Space Network operates several orbiting geostationary platforms (the Tracking and Data Relay Satellite System (TDRSS)), each with its own servicedelivery antennas onboard. The Ground Network operates service-delivery antennas at ground stations located around the world. Together, these networks enable data transfer between user spacecraft and their mission control centers on Earth. Scheduling data-communications events for spacecraft that use the NASA communications infrastructure-the relay satellites and the ground stations-can be accomplished today with software having an operational heritage dating from the 1980s or earlier. An implementation of the scheduling methods and algorithms disclosed and formally specified herein will produce globally optimized schedules with not only optimized service delivery by the space data-communications infrastructure but also optimized satisfaction of all user requirements and prescribed constraints, including radio frequency interference (RFI) constraints. Evolutionary algorithms, a class of probabilistic strategies for searching large solution spaces, is the essential technology invoked and exploited in this disclosure. Also disclosed are secondary methods and algorithms for optimizing the execution efficiency of the schedule-generation algorithms themselves. The scheduling methods and algorithms as presented are adaptable to accommodate the complexity of scheduling the civilian and/or military data-communications infrastructure within the expected range of future users and space- or ground-based service-delivery assets. Finally, the problem itself, and the methods and algorithms, are generalized and specified formally. The generalized methods and algorithms are applicable to a very broad class of combinatorial-optimization problems that encompasses, among many others, the problem of generating optimal space-data communications schedules.

Employer Engagement: The Critical Role of Employee Commitment

ERIC Educational Resources Information Center

Drake, Julie; Blake, Joanne; Swallow, Wayne

2009-01-01

Purpose: The purpose of this paper is to introduce a case study that identifies the practical issues and implications of employer engagement through course design, delivery and employee commitment in a higher education course delivered in the financial services sector. Design/methodology/approach: Using a case study the paper draws on the course…

48 CFR 252.217-7001 - Surge option.

Code of Federal Regulations, 2012 CFR

2012-10-01

... sustainable rate of delivery for items in this contract. This delivery schedule shall provide acceleration by month up to the maximum sustainable rate of delivery achievable within the Contractor's existing... than the maximum sustainable delivery rate under paragraph (b)(2) of this clause, nor will the exercise...

48 CFR 252.217-7001 - Surge option.

Code of Federal Regulations, 2013 CFR

2013-10-01

... sustainable rate of delivery for items in this contract. This delivery schedule shall provide acceleration by month up to the maximum sustainable rate of delivery achievable within the Contractor's existing... than the maximum sustainable delivery rate under paragraph (b)(2) of this clause, nor will the exercise...

48 CFR 252.217-7001 - Surge option.

Code of Federal Regulations, 2014 CFR

2014-10-01

... sustainable rate of delivery for items in this contract. This delivery schedule shall provide acceleration by month up to the maximum sustainable rate of delivery achievable within the Contractor's existing... than the maximum sustainable delivery rate under paragraph (b)(2) of this clause, nor will the exercise...

48 CFR 252.217-7001 - Surge option.

Code of Federal Regulations, 2011 CFR

2011-10-01

... sustainable rate of delivery for items in this contract. This delivery schedule shall provide acceleration by month up to the maximum sustainable rate of delivery achievable within the Contractor's existing... than the maximum sustainable delivery rate under paragraph (b)(2) of this clause, nor will the exercise...

Consumption-leisure tradeoffs in pigeons: Effects of changing marginal wage rates by varying amount of reinforcement.

PubMed

Green, L; Kagel, J H; Battalio, R C

1987-01-01

Pigeons' rates of responding and food reinforcement under simple random-ratio schedules were compared with those obtained under comparable ratio schedules in which free food deliveries were added, but the duration of each food delivery was halved. These ratio-with-free-food schedules were constructed so that, were the pigeon to maintain the same rate of responding as it had under the simple ratio schedule, total food obtained (earned plus free) would remain unchanged. However, any reduction in responding would reduce total food consumption below that under the simple ratio schedule. These "compensated wage decreases" led to decreases in responding and decreases in food consumption, as predicted by an economic model of labor supply. Moreover, the reductions in responding increased as the ratio value increased (i.e., as wage rates decreased). Pigeons, therefore, substituted leisure for consumption. The relationship between these procedures and negative-income-tax programs is noted.

Predicting Future Commitment to Care for Frail Parents Among Employed Caregivers.

PubMed

Lechner, Viola M

1992-06-01

A study of 133 full time employees with parent care responsibilities investigated various factors that could reduce this group's future caregiving commitment to aging parents. Study factors included: caregiver attributes, level of caregiving involvement, job stress, tensions between the caregiver and the dependent parent, caregiver's level of physical and mental strain, and limited support from family and friends. The relationship between the caregiver and the parent was the best predictor of sustained commitment to caregiving. One aspect of the employees' work experience made a small, but important contribution to respondents' future care plans. Those employees who frequently adjusted their work schedule and routine to accommodate parent care demands were less likely to sustain their caregiving commitment. Reasons for these findings are explored and implications for social policy and clinical practice are discussed.

Family Commitment and Work Characteristics among Pharmacists

PubMed Central

Gubbins, Paul O.; Ragland, Denise; Castleberry, Ashley N.; Payakachat, Nalin

2015-01-01

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse’s family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants’ mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males (p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment (p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated. PMID:28975924

Family Commitment and Work Characteristics among Pharmacists.

PubMed

Gubbins, Paul O; Ragland, Denise; Castleberry, Ashley N; Payakachat, Nalin

2015-12-17

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse's family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants' mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males ( p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment ( p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated.

Family-supportive organization perceptions and organizational commitment: the mediating role of work-family conflict and enrichment and partner attitudes.

PubMed

Wayne, Julie Holliday; Casper, Wendy J; Matthews, Russell A; Allen, Tammy D

2013-07-01

The present study aims to explain the processes through which family-supportive organizational perceptions (FSOP) relate to employee affective commitment. We suggest multiple mechanisms through which this relationship transpires-(a) the focal employee's experience of work-to-family conflict and enrichment and (b) the attitudes of the employee's spouse/partner. Hypotheses are tested with data from 408 couples. Results suggest that employee FSOP is positively associated with employee commitment through both employee work-to-family experiences and partner attitudes. FSOP was positively related to employee work-to-family enrichment, which was positively associated with employee affective commitment. FSOP was negatively associated with employee work-to-family conflict, which related to a partner's more positive attitude toward the employee's work schedule and higher commitment to the employee's firm. Partner commitment was positively and reciprocally related to employee affective commitment. These relationships partially mediated the FSOP-employee affective commitment relationship and varied as a function of parental status and single- versus dual-earner couple status but not as a function of employee gender. Theoretical and practical implications are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Treatment with Youth Who Have Committed Sexual Offences: Extending the Reach of Systemic Interventions through Collaborative Partnerships

ERIC Educational Resources Information Center

Smallbone, Stephen; Rayment-McHugh, Susan; Crissman, Belinda; Shumack, Danielle

2008-01-01

Delivery of high-quality mental health services to clients in regional and remote areas in Australia presents significant challenges. Griffith Youth Forensic Service (GYFS) provides specialised, state-wide assessment and systemic treatment services for young people in Queensland who have committed sexual offences. In an effort to provide…

48 CFR 11.402 - Factors to consider in establishing schedules.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REGULATION ACQUISITION PLANNING DESCRIBING AGENCY NEEDS Delivery or Performance Schedules 11.402 Factors to...) Industry practices; (3) Market conditions; (4) Transportation time; (5) Production time; (6) Capabilities...

48 CFR 11.402 - Factors to consider in establishing schedules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REGULATION ACQUISITION PLANNING DESCRIBING AGENCY NEEDS Delivery or Performance Schedules 11.402 Factors to...) Industry practices; (3) Market conditions; (4) Transportation time; (5) Production time; (6) Capabilities...

48 CFR 11.402 - Factors to consider in establishing schedules.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REGULATION ACQUISITION PLANNING DESCRIBING AGENCY NEEDS Delivery or Performance Schedules 11.402 Factors to...) Industry practices; (3) Market conditions; (4) Transportation time; (5) Production time; (6) Capabilities...

48 CFR 11.402 - Factors to consider in establishing schedules.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REGULATION ACQUISITION PLANNING DESCRIBING AGENCY NEEDS Delivery or Performance Schedules 11.402 Factors to...) Industry practices; (3) Market conditions; (4) Transportation time; (5) Production time; (6) Capabilities...

48 CFR 11.402 - Factors to consider in establishing schedules.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REGULATION ACQUISITION PLANNING DESCRIBING AGENCY NEEDS Delivery or Performance Schedules 11.402 Factors to...) Industry practices; (3) Market conditions; (4) Transportation time; (5) Production time; (6) Capabilities...

Unit Price and Choice in a Token-Reinforcement Context

ERIC Educational Resources Information Center

Foster, Theresa A.; Hackenberg, Timothy D.

2004-01-01

Pigeons were exposed to multiple and concurrent second-order schedules of token reinforcement, with stimulus lights serving as token reinforcers. Tokens were produced and exchanged for food according to various fixed-ratio schedules, yielding equal and unequal unit prices (responses per unit food delivery). On one schedule (termed the "standard…

48 CFR 815.304-70 - Evaluation factor commitments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SDVOSBs; (2) Use past performance in meeting SDVOSB subcontracting goals as a non-price evaluation factor... as an evaluation factor when competitively negotiating the award of contracts or task or delivery... competitively negotiating the award of contracts or task or delivery orders. (b) If an offeror proposes to use...

76 FR 20010 - Layfe Robert Anthony, M.D.; Denial of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... this provision, the Government maintains that his registration has continued in effect.\\1\\ It has not... testosterone, a schedule III steroid) for review by the Division, id. at 21-22; that he had committed...

Flexible operation of batteries in power system scheduling with renewable energy

DOE PAGES

Li, Nan; Uckun, Canan; Constantinescu, Emil M.; ...

2015-12-17

The fast growing expansion of renewable energy increases the complexities in balancing generation and demand in the power system. The energy-shifting and fast-ramping capability of energy storage has led to increasing interests in batteries to facilitate the integration of renewable resources. In this paper, we present a two-step framework to evaluate the potential value of energy storage in power systems with renewable generation. First, we formulate a stochastic unit commitment approach with wind power forecast uncertainty and energy storage. Second, the solution from the stochastic unit commitment is used to derive a flexible schedule for energy storage in economic dispatchmore » where the look-ahead horizon is limited. Here, analysis is conducted on the IEEE 24-bus system to demonstrate the benefits of battery storage in systems with renewable resources and the effectiveness of the proposed battery operation strategy.« less

The effects of variable-time versus contingent reinforcement delivery on problem behavior maintained by escape.

PubMed

Lomas Mevers, Joanna E; Fisher, Wayne W; Kelley, Michael E; Fredrick, Laura D

2014-01-01

Results of previous research indicate that the delivery of positive reinforcement (e.g., food) for an appropriate, alternative target response (e.g., compliance) or delivery of food on a time-based schedule can decrease problem behavior reinforced by escape, even when problem behavior continues to produce negative reinforcement (e.g., Lalli et al., ; Lomas, Fisher, & Kelley, ). In this study, we compared the levels of both compliance and problem behavior when food and praise were delivered either contingent on compliance or on a time-based schedule. Results for 3 of the 4 participants showed that contingent delivery of preferred edible items and praise was more effective in both reducing problem behavior and increasing compliance compared to variable-time delivery of these same items. These findings are discussed in the context of motivating operations and competition between positive and negative reinforcement. © Society for the Experimental Analysis of Behavior.

Amphetamine increases schedule-induced drinking reduced by negative punishment procedures.

PubMed

Pérez-Padilla, Angeles; Pellón, Ricardo

2003-05-01

d-Amphetamine has been reported to increase schedule-induced drinking punished by lick-dependent signalled delays in food delivery. This might reflect a drug-behaviour interaction dependent on the type of punisher, because no such effect has been found when drinking was reduced by lick-contingent electric shocks. However, the anti-punishment effect of amphetamine could be mediated by other behavioural processes, such as a loss of discriminative control or an increase in the value of delayed reinforcers. To test the effects of d-amphetamine on the acquisition and maintenance of schedule-induced drinking reduced by unsignalled delays in food delivery. Rats received 10-s unsignalled delays initiated by each lick after polydipsia was induced by a fixed-time 30-s food reinforcement schedule or from the outset of the experiment. Yoked-control rats received these same delays but independently of their own behaviour. d-Amphetamine (0.1-3.0 mg/kg) was then tested IP. d-Amphetamine dose-dependently increased and then decreased punished schedule-induced drinking. The drug led to dose-dependent reductions when the delays were not contingent or when they were applied from the outset of training. These results support the contention that d-amphetamine has an increasing effect on schedule-induced drinking that has been previously reduced by a negative punishment procedure. This effect cannot be attributed to other potentially involved processes, and therefore support the idea that drug effects on punished behaviour depend on punishment being delays in food or shock deliveries.

The Impact of Structured On-the-Job Training (S-OJT) on a Trainer's Organizational Commitment

ERIC Educational Resources Information Center

Cho, Daeyeon

2009-01-01

The purpose of this study was to examine the causal relationships between S-OJT trainer preparation, self-efficacy as a trainer, trainers' delivery of S-OJT, and organizational commitment as a consequence of employing S-OJT. This study proposed a theoretical model from the review of related literature and then empirically investigated the fitness…

The Evolution of Middle Schools.

ERIC Educational Resources Information Center

George, Paul S.

2001-01-01

Over the past 30 years, Florida's 500 middle schools have become more sizeable, racially segregated, and security conscious. Other features include interdisciplinary team organization, warring curricula, block schedules, integrated technology, inclusion, ability grouping, corporate practices, and female and minority principals committed to…

Wireless Sensor Network Metrics for Real-Time Systems

DTIC Science & Technology

2009-05-20

to compute the probability of end-to-end packet delivery as a function of latency, the expected radio energy consumption on the nodes from relaying... schedules for WSNs. Particularly, we focus on the impact scheduling has on path diversity, using short repeating schedules and Greedy Maximal Matching...a greedy algorithm for constructing a mesh routing topology. Finally, we study the implications of using distributed scheduling schemes to generate

Improving the LMS Selection Process: Instructor Concerns, Usage and Perceived Value of Online Course Delivery Tools

ERIC Educational Resources Information Center

Laverty, Joseph Packy; Wood, David; Tannehill, Darcy B.; Kohun, Fred; Turchek, John

2012-01-01

Selecting or upgrading a university's Learning Management System (LMS) involves complex decisions concerning curriculum delivery, students, financial commitments, technology and support services, and faculty. The purpose of this paper is to study faculty concerns, usage and perceptions of the instructional value of online course management tools.…

The Use of the MASCOT Philosophy for the Construction of Ada Programs,

DTIC Science & Technology

1983-10-01

dependent units must be recompiled. Because of Ada’s commitment to abstract data types tasks are treated as data types with certain restrictions. A task...3.3.3.1.4 End of Slice Action The scheduling algorithm determines, for each type of Slice termination, how the Scheduler treats Activities whose Slice has...Pools. The MASCOT Machine treats them as constructionally equivalent (refer 3.3.1.1.1). Because of the constraints brought in by the formulation of

Influence of intravenous self-administered psychomotor stimulants on performance of rhesus monkeys in a multiple schedule paradigm.

PubMed

Hoffmeister, F

1980-01-01

Rhesus monkeys were trained to complete three multiple schedules. The schedules consisted of three components: a fixed interval (component 1), a variable interval (component 2), and a fixed ratio (component 3). During components 1 and 2, pressing lever 1 was always reinforced by food delivery. During component 3, pressing lever 2 resulted in either food delivery or intravenous infusions of saline solution, solutions of cocaine, of d-amphetamine, of phenmetrazine, or fenetylline. In schedule I, animals were presented with all three components independent of key-pressing behavior during components 1 and 2. In schedule II the availability of component 2 was dependent on completion of component 1. Component 3 was made available only on completion of component 2. Noncompletion of components 1 or 2 resulted in time-out of 15 and 10 min, respectively. Schedule III was identical with schedule II, except that in schedule III the completion of components was indicated only by a change in the lever lights. The influence of self-administered drugs on behavior in all three components was evaluated. Self-administration of psychomotor stimulants impaired the performance of animals and delayed completion of components 1 and 2 of schedules I, II, and III. The effects on behavior were similar with low drug intake in schedule III, moderate intake in schedule II, and high drug intake in schedule I. These effects were strong with self-administration of phenmetrazine, moderate with self-administration of cocaine and d-amphetamine, and weak with self-administration of fenetylline.

77 FR 42525 - Self-Regulatory Organizations; New York Stock Exchange LLC; NYSE Amex LLC; Order Disapproving...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-19

... and (c) the interest included in DMM interest files, excluding Capital Commitment Schedule (``CCS...\\ Because DMMs on the trading floor do not have access to CCS interest information, the proposed rule does...

40 CFR 52.2059 - Control strategy: Particulate matter.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Control strategy: Particulate matter... Control strategy: Particulate matter. (a) Pennsylvania has committed to undertake a comprehensive program... Investigating and Controlling Nontraditional Particulate Matter Emissions Task Completion date Scheduled tasks...

40 CFR 52.2059 - Control strategy: Particulate matter.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Control strategy: Particulate matter... Control strategy: Particulate matter. (a) Pennsylvania has committed to undertake a comprehensive program... Investigating and Controlling Nontraditional Particulate Matter Emissions Task Completion date Scheduled tasks...

40 CFR 52.2059 - Control strategy: Particulate matter.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Particulate matter... Control strategy: Particulate matter. (a) Pennsylvania has committed to undertake a comprehensive program... Investigating and Controlling Nontraditional Particulate Matter Emissions Task Completion date Scheduled tasks...

40 CFR 52.2059 - Control strategy: Particulate matter.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Control strategy: Particulate matter... Control strategy: Particulate matter. (a) Pennsylvania has committed to undertake a comprehensive program... Investigating and Controlling Nontraditional Particulate Matter Emissions Task Completion date Scheduled tasks...

Strengthening healthcare delivery in Haiti through nursing continuing education.

PubMed

Clark, M; Julmisse, M; Marcelin, N; Merry, L; Tuck, J; Gagnon, A J

2015-03-01

The aim of this paper was to (1) highlight nursing continuing education as a key initiative for strengthening healthcare delivery in low-resource settings, and (2) provide an example of a nursing continuing education programme in Haiti. Haiti and other low-resource settings face extreme challenges including severe shortages of healthcare workers, high rates of nurse out-migration and variations in nurse competency at entry-to-practice. Nursing continuing education has the potential to address these challenges and improve healthcare delivery through enhanced nurse performance and retention; however, it is underutilized in low-resource settings. A case study is presented from the Hôpital Universitaire de Mirebalais in Mirebalais, Haiti of a new nursing continuing education programme called the Beyond Expert Program. The case study highlights eight key dimensions of nursing continuing education in low-resource settings: (1) involving local stakeholders in planning process, (2) targeting programme to nurse participant level and area of care, (3) basing course content on local context, (4) including diverse range of nursing topics, (5) using participatory teaching methods, (6) addressing resource constraints in time and scheduling, (7) evaluating and monitoring outcomes, and (8) establishing partnerships. The case study provides guidance for others wishing to develop programmes in similar settings. Creating a nursing continuing education programme in a low-resource setting is possible when there is commitment and engagement for nursing continuing education at all levels of the organization. Our report suggests a need for policy-makers in resource-limited settings to make greater investments in nursing continuing education as a focus of human resources for health, as it is an important strategy for promoting nurse retention, building the knowledge and skill of the existing nursing workforce, and raising the image of nursing in low-resource settings. © 2015 International Council of Nurses.

77 FR 10529 - Federal Acquisition Regulation; Information Collection; Delivery Schedules

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

...''. Select the link ``Submit a Comment'' that corresponds with ``Information Collection 9000-0043, Delivery..., by inserting in solicitations and contracts a clause substantially the same as either FAR 52.211-8...

ORNL Direct Purchase Information System (DPIS) user's manual. [For PDP-10

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

Grubb, J.W.; Lovin, J.K.; Smith, M.B.

1980-08-01

The ORNL Management Information System (MIS) Direct Purchase Information System (DPIS) is an on-line interactive system of computer programs. The system can provide a manager with commitment and delivery schedule information on current direct purchase requisitions. The commitment data accounts for the orders that have been placed and those requisitions yet to be placed with a vendor. Information can be summarized at many different levels, and individuals can quickly determine the status of their requisitions. DPIS contains data only on active outside direct purchases, but has the capability to access historical data. It provides sufficient flexibility to be used tomore » answer many questions pertinent to the status of these direct purchases and their obligating costs. Even an inexperienced computer user should have little difficulty in learning to use DPIS. The User Module prompts the user on what type of response it is expecting. If the user has doubts as to the response, or if the meaning of the response is not clear, the module will give a detailed list of the options available at that level. The user has control of what data are to be considered, how they are to be grouped, and what format the output will take. As the user selects the options available at a given level, the module proceeds to the next lower level until sufficient input has been supplied to provide the requested information. A major benefit of this interactive, user-oriented system is that the manager can specify the information requirements and does not have to spend time going through a great deal of other data to locate what is needed. Because it is interactive, a search can begin at a summary level and then resort to a more detailed level if needed. DPIS allows the user direct control for selecting the type of commitment data, output, funds, and direct purchase.« less

Joint Cross-Layer Design for Wireless QoS Content Delivery

NASA Astrophysics Data System (ADS)

Chen, Jie; Lv, Tiejun; Zheng, Haitao

2005-12-01

In this paper, we propose a joint cross-layer design for wireless quality-of-service (QoS) content delivery. Central to our proposed cross-layer design is the concept of adaptation. Adaptation represents the ability to adjust protocol stacks and applications to respond to channel variations. We focus our cross-layer design especially on the application, media access control (MAC), and physical layers. The network is designed based on our proposed fast frequency-hopping orthogonal frequency division multiplex (OFDM) technique. We also propose a QoS-awareness scheduler and a power adaptation transmission scheme operating at both the base station and mobile sides. The proposed MAC scheduler coordinates the transmissions of an IP base station and mobile nodes. The scheduler also selects appropriate transmission formats and packet priorities for individual users based on current channel conditions and the users' QoS requirements. The test results show that our cross-layer design provides an excellent framework for wireless QoS content delivery.

Response-food delay gradients for lever pressing and schedule-induced licking in rats.

PubMed

Pellón, Ricardo; Pérez-Padilla, Angeles

2013-06-01

Eight food-deprived Wistar rats developed stable patterns of lever pressing and licking when exposed to a fixed-time 30-s schedule of food pellet presentation. The rats were trained to lever press by presenting the lever 10 s before the programmed food delivery, with the food pellet being delivered immediately upon a lever press. The operant contingency was then removed and the lever was inserted through the entire interfood interval, being withdrawn with food delivery and reinserted 2 s later. On successive phases of the study, a protective contingency postponed food delivery if responses (lever presses or licks) occurred within the last 1, 2, 5, 10, 20, or 25 s of the interfood interval. Lever pressing was reduced at much shorter response-food delays than those that reduced licking. These results demonstrate that reinforcement contributes to the maintenance of different response patterns on periodic schedules, and that different responses are differentially sensitive to delays.

Integrating Solar PV in Utility System Operations

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

Mills, A.; Botterud, A.; Wu, J.

2013-10-31

This study develops a systematic framework for estimating the increase in operating costs due to uncertainty and variability in renewable resources, uses the framework to quantify the integration costs associated with sub-hourly solar power variability and uncertainty, and shows how changes in system operations may affect these costs. Toward this end, we present a statistical method for estimating the required balancing reserves to maintain system reliability along with a model for commitment and dispatch of the portfolio of thermal and renewable resources at different stages of system operations. We estimate the costs of sub-hourly solar variability, short-term forecast errors, andmore » day-ahead (DA) forecast errors as the difference in production costs between a case with “realistic” PV (i.e., subhourly solar variability and uncertainty are fully included in the modeling) and a case with “well behaved” PV (i.e., PV is assumed to have no sub-hourly variability and can be perfectly forecasted). In addition, we highlight current practices that allow utilities to compensate for the issues encountered at the sub-hourly time frame with increased levels of PV penetration. In this analysis we use the analytical framework to simulate utility operations with increasing deployment of PV in a case study of Arizona Public Service Company (APS), a utility in the southwestern United States. In our analysis, we focus on three processes that are important in understanding the management of PV variability and uncertainty in power system operations. First, we represent the decisions made the day before the operating day through a DA commitment model that relies on imperfect DA forecasts of load and wind as well as PV generation. Second, we represent the decisions made by schedulers in the operating day through hour-ahead (HA) scheduling. Peaking units can be committed or decommitted in the HA schedules and online units can be redispatched using forecasts that are improved relative to DA forecasts, but still imperfect. Finally, we represent decisions within the operating hour by schedulers and transmission system operators as real-time (RT) balancing. We simulate the DA and HA scheduling processes with a detailed unit-commitment (UC) and economic dispatch (ED) optimization model. This model creates a least-cost dispatch and commitment plan for the conventional generating units using forecasts and reserve requirements as inputs. We consider only the generation units and load of the utility in this analysis; we do not consider opportunities to trade power with neighboring utilities. We also do not consider provision of reserves from renewables or from demand-side options. We estimate dynamic reserve requirements in order to meet reliability requirements in the RT operations, considering the uncertainty and variability in load, solar PV, and wind resources. Balancing reserve requirements are based on the 2.5th and 97.5th percentile of 1-min deviations from the HA schedule in a previous year. We then simulate RT deployment of balancing reserves using a separate minute-by-minute simulation of deviations from the HA schedules in the operating year. In the simulations we assume that balancing reserves can be fully deployed in 10 min. The minute-by-minute deviations account for HA forecasting errors and the actual variability of the load, wind, and solar generation. Using these minute-by-minute deviations and deployment of balancing reserves, we evaluate the impact of PV on system reliability through the calculation of the standard reliability metric called Control Performance Standard 2 (CPS2). Broadly speaking, the CPS2 score measures the percentage of 10-min periods in which a balancing area is able to balance supply and demand within a specific threshold. Compliance with the North American Electric Reliability Corporation (NERC) reliability standards requires that the CPS2 score must exceed 90% (i.e., the balancing area must maintain adequate balance for 90% of the 10-min periods). The combination of representing DA forecast errors in the DA commitments, using 1-min PV data to simulate RT balancing, and estimates of reliability performance through the CPS2 metric, all factors that are important to operating systems with increasing amounts of PV, makes this study unique in its scope.« less

Scheduling the Stork: Media Portrayals of Women's and Physicians' Reasons for Elective Cesarean Delivery.

PubMed

Campo-Engelstein, Lisa; Howland, Lauren E; Parker, Wendy M; Burcher, Paul

2015-06-01

Media interest in cesarean delivery has grown in recent years driven both by rising cesarean delivery rates and the decision by the American College of Obstetrics and Gynecology (ACOG) to permit elective cesarean (EC) delivery. A content analysis of United States newspaper and magazine articles from 2000 to 2013 (n = 131 articles) was completed to understand how the news media portrays ECs. The majority of articles (71.8%) emphasized reasons to support women having an EC, while 38.2 percent of the articles exhibited themes of physician support for ECs. Relatively few articles mentioned reasons against ECs either from the women's perspective (11.5%) or the practitioners' (3.8%). The most common themes given for women choosing ECs were convenience/scheduling (48.9%), avoidance of pain or fear of labor (29.8%), and physical harm to women from vaginal birth (17.6%). Doctors' perspectives were less prevalent in the media than women's perspectives, but when mentioned they were almost exclusively in support of ECs for reasons including avoiding malpractice (28.2%), avoiding physical harm to the woman or baby (16.8%), and timing/scheduling (14.5%). Media coverage suggests ECs are widely accepted by both women and doctors, with women choosing an EC mainly for convenience/scheduling and fear. However, 43 percent of doctors surveyed by ACOG said they were not willing to perform the procedure, and surveys report that mothers rarely request an EC. © 2015 Wiley Periodicals, Inc.

76 FR 82326 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of a...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... as the DMM Capital Commitment Schedule (``CCS'').\\10\\ CCS provides the Display Book[supreg] \\11\\ with... Exchange Best Bid or Best Offer (``BBO''). CCS interest is separate and distinct from other DMM interest in...

78 FR 38753 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

... as the DMM Capital Commitment Schedule (``CCS'').\\10\\ CCS provides the Display Book[supreg] \\11\\ with... Exchange Best Bid or Best Offer (``BBO''). CCS interest is separate and distinct from other DMM interest in...

76 FR 39453 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-06

... Commitment Schedule (``CCS'').\\10\\ CCS provides the Display Book[supreg] \\11\\ with the amount of shares that... (``BBO''). CCS interest is separate and distinct from other DMM interest in that it serves as the...

76 FR 598 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... as the DMM Capital Commitment Schedule (``CCS'').\\10\\ CCS provides the Display Book[reg] \\11\\ with... Exchange Best Bid or Best Offer (``BBO''). CCS interest is separate and distinct from other DMM interest in...

77 FR 45408 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-31

... as the DMM Capital Commitment Schedule (``CCS'').\\10\\ CCS provides the Display Book[supreg] \\11\\ with... Exchange Best Bid or Best Offer (``BBO''). CCS interest is separate and distinct from other DMM interest in...

Team approach to care in labor and delivery.

PubMed

Mann, Susan; Pratt, Stephen D

2008-12-01

Changing to a teamwork culture in labor and delivery requires a real commitment. The skills involved can be taught to all healthcare providers. The benefits of a teamwork culture may include improved patient outcomes, less medical errors, and improved patient and staff satisfaction. Malpractice claim reduction may possibly occur through these improved outcomes and better communication with our patients.

Physical and Organizational Job Stressors in Pregnancy and Associations With Primary Cesarean Deliveries.

PubMed

Guendelman, Sylvia; Gemmill, Alison; Hosang, Nap; MacDonald, Leslie A

2017-06-01

The aim of this study was to assess the relationship between exposure to physical and organizational job stressors during pregnancy and cesarean delivery. We sampled 580 employed women in California who participated in a nested population-based case-control study of birth outcomes. Adjusted multivariate regression analyses estimated associations between heavy lifting, frequent bending, high noise, extreme temperature, prolonged standing and organizational stressors (shift work, inflexible schedules, effort-reward ratio), and primary cesarean (vs vaginal) delivery, controlling for covariates. Women occupationally exposed had higher odds of cesarean. Those exposed to daily manual lifting more than 15 pounds [adjusted odds ratio = 2.54; 95% confidence interval (95% CI) 1.21 to 5.32] and at least four physical job stressors (adjusted odds ratio = 3.49; 95% CI 1.21 to 10.09) had significantly elevated odds of cesarean delivery. Exposed morbid women experienced greater risk; risk was lower among those with schedule flexibility. Associations were found between modifiable exposure to physical job stressors during pregnancy and cesarean delivery.

Integrated model for pricing, delivery time setting, and scheduling in make-to-order environments

NASA Astrophysics Data System (ADS)

Garmdare, Hamid Sattari; Lotfi, M. M.; Honarvar, Mahboobeh

2018-03-01

Usually, in make-to-order environments which work only in response to the customer's orders, manufacturers for maximizing the profits should offer the best price and delivery time for an order considering the existing capacity and the customer's sensitivity to both the factors. In this paper, an integrated approach for pricing, delivery time setting and scheduling of new arrival orders are proposed based on the existing capacity and accepted orders in system. In the problem, the acquired market demands dependent on the price and delivery time of both the manufacturer and its competitors. A mixed-integer non-linear programming model is presented for the problem. After converting to a pure non-linear model, it is validated through a case study. The efficiency of proposed model is confirmed by comparing it to both the literature and the current practice. Finally, sensitivity analysis for the key parameters is carried out.

Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94

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

Fietkau, Rainer; Roedel, Claus; Hohenberger, Werner

2007-03-15

Purpose: The impact of the delivery of radiotherapy (RT) on treatment results in rectal cancer patients is unknown. Methods and Materials: The data from 788 patients with rectal cancer treated within the German CAO/AIO/ARO-94 phase III trial were analyzed concerning the impact of the delivery of RT (adequate RT: minimal radiation RT dose delivered, 4300 cGy for neoadjuvant RT or 4700 cGy for adjuvant RT; completion of RT in <44 days for neoadjuvant RT or <49 days for adjuvant RT) in different centers on the locoregional recurrence rate (LRR) and disease-free survival (DFS) at 5 years. The LRR, DFS, andmore » delivery of RT were analyzed as endpoints in multivariate analysis. Results: A significant difference was found between the centers and the delivery of RT. The overall delivery of RT was a prognostic factor for the LRR (no RT, 29.6% {+-} 7.8%; inadequate RT, 21.2% {+-} 5.6%; adequate RT, 6.8% {+-} 1.4%; p = 0.0001) and DFS (no RT, 55.1% {+-} 9.1%; inadequate RT, 57.4% {+-} 6.3%; adequate RT, 69.1% {+-} 2.3%; p = 0.02). Postoperatively, delivery of RT was a prognostic factor for LRR on multivariate analysis (together with pathologic stage) but not for DFS (independent parameters, pathologic stage and age). Preoperatively, on multivariate analysis, pathologic stage, but not delivery of RT, was an independent prognostic parameter for LRR and DFS (together with adequate chemotherapy). On multivariate analysis, the treatment center, treatment schedule (neoadjuvant vs. adjuvant RT), and gender were prognostic parameters for adequate RT. Conclusion: Delivery of RT should be regarded as a prognostic factor for LRR in rectal cancer and is influenced by the treatment center, treatment schedule, and patient gender.« less

17 CFR 300.300 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Definitions. 300.300 Section 300.300 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) Schedule A... Contractual Commitments § 300.300 Definitions. For the purpose of these rules, adopted pursuant to section 8(e...

17 CFR 300.300 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Definitions. 300.300 Section 300.300 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) Schedule A... Contractual Commitments § 300.300 Definitions. For the purpose of these rules, adopted pursuant to section 8(e...

17 CFR 300.300 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Definitions. 300.300 Section 300.300 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) Schedule A... Contractual Commitments § 300.300 Definitions. For the purpose of these rules, adopted pursuant to section 8(e...

17 CFR 300.300 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 3 2012-04-01 2012-04-01 false Definitions. 300.300 Section 300.300 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) Schedule A... Contractual Commitments § 300.300 Definitions. For the purpose of these rules, adopted pursuant to section 8(e...

Multi-time scale energy management of wind farms based on comprehensive evaluation technology

NASA Astrophysics Data System (ADS)

Xu, Y. P.; Huang, Y. H.; Liu, Z. J.; Wang, Y. F.; Li, Z. Y.; Guo, L.

2017-11-01

A novel energy management of wind farms is proposed in this paper. Firstly, a novel comprehensive evaluation system is proposed to quantify economic properties of each wind farm to make the energy management more economical and reasonable. Then, a combination of multi time-scale schedule method is proposed to develop a novel energy management. The day-ahead schedule optimizes unit commitment of thermal power generators. The intraday schedule is established to optimize power generation plan for all thermal power generating units, hydroelectric generating sets and wind power plants. At last, the power generation plan can be timely revised in the process of on-line schedule. The paper concludes with simulations conducted on a real provincial integrated energy system in northeast China. Simulation results have validated the proposed model and corresponding solving algorithms.

Manufacturing Technology Support (MATES). Delivery Order 0002: Business Practices Assessment (BPA) Development

DTIC Science & Technology

2008-03-01

order fulfillment visibility, Kanban deployment, inventory count can be made visually, machines and tool labeling, costs, preventive maintenance...order fulfillment, computer scheduling versus Kanban , pull versus push systems, flow time efficiencies, back room costs of scheduling, MRP costs

Does the Discourse of Employer Linked Charter Schools Signal a Commitment to Work Force Development or Transformational Learning?

ERIC Educational Resources Information Center

Freeman, Eric; Lakes, Richard D.

2005-01-01

The latest model for educational reform emerging in the US vocational-technical delivery system is the employer linked charter school (ELCS). This emerging concept is viewed as a partnership between constituents in the regular school organization and employers who are directly involved in the school's design, governance, and delivery of learning…

Public Investments in Training: Perspectives on Macro-Level Structural Issues and Micro-Level Delivery Systems. EQW Working Papers WP24.

ERIC Educational Resources Information Center

Cascio, Wayne F.

Training issues can be examined from at least two perspectives: the structural level (macro-level) and the micro-level. Structural issues in the delivery of training include the following: absent or uneven corporate commitment, inadequate expenditures by businesses, degrees awarded by schools that do not guarantee skill mastery, poaching of…

Flexible Energy Scheduling Tool for Integrating Variable Generation | Grid

Science.gov Websites

, security-constrained economic dispatch, and automatic generation control programs. DOWNLOAD PAPER Electric commitment, security-constrained economic dispatch, and automatic generation control sub-models. Each sub resolutions and operating strategies can be explored. FESTIV produces not only economic metrics but also

Dredging Research

DTIC Science & Technology

1993-02-01

Engineer Waterways Experiment Station, Vicksburg, MS, POC: Dr. Nicholas Kraus, (601) 634- 2018 . ______________’I.9 DRP Technical Area 1 workshop scheduled...I uold ask you is, ’What are which has been the " bible "of coastal en- videotape to reaffirm my commitment to the avenues we should pursue in this

Integrated production and distribution scheduling problems related to fixed delivery departure dates and weights of late orders.

PubMed

Li, Shanlin; Li, Maoqin

2015-01-01

We consider an integrated production and distribution scheduling problem faced by a typical make-to-order manufacturer which relies on a third-party logistics (3PL) provider for finished product delivery to customers. In the beginning of a planning horizon, the manufacturer has received a set of orders to be processed on a single production line. Completed orders are delivered to customers by a finite number of vehicles provided by the 3PL company which follows a fixed daily or weekly shipping schedule such that the vehicles have fixed departure dates which are not part of the decisions. The problem is to find a feasible schedule that minimizes one of the following objective functions when processing times and weights are oppositely ordered: (1) the total weight of late orders and (2) the number of vehicles used subject to the condition that the total weight of late orders is minimum. We show that both problems are solvable in polynomial time.

Integrated Production and Distribution Scheduling Problems Related to Fixed Delivery Departure Dates and Weights of Late Orders

PubMed Central

Li, Shanlin; Li, Maoqin

2015-01-01

We consider an integrated production and distribution scheduling problem faced by a typical make-to-order manufacturer which relies on a third-party logistics (3PL) provider for finished product delivery to customers. In the beginning of a planning horizon, the manufacturer has received a set of orders to be processed on a single production line. Completed orders are delivered to customers by a finite number of vehicles provided by the 3PL company which follows a fixed daily or weekly shipping schedule such that the vehicles have fixed departure dates which are not part of the decisions. The problem is to find a feasible schedule that minimizes one of the following objective functions when processing times and weights are oppositely ordered: (1) the total weight of late orders and (2) the number of vehicles used subject to the condition that the total weight of late orders is minimum. We show that both problems are solvable in polynomial time. PMID:25785285

BEHAVIORAL MOMENTUM AND ACCUMULATION OF MASS IN MULTIPLE SCHEDULES

PubMed Central

Craig, Andrew R.; Cunningham, Paul J.; Shahan, Timothy A.

2015-01-01

Behavioral momentum theory suggests that the relation between a discriminative-stimulus situation and reinforcers obtained in that context (i.e., the Pavlovian stimulus–reinforcer relation) governs persistence of operant behavior. Within the theory, a mass-like aspect of behavior has been shown to be a power function of predisruption reinforcement rates. Previous investigations of resistance to change in multiple schedules, however, have been restricted to examining response persistence following protracted periods of stability in reinforcer rates within a discriminative situation. Thus, it is unclear how long a stimulus–reinforcer relation must be in effect prior to disruption in order to affect resistance to change. The present experiment examined resistance to change of pigeon’s key pecking following baseline conditions where reinforcer rates that were correlated with discriminative-stimulus situations changed. Across conditions, one multiple-schedule component arranged either relatively higher rates or lower rates of variable-interval food delivery, while the other component arranged the opposite rate. These schedules alternated between multiple-schedule components across blocks of sessions such that reinforcer rates in the components were held constant for 20, 5, 3, 2, or 1 session(s) between alternations. Resistance to extinction was higher in the component that most recently was associated with higher rates of food delivery in all conditions except when schedules alternated daily or every other day. These data suggest that resistance to change in multiple schedules is related to recently experienced reinforcer rates but only when multiple-schedule components are associated with specific reinforcer rates for several sessions. PMID:25787824

Steel for Bodies: Ammunition Readiness During the Korean War

DTIC Science & Technology

2003-01-01

Committee, contradicted Secretary of Defense Robert Lovett by stating that serious bottlenecks still existed and that deliveries were well behind schedule ...disagreement over whether there had in fact been shortages, Chairman Saltonstall scheduled a hearing on 10 March 1953, at which both Army Chief of...packaging for shipment were contracted out to manufacturers. The planning and coordination to schedule components to be completed, on hand, and ready for

Care delivery and compensation system changes: a case study of organizational readiness within a large dental care practice organization in the United States.

PubMed

Cunha-Cruz, Joana; Milgrom, Peter; Huebner, Colleen E; Scott, JoAnna; Ludwig, Sharity; Dysert, Jeanne; Mitchell, Melissa; Allen, Gary; Shirtcliff, R Mike

2017-12-20

Dental care delivery systems in the United States are consolidating and large practice organizations are becoming more common. At the same time, greater accountability for addressing disparities in access to care is being demanded when public funds are used to pay for care. As change occurs within these new practice structures, attempts to implement change in the delivery system may be hampered by failure to understand the organizational climate or fail to prepare employees to accommodate new goals or processes. Studies of organizational behavior within oral health care are sparse and have not addressed consolidation of current delivery systems. The objective of this case study was to assess organizational readiness for implementing change in a large dental care organization consisting of staff model clinics and affiliated dental practices and test associations of readiness with workforce characteristics and work environment. A dental care organization implemented a multifaceted quality improvement program, called PREDICT, in which community-based mobile and clinic-based dental services were integrated and the team compensated based in part on meeting performance targets. Dental care providers and supporting staff members (N = 181) were surveyed before program implementation and organizational readiness for implementing change (ORIC) was assessed by two 5-point scales: change commitment and efficacy. Providers and staff demonstrated high organizational readiness for change. Median change commitment was 3.8 (Interquartile range [IQR]: 3.3-4.3) and change efficacy was 3.8 (IQR: 3.0-4.2). In the adjusted regression model, change commitment was associated with organizational climate, support for methods to arrest tooth decay and was inversely related to office chaos. Change efficacy was associated with organizational climate, support for the company's mission and was inversely related to burnout. Each unit increase in the organizational climate scale predicted 0.45 and 0.8-unit increases in change commitment and change efficacy. The survey identified positive readiness for change and highlighted weaknesses that are important cautions for this organization and others initiating change. Future studies will examine how organizational readiness to change, workforce characteristics and work environment influenced successful implementation within this organization.

The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery.

PubMed

Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

2016-01-01

The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%-12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France). Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity.

From traditional cognitive-behavioural therapy to acceptance and commitment therapy for chronic pain: a mixed-methods study of staff experiences of change.

PubMed

Barker, Estelle; McCracken, Lance M

2014-08-01

Health care organizations, both large and small, frequently undergo processes of change. In fact, if health care organizations are to improve over time, they must change; this includes pain services. The purpose of the present study was to examine a process of change in treatment model within a specialty interdisciplinary pain service in the UK. This change entailed a switch from traditional cognitive-behavioural therapy to a form of cognitive-behavioural therapy called acceptance and commitment therapy. An anonymous online survey, including qualitative and quantitative components, was carried out approximately 15 months after the initial introduction of the new treatment model and methods. Fourteen out of 16 current clinical staff responded to the survey. Three themes emerged in qualitative analyses: positive engagement in change; uncertainty and discomfort; and group cohesion versus discord. Quantitative results from closed questions showed a pattern of uncertainty about the superiority of one model over the other, combined with more positive views on progress reflected, and the experience of personal benefits, from adopting the new model. The psychological flexibility model, the model behind acceptance and commitment therapy, may clarify both processes in patient behaviour and processes of staff experience and skilful treatment delivery. This integration of processes on both sides of treatment delivery may be a strength of acceptance and commitment therapy.

A retrospective cohort study of mode of delivery among public and private patients in an integrated maternity hospital setting

PubMed Central

Murphy, Deirdre J; Fahey, Tom

2013-01-01

Objective To examine the associations between mode of delivery and public versus privately funded obstetric care within the same hospital setting. Design Retrospective cohort study. Setting Urban maternity hospital in Ireland. Population A total of 30 053 women with singleton pregnancies who delivered between 2008 and 2011. Methods The study population was divided into those who booked for obstetric care within the public (n=24 574) or private clinics (n=5479). Logistic regression analyses were performed to examine the associations between operative delivery and type of care, adjusting for potential confounding factors. Main outcome measures Caesarean section (scheduled or emergency), operative vaginal delivery (vacuum or forceps), indication for caesarean section as classified by the operator. Results Compared with public patients, private patients were more likely to be delivered by caesarean section (34.4% vs 22.5%, OR 1.81; 95% CI 1.70 to 1.93) or operative vaginal delivery (20.1% vs 16.5%, OR 1.28; 95% CI 1.19 to 1.38). The greatest disparity was for scheduled caesarean sections; differences persisted for nulliparous and parous women after controlling for medical and social differences between the groups (nulliparous 11.9% vs 4.6%, adjusted (adj) OR 1.82; 95% CI 1.49 to 2.24 and parous 26% vs 12.2%, adj OR 2.08; 95% CI 1.86 to 2.32). Scheduled repeat caesarean section accounted for most of the disparity among parous patients. Maternal request per se was an uncommonly reported indication for caesarean section (35 in each group, p<0.000). Conclusions Privately funded obstetric care is associated with higher rates of operative deliveries that are not fully accounted for by medical or obstetric risk differences. PMID:24277646

A best on-line algorithm for single machine scheduling the equal length jobs with the special chain precedence and delivery time

NASA Astrophysics Data System (ADS)

Gu, Cunchang; Mu, Yundong

2013-03-01

In this paper, we consider a single machine on-line scheduling problem with the special chains precedence and delivery time. All jobs arrive over time. The chains chainsi arrive at time ri , it is known that the processing and delivery time of each job on the chain satisfy one special condition CD a forehand: if the job J(i)j is the predecessor of the job J(i)k on the chain chaini, then they satisfy p(i)j = p(i)k = p >= qj >= qk , i = 1,2, ---,n , where pj and qj denote the processing time and the delivery time of the job Jj respectively. Obviously, if the arrival jobs have no chains precedence, it shows that the length of the corresponding chain is 1. The objective is to minimize the time by which all jobs have been delivered. We provide an on-line algorithm with a competitive ratio of √2 , and the result is the best possible.

Incident reporting.

PubMed

Wilson, J

Healthcare delivery is a risky business. People view the NHS in the same light as other commercial businesses such as the hotel, retail and airline industries. The White Paper 'The New NHS: Modern, Dependable' (Secretary of State for Health, 1997) places statutory responsibilities on managers and clinicians to provide a quality service and to have accountability for clinical governance and performance management. Quality and risk are two sides of the same coin, i.e. if you have good quality you have low risk, and this firmly supports the clinical effectiveness agenda. Healthcare organizations in all sectors of care delivery need to demonstrate their high levels of achievement and commitment to continuous quality improvements. Risk management is a process for identifying, assessing and evaluating risks which have adverse effects on the quality, safety and effectiveness of service delivery, and taking positive action to eliminate or reduce them. Having an open, honest and blame-free organization which is open to improving processes and systems of care is a big step towards having staff who are committed to quality and getting things right. Near-miss, incident and indicator recording and reporting are cornerstones of any quality and risk management system.

Targeted Therapies for Myeloma and Metastatic Bone Cancers

DTIC Science & Technology

2006-02-01

present results from this program at talk at the Particles 2006 - Medical/Biochemical Diagnostic , Pharmaceutical, and Drug Delivery Applications of Particle...Technology Forum scheduled for May 13 -16, in Orlando, FL. "* Invited to give a guest lecture on nanoparticle drug delivery technology to the...The principal investigator was invited to give a talk at the Particles 2006 - Medical/Biochemical Diagnostic , Pharmaceutical, and Drug Delivery

Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning.

PubMed

Liu, Shi; Wu, Yu; Wooten, H Omar; Green, Olga; Archer, Brent; Li, Harold; Yang, Deshan

2016-03-08

A software tool is developed, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image-guided radiation therapy (MR-IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in our clinic. The predicted treatment delivery time and the assessment of plan complexities could also be useful to aid treatment planning. A patient's total treatment delivery time, not including time required for localization, is modeled as the sum of four components: 1) the treatment initialization time; 2) the total beam-on time; 3) the gantry rotation time; and 4) the multileaf collimator (MLC) motion time. Each of the four components is predicted separately. The total beam-on time can be calculated using both the planned beam-on time and the decay-corrected dose rate. To predict the remain-ing components, we retrospectively analyzed the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, linear regression is applied to predict the gantry rotation time. The MLC motion time is calculated using the leaves delay modeling method and the leaf motion speed. A quantitative analysis was performed to understand the correlation between the total treatment time and the plan complexity. The proposed algorithm is able to predict the ViewRay treatment delivery time with the average prediction error 0.22min or 1.82%, and the maximal prediction error 0.89 min or 7.88%. The analysis has shown the correlation between the plan modulation (PM) factor and the total treatment delivery time, as well as the treatment delivery duty cycle. A possibility has been identified to significantly reduce MLC motion time by optimizing the positions of closed MLC pairs. The accuracy of the proposed prediction algorithm is sufficient to support patient treatment appointment scheduling. This developed software tool is currently applied in use on a daily basis in our clinic, and could also be used as an important indicator for treatment plan complexity.

Creating the Business Case for Achieving Health Equity.

PubMed

Chin, Marshall H

2016-07-01

Health care organizations have increasingly acknowledged the presence of health care disparities across race/ethnicity and socioeconomic status, but significantly fewer have made health equity for diverse patients a true priority. Lack of financial incentives is a major barrier to achieving health equity. To create a business case for equity, governmental and private payors can: 1) Require health care organizations to report clinical performance data stratified by race, ethnicity, and socioeconomic status. 2) Incentivize preventive care and primary care. Implement more aggressive shared savings plans, update physician relative value unit fee schedules, and encourage partnerships across clinical and non-clinical sectors. 3) Incentivize the reduction of health disparities with equity accountability measures in payment programs. 4) Align equity accountability measures across public and private payors. 5) Assist safety-net organizations. Provide adequate Medicaid reimbursement, risk-adjust clinical performance scores for sociodemographic characteristics of patients, provide support for quality improvement efforts, and calibrate cuts to Disproportionate Share Hospital (DSH) payments to the pace of health insurance expansion. 6) Conduct demonstration projects to test payment and delivery system reform interventions to reduce disparities. Commitment to social justice is essential to achieve health equity, but insufficient without a strong business case that makes interventions financially feasible.

A Digital Library in the Mid-Nineties, Ahead or On Schedule?

ERIC Educational Resources Information Center

Dijkstra, Joost

1994-01-01

Discussion of the future possibilities of digital library systems highlights digital projects developed at Tilburg University (Netherlands). Topics addressed include online access to databases; electronic document delivery; agreements between libraries and Elsevier Science publishers to provide journal articles; full text document delivery; and…

Shaping the Corporate Response to Workers with Elder Care Commitments: Considerations for Gerontologists.

ERIC Educational Resources Information Center

Dellmann-Jenkins, Mary; And Others

1994-01-01

Initially designed in response to substance abuse, employee assistance programs are now recognizing needs of family caregivers of the elderly by providing such services as referral, education, information, flexible schedules/leaves, counseling, health promotion, financial assistance, and direct services--respite care and onsite adult day care. (SK)

Alternative Work Patterns as Innovations in the Work Place. Overview: ERIC Fact Sheet No. 19.

ERIC Educational Resources Information Center

Denniston, Denie

Alternative work patterns are work schedules that allow employees to select the hours and length of their workweeks. Reasons for choosing alternative work patterns include transportation considerations, participation in outside activities, ability to work better during certain hours, child care, and household commitments. Examples of alternative…

Constellation Lessons Learned Executive Summary

NASA Technical Reports Server (NTRS)

Thomas, L. Dale; Neubek, Deb

2011-01-01

This slide presentation reviews the lessons learned from the Constellation Program (CxP) and identified several factors that contributed to the inability of the CxP to meet the cost and schedule commitments. The review includes a significant section on the context in which the CxP operated since new programs are likely to experience the same constraints.

Flexible work schedules, older workers, and retirement.

PubMed

Siegenthaler, J K; Brenner, A M

2000-01-01

Older workers in the United States indicate that they would prefer flexible work arrangements rather than abrupt retirement, yet management has done very little to make this possible. A review of two bodies of literature from the late 1980s is presented: social science writings including sociological, gerontological, and economic literature, and business and management literature. There is a clash between the way jobs are traditionally scheduled and the needs of growing numbers of older workers. Workers continue to be subject to obstacles to phased retirement due to the structuring of health care and pension benefits, downsizing, organizational inflexibility, and "corporate culture." Thus, general views among social scientists regarding the desirability of flexible schedules toward retirement will not produce real changes unless management becomes committed to such changes and they are securely embedded in company policies.

Feasibility Analysis of Developing Cross-border Network Education in China

NASA Astrophysics Data System (ADS)

Lan, Jun

In the era of economic globalization, strengthen of international cooperation on network education is a general trend. Although China has not made commitments about the market access and national treatment of cross-border supply in Schedule of Specific Commitments on Services, the basic conditions of network education development in China have been met. The Chinese government should formulate strategies for the development of cross-border network education and take relevant measures to implement them. In the near future, the carrying out of cross-border network education in China will become an irreversible trend, and will possess broad prospect with the advance of globalization of Chinese education.

Discriminated Timeout Avoidance in Pigeons: The Roles of Added Stimuli

ERIC Educational Resources Information Center

DeFulio, Anthony; Hackenberg, Timothy D.

2007-01-01

Two experiments examined pigeons' postponement of a signaled extinction period, or timeout (TO), from an ongoing schedule of response-dependent food delivery. A concurrent-operant procedure was used in which responses on one (food) key produced food according to a variable-interval schedule and responses on a second (postponement) key delayed the…

75 FR 16337 - Standards for Business Practices for Interstate Natural Gas Pipelines

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

... transportation by power plant operators more difficult. In response to this need, in early 2004, NAESB... receipt and delivery points; and (3) changes to the intraday nomination schedule to increase the number of... conference on the issue of intraday pipeline nomination schedules. In this regard, NGSA asserts that NAESB...

Serving Communities.

ERIC Educational Resources Information Center

Brook, Les, Ed.

This book contains 15 articles about various aspects of community further education (FE) programs in Great Britain, including program rationales/benefits, administration, and delivery. The following articles are included: "Foreword" (Bradshaw); "Commitment to Community Is Good Business and Practical Politics" (Brook); "Can…

Risk factors for unscheduled delivery in patients with placenta accreta.

PubMed

Bowman, Zachary S; Manuck, Tracy A; Eller, Alexandra G; Simons, Marilee; Silver, Robert M

2014-03-01

Patients with suspected placenta accreta have improved outcomes with scheduled delivery. Our objective was to identify risk factors for unscheduled delivery in patients with suspected placenta accreta. This was a cohort study of women with antenatally suspected placenta accreta. Women who delivered prior to a planned delivery date were compared with women who had a scheduled delivery. Data were analyzed using a Student t test, χ(2), logistic regression, and survival analyses. Variables included in the analyses were episodes of antenatal vaginal bleeding, preterm premature rupture of membranes (PPROM), uterine contractions, prior cesarean deliveries, interpregnancy interval, parity, and patient demographic factors. A value of P < .05 was considered significant. Seventy-seven women with antenatal suspicion for placenta accreta were identified. Thirty-eight (49.4%) had an unscheduled delivery. Demographics were similar between groups. Unscheduled patients delivered earlier (mean 32.3 vs 35.7 weeks, P < .001) and were significantly more likely to have had vaginal bleeding (86.8% vs 35.9%, P < .001) and uterine activity (47.4% vs 2.6%, P < .001). Each episode of antenatal vaginal bleeding was associated with an increased risk of unscheduled delivery (adjusted odds ratio, 3.8; 95% confidence interval, 1.8-7.8). Risk of earlier delivery was even greater when associated with PPROM (P < .001). Among women with suspected placenta accreta, those with antenatal vaginal bleeding were more likely to require unscheduled delivery. This risk increases further in the setting of PPROM and/or uterine contractions. These clinical factors should be considered when determining the optimal delivery gestational age for women with placental accreta. Copyright © 2014 Mosby, Inc. All rights reserved.

CONTEXTUAL INTERFERENCE AND INTROVERSION/EXTRAVERSION IN MOTOR LEARNING.

PubMed

Meira, Cassio M; Fairbrother, Jeffrey T; Perez, Carlos R

2015-10-01

The Introversion/Extraversion dimension may interact with contextual interference, as random and blocked practice schedules imply distinct levels of variation. This study investigated the effect of different practice schedules in the acquisition of a motor skill in extraverts and introverts. Forty male undergraduate students (M = 24.3 yr., SD = 5.6) were classified as extraverts (n = 20) and introverts (n = 20) by the Eysenck Personality Questionnaire and allocated in one of two practice schedules with different levels of contextual interference: blocked (low contextual interference) and random (high contextual interference). Half of each group was assigned to a blocked practice schedule, and the other half was assigned to a random practice schedule. The design had two phases: acquisition and transfer (5 min. and 24 hr.). The participants learned variations of a sequential timing keypressing task. Each variation required the same sequence but different timing; three variations were used in acquisition, and one variation of intermediate length was used in transfer. Results for absolute error and overall timing error (root mean square error) indicated that the contextual interference effect was more pronounced for introverts. In addition, introverts who practiced according to the blocked schedule committed more errors during the 24-hr. transfer, suggesting that introverts did not appear to be challenged by a low contextual interference practice schedule.

A Genetic Algorithm Tool (splicer) for Complex Scheduling Problems and the Space Station Freedom Resupply Problem

NASA Technical Reports Server (NTRS)

Wang, Lui; Valenzuela-Rendon, Manuel

1993-01-01

The Space Station Freedom will require the supply of items in a regular fashion. A schedule for the delivery of these items is not easy to design due to the large span of time involved and the possibility of cancellations and changes in shuttle flights. This paper presents the basic concepts of a genetic algorithm model, and also presents the results of an effort to apply genetic algorithms to the design of propellant resupply schedules. As part of this effort, a simple simulator and an encoding by which a genetic algorithm can find near optimal schedules have been developed. Additionally, this paper proposes ways in which robust schedules, i.e., schedules that can tolerate small changes, can be found using genetic algorithms.

Desert Survivors: The Design and Implementation of a Television Program to Enhance Local Scientific Literacy

ERIC Educational Resources Information Center

Utz, Jenifer C.; Rausch, Candice M.; Fruth, Laurie; Thomas, Megan E.; van Breukelen, Frank

2007-01-01

Outreach efforts by faculty members are oftentimes limited in scope due to hectic schedules. We developed a program to enhance science literacy in elementary school children that allows experts to reach a tremendous audience while minimizing their time commitment. The foundation of the program is a television series entitled "Desert Survivors."…

3 CFR 8818 - Proclamation 8818 of May 14, 2012. To Implement the United States-Colombia Trade Promotion...

Code of Federal Regulations, 2013 CFR

2013-01-01

..., 2009, modified certain rules of origin under the North American Free Trade Agreement and incorporated... Schedule of the United States to Adjust Rules of Origin Under the North American Free Trade Agreement... commitments under the United States-Korea Free Trade Agreement and incorporated by reference Publication 4308...

Quantitative trait loci associated with phenological development, low temperature tolerance, grain quality, and agronomic characters in wheat (Triticum aestivum L.)

USDA-ARS?s Scientific Manuscript database

Plants must respond to environmental cues and schedule their development in order to react to periods of abiotic stress and commit fully to growth and reproduction under favorable conditions. This study was initiated to identify SNP markers for characters expressed from the seedling stage to plant m...

Impact on community organisations that partnered with the Act-Belong-Commit mental health promotion campaign.

PubMed

Jalleh, Geoffrey; Anwar-McHenry, Julia; Donovan, Robert J; Laws, Amberlee

2013-04-01

A primary aim of the pilot phase of the Act-Belong-Commit mental health promotion campaign was to form partnerships with community organisations. As a component of the broader campaign strategy, collaborating organisations promoted their activities under the Act-Belong-Commit banner in exchange for resources, promotional opportunities and capacity building in event management and funding. The impact of the Act-Belong-Commit campaign on the capacity and activities of collaborating organisations during the pilot phase was evaluated using self-completed mail surveys in 2006 and 2008. Collaboration with the campaign had a positive impact on community organisations' capacity, including staff expertise, media publicity and funding applications. Collaborating organisations had strong positive perceptions of Act-Belong-Commit officers and all expressed a willingness to collaborate in future events and activities. The partnership model used during the pilot phase of the Act-Belong-Commit campaign was successful in creating mutually beneficial exchanges with collaborating organisations. So what? Community partnerships are necessary for the effective delivery of mental health promotion campaigns at a local level. Successful partnerships involve the provision of real and valuable benefits to collaborating organisations in return for their cooperation in promoting health messages.

A practical guide to failure mode and effects analysis in health care: making the most of the team and its meetings.

PubMed

Ashley, Laura; Armitage, Gerry; Neary, Maria; Hollingsworth, Gillian

2010-08-01

Failure Mode and Effects Analysis (FMEA) is a proactive risk assessment tool used to identify potential vulnerabilities in complex, high-risk processes and to generate remedial actions before the processes result in adverse events. FMEA is increasingly used to proactively assess and improve the safety of complex health care processes such as drug administration and blood transfusion. A central feature of FMEA is that it is undertaken by a multidisciplinary team, and because it entails numerous analytical steps, it takes a series of several meetings. Composing a team of busy health care professionals with the appropriate knowledge, skill mix, and logistical availability for regular meetings is, however, a serious challenge. Despite this, information and advice on FMEA team assembly and meetings scheduling are scarce and diffuse and often presented without the accompanying rationale. Assemble an eight-member team composed of clinically active health care staff, from every profession involved in delivery of the process-and who regularly perform it; staff from a range of seniority levels; outsider(s) to the process-and perhaps even to health care; a leader (and facilitator); and researchers. Plan for 10-15 hours of team meeting time for first-time, narrowly defined FMEAs, scheduled as four to six meetings lasting 2 to 3 hours each, spaced weekly to biweekly. Meet in a venue that seats the team around one table and is off the hospital floor but within its grounds. FMEA, generally acknowledged to be a useful addition to the patient safety toolkit, is a meticulous and time- and resource-intensive methodology, and its successful completion is highly dependent on the team members' aptitude and on the facility's and team members' commitment to hold regular, productive meetings.

The assessment of insight in psychosis.

PubMed

David, A; Buchanan, A; Reed, A; Almeida, O

1992-11-01

An assessment schedule was used to determine the nature of insight in 91 mixed psychotic patients, and to examine its distribution and associations. While all the components of the schedule intercorrelated significantly, scores for compliance were only weakly related to those for ability to label psychotic phenomena as abnormal. Compliance and illness recognition were related to IQ. Total insight score was inversely correlated, moderately, with a global measure of psychopathology derived from the PSE, and was less in patients involuntarily committed. Age, sex, diagnosis, and the number of previous hospital admissions had little effect. The results support the notion that insight is not a unitary concept.

Two tradeoffs between economy and reliability in loss of load probability constrained unit commitment

NASA Astrophysics Data System (ADS)

Liu, Yuan; Wang, Mingqiang; Ning, Xingyao

2018-02-01

Spinning reserve (SR) should be scheduled considering the balance between economy and reliability. To address the computational intractability cursed by the computation of loss of load probability (LOLP), many probabilistic methods use simplified formulations of LOLP to improve the computational efficiency. Two tradeoffs embedded in the SR optimization model are not explicitly analyzed in these methods. In this paper, two tradeoffs including primary tradeoff and secondary tradeoff between economy and reliability in the maximum LOLP constrained unit commitment (UC) model are explored and analyzed in a small system and in IEEE-RTS System. The analysis on the two tradeoffs can help in establishing new efficient simplified LOLP formulations and new SR optimization models.

Waste-efficient materials procurement for construction projects: A structural equation modelling of critical success factors.

PubMed

Ajayi, Saheed O; Oyedele, Lukumon O

2018-05-01

Albeit the understanding that construction waste is caused by activities ranging from all stages of project delivery process, research efforts have been concentrated on design and construction stages, while the possibility of reducing waste through materials procurement process is widely neglected. This study aims at exploring and confirming strategies for achieving waste-efficient materials procurement in construction activities. The study employs sequential exploratory mixed method approach as its methodological framework, using focus group discussion, statistical analysis and structural equation modelling. The study suggests that for materials procurement to enhance waste minimisation in construction projects, the procurement process would be characterised by four features. These include suppliers' commitment to low waste measures, low waste purchase management, effective materials delivery management and waste-efficient Bill of Quantity, all of which have significant impacts on waste minimisation. This implies that commitment of materials suppliers to such measures as take back scheme and flexibility in supplying small materials quantity, among others, are expected of materials procurement. While low waste purchase management stipulates the need for such measures as reduced packaging and consideration of pre-assembled/pre-cut materials, efficient delivery management entails effective delivery and storage system as well as adequate protection of materials during the delivery process, among others. Waste-efficient specification and bill of quantity, on the other hand, requires accurate materials take-off and ordering of materials based on accurately prepared design documents and bill of quantity. Findings of this study could assist in understanding a set of measures that should be taken during materials procurement process, thereby corroborating waste management practices at other stages of project delivery process. Copyright © 2018. Published by Elsevier Ltd.

An Example of Discovery Research Involving the Transfer of Stimulus Control

PubMed Central

2005-01-01

The initial purpose of the present study was to replicate procedures for teaching preschool children to recruit attention at appropriate times by having an experimenter signal the availability and unavailability of attention (i.e., arrange a multiple schedule involving reinforcement and extinction; Tiger & Hanley, 2004). Following the development of discriminated social responding, the schedule-correlated stimuli were removed (i.e., a mixed schedule of reinforcement was arranged). However, discriminated responding continued during these conditions. Further evaluation suggested that stimulus control over children's social responding had transferred from the schedule-correlated stimuli to the delivery of reinforcement. The effect of a history of reinforcement under multiple-schedule conditions on performance under mixed schedules was then replicated with 2 participants in a reversal design. These findings suggest that following experience with schedule-correlated stimuli, these stimuli may be removed with only modest disruption to discriminated responding. PMID:16463530

Professional commitment to changing chronic illness care: results from disease management programmes.

PubMed

Lemmens, Karin; Strating, Mathilde; Huijsman, Robbert; Nieboer, Anna

2009-08-01

The aim of this exploratory study was to investigate to what extent primary care professionals are able to change their systems for delivering care to chronic obstructive pulmonary disease (COPD) patients and what professional and organizational factors are associated with the degree of process implementation. Quasi-experimental design with 1 year follow-up after intervention. Three regional COPD management programmes in the Netherlands, in which general practices cooperated with regional hospitals. All participating primary care professionals (n = 52). COPD management programme. Professional commitment, organizational context and degree of process implementation. Professionals significantly changed their systems for delivering care to COPD patients, namely self-management support, decision support, delivery system design and clinical information systems. Associations were found between organizational factors, professional commitment and changes in processes of care. Group culture and professional commitment appeared to be, to a moderate degree, predictors of process implementation. COPD management was effective; all processes improved significantly. Moreover, theoretically expected associations between organizational context and professional factors with the implementation of COPD management were indeed confirmed to some extent. Group culture and professional commitment are important facilitators.

Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning

PubMed Central

Liu, Shi; Wu, Yu; Wooten, H. Omar; Green, Olga; Archer, Brent; Li, Harold

2016-01-01

A software tool is developed, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image‐guided radiation therapy (MR‐IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in our clinic. The predicted treatment delivery time and the assessment of plan complexities could also be useful to aid treatment planning. A patient's total treatment delivery time, not including time required for localization, is modeled as the sum of four components: 1) the treatment initialization time; 2) the total beam‐on time; 3) the gantry rotation time; and 4) the multileaf collimator (MLC) motion time. Each of the four components is predicted separately. The total beam‐on time can be calculated using both the planned beam‐on time and the decay‐corrected dose rate. To predict the remain‐ing components, we retrospectively analyzed the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, linear regression is applied to predict the gantry rotation time. The MLC motion time is calculated using the leaves delay modeling method and the leaf motion speed. A quantitative analysis was performed to understand the correlation between the total treatment time and the plan complexity. The proposed algorithm is able to predict the ViewRay treatment delivery time with the average prediction error 0.22 min or 1.82%, and the maximal prediction error 0.89 min or 7.88%. The analysis has shown the correlation between the plan modulation (PM) factor and the total treatment delivery time, as well as the treatment delivery duty cycle. A possibility has been identified to significantly reduce MLC motion time by optimizing the positions of closed MLC pairs. The accuracy of the proposed prediction algorithm is sufficient to support patient treatment appointment scheduling. This developed software tool is currently applied in use on a daily basis in our clinic, and could also be used as an important indicator for treatment plan complexity. PACS number(s): 87.55.N PMID:27074472

Impact of Feed Delivery Pattern on Aerial Particulate Matter and Behavior of Feedlot Cattle †

PubMed Central

Mitloehner, Frank M.; Dailey, Jeff W.; Morrow, Julie L.; McGlone, John J.

2017-01-01

Simple Summary Fine particulate matter (with less than 2.5 microns diameter; aka PM2.5) are a human and animal health concern because they can carry microbes and chemicals into the lungs. Particulate matter (PM) in general emitted from cattle feedlots can reach high concentrations. When feedlot cattle were given an altered feeding schedule (ALT) that more closely reflected their biological feeding times compared with conventional morning feeding (CON), PM2.5 generation at peak times was substantially lowered. Average daily generation of PM2.5 was decreased by 37% when cattle behavior was redirected away from PM-generating behaviors and toward evening feeding behaviors. Behavioral problems such as agonistic (i.e., aggressive) and bulling (i.e., mounting each other) behaviors also were reduced several fold among ALT compared with CON cattle. Intake of feed was less and daily body weight gain tended to be less with the altered feeding schedule while efficiency of feed utilization was not affected. Although ALT may pose a challenge in feed delivery and labor scheduling, cattle had fewer behavioral problems and reduced PM2.5 generation when feed delivery times matched with the natural drive to eat in a crepuscular pattern. Abstract Fine particulate matter with less than 2.5 microns diameter (PM2.5) generated by cattle in feedlots is an environmental pollutant and a potential human and animal health issue. The objective of this study was to determine if a feeding schedule affects cattle behaviors that promote PM2.5 in a commercial feedlot. The study used 2813 crossbred steers housed in 14 adjacent pens at a large-scale commercial West Texas feedlot. Treatments were conventional feeding at 0700, 1000, and 1200 (CON) or feeding at 0700, 1000, and 1830 (ALT), the latter feeding time coincided with dusk. A mobile behavior lab was used to quantify behaviors of steers that were associated with generation of PM2.5 (e.g., fighting, mounting of peers, and increased locomotion). PM2.5 samplers measured respirable particles with a mass median diameter ≤2.5 μm (PM2.5) every 15 min over a period of 7 d in April and May. Simultaneously, the ambient temperature, humidity, wind speed and direction, precipitation, air pressure, and solar radiation were measured with a weather station. Elevated downwind PM2.5 concentrations were measured at dusk, when cattle that were fed according to the ALT vs. the CON feeding schedule, demonstrated less PM2.5-generating behaviors (p < 0.05). At dusk, steers on ALT vs. CON feeding schedules ate or were waiting to eat (standing in second row behind feeding cattle) at much greater rates (p < 0.05). Upwind PM2.5 concentrations were similar between the treatments. Downwind PM2.5 concentrations averaged over 24 h were lower from ALT compared with CON pens (0.072 vs. 0.115 mg/m3, p < 0.01). However, dry matter intake (DMI) was less (p < 0.05), and average daily gain (ADG) tended to be less (p < 0.1) in cattle that were fed according to the ALT vs. the CON feeding schedules, whereas feed efficiency (aka gain to feed, G:F) was not affected. Although ALT feeding may pose a challenge in feed delivery and labor scheduling, cattle exhibited fewer PM2.5-generating behaviors and reduced generation of PM2.5 when feed delivery times matched the natural desires of cattle to eat in a crepuscular pattern. PMID:28257061

77 FR 74533 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Filing and Immediate...

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... ``Fee Schedule'') issued pursuant to Exchange Rule 16.1(a) to: (1) Modify the Quotation Update Fee charged for each quotation update \\3\\ transmitted to the Exchange by an Equity Trading Permit (``ETP'') \\4\\ Holder using the Exchange's Order Delivery mode (``Order Delivery Mode''); and (2) cap the Quotation...

78 FR 72965 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing of Proposed Rule Change Amending...

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... Commitment Schedule (``CCS'') of the Designated Market Maker provided for in NYSE Rule 1000(d)(i). The text..., if any, in the CCS of the Designated Market Maker. As the execution of the order proceeds, the... to DBK due to the possibility of interaction with CCS interest. Note that no orders were routed to...

The French World of Business: Culture and Commerce. The Case of the Wharton School.

ERIC Educational Resources Information Center

Slowinski, Betty J.

This paper discusses French and American cultural differences and their effect on the conduct of business in both countries, as well as the results of the Banque Indosuez survey of French and American attitudes towards each other. The French tend to be less committed to schedules, appointments, and deadlines than Americans, and are more…

Establish Time for Learning: Finding Time to Collaborate Takes Creativity and Commitment

ERIC Educational Resources Information Center

Killion, Joellen

2016-01-01

The major challenge with time is finding it. Current school-day schedules and school-year calendars are leaner than ever because of budget reductions. States and districts have implemented furlough days to balance lean-and-mean budgets that show no sign of improving. Few are willing to take the leap toward reducing instructional time to improve…

Westinghouse Hanford Company health and safety performance report. Fourth quarter calendar year 1994

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

Lansing, K.A.

1995-03-01

Detailed information pertaining to As Low As Reasonably Achievable/Contamination Control Improvement Project (ALARA/CCIP) activities are outlined. Improved commitment to the WHC ALARA/CCIP Program was experienced throughout FY 1994. During CY 1994, 17 of 19 sitewide ALARA performance goals were completed on or ahead of schedule. Estimated total exposure by facility for CY 1994 is listed in tables by organization code for each dosimeter frequency. Facilities/areas continue to utilize the capabilities of the RPR tracking system in conjunction with the present site management action-tracking system to manage deficiencies, trend performance, and develop improved preventive efforts. Detailed information pertaining to occupational injuries/illnessesmore » are provided. The Industrial Safety and Hygiene programs are described which have generated several key initiatives that are believed responsible for improved safety performance. A breakdown of CY 1994 occupational injuries/illnesses by type, affected body group, cause, job type, age/gender, and facility is provided. The contributing experience of each WHC division/department in attaining this significant improvement is described along with tables charting specific trends. The Radiological Control Program is on schedule to meet all RL Site Management System milestones and program commitments.« less

Utilizing AI in Temporal, Spatial, and Resource Scheduling

NASA Technical Reports Server (NTRS)

Stottler, Richard; Kalton, Annaka; Bell, Aaron

2006-01-01

Aurora is a software system enabling the rapid, easy solution of complex scheduling problems involving spatial and temporal constraints among operations and scarce resources (such as equipment, workspace, and human experts). Although developed for use in the International Space Station Processing Facility, Aurora is flexible enough that it can be easily customized for application to other scheduling domains and adapted as the requirements change or become more precisely known over time. Aurora s scheduling module utilizes artificial-intelligence (AI) techniques to make scheduling decisions on the basis of domain knowledge, including knowledge of constraints and their relative importance, interdependencies among operations, and possibly frequent changes in governing schedule requirements. Unlike many other scheduling software systems, Aurora focuses on resource requirements and temporal scheduling in combination. For example, Aurora can accommodate a domain requirement to schedule two subsequent operations to locations adjacent to a shared resource. The graphical interface allows the user to quickly visualize the schedule and perform changes reflecting additional knowledge or alterations in the situation. For example, the user might drag the activity corresponding to the start of operations to reflect a late delivery.

Statistics on Diphtheria

MedlinePlus

... and diseases Global Vaccine Action Plan WHO policy recommendations SAGE Immunization schedules Position papers Advisory committees National programmes and systems Policy and strategies Service delivery Linking with other ...

Modernizing sports facilities

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

Dustin, R.

Modernization and renovation of sports facilities challenge the design team to balance a number of requirements: spectator and owner expectations, existing building and site conditions, architectural layouts, code and legislation issues, time constraints and budget issues. System alternatives are evaluated and selected based on the relative priorities of these requirements. These priorities are unique to each project. At Alexander Memorial Coliseum, project schedules, construction funds and facility usage became the priorities. The ACC basketball schedule and arrival of the Centennial Olympics dictated the construction schedule. Initiation and success of the project depended on the commitment of the design team tomore » meet coliseum funding levels established three years ago. Analysis of facility usage and system alternative capabilities drove the design team to select a system that met the project requirements and will maximize the benefits to the owner and spectators for many years to come.« less

Using Focus Groups to Modify the Workplace Affective Commitment Multidimensional Questionnaire (WACMQ) for use in Health Care.

PubMed

Perreira, Tyrone; Berta, Whitney

2016-01-01

BACKGROUND: The Workplace Affective Commitment Multidimensional Questionnaire (W ACMQ) measures affective commitment towards eight work-related targets. While this questionnaire was developed in the business sector, we believe that the multi-target conceptualization of affective commitment has applicability to complex health care contexts where providers of care, in the production and delivery of care, likely develop commitment toward a multiplicity of targets. Affective commitment is a strong predictor of extra-role workplace behavior; indispensable behaviors which enable health systems to function. OBJECTIVE: The aim of this psychometric exercise is to content validate the WACMQ questions for use in health care. METHODS: Two focus groups were conducted, consisting of nurses working in acute care and emergency hospitals in Ontario. Linguistic validation and cognitive debriefing were used. RESULTS: A total of 14 modifications to the wording of items on the original WACMQ questionnaire were made. CONCLUSIONS: This modified version of the WACMQ reflects the need for researchers in health care settings to acknowledge the complex context of health care and the attendant complexities of worker attitudes. Health care workers can experience affective commitment toward leadership (clinical or administrative), co-workers (nurses or interprofessional), patients, their profession, organization, work or tasks. Further, in some health care settings, features like union membership may have important implications when examining affective commitment or behaviors. Psychometric properties of the modified WACMQ will be established in an upcoming study that will examine the relationships between extra-role behaviors, commitment, perceived organizational support and justice within acute care and emergency departments of hospitals operating in Ontario.

Distributed network scheduling

NASA Technical Reports Server (NTRS)

Clement, Bradley J.; Schaffer, Steven R.

2004-01-01

Distributed Network Scheduling is the scheduling of future communications of a network by nodes in the network. This report details software for doing this onboard spacecraft in a remote network. While prior work on distributed scheduling has been applied to remote spacecraft networks, the software reported here focuses on modeling communication activities in greater detail and including quality of service constraints. Our main results are based on a Mars network of spacecraft and include identifying a maximum opportunity of improving traverse exploration rate a factor of three; a simulation showing reduction in one-way delivery times from a rover to Earth from as much as 5 to 1.5 hours; simulated response to unexpected events averaging under an hour onboard; and ground schedule generation ranging from seconds to 50 minutes for 15 to 100 communication goals.

The MER/CIP Portal for Ground Operations

NASA Technical Reports Server (NTRS)

Chan, Louise; Desai, Sanjay; DOrtenzio, Matthew; Filman, Robtert E.; Heher, Dennis M.; Hubbard, Kim; Johan, Sandra; Keely, Leslie; Magapu, Vish; Mak, Ronald

2003-01-01

We developed the Mars Exploration Rover/Collaborative Information Portal (MER/CIP) to facilitate MER operations. MER/CIP provides a centralized, one-stop delivery platform integrating science and engineering data from several distributed heterogeneous data sources. Key issues for MER/CIP include: 1) Scheduling and schedule reminders; 2) Tracking the status of daily predicted outputs; 3) Finding and analyzing data products; 4) Collaboration; 5) Announcements; 6) Personalization.

Stochastic Optimization for Unit Commitment-A Review

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

Zheng, Qipeng P.; Wang, Jianhui; Liu, Andrew L.

2015-07-01

Optimization models have been widely used in the power industry to aid the decision-making process of scheduling and dispatching electric power generation resources, a process known as unit commitment (UC). Since UC's birth, there have been two major waves of revolution on UC research and real life practice. The first wave has made mixed integer programming stand out from the early solution and modeling approaches for deterministic UC, such as priority list, dynamic programming, and Lagrangian relaxation. With the high penetration of renewable energy, increasing deregulation of the electricity industry, and growing demands on system reliability, the next wave ismore » focused on transitioning from traditional deterministic approaches to stochastic optimization for unit commitment. Since the literature has grown rapidly in the past several years, this paper is to review the works that have contributed to the modeling and computational aspects of stochastic optimization (SO) based UC. Relevant lines of future research are also discussed to help transform research advances into real-world applications.« less

Effect of accuracy of wind power prediction on power system operator

NASA Technical Reports Server (NTRS)

Schlueter, R. A.; Sigari, G.; Costi, T.

1985-01-01

This research project proposed a modified unit commitment that schedules connection and disconnection of generating units in response to load. A modified generation control is also proposed that controls steam units under automatic generation control, fast responding diesels, gas turbines and hydro units under a feedforward control, and wind turbine array output under a closed loop array control. This modified generation control and unit commitment require prediction of trend wind power variation one hour ahead and the prediction of error in this trend wind power prediction one half hour ahead. An improved meter for predicting trend wind speed variation is developed. Methods for accurately simulating the wind array power from a limited number of wind speed prediction records was developed. Finally, two methods for predicting the error in the trend wind power prediction were developed. This research provides a foundation for testing and evaluating the modified unit commitment and generation control that was developed to maintain operating reliability at a greatly reduced overall production cost for utilities with wind generation capacity.

"Fiefdoms" and co-management: the paradox of autonomy in an experience of democratization of hospital management.

PubMed

da Silva, Atila Mendes; Sá, Marilene de Castilho; Miranda, Lilian

2015-10-01

This study aimed to analyze the implementation of Management Committees and Production Units in a hospital in Rio de Janeiro based on the views of the actors responsible for this process, focusing on the issue of autonomy of the subjects involved in care delivery. This case study adopted a qualitative clinical psychosociological research approach using mainly semi-structured interviews. The management arrangements were valued by the interviewees principally as a way of increasing worker commitment, since the inclusion of workers in the Management Committees is likely to widen decision-making capacity and, at the same time, make staff more committed to care delivery. On the other hand, workers mentioned resistance arising from a struggle to maintain the concentration of power within the professional categories, and the challenge of dealing with differing conflicts of interests. The study suggests that the Management Committees and Production Units should include possibilities of addressing conflicts and intersubjective processes to avoid becoming excessively idealized and ineffective spaces.

Feasibility randomized-controlled trial of online Acceptance and Commitment Therapy for patients with complex chronic pain in the United Kingdom.

PubMed

Scott, W; Chilcot, J; Guildford, B; Daly-Eichenhardt, A; McCracken, L M

2018-04-28

Acceptance and Commitment Therapy (ACT) has growing support for chronic pain. However, more accessible treatment delivery is needed. This study evaluated the feasibility of online ACT for patients with complex chronic pain in the United Kingdom to determine whether a larger trial is justified. Participants with chronic pain and clinically meaningful disability and distress were randomly assigned to ACT online plus specialty medical pain management, or specialty medical management alone. Participants completed questionnaires at baseline, and 3- and 9-month post-randomization. Primary feasibility outcomes included recruitment, retention and treatment completion rates. Secondary outcomes were between-groups effects on treatment outcomes and psychological flexibility. Of 139 potential participants, 63 were eligible and randomized (45% recruitment rate). Retention rates were 76-78% for follow-up assessments. Sixty-one per cent of ACT online participants completed treatment. ACT online was less often completed by employed (44%) compared to unemployed (80%) participants. Fifty-six per cent of ACT online participants rated themselves as 'much improved' or better on a global impression of change rating, compared to only 20 per cent of control participants. Three-month effects favouring ACT online were small for functioning, medication and healthcare use, committed action and decentring, medium for mood, and large for acceptance. Small-to-medium effects were maintained for functioning, healthcare use and committed action at 9 months. Online ACT for patients with chronic pain in the United Kingdom appears feasible to study in a larger efficacy trial. Some adjustments to treatment and trial procedures are warranted, particularly to enhance engagement among employed participants. This study supports the feasibility of online Acceptance and Commitment Therapy for chronic pain in the United Kingdom and a larger efficacy trial. Refinements to treatment delivery, particularly to better engage employed patients, may improve treatment completion and outcomes. © 2018 European Pain Federation - EFIC®.

Waste Feed Delivery System Phase 1 Preliminary Reliability and Availability and Maintainability Analysis [SEC 1 and 2

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

CARLSON, A.B.

The document presents updated results of the preliminary reliability, availability, maintainability analysis performed for delivery of waste feed from tanks 241-AZ-101 and 241-AN-105 to British Nuclear Fuels Limited, inc. under the Tank Waste Remediation System Privatization Contract. The operational schedule delay risk is estimated and contributing factors are discussed.

78 FR 72968 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

... Capital Commitment Schedule (``CCS'') interest; (3) NYSE Rule 70.25 to permit d-Quotes to be designated... that MPL Orders may interact with CCS interest; (3) NYSE Rule 70.25 to permit d- Quotes to be... the CCS pursuant to Rule 1000 would not be permitted to be designated as MPL Orders. The CCS is a...

EXAMINING THE GENERALITY OF CHILDREN'S PREFERENCE FOR CONTINGENT REINFORCEMENT VIA EXTENSION TO DIFFERENT RESPONSES, REINFORCERS, AND SCHEDULES

PubMed Central

Luczynski, Kevin C; Hanley, Gregory P

2010-01-01

Studies that have assessed whether children prefer contingent reinforcement (CR) or noncontingent reinforcement (NCR) have shown that they prefer CR. Preference for CR has, however, been evaluated only under continuous reinforcement (CRF) schedules. The prevalence of intermittent reinforcement (INT) warrants an evaluation of whether preference for CR persists as the schedule of reinforcement is thinned. In the current study, we evaluated 2 children's preference for contingent versus noncontingent delivery of highly preferred edible items for academic task completion under CRF and INT schedules. Children (a) preferred CR to NCR under the CRF schedule, (b) continued to prefer CR as the schedule of reinforcement became intermittent, and (c) exhibited a shift in preference from CR to NCR as the schedule became increasingly thin. These findings extend the generality of and provide one set of limits to the preference for CR. Applied implications, variables controlling preferences, and future research are discussed. PMID:21358901

Impact of Intended Mode of Delivery on Outcomes in Preterm Growth-Restricted Fetuses.

PubMed

Baalbaki, Sima H; Kuper, Spencer G; Wang, Michelle J; Steele, Robin A; Biggio, Joseph R; Harper, Lorie M

2018-06-01

 Scheduled cesarean is frequently performed for fetal growth restriction due to concerns for fetal intolerance of labor.  We compared neonatal outcomes in preterm growth-restricted fetuses by intended mode of delivery.  We performed a retrospective cohort study of indicated preterm births with prenatally diagnosed growth restriction from 2011 to 2014 at a single institution. Patients were classified by intended mode of delivery. The primary outcome was a composite of adverse neonatal outcomes, including perinatal death, cord blood acidemia, chest compressions during neonatal resuscitation, seizures, culture-proven sepsis, necrotizing enterocolitis, and grade III-IV intraventricular hemorrhage. Secondary analysis was performed examining the impact of umbilical artery Dopplers.  Of 101 fetuses with growth restriction, 75 underwent planned cesarean deliveries. Of those induced, 46.2% delivered vaginally. Delivery by scheduled cesarean was not associated with a decreased risk of the composite outcome (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 0.45-5.78), even when only those with abnormal umbilical artery Dopplers were considered (aOR, 2.8; 95% CI, 0.40-20.2).  In this cohort, planned cesarean was not associated with a reduction in neonatal morbidity, even when considering only those with abnormal umbilical artery Dopplers. In otherwise appropriate candidates for vaginal delivery, fetal growth restriction should not be considered a contraindication to trial of labor. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Best kept secrets ... First Coast Systems, Inc. (FCS).

PubMed

Andrew, W F

1991-04-01

The FCS/APaCS system is a viable option for small-to medium-size hospitals (up to 400 beds). The table-driven system takes full advantage of IBM AS/400 computer architecture. A comprehensive application set, provided in an integrated database environment, is adaptable to multi-facility environments. Price/performance appears to be competitive. Commitment to IBM AS/400 environment assures cost-effective hardware platforms backed by IBM support and resources. As an IBM Health Industry Business Partner, FCS (and its clients) benefits from IBM's well-known commitment to quality and service. Corporate emphasis on user involvement and satisfaction, along with a commitment to quality and service for the APaCS systems, assures clients of "leading edge" capabilities in this evolutionary healthcare delivery environment. FCS/APaCS will be a strong contender in selected marketing environments.

Part-Time Occupational Faculty: A Contribution to Excellence. Information Series No. 300.

ERIC Educational Resources Information Center

Parsons, Michael H.

Part-time faculty are essential to the accomplishment of the mission of postsecondary occupational education institutions. A commitment to excellence requires a comprehensive, systematic design for part-time faculty recruitment, development, assessment, and integration into the institution's delivery system. Careful attention to recruitment…

IDC Integrated Master Plan.

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

Clifford, David J.; Harris, James M.

2014-12-01

This is the IDC Re-Engineering Phase 2 project Integrated Master Plan (IMP). The IMP presents the major accomplishments planned over time to re-engineer the IDC system. The IMP and the associate Integrated Master Schedule (IMS) are used for planning, scheduling, executing, and tracking the project technical work efforts. REVISIONS Version Date Author/Team Revision Description Authorized by V1.0 12/2014 IDC Re- engineering Project Team Initial delivery M. Harris

Reinforcement of schedule-induced drinking in rats by lick-contingent shortening of food delivery.

PubMed

Álvarez, Beatriz; Íbias, Javier; Pellón, Ricardo

2016-12-01

Schedule-induced drinking has been a theoretical question of concern ever since it was first described more than 50 years ago. It has been classified as adjunctive behavior; that is, behavior that is induced by an incentive but not reinforced by it. Nevertheless, some authors have argued against this view, claiming that adjunctive drinking is actually a type of operant behavior. If this were true, schedule-induced drinking should be controlled by its consequences, which is the major definition of an operant. The present study tested this hypothesis. In a first experimental phase, a single pellet of food was delivered at regular 90-s intervals, but the interfood interval could be shortened depending on the rat's licking. The degree of contingency between licking the bottle spout and hastening the delivery of the food pellet was 100 %, 50 %, and 0 % for 3 separate groups of animals. Rats that could shorten the interval (100 % and 50 % contingency) drank at a higher rate than those that could not (0 %), and the level of acquisition was positively related to the degree of contingency. In a second phase of the experiment, all groups were exposed to a 100 % contingency, which resulted in all rats developing high levels of schedule-induced drinking. Licking is enhanced if it hastens reinforcement, and can do so at delay characteristics of those present in studies of schedule-induced drinking, thus supporting the view that adjunctive behavior is an operant.

Provision of information to consumers about the calorie content of alcoholic drinks: did the Responsibility Deal pledge by alcohol retailers and producers increase the availability of calorie information?

PubMed

Petticrew, M; Douglas, N; Knai, C; Maani Hessari, N; Durand, M A; Eastmure, E; Mays, N

2017-08-01

Alcohol is a significant source of dietary calories and is a contributor to obesity. Industry pledges to provide calorie information to consumers have been cited as reasons for not introducing mandatory ingredient labelling. As part of the Public Health Responsibility Deal (RD) in England, alcohol retailers and producers committed to providing consumers with information on the calorie content of alcoholic drinks. This study examines what was achieved following this commitment and considers the implications for current industry commitments to provide information on alcohol calories. Analysis of RD pledge delivery plans and progress reports. Assessment of calorie information in supermarkets and in online stores. (i) Analysis of the content of pledge delivery plans and annual progress reports of RD signatories to determine what action they had committed to, and had taken, to provide calorie information. (ii) Analysis of the availability of calorie information on product labels; in UK supermarkets; and on online shopping sites and websites. No information was provided in any of 55 stores chosen to represent all the main UK supermarkets. Calorie information was not routinely provided on supermarkets' websites, or on product labels. One of the stated purposes of the RD was to provide consumers with the information to make informed health-related choices, including providing information on the calorie content of alcoholic drinks. This study indicates that this did not take place to any significant extent. The voluntary implementation of alcohol calorie labelling by industry needs to continue to be carefully monitored to determine whether and how it is done. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Modeling the dynamics of choice.

PubMed

Baum, William M; Davison, Michael

2009-06-01

A simple linear-operator model both describes and predicts the dynamics of choice that may underlie the matching relation. We measured inter-food choice within components of a schedule that presented seven different pairs of concurrent variable-interval schedules for 12 food deliveries each with no signals indicating which pair was in force. This measure of local choice was accurately described and predicted as obtained reinforcer sequences shifted it to favor one alternative or the other. The effect of a changeover delay was reflected in one parameter, the asymptote, whereas the effect of a difference in overall rate of food delivery was reflected in the other parameter, rate of approach to the asymptote. The model takes choice as a primary dependent variable, not derived by comparison between alternatives-an approach that agrees with the molar view of behaviour.

Short hospitalization after caesarean delivery: effects on maternal pain and stress at discharge.

PubMed

Zanardo, Vincenzo; Giliberti, Lara; Volpe, Francesca; Simbi, Alphonse; Guerrini, Pietro; Parotto, Matteo; Straface, Gianluca

2018-09-01

To characterize predischarge maternal pain and stress after caesarean delivery and short hospitalization. This is a descriptive study with 60 women in the postoperative period of caesarean section and 60 control women after vaginal delivery. Pain and stress were measured by McGill Pain Questionnaire (MGPQ) and by the Stress Measure (Psychological Stress Measure (PSM)), respectively, at mother-infant dyad discharge, scheduled at 36 hours after delivery. Caesarean section was the delivery modality with the highest MGPQ pain and sensorial, evaluative and mixed pain descriptive categories scores. The pain location involved lower abdomen, with associated localizations at back, breast and shoulders. Conversely, vaginal delivery was the delivery modality with the highest stress scores. This study provides important information on the quality of care implications of early discharge practices in puerperae after caesarean delivery, a critical time characterized by qualitatively and quantitatively high pain and stress.

Convection-Enhanced Delivery (CED) in an Animal Model of Malignant Peripheral Nerve Sheath Tumors and Plexiform Neurofibromas

DTIC Science & Technology

2011-09-01

with an accelerated schedule Convection-Enhanced Delivery ( CED ), Malignant Peripheral Nerve Sheath ( MPNST ), Plexiform Neurofibromas (PN...the distribution of macromolecules delivered to intraneural PNs and MPNST via CED . Design: Orthotopic xenograft models of sciatic intraneural NF1...determine the efficacy CED of the epidermal growth factor receptor (EGFR) inhibitor erlotinib in animal models of intraneural PNs and MPNST

Placenta accreta spectrum: accreta, increta, and percreta.

PubMed

Silver, Robert M; Barbour, Kelli D

2015-06-01

Placenta accreta can lead to hemorrhage, resulting in hysterectomy, blood transfusion, multiple organ failure, and death. Accreta has been increasing steadily in incidence owing to an increase in the cesarean delivery rate. Major risk factors are placenta previa in women with prior cesarean deliveries. Obstetric ultrasonography can be used to diagnose placenta accreta antenatally, which allows for scheduled delivery in a multidisciplinary center of excellence for accreta. Controversies exist regarding optimal management, including optimal timing of delivery, surgical approach, use of adjunctive measures, and conservative (uterine-sparing) therapy. We review the definition, risk factors, diagnosis, management, and controversies regarding placenta accreta. Copyright © 2015 Elsevier Inc. All rights reserved.

Cost-effectiveness of external cephalic version for term breech presentation.

PubMed

Tan, Jonathan M; Macario, Alex; Carvalho, Brendan; Druzin, Maurice L; El-Sayed, Yasser Y

2010-01-21

External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc.) was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery), utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY) was used to determine cost-effectiveness. The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion to breech, successful second ECV trial, or adverse outcome from emergency cesarean. From society's perspective, ECV trial is cost-effective when compared to a scheduled cesarean for breech presentation provided the probability of successful ECV is > 32%. Improved algorithms are needed to more precisely estimate the likelihood that a patient will have a successful ECV.

Washington State's Corrections Clearinghouse: A Comprehensive Approach to Offender Employment.

ERIC Educational Resources Information Center

Finn, Peter

Since 1976, the Correctional Clearinghouse (CCH), which is a unit of the Washington State Employment Security Department, has been committed to preparing offenders for the workplace and finding employment. The CCH's principal service delivery strategies are as follows: (1) providing direct services (teaching job readiness courses in prisons and…

17 CFR 229.1207 - (Item 1207) Delivery commitments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... information required by this Item: (1) In a form understandable to investors; and (2) Based upon the facts and... subject to priorities or curtailments which may affect quantities delivered to certain classes of... factors beyond the registrant's control that may affect the registrant's ability to meet its contractual...

JPRS Report, East Europe

DTIC Science & Technology

1991-04-03

deliveries of goods from the indication lists in equal defray the costs related to setting up the new jobs . This annual amounts between 1991 and 1994, with...Development of Nuclear Energy Industry must also contain a commitment by the employer that Described the new jobs will be filled by applicants recommended by

The National Home Visiting Coalition: A History of Collaboration

ERIC Educational Resources Information Center

Callahan, Jane; Gavaghan, Bridget; Howard, Karen; Kelley, Melissa L.; Schwartz, Marvin; Walzer, Sarah

2010-01-01

The Home Visiting Coalition represents more than 75 organizations working together to articulate the effectiveness of home visiting to a range of policymakers and stakeholders in the early childhood field. Despite varying program goals and service delivery strategies, the Coalition participants share a commitment to expanding access to…

A brief survey of Department of Defense Telemedicine.

PubMed

Zimnik, P R

1996-01-01

This paper describes current telemedical projects sponsored by the Department of Defense (DoD) and provides points of contact for further communication. The scope and scale of these projects demonstrate the DoD commitment to the development and deployment of telemedicine and advanced medical information technologies in health care delivery.

Evidence for E-Learning Policy

ERIC Educational Resources Information Center

Pittard, Vanessa

2004-01-01

E-learning is becoming an increasingly mainstream feature of educational delivery. The launch of a national e-learning strategy in England signals the Government's commitment to maximising the potential benefits of investment in information and communications technology (ICT). The vision for e-learning set out in this strategy is ambitious. At…

ALMA's long look

NASA Astrophysics Data System (ADS)

Morata, Oscar; Huang, Ted

2017-06-01

ALMA's Band 1 receivers will open up the 7 mm window to the 66 antennas on Chajnantor Plateau. Oscar Morata and Ted Huang relate the expected delivery schedule and science goals for these instruments.

An Event-driven, Value-based, Pull Systems Engineering Scheduling Approach

DTIC Science & Technology

2012-03-01

engineering in rapid response environments has been difficult, particularly those where large, complex brownfield systems or systems of systems exist and...where large, complex brownfield systems or systems of systems exist and are constantly being updated with both short and long term software enhancements...2004. [13] B. Boehm, “Applying the Incremental Commitment Model to Brownfield System Development,” Proceedings, CSER, 2009. [14] A. Borshchev and A

JPRS Report, East Europe

DTIC Science & Technology

1987-10-19

Committee and head of the committee’s Foreign Affairs Department, and Medgyessy Peter, member of the party Central Commit- tee and head of the...vice-premier, and Zhu Liang, head of the International Liaison Department of the CPC Cen- tral Committee. A formal welcoming ceremony is scheduled...forthcoming party congress he will resign even as head of the Central Advisory Commission, the body consisting of elderly politicians. He would then only

Applying Japanese management tips to patient accounts.

PubMed

Groenevelt, C J

1990-04-01

"Just in time," a Japanese management philosophy that has been applied successfully in manufacturing operations, also can be used to improve management of patient accounts departments. Under its principles, healthcare organizations would develop standardized procedures; involve workers in decision making; set up training and education programs aimed at creating a multi-skilled pool of workers; establish smooth production schedules; and foster cooperation and commitment to the philosophy throughout the organization.

Bridging the Silos of Service Delivery for High-Need, High-Cost Individuals.

PubMed

Sherry, Melissa; Wolff, Jennifer L; Ballreich, Jeromie; DuGoff, Eva; Davis, Karen; Anderson, Gerard

2016-12-01

Health care reform efforts that emphasize value have increased awareness of the importance of nonmedical factors in achieving better care, better health, and lower costs in the care of high-need, high-cost individuals. Programs that care for socioeconomically disadvantaged, high-need, high-cost individuals have achieved promising results in part by bridging traditional service delivery silos. This study examined 5 innovative community-oriented programs that are successfully coordinating medical and nonmedical services to identify factors that stimulate and sustain community-level collaboration and coordinated care across silos of health care, public health, and social services delivery. The authors constructed a conceptual framework depicting community health systems that highlights 4 foundational factors that facilitate community-oriented collaboration: flexible financing, shared leadership, shared data, and a strong shared vision of commitment toward delivery of person-centered care.

"Sleep well, our tough heroes!"--in adolescence, greater mental toughness is related to better sleep schedules.

PubMed

Brand, Serge; Gerber, Markus; Kalak, Nadeem; Kirov, Roumen; Lemola, Sakari; Clough, Peter J; Pühse, Uwe; Holsboer-Trachsler, Edith

2014-01-01

Mental toughness (MT) is understood as the display of confidence, commitment, challenge, and control. The aim of this study was to explore the extent to which greater MT is associated with subjectively assessed sleep among adolescents. A total of 284 adolescents (M = 18.26 years) completed a series of questionnaires assessing MT, psychological functioning, and sleep. Greater MT was significantly associated with better sleep quality, shorter sleep onset latency, fewer awakenings after sleep onset, and longer sleep duration. Greater MT was also associated with less perceived stress and less depressive symptoms. MT was directly and indirectly associated with sleep quality. Mentally tough adolescents report good sleep quality and sleep schedules, along with psychological wellbeing.

The Compact Ignition Tokamak and electron cyclotron heating: Description of need; assessment of prospects

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

Ignat, D.W.; Cohn, D.R.; Woskov, P.P.

1989-01-01

The CIT will benefit from auxiliary heating of 10 to 40 MW. The schedules of both the CIT construction project and the operating plan contain adequate time to develop and implement ECH systems based on the gyrotron and the induction free electron laser (IFEL). Each approach has advantages and is the object of R and D at the level of many millions of dollars per year. While the gyrotron is further advanced in terms of power and pulse length achieved, rapid progress is scheduled for the IFEL, including experiments on tokamaks. Plans of CIT, gyrotron, and IFEL make 1992 anmore » appropriate time frame to commit to one or both systems. 12 refs., 8 figs., 2 tabs.« less

Alternative contracting research : final report.

DOT National Transportation Integrated Search

2016-08-01

Alternative contracting methods have become popular alternatives to the traditional practice whose emphasis is on low bid acquisition. The benefits of decreased project schedule, increased job quality, and improved delivery process have demonstrated ...

Committing to coal and gas: Long-term contracts, regulation, and fuel switching in power generation

NASA Astrophysics Data System (ADS)

Rice, Michael

Fuel switching in the electricity sector has important economic and environmental consequences. In the United States, the increased supply of gas during the last decade has led to substantial switching in the short term. Fuel switching is constrained, however, by the existing infrastructure. The power generation infrastructure, in turn, represents commitments to specific sources of energy over the long term. This dissertation explores fuel contracts as the link between short-term price response and long-term plant investments. Contracting choices enable power plant investments that are relationship-specific, often regulated, and face uncertainty. Many power plants are subject to both hold-up in investment and cost-of-service regulation. I find that capital bias is robust when considering either irreversibility or hold-up due to the uncertain arrival of an outside option. For sunk capital, the rental rate is inappropriate for determining capital bias. Instead, capital bias depends on the regulated rate of return, discount rate, and depreciation schedule. If policies such as emissions regulations increase fuel-switching flexibility, this can lead to capital bias. Cost-of-service regulation can shorten the duration of a long-term contract. From the firm's perspective, the existing literature provides limited guidance when bargaining and writing contracts for fuel procurement. I develop a stochastic programming framework to optimize long-term contracting decisions under both endogenous and exogenous sources of hold-up risk. These typically include policy changes, price shocks, availability of fuel, and volatility in derived demand. For price risks, the optimal contract duration is the moment when the expected benefits of the contract are just outweighed by the expected opportunity costs of remaining in the contract. I prove that imposing early renegotiation costs decreases contract duration. Finally, I provide an empirical approach to show how coal contracts can limit short-term fuel switching in power production. During the era prior to shale gas and electricity market deregulation, I do not find evidence that gas generation substituted for coal in response to fuel price changes. However, I do find evidence that coal plant operations are constrained by fuel contracts. As the min-take commitment to coal increases, changes to annual coal plant output decrease. My conclusions are robust in spite of bias due to the selective reporting of proprietary coal delivery contracts by utilities.

Escalator: An Autonomous Scheduling Scheme for Convergecast in TSCH

PubMed Central

Oh, Sukho; Hwang, DongYeop; Kim, Ki-Hyung; Kim, Kangseok

2018-01-01

Time Slotted Channel Hopping (TSCH) is widely used in the industrial wireless sensor networks due to its high reliability and energy efficiency. Various timeslot and channel scheduling schemes have been proposed for achieving high reliability and energy efficiency for TSCH networks. Recently proposed autonomous scheduling schemes provide flexible timeslot scheduling based on the routing topology, but do not take into account the network traffic and packet forwarding delays. In this paper, we propose an autonomous scheduling scheme for convergecast in TSCH networks with RPL as a routing protocol, named Escalator. Escalator generates a consecutive timeslot schedule along the packet forwarding path to minimize the packet transmission delay. The schedule is generated autonomously by utilizing only the local routing topology information without any additional signaling with other nodes. The generated schedule is guaranteed to be conflict-free, in that all nodes in the network could transmit packets to the sink in every slotframe cycle. We implement Escalator and evaluate its performance with existing autonomous scheduling schemes through a testbed and simulation. Experimental results show that the proposed Escalator has lower end-to-end delay and higher packet delivery ratio compared to the existing schemes regardless of the network topology. PMID:29659508

Escalator: An Autonomous Scheduling Scheme for Convergecast in TSCH.

PubMed

Oh, Sukho; Hwang, DongYeop; Kim, Ki-Hyung; Kim, Kangseok

2018-04-16

Time Slotted Channel Hopping (TSCH) is widely used in the industrial wireless sensor networks due to its high reliability and energy efficiency. Various timeslot and channel scheduling schemes have been proposed for achieving high reliability and energy efficiency for TSCH networks. Recently proposed autonomous scheduling schemes provide flexible timeslot scheduling based on the routing topology, but do not take into account the network traffic and packet forwarding delays. In this paper, we propose an autonomous scheduling scheme for convergecast in TSCH networks with RPL as a routing protocol, named Escalator. Escalator generates a consecutive timeslot schedule along the packet forwarding path to minimize the packet transmission delay. The schedule is generated autonomously by utilizing only the local routing topology information without any additional signaling with other nodes. The generated schedule is guaranteed to be conflict-free, in that all nodes in the network could transmit packets to the sink in every slotframe cycle. We implement Escalator and evaluate its performance with existing autonomous scheduling schemes through a testbed and simulation. Experimental results show that the proposed Escalator has lower end-to-end delay and higher packet delivery ratio compared to the existing schemes regardless of the network topology.

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

Coston, V.A.

There is a great deal of emphasis today on management's commitment to quality. Yet with all the hue and cry about this commitment do we find much more happening than just lip service. Are quality professionals aiding and abetting the nonacceptance of quality organizations, resulting in their exclusion from the management. Quality professionals must recognize they cannot divorce themselves from cost and schedule. They must recognize they are not policemen with omnipotent authority. Self-recognition must occur and be acted upon for changes in attitudes and opinions of others to be affected. There are, of course, other factors involved. But inmore » searching for the root cause of the problem, does the evidence of those other factors again point back to the Quality professionals. Quality is not a dirty word. We must convince ourselves before we can convince others.« less

A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma.

PubMed

Yorke, Janelle; Adair, Pauline; Doyle, Anne-Marie; Dubrow-Marshall, Linda; Fleming, Sharon; Holmes, Leanne; Menzies-Gow, Andrew; Niven, Rob; Pilling, Mark; Shuldham, Caroline

2017-06-01

Evidence for the efficacy of Cognitive Behavioural Therapy (CBT) in asthma is developing but it is not known if this translates to benefits in severe asthma or if a group approach is acceptable to this patient group. This study aimed to assess the feasibility and acceptability of Group-CBT in severe asthma. This was a two-centre, randomised controlled parallel group feasibility study. Eligible participants (patients with severe asthma and a clinically significant diagnosis of anxiety and/or depression - Hospital Anxiety and Depression Scale (HAD) score greater than 8 for the anxiety or depression sub-scale) received Group-CBT in weekly sessions for eight consecutive weeks and usual care or usual care only. Follow-up was for 16 weeks and end points were: Asthma Quality of Life Questionnaire, Asthma Control Questionnaire, HAD, Dyspnoea-12, EuroQual-5D and EuroQuol-VAS. 51 patients were randomised: 36% (51 out of 140) consent rate and attrition at week 16 was 12. Screening logs indicated that study take-up was influenced by patients living long distances from the treatment centre and inability to commit to the weekly demands of the programme. Drop-out was higher in Group-CBT compared due to inability to commit to the weekly programme because of poor health. Participants who contributed to focus group discussions reported that Group-CBT contributed to a better understanding of their illness and related approaches to anxiety management and acceptance of their asthma condition. Although weekly face-to-face sessions were challenging, this was the preferred method of delivery for these participants. This feasibility study shows that Group-CBT warrants further investigation as a potentially promising treatment option for patients with severe asthma. It has been possible but not easy to recruit and retain the sample. Options for a less demanding intervention schedule, such as less frequent face-to-face visits and the use of web-based interventions, require careful consideration.

Elimination of mother-to-child transmission of HIV and syphilis: A dual approach in the African Region to improve quality of antenatal care and integrated disease control.

PubMed

Newman Owiredu, Morkor; Newman, Lori; Nzomo, Theresa; Conombo Kafando, Ghislaine; Sanni, Saliyou; Shaffer, Nathan; Bucagu, Maurice; Peeling, Rosanna; Mark, Jennifer; Diop Toure, Isseu

2015-06-01

The World Health Organization's (WHO) Strategic Framework for the Elimination of New HIV Infections among Children in Africa by 2015 identifies important synergies for the elimination of mother-to-child transmission of HIV and syphilis in terms of prevention interventions, implementation logistics and service delivery, monitoring and evaluation systems, and need for sustained political commitment. The WHO advocates the use of an integrated, rights-based dual approach with partnerships and collaboration to make the best use of available resources. Through a consultative approach, six countries in the African Region committed to dual elimination and developed and implemented action plans for this purpose. Where interest and commitment are high, this may also be possible and effective in other African countries. Copyright © 2015. Published by Elsevier Ireland Ltd.

Optimizing Chemotherapy Dose and Schedule by Norton-Simon Mathematical Modeling

PubMed Central

Traina, Tiffany A.; Dugan, Ute; Higgins, Brian; Kolinsky, Kenneth; Theodoulou, Maria; Hudis, Clifford A.; Norton, Larry

2011-01-01

Background To hasten and improve anticancer drug development, we created a novel approach to generating and analyzing preclinical dose-scheduling data so as to optimize benefit-to-toxicity ratios. Methods We applied mathematical methods based upon Norton-Simon growth kinetic modeling to tumor-volume data from breast cancer xenografts treated with capecitabine (Xeloda®, Roche) at the conventional schedule of 14 days of treatment followed by a 7-day rest (14 - 7). Results The model predicted that 7 days of treatment followed by a 7-day rest (7 - 7) would be superior. Subsequent preclinical studies demonstrated that this biweekly capecitabine schedule allowed for safe delivery of higher daily doses, improved tumor response, and prolonged animal survival. Conclusions We demonstrated that the application of Norton-Simon modeling to the design and analysis of preclinical data predicts an improved capecitabine dosing schedule in xenograft models. This method warrants further investigation and application in clinical drug development. PMID:20519801

Transuranic Waste Program Framework Agreement - December Deliverable July 2012

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

Jones, Patricia

Framework agreement deliverables are: (1) 'DOE/NNSA commits to complete removal of all non-cemented above-ground EM Legacy TRU and newly generated TRU currently-stored at Area G as of October 1, 2011, by no later than June 30, 2014. This inventory of above-ground TRU is defined as 3706 cubic meters of material.' (2) 'DOE commits to the complete removal of all newly generated TRU received in Area G during FY 2012 and 2013 by no later than December 31, 2014.' (3) 'Based on projected funding profiles, DOE/NNSA will develop by December 31, 2012, a schedule, including pacing milestones, for disposition of themore » below-ground TRU requiring retrieval at Area G.' Objectives are to: (1) restore the 'Core Team' to develop the December, 2012 deliverable; (2) obtain agreement on the strategy for below ground water disposition; and (3) establish timeline for completion of the deliverable. Below Grade Waste Strategy is to: (1) Perform an evaluation on below grade waste currently considered retrievable TRU; (2) Only commit to retrieve waste that must be retrieved; (3) Develop the Deliverable including Pacing Milestones based on planned commitments; (4) Align all Regulatory Documents for Consistency; and (5) answer these 3 primary questions, is the waste TRU; is the waste retrievable, can retrieval cause more harm than benefit?« less

Choice in situations of time-based diminishing returns: immediate versus delayed consequences of action.

PubMed Central

Hackenberg, T D; Hineline, P N

1992-01-01

Pigeons chose between two schedules of food presentation, a fixed-interval schedule and a progressive-interval schedule that began at 0 s and increased by 20 s with each food delivery provided by that schedule. Choosing one schedule disabled the alternate schedule and stimuli until the requirements of the chosen schedule were satisfied, at which point both schedules were again made available. Fixed-interval duration remained constant within individual sessions but varied across conditions. Under reset conditions, completing the fixed-interval schedule not only produced food but also reset the progressive interval to its minimum. Blocks of sessions under the reset procedure were interspersed with sessions under a no-reset procedure, in which the progressive schedule value increased independent of fixed-interval choices. Median points of switching from the progressive to the fixed schedule varied systematically with fixed-interval value, and were consistently lower during reset than during no-reset conditions. Under the latter, each subject's choices of the progressive-interval schedule persisted beyond the point at which its requirements equaled those of the fixed-interval schedule at all but the highest fixed-interval value. Under the reset procedure, switching occurred at or prior to that equality point. These results qualitatively confirm molar analyses of schedule preference and some versions of optimality theory, but they are more adequately characterized by a model of schedule preference based on the cumulated values of multiple reinforcers, weighted in inverse proportion to the delay between the choice and each successive reinforcer. PMID:1548449

Paperless Procurement: The Impact of Advanced Automation

DTIC Science & Technology

1992-09-01

System. POPS = Paperless Order Processing System; RADMIS = Research and Development Management Information System; SAACONS=Standard Army Automated... order processing system, which then updates the contractor’s production (or delivery) scheduling and contract accounting applications. In return, the...used by the DLA’s POPS. 3-5 into an EDI delivery order and pass it directly to the distributor’s or manufacturer’s order processing system. That

An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation.

PubMed

Rochester, Carolyn L; Vogiatzis, Ioannis; Holland, Anne E; Lareau, Suzanne C; Marciniuk, Darcy D; Puhan, Milo A; Spruit, Martijn A; Masefield, Sarah; Casaburi, Richard; Clini, Enrico M; Crouch, Rebecca; Garcia-Aymerich, Judith; Garvey, Chris; Goldstein, Roger S; Hill, Kylie; Morgan, Michael; Nici, Linda; Pitta, Fabio; Ries, Andrew L; Singh, Sally J; Troosters, Thierry; Wijkstra, Peter J; Yawn, Barbara P; ZuWallack, Richard L

2015-12-01

Pulmonary rehabilitation (PR) has demonstrated physiological, symptom-reducing, psychosocial, and health economic benefits for patients with chronic respiratory diseases, yet it is underutilized worldwide. Insufficient funding, resources, and reimbursement; lack of healthcare professional, payer, and patient awareness and knowledge; and additional patient-related barriers all contribute to the gap between the knowledge of the science and benefits of PR and the actual delivery of PR services to suitable patients. The objectives of this document are to enhance implementation, use, and delivery of pulmonary rehabilitation to suitable individuals worldwide. Members of the American Thoracic Society (ATS) Pulmonary Rehabilitation Assembly and the European Respiratory Society (ERS) Rehabilitation and Chronic Care Group established a Task Force and writing committee to develop a policy statement on PR. The document was modified based on feedback from expert peer reviewers. After cycles of review and revisions, the statement was reviewed and formally approved by the Board of Directors of the ATS and the Science Council and Executive Committee of the ERS. This document articulates policy recommendations for advancing healthcare professional, payer, and patient awareness and knowledge of PR, increasing patient access to PR, and ensuring quality of PR programs. It also recommends areas of future research to establish evidence to support the development of an updated funding and reimbursement policy regarding PR. The ATS and ERS commit to undertake actions that will improve access to and delivery of PR services for suitable patients. They call on their members and other health professional societies, payers, patients, and patient advocacy groups to join in this commitment.

48 CFR 8.602 - Policy.

Code of Federal Regulations, 2011 CFR

2011-10-01

...— (1) Before purchasing an item of supply listed in the FPI Schedule, conduct market research to... assessment of price, quality, and time of delivery, based on the results of market research comparing the FPI...

48 CFR 52.233-3 - Protest After Award.

Code of Federal Regulations, 2012 CFR

2012-10-01

... resume work. The Contracting Officer shall make an equitable adjustment in the delivery schedule or... between the Contractor and the Government. (End of clause) Alternate I (JUN 1985). As prescribed in 33.106...

48 CFR 52.233-3 - Protest After Award.

Code of Federal Regulations, 2011 CFR

2011-10-01

... resume work. The Contracting Officer shall make an equitable adjustment in the delivery schedule or... between the Contractor and the Government. (End of clause) Alternate I (JUN 1985). As prescribed in 33.106...

48 CFR 52.233-3 - Protest After Award.

Code of Federal Regulations, 2013 CFR

2013-10-01

... resume work. The Contracting Officer shall make an equitable adjustment in the delivery schedule or... between the Contractor and the Government. (End of clause) Alternate I (JUN 1985). As prescribed in 33.106...

48 CFR 52.233-3 - Protest After Award.

Code of Federal Regulations, 2014 CFR

2014-10-01

... resume work. The Contracting Officer shall make an equitable adjustment in the delivery schedule or... between the Contractor and the Government. (End of clause) Alterate I (JUN 1985). As prescribed in 33.106...

48 CFR 52.233-3 - Protest After Award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... resume work. The Contracting Officer shall make an equitable adjustment in the delivery schedule or... between the Contractor and the Government. (End of clause) Alternate I (JUN 1985). As prescribed in 33.106...

Evaluation of Absolute and Relative Reinforcer Value Using Progressive-Ratio Schedules

PubMed Central

Francisco, Monica T; Borrero, John C; Sy, Jolene R

2008-01-01

We evaluated behavior exhibited by individuals with developmental disabilities using progressive-ratio (PR) schedules. High- and low-preference stimuli were determined based on the results of a paired-stimulus preference assessment and were evaluated in subsequent reinforcer and PR assessments using concurrent and single schedules of presentation. In Experiment 1, results showed that for 2 of 3 participants, stimuli determined to be low-preference functioned as reinforcers when evaluated independent of high-preference stimuli. Further, the results from Experiment 2 showed that low-preference stimuli also functioned as reinforcers under gradually increasing PR requirements. Results suggest that for cases in which a high-preference stimulus is unavailable or impractical, the contingent delivery of relatively less preferred stimuli may maintain appropriate behavior, even as schedule requirements increase. PMID:18595283

Reserve valuation in electric power systems

NASA Astrophysics Data System (ADS)

Ruiz, Pablo Ariel

Operational reliability is provided in part by scheduling capacity in excess of the load forecast. This reserve capacity balances the uncertain power demand with the supply in real time and provides for equipment outages. Traditionally, reserve scheduling has been ensured by enforcing reserve requirements in the operations planning. An alternate approach is to employ a stochastic formulation, which allows the explicit modeling of the sources of uncertainty. This thesis compares stochastic and reserve methods and evaluates the benefits of a combined approach for the efficient management of uncertainty in the unit commitment problem. Numerical studies show that the unit commitment solutions obtained for the combined approach are robust and superior with respect to the traditional approach. These robust solutions are especially valuable in areas with a high proportion of wind power, as their built-in flexibility allows the dispatch of practically all the available wind power while minimizing the costs of operation. The scheduled reserve has an economic value since it reduces the outage costs. In several electricity markets, reserve demand functions have been implemented to take into account the value of reserve in the market clearing process. These often take the form of a step-down function at the reserve requirement level, and as such they may not appropriately represent the reserve value. The value of reserve is impacted by the reliability, dynamic and stochastic characteristics of system components, the system operation policies, and the economic aspects such as the risk preferences of the demand. In this thesis, these aspects are taken into account to approximate the reserve value and construct reserve demand functions. Illustrative examples show that the demand functions constructed have similarities with those implemented in some markets.

Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

PubMed Central

2012-01-01

Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP). However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA) to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1) poor access to information and services in rural settings; 2) inadequate knowledge and skills among local practitioners; 3) feelings of isolation and frustration; 4) psychological burden associated with CLBP; and 5) competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing lifestyle demands such as work and family commitments were cited as key barriers to adopting regular self-management practices. Consumer expectations for improved health service coordination and a workforce skilled in pain management are relevant to future service planning, particularly in the contexts of workforce capacity, community health services, and enablers to effective service delivery in primary care. PMID:23057669

STS_135_Pad

NASA Image and Video Library

2011-06-02

JSC2011-E-059493 (31 May 2011) --- The space shuttle Atlantis is seen in the background on Launch Pad 39A at NASA?s Kennedy Space Center in Florida on May 31, 2011. The crawler/transporter is seen slowly driving away from the launch pad after making its final scheduled delivery of a shuttle. The orbiter is scheduled to fly the final mission of the Space Shuttle Program, launching on July 8. Photo credit: NASA Photo/Houston Chronicle, Smiley N. Pool

Analysis of Competencies, Job Satisfaction and Organizational Commitment as Indicators of Job Performance: A Conceptual Framework

ERIC Educational Resources Information Center

Khan, Asad; Masrek, Mohamad Noorman; Nadzar, Fuziah Mohamad

2015-01-01

Like other disciplines, organizational and technological innovations have influenced the standard philosophies of librarianship. These innovations have changed the basics of information retrieval and delivery in libraries. As a result, library authorities are demanding competency-based job performance. Nonetheless, there is a scarcity of research…

78 FR 10222 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... purchase or sell securities on a when-issued, delayed-delivery, or forward-commitment basis and may engage... (typically purchase price plus accrued interest). \\13\\ Reverse repurchase agreements involve the sale of... and have the characteristics of borrowing. The securities purchased with the funds obtained from the...

Using Continuous Improvement in Online Program Design: DMAIC as a Tool for Assurance of Learning Assessments

ERIC Educational Resources Information Center

Carnovale, Steven; Allen, Cliff; Pullman, Madeleine; Wong, Daniel

2016-01-01

The integration of technology into education has forced radical innovations to traditional instructional delivery models. Given its prevalence, a thorough understanding of pedagogical best practices associated with the design and implementation of such programs is critical. Furthermore, the need for an institutional commitment to assessment and a…

Flexible Delivery Approach in Architecture and Construction Management Course

ERIC Educational Resources Information Center

Chan, Eric

2013-01-01

The millennial generation is facing challenges in their career path and they believe that tertiary education can help them to equip better to tackle against. However, some students find it difficult to rush back to classroom due to work commitment. Fortunately, flexible education developed these years allows students to capture knowledge anytime…

Oil fuel delivery optimization for multi product and multi depot: the case of petrol station replenishment problem (PSRP)

NASA Astrophysics Data System (ADS)

Surjandari, Isti; Rachman, Amar; Dianawati, Fauzia; Wibowo, R. Pramono

2011-10-01

With the Oil and Gas Law No. 22 of 2001, national and foreign private enterprises can invest in all sectors of Oil and Gas in Indonesia. In anticipation of this free competition, Pertamina, as a state-owned enterprises, which previously had monopolized the oil and gas business activities in Indonesia, should be able to improve services as well as the efficiency in order to compete in the free market, especially in terms of cost efficiency of fuel distribution to gas station (SPBU). To optimize the distribution activity, it is necessary to design a scheduling system and its fuel delivery routes daily to every SPBU. The determination of routes and scheduling delivery of fuel to the SPBU can be modeled as a Petrol Station Replenishment Problem (PSRP) with the multi-depot, multi-product, time windows and split deliveries, which in this study will be completed by the Tabu Search algorithm (TS). This study was conducted in the area of Bandung, the capital of West Java province, which is a big city and the neighboring city of Jakarta, the capital city of Indonesia. By using the fuel delivery data for one day, the results showed a decrease of 16.38% of the distance of the route compared to the current conditions, which impacted on the reduction of distribution costs and decrease the number of total trips by 5.22% and 3.83%.

Navy Aegis Ballistic Missile Defense (BMD) Program: Background and Issues for Congress

DTIC Science & Technology

2016-10-25

for European BMD On September 17, 2009, the Obama Administration announced a new approach for regional BMD operations called the Phased Adaptive...December 2010, the U.S. missile defense approach in Europe commits MDA to delivering systems and associated capabilities on a schedule that requires...announcement of the European Phased Adaptive Approach on September 17, 2009, stated, “This approach is based on an assessment of the Iranian missile

NASA, John F. Kennedy Space Center environmental impact statement

NASA Technical Reports Server (NTRS)

1971-01-01

The probable total impact of the John F. Kennedy Space Center (KSC) operations on the environment is discussed in terms of launch operations emissions and environmental quality. A schedule of planned launches through 1973 is included with a description of the systems for eliminating harmful emissions during launch operations. The effects of KSC on wild life and environmental quality are discussed along with the irreversible and irretrievable commitments of natural resources.

Dedication file preparation for commercial-grade electric components

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

Hendricks, J.R.; Farwell, C.R. Jr.

1988-01-01

Dedication is the process of making a commercial-grade item into a basic component that can be installed in safety systems. This process ensures that the commercially manufactured items are of the same or equivalent form, fit, function, and materials as the originally provided safety item. This process must ensure that the original utility's equipment qualification program is maintained per licensing commitments to 10CFR50.49 and general design criterion No. 4. Today, utilities recognize the need for establishing a dedication program to provide the flexibility in obtaining replacement items directly from the original manufacturers. This need has arisen because (a) most systemmore » houses, large manufacturers, and component manufacturers will sell their products only through distributors as straight commercial-grade items or only service former clients, and (b) lack of competition for specific safety-related items has resulted in excessive hardware cost and very long delivery schedules, which could affect plant availability. The vehicle for utilities to obtain safety-related items is to establish and manage a comprehensive dedication program for their own use or provide the direction for a nuclear supplier to follow. This paper provides both utilities and nuclear suppliers insight into the complexities of a dedication program. This insight is provided from our experience as a utilities agent and as a third-party nuclear supplier.« less

Wind Power Ramping Product for Increasing Power System Flexibility

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

Cui, Mingjian; Zhang, Jie; Wu, Hongyu

With increasing penetrations of wind power, system operators are concerned about a potential lack of system flexibility and ramping capacity in real-time dispatch stages. In this paper, a modified dispatch formulation is proposed considering the wind power ramping product (WPRP). A swinging door algorithm (SDA) and dynamic programming are combined and used to detect WPRPs in the next scheduling periods. The detected WPRPs are included in the unit commitment (UC) formulation considering ramping capacity limits, active power limits, and flexible ramping requirements. The modified formulation is solved by mixed integer linear programming. Numerical simulations on a modified PJM 5-bus Systemmore » show the effectiveness of the model considering WPRP, which not only reduces the production cost but also does not affect the generation schedules of thermal units.« less

Design of a QoS-controlled ATM-based communications system in chorus

NASA Astrophysics Data System (ADS)

Coulson, Geoff; Campbell, Andrew; Robin, Philippe; Blair, Gordon; Papathomas, Michael; Shepherd, Doug

1995-05-01

We describe the design of an application platform able to run distributed real-time and multimedia applications alongside conventional UNIX programs. The platform is embedded in a microkernel/PC environment and supported by an ATM-based, QoS-driven communications stack. In particular, we focus on resource-management aspects of the design and deal with CPU scheduling, network resource-management and memory-management issues. An architecture is presented that guarantees QoS levels of both communications and processing with varying degrees of commitment as specified by user-level QoS parameters. The architecture uses admission tests to determine whether or not new activities can be accepted and includes modules to translate user-level QoS parameters into representations usable by the scheduling, network, and memory-management subsystems.

Measurement and evaluation of transit travel time reliability

DOT National Transportation Integrated Search

2011-01-01

Transportation system customers need consistency in their daily travel times to enable them to plan their daily : activities, whether that is a commuter on their way to work, a company setting up delivery schedules for justintime : manufacturin...

Cost-effectiveness of external cephalic version for term breech presentation

PubMed Central

2010-01-01

Background External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. Methods A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc.) was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery), utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY) was used to determine cost-effectiveness. Results The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion to breech, successful second ECV trial, or adverse outcome from emergency cesarean. Conclusions From society's perspective, ECV trial is cost-effective when compared to a scheduled cesarean for breech presentation provided the probability of successful ECV is > 32%. Improved algorithms are needed to more precisely estimate the likelihood that a patient will have a successful ECV. PMID:20092630

Collaboration in the design and delivery of a mental health Recovery College course: experiences of students and tutors.

PubMed

Cameron, Josh; Hart, Angie; Brooker, Saff; Neale, Paul; Reardon, Mair

2018-05-15

Recovery Colleges address mental health challenges using an educative approach underpinned by a collaborative recovery orientated philosophy. Research has been limited with no studies identified reporting research on the design and delivery of a specific course. To understand how Recovery College students and tutors experience the design and delivery of a mental health Recovery College course, specifically the "'Building Resilience" course. Thematic analysis of qualitative data related to the experience and process of collaboration in recovery college course design and delivery. Data included 13 qualitative individual interviews with course students and tutors and "naturally occurring" data generated through course preparation and delivery. Findings drew attention to the centrality of: prior experience and design related to students, tutors and the course structure; co-delivery related to tutors and co-learner impacts; and to the course methods and environment. Commitment to collaboration in design and delivery of Recovery College courses can mobilise the diverse experiences and expertise of tutors and students. The environment and methods of learning have a significant impact and should be considered alongside content. Boundaries between people and areas of knowledge and experience that arise can be viewed as sources of creativity that can enrich courses.

Forest landscape restoration: increasing the positive impacts of forest restoration or simply the area under tree cover?

Treesearch

Stephanie Mansourian; John A. Stanturf; Mercy Afua Adutwumwaa Derkyi; Vera Lex Engel

2017-01-01

Restoring forest landscapes is critical in the face of continued global forest loss and degradation. In this article, weexplore some challenges underlying the delivery of global commitments to restore forest landscapes. We propose that threefundamental questions need to be resolved upfront for the effective implementation of Forest Landscape...

Community Mental Health: Issues for Social Work Practice and Education.

ERIC Educational Resources Information Center

Katz, Arthur J., Ed.

Articles by social work educators on some of the critical issues in community mental health are presented. Examined are some conceptual and program developments related to coordination, continuity of care, and the use of teams in planning and service delivery for community mental health (Lawrence K. Berg). The issue of civil commitment to and…

Exploring Commitment to Teaching through Personalized Delivery Systems in an Introductory Education Course.

ERIC Educational Resources Information Center

Bowman, David L.; Weisse, Edward B.

Two instructional models offer alternatives to the traditional lecture-discussion of undergraduate teacher aspirants. A self-paced model is composed of videotaped lectures, a learning package, and the use of both student proctors and instructor contact. Each student must develop his/her own time to be allotted structure for the course. An…

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

Klitsner, Tom

The recent Executive Order creating the National Strategic Computing Initiative (NSCI) recognizes the value of high performance computing for economic competitiveness and scientific discovery and commits to accelerate delivery of exascale computing. The HPC programs at Sandia –the NNSA ASC program and Sandia’s Institutional HPC Program– are focused on ensuring that Sandia has the resources necessary to deliver computation in the national interest.

Eastern Airlines LOFT program

NASA Technical Reports Server (NTRS)

Beach, B. E.

1981-01-01

Beginning with scenario design and development issues, Eastern Airlines committed itself to the full four-hour LOFT training format without the additional time for specific maneuvers. Abnormals and emergency conditions, pacing, and quiet periods are included in the scenarios which are written for the instructor to follow verbatim. Simulator capabilities, performance assessment; training vs. checking; crew composition and scheduling; satisfactory completion; the use of video performance printouts; the number of instructors; instructor training and standardization; and initial, transition, and upgrade training are discussed.

Short-term bulk energy storage system scheduling for load leveling in unit commitment: modeling, optimization, and sensitivity analysis

PubMed Central

Hemmati, Reza; Saboori, Hedayat

2016-01-01

Energy storage systems (ESSs) have experienced a very rapid growth in recent years and are expected to be a promising tool in order to improving power system reliability and being economically efficient. The ESSs possess many potential benefits in various areas in the electric power systems. One of the main benefits of an ESS, especially a bulk unit, relies on smoothing the load pattern by decreasing on-peak and increasing off-peak loads, known as load leveling. These devices require new methods and tools in order to model and optimize their effects in the power system studies. In this respect, this paper will model bulk ESSs based on the several technical characteristics, introduce the proposed model in the thermal unit commitment (UC) problem, and analyze it with respect to the various sensitive parameters. The technical limitations of the thermal units and transmission network constraints are also considered in the model. The proposed model is a Mixed Integer Linear Programming (MILP) which can be easily solved by strong commercial solvers (for instance CPLEX) and it is appropriate to be used in the practical large scale networks. The results of implementing the proposed model on a test system reveal that proper load leveling through optimum storage scheduling leads to considerable operation cost reduction with respect to the storage system characteristics. PMID:27222741

Short-term bulk energy storage system scheduling for load leveling in unit commitment: modeling, optimization, and sensitivity analysis.

PubMed

Hemmati, Reza; Saboori, Hedayat

2016-05-01

Energy storage systems (ESSs) have experienced a very rapid growth in recent years and are expected to be a promising tool in order to improving power system reliability and being economically efficient. The ESSs possess many potential benefits in various areas in the electric power systems. One of the main benefits of an ESS, especially a bulk unit, relies on smoothing the load pattern by decreasing on-peak and increasing off-peak loads, known as load leveling. These devices require new methods and tools in order to model and optimize their effects in the power system studies. In this respect, this paper will model bulk ESSs based on the several technical characteristics, introduce the proposed model in the thermal unit commitment (UC) problem, and analyze it with respect to the various sensitive parameters. The technical limitations of the thermal units and transmission network constraints are also considered in the model. The proposed model is a Mixed Integer Linear Programming (MILP) which can be easily solved by strong commercial solvers (for instance CPLEX) and it is appropriate to be used in the practical large scale networks. The results of implementing the proposed model on a test system reveal that proper load leveling through optimum storage scheduling leads to considerable operation cost reduction with respect to the storage system characteristics.

The effects of signalled and unsignalled lick-dependent delays on the development of schedule-induced drinking in rats.

PubMed

Pellon, R; Blackman, D E

1991-02-01

Food pellets were programmed to be delivered to rats every 60 sec (Fixed Time 60-sec schedule), and the development of schedule-induced drinking was measured in terms of the amount of water consumed and the number of licks per inter-pellet interval. For some rats (masters) 10-sec delays in food delivery were dependent on licks. Yoked-control rats received food at the same time as their masters and independently of their own behaviour. In Experiment 1, in which the delays were signalled by a blackout, the master rats began to drink, but this schedule-induced behaviour then decreased to levels lower than those shown by the yoked controls. When the signalled delays were discontinued, the drinking of the master rats recovered. In Experiment 2, in which the delays were not signalled, the master rats did not develop as much schedule-induced drinking as the yoked controls, and discontinuing the delays led to only small increases in drinking. These results support the view that schedule-induced drinking is subject to control by its consequences.

An Optimizing Space Data-Communications Scheduling Method and Algorithm with Interference Mitigation, Generalized for a Broad Class of Optimization Problems

NASA Technical Reports Server (NTRS)

Rash, James L.

2010-01-01

NASA's space data-communications infrastructure, the Space Network and the Ground Network, provide scheduled (as well as some limited types of unscheduled) data-communications services to user spacecraft via orbiting relay satellites and ground stations. An implementation of the methods and algorithms disclosed herein will be a system that produces globally optimized schedules with not only optimized service delivery by the space data-communications infrastructure but also optimized satisfaction of all user requirements and prescribed constraints, including radio frequency interference (RFI) constraints. Evolutionary search, a class of probabilistic strategies for searching large solution spaces, constitutes the essential technology in this disclosure. Also disclosed are methods and algorithms for optimizing the execution efficiency of the schedule-generation algorithm itself. The scheduling methods and algorithms as presented are adaptable to accommodate the complexity of scheduling the civilian and/or military data-communications infrastructure. Finally, the problem itself, and the methods and algorithms, are generalized and specified formally, with applicability to a very broad class of combinatorial optimization problems.

Schedule-induced drinking: rate of food delivery and Herrnstein's equation.

PubMed Central

Wetherington, C L

1979-01-01

Schedule-induced drinking was measured in four rats exposed to fixed-time schedules of food ranging from 30 to 480 seconds. Herrnstein's (1970, 1974) equation relating rate of a single response as a hyperbolic function of reinforcement rate provided a good fit to three measures of drinking: lick rate, ingestion rate, and relative time spent drinking. The functions relating the three measures of drinking to reinforcement rate were of similar form. Herrnstein's equation also provided a good description of some already published data on schedule-induced drinking. The fit both to the present data and to the already published data was improved somewhat by computing the measures by subtracting from the time base a latency constant representing the minimal time required to consume the food pellet and travel to the water source. The data from this study provide two correspondences between operant behavior and schedule-induced behavior: (a) conformity to Herrnstein's equation and (b) equivalence of rate and relative time measures. PMID:512568

Schedules of electric shock presentation in the behavioral control of imprinted ducklings.

PubMed

Barrett, J E

1972-09-01

The behavioral effects of various schedules of electric shock presentation were investigated during and after the imprinting of Peking ducklings to moving stimuli. The behavior of following a moving imprinted stimulus was differentially controlled by a multiple schedule of punishment and avoidance that respectively suppressed and maintained following behavior. Pole-pecking, reinforced by presentations of the imprinted stimulus, was suppressed by response-produced shock (punishment); various schedules of response-independent shock and delayed punishment had an overall minimal effect. The delivery of response-independent shock in the presence of one of two stimuli, both during and after imprinting, resulted in a marked reduction in choice of the stimulus paired with shock. The experiments provide no support for a differentiation of imprinting from learning on the basis of the behavioral effects of aversive stimuli. Instead, as is the case with other organisms, the schedule under which shock is delivered to imprinted ducklings appears to be an important determinant of the temporal patterning of subsequent behavior.

Scientists Admitting to Plagiarism: A Meta-analysis of Surveys.

PubMed

Pupovac, Vanja; Fanelli, Daniele

2015-10-01

We conducted a systematic review and meta-analysis of anonymous surveys asking scientists whether they ever committed various forms of plagiarism. From May to December 2011 we searched 35 bibliographic databases, five grey literature databases and hand searched nine journals for potentially relevant studies. We included surveys that asked scientists if, in a given recall period, they had committed or knew of a colleague who committed plagiarism, and from each survey extracted the proportion of those who reported at least one case. Studies that focused on academic (i.e. student) plagiarism were excluded. Literature searches returned 12,460 titles from which 17 relevant survey studies were identified. Meta-analysis of studies reporting committed (N = 7) and witnessed (N = 11) plagiarism yielded a pooled estimate of, respectively, 1.7% (95% CI 1.2-2.4) and 30% (95% CI 17-46). Basic methodological factors, including sample size, year of survey, delivery method and whether survey questions were explicit rather than indirect made a significant difference on survey results. Even after controlling for these methodological factors, between-study differences in admission rates were significantly above those expected by sampling error alone and remained largely unexplained. Despite several limitations of the data and of this meta-analysis, we draw three robust conclusions: (1) The rate at which scientists report knowing a colleague who committed plagiarism is higher than for data fabrication and falsification; (2) The rate at which scientists report knowing a colleague who committed plagiarism is correlated to that of fabrication and falsification; (3) The rate at which scientists admit having committed either form of misconduct (i.e. fabrication, falsification and plagiarism) in surveys has declined over time.

Misrecognition of need: women's experiences of and explanations for undergoing cesarean delivery.

PubMed

Tully, Kristin P; Ball, Helen L

2013-05-01

International rates of operative delivery are consistently higher than the World Health Organization determined is appropriate. This suggests that factors other than clinical indications contribute to cesarean section. Data presented here are from interviews with 115 mothers on the postnatal ward of a hospital in Northeast England during February 2006 to March 2009 after the women underwent either unscheduled or scheduled cesarean childbirth. Using thematic content analysis, we found women's accounts of their experiences largely portrayed cesarean section as everything that they had wanted to avoid, but necessary given their situations. Contrary to popular suggestion, the data did not indicate impersonalized medical practice, or that cesareans were being performed 'on request.' The categorization of cesareans into 'emergency' and 'elective' did not reflect maternal experiences. Rather, many unscheduled cesareans were conducted without indications of fetal distress and most scheduled cesareans were not booked because of 'choice.' The authoritative knowledge that influenced maternal perceptions of the need to undergo operative delivery included moving forward from 'prolonged' labor and scheduling cesarean as a prophylactic to avoid anticipated psychological or physical harm. In spontaneously defending themselves against stigma from the 'too posh to push' label that is currently common in the media, women portrayed debate on the appropriateness of cesarean childbirth as a social critique instead of a health issue. The findings suggest the 'need' for some cesareans is due to misrecognition of indications by all involved. The factors underlying many cesareans may actually be modifiable, but informed choice and healthful outcomes are impeded by lack of awareness regarding the benefits of labor on the fetal transition to extrauterine life, the maternal desire for predictability in their parturition and recovery experiences, and possibly lack of sufficient experience for providers in a variety of vaginal delivery scenarios (non-progressive labor, breech presentation, and/or after previous cesarean). Copyright © 2013 Elsevier Ltd. All rights reserved.

Analysis of oil-pipeline distribution of multiple products subject to delivery time-windows

NASA Astrophysics Data System (ADS)

Jittamai, Phongchai

This dissertation defines the operational problems of, and develops solution methodologies for, a distribution of multiple products into oil pipeline subject to delivery time-windows constraints. A multiple-product oil pipeline is a pipeline system composing of pipes, pumps, valves and storage facilities used to transport different types of liquids. Typically, products delivered by pipelines are petroleum of different grades moving either from production facilities to refineries or from refineries to distributors. Time-windows, which are generally used in logistics and scheduling areas, are incorporated in this study. The distribution of multiple products into oil pipeline subject to delivery time-windows is modeled as multicommodity network flow structure and mathematically formulated. The main focus of this dissertation is the investigation of operating issues and problem complexity of single-source pipeline problems and also providing solution methodology to compute input schedule that yields minimum total time violation from due delivery time-windows. The problem is proved to be NP-complete. The heuristic approach, a reversed-flow algorithm, is developed based on pipeline flow reversibility to compute input schedule for the pipeline problem. This algorithm is implemented in no longer than O(T·E) time. This dissertation also extends the study to examine some operating attributes and problem complexity of multiple-source pipelines. The multiple-source pipeline problem is also NP-complete. A heuristic algorithm modified from the one used in single-source pipeline problems is introduced. This algorithm can also be implemented in no longer than O(T·E) time. Computational results are presented for both methodologies on randomly generated problem sets. The computational experience indicates that reversed-flow algorithms provide good solutions in comparison with the optimal solutions. Only 25% of the problems tested were more than 30% greater than optimal values and approximately 40% of the tested problems were solved optimally by the algorithms.

Do Conditional Reinforcers Count?

PubMed Central

Davison, Michael; Baum, William M

2006-01-01

Six pigeons were trained on a procedure in which seven components arranged different food-delivery ratios on concurrent variable-interval schedules each session. The components were unsignaled, lasted for 10 food deliveries, and occurred in random order with a 60-s blackout between components. The schedules were arranged using a switching-key procedure in which two responses on a center key changed the schedules and associated stimuli on two side keys. In Experiment 1, over five conditions, an increasing proportion of food deliveries accompanied by a magazine light was replaced with the presentation of the magazine light only. Local analyses of preference showed preference pulses toward the alternative that had just produced either a food-plus-magazine-light or magazine-light-only presentation, but pulses after food deliveries were always greater than those after magazine lights. Increasing proportions of magazine lights did not change the size of preference pulses after food or magazine-light presentations. Experiment 2 investigated the effects of correlations between food ratios and magazine-light ratios: In Condition 6, magazine-light ratios in components were inversely correlated (−1.0) with food ratios, and in Condition 7, magazine-light ratios were uncorrelated with food ratios. In Conditions 8 and 9, pecks also produced occasional 2.5-s flashes of a green keylight. In Condition 8, food and magazine-light ratios were correlated 1.0 whereas food and green-key ratios were correlated −1.0. In Condition 9, food and green-key ratios were correlated 1.0 whereas food and magazine-light ratios were correlated −1.0. Preference pulses toward alternatives after magazine lights and green keys depended on the correlation between these event ratios and the food ratios: If the ratios were correlated +1.0, positive preference pulses resulted; if the correlation was −1.0, preference pulses were negative. These results suggest that the Law of Effect has more to do with events signaling consequences than with strengthening responses. PMID:17191753

Strategic Teleconference Planning in Rural Health Education.

ERIC Educational Resources Information Center

Nagel, Liza; Boswell, Judy

1997-01-01

An introduction to planning interactive health education teleconferences via satellite discusses participant recruitment, satellite transmission coordination, scheduling considerations, format design, and use of site facilitators. Teleconference training of community service providers and community leaders should combine passive delivery of…

48 CFR 43.204 - Administration.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Administration. 43.204... CONTRACT MODIFICATIONS Change Orders 43.204 Administration. (a) Change order documentation. When change... adjusting the contract delivery schedule. (3) Contracting offices and contract administration offices, as...

48 CFR 43.204 - Administration.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Administration. 43.204... CONTRACT MODIFICATIONS Change Orders 43.204 Administration. (a) Change order documentation. When change... adjusting the contract delivery schedule. (3) Contracting offices and contract administration offices, as...

10 CFR 626.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) SALES REGULATION PROCEDURES FOR ACQUISITION OF PETROLEUM FOR THE STRATEGIC PETROLEUM RESERVE § 626.1 Purpose. This part establishes the procedures for acquiring petroleum for, and deferring contractually scheduled deliveries to, the Strategic Petroleum Reserve. The procedures do not represent actual...

10 CFR 626.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (CONTINUED) SALES REGULATION PROCEDURES FOR ACQUISITION OF PETROLEUM FOR THE STRATEGIC PETROLEUM RESERVE § 626.1 Purpose. This part establishes the procedures for acquiring petroleum for, and deferring contractually scheduled deliveries to, the Strategic Petroleum Reserve. The procedures do not represent actual...

48 CFR 43.204 - Administration.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Administration. 43.204... CONTRACT MODIFICATIONS Change Orders 43.204 Administration. (a) Change order documentation. When change... adjusting the contract delivery schedule. (3) Contracting offices and contract administration offices, as...

Optimization-based manufacturing scheduling with multiple resources and setup requirements

NASA Astrophysics Data System (ADS)

Chen, Dong; Luh, Peter B.; Thakur, Lakshman S.; Moreno, Jack, Jr.

1998-10-01

The increasing demand for on-time delivery and low price forces manufacturer to seek effective schedules to improve coordination of multiple resources and to reduce product internal costs associated with labor, setup and inventory. This study describes the design and implementation of a scheduling system for J. M. Product Inc. whose manufacturing is characterized by the need to simultaneously consider machines and operators while an operator may attend several operations at the same time, and the presence of machines requiring significant setup times. The scheduling problem with these characteristics are typical for many manufacturers, very difficult to be handled, and have not been adequately addressed in the literature. In this study, both machine and operators are modeled as resources with finite capacities to obtain efficient coordination between them, and an operator's time can be shared by several operations at the same time to make full use of the operator. Setups are explicitly modeled following our previous work, with additional penalties on excessive setups to reduce setup costs and avoid possible scraps. An integer formulation with a separable structure is developed to maximize on-time delivery of products, low inventory and small number of setups. Within the Lagrangian relaxation framework, the problem is decomposed into individual subproblems that are effectively solved by using dynamic programming with additional penalties embedded in state transitions. Heuristics is then developed to obtain a feasible schedule following on our previous work with new mechanism to satisfy operator capacity constraints. The method has been implemented using the object-oriented programming language C++ with a user-friendly interface, and numerical testing shows that the method generates high quality schedules in a timely fashion. Through simultaneous consideration of machines and operators, machines and operators are well coordinated to facilitate the smooth flow of parts through the system. The explicit modeling of setups and the associated penalties let parts with same setup requirements clustered together to avoid excessive setups.

Delivery of Type 2 diabetes care in low- and middle-income countries: lessons from Lima, Peru.

PubMed

Cardenas, M K; Miranda, J J; Beran, D

2016-06-01

The health system's response is crucial to addressing the increasing burden of diabetes, particularly that affecting low- and middle-income countries. This study aims to assess the facilitators and barriers that help or hinder access to care for people with diabetes in Peru. We used a survey tool to design and collect qualitative and quantitative data from primary and secondary sources of information at different levels of the health system. We performed 111 interviews in Lima, the capital city of Peru, with patients with diabetes, healthcare providers and healthcare officials. We applied the six building blocks framework proposed by the World Health Organization in our analysis. We found low political commitment, as well as several barriers that directly affect access to medicines, regular laboratory check-ups and follow-up appointments for diabetes, especially at the primary healthcare level. Three major system-level barriers were identified: (1) the availability of information at different healthcare system levels that affects several processes in the healthcare provision; (2) insufficient financial resources; and (3) insufficient human resources trained in diabetes management. Despite an initial political commitment by the Peruvian government to improve the delivery of diabetes care, there exist several key limitations that affect access to adequate diabetes care, especially at the primary healthcare level. In a context in which various low- and middle-income countries are aiming to achieve universal health coverage, this study provides lessons for the implementation of strategies related to diabetes care delivery. © 2016 Diabetes UK.

Discrete Optimization Model for Vehicle Routing Problem with Scheduling Side Cosntraints

NASA Astrophysics Data System (ADS)

Juliandri, Dedy; Mawengkang, Herman; Bu'ulolo, F.

2018-01-01

Vehicle Routing Problem (VRP) is an important element of many logistic systems which involve routing and scheduling of vehicles from a depot to a set of customers node. This is a hard combinatorial optimization problem with the objective to find an optimal set of routes used by a fleet of vehicles to serve the demands a set of customers It is required that these vehicles return to the depot after serving customers’ demand. The problem incorporates time windows, fleet and driver scheduling, pick-up and delivery in the planning horizon. The goal is to determine the scheduling of fleet and driver and routing policies of the vehicles. The objective is to minimize the overall costs of all routes over the planning horizon. We model the problem as a linear mixed integer program. We develop a combination of heuristics and exact method for solving the model.

"Health for all" in a least-developed country.

PubMed Central

Shonubi, Aderibigbe M. O.; Odusan, Olatunde; Oloruntoba, David O.; Agbahowe, Solomon A.; Siddique, M. A.

2005-01-01

The World Health Organization's (WHO) concept of primary healthcare as the basis for comprehensive healthcare delivery for developing countries has not been effectively applied in many of these countries. The Kingdom of Lesotho, one of the world's least-developed countries, has been able to provide a fairly comprehensive healthcare system for its citizenry based on prmary healthcare principles and a strong commitment on the part of the government despite severe limitations of finance and human resource capacity as well as difficult mountainous terrains. This paper presents the highlights of this system of healthcare delivery with the hope that other developing countries would draw some lessons from the model. PMID:16080673

Mechanical Modulation of Nascent Stem Cell Lineage Commitment in Tissue Engineering Scaffolds

PubMed Central

Song, Min Jae; Dean, David; Tate, Melissa L. Knothe

2013-01-01

Taking inspiration from tissue morphogenesis in utero, this study tests the concept of using tissue engineering scaffolds as delivery devices to modulate emergent structure-function relationships at early stages of tissue genesis. We report on the use of a combined computational fluid dynamics (CFD) modeling, advanced manufacturing methods, and experimental fluid mechanics (micro-piv and strain mapping) for the prospective design of tissue engineering scaffold geometries that deliver spatially resolved mechanical cues to cells seeded within. When subjected to a constant magnitude global flow regime, the local scaffold geometry dictates the magnitudes of mechanical stresses and strains experienced by a given cell, and in a spatially resolved fashion, similar to patterning during morphogenesis. In addition, early markers of mesenchymal stem cell lineage commitment relate significantly to the local mechanical environment of the cell. Finally, by plotting the range of stress-strain states for all data corresponding to nascent cell lineage commitment (95% CI), we begin to “map the mechanome”, defining stress-strain states most conducive to targeted cell fates. In sum, we provide a library of reference mechanical cues that can be delivered to cells seeded on tissue engineering scaffolds to guide target tissue phenotypes in a temporally and spatially resolved manner. Knowledge of these effects allows for prospective scaffold design optimization using virtual models prior to prototyping and clinical implementation. Finally, this approach enables the development of next generation scaffolds cum delivery devices for genesis of complex tissues with heterogenous properties, e.g., organs, joints or interface tissues such as growth plates. PMID:23660249

Mechanical modulation of nascent stem cell lineage commitment in tissue engineering scaffolds.

PubMed

Song, Min Jae; Dean, David; Knothe Tate, Melissa L

2013-07-01

Taking inspiration from tissue morphogenesis in utero, this study tests the concept of using tissue engineering scaffolds as delivery devices to modulate emergent structure-function relationships at early stages of tissue genesis. We report on the use of a combined computational fluid dynamics (CFD) modeling, advanced manufacturing methods, and experimental fluid mechanics (micro-piv and strain mapping) for the prospective design of tissue engineering scaffold geometries that deliver spatially resolved mechanical cues to stem cells seeded within. When subjected to a constant magnitude global flow regime, the local scaffold geometry dictates the magnitudes of mechanical stresses and strains experienced by a given cell, and in a spatially resolved fashion, similar to patterning during morphogenesis. In addition, early markers of mesenchymal stem cell lineage commitment relate significantly to the local mechanical environment of the cell. Finally, by plotting the range of stress-strain states for all data corresponding to nascent cell lineage commitment (95% CI), we begin to "map the mechanome", defining stress-strain states most conducive to targeted cell fates. In sum, we provide a library of reference mechanical cues that can be delivered to cells seeded on tissue engineering scaffolds to guide target tissue phenotypes in a temporally and spatially resolved manner. Knowledge of these effects allows for prospective scaffold design optimization using virtual models prior to prototyping and clinical implementation. Finally, this approach enables the development of next generation scaffolds cum delivery devices for genesis of complex tissues with heterogenous properties, e.g., organs, joints or interface tissues such as growth plates. Copyright © 2013 Elsevier Ltd. All rights reserved.

Value of its information for congestion avoidance in inter-modal transportation systems.

DOT National Transportation Integrated Search

2012-01-01

This paper considers a freight forwarder's problem of selecting air cargo ight itineraries to a given set of heterogeneous customers and, simultaneously, planning the pickup and airport delivery schedule of customer loads. The air cargo ight itinerar...

43 CFR 34.4 - Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-10-01

... DURING CONSTRUCTION AND OPERATION OF THE ALASKA NATURAL GAS TRANSPORTATION SYSTEM § 34.4 Discrimination... or bids, the designation of quantities, delivery schedules or other specifications, selection... individuals or establishments to be provided an opportunity to participate in any activity; and (ix) Selection...

43 CFR 34.4 - Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DURING CONSTRUCTION AND OPERATION OF THE ALASKA NATURAL GAS TRANSPORTATION SYSTEM § 34.4 Discrimination... or bids, the designation of quantities, delivery schedules or other specifications, selection... individuals or establishments to be provided an opportunity to participate in any activity; and (ix) Selection...

Exploiting Identical Generators in Unit Commitment

DOE PAGES

Knueven, Ben; Ostrowski, Jim; Watson, Jean -Paul

2017-12-14

Here, we present sufficient conditions under which thermal generators can be aggregated in mixed-integer linear programming (MILP) formulations of the unit commitment (UC) problem, while maintaining feasibility and optimality for the original disaggregated problem. Aggregating thermal generators with identical characteristics (e.g., minimum/maximum power output, minimum up/down-time, and cost curves) into a single unit reduces redundancy in the search space induced by both exact symmetry (permutations of generator schedules) and certain classes of mutually non-dominated solutions. We study the impact of aggregation on two large-scale UC instances, one from the academic literature and another based on real-world operator data. Our computationalmore » tests demonstrate that when present, identical generators can negatively affect the performance of modern MILP solvers on UC formulations. Further, we show that our reformation of the UC MILP through aggregation is an effective method for mitigating this source of computational difficulty.« less

Exploiting Identical Generators in Unit Commitment

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

Knueven, Ben; Ostrowski, Jim; Watson, Jean -Paul

Here, we present sufficient conditions under which thermal generators can be aggregated in mixed-integer linear programming (MILP) formulations of the unit commitment (UC) problem, while maintaining feasibility and optimality for the original disaggregated problem. Aggregating thermal generators with identical characteristics (e.g., minimum/maximum power output, minimum up/down-time, and cost curves) into a single unit reduces redundancy in the search space induced by both exact symmetry (permutations of generator schedules) and certain classes of mutually non-dominated solutions. We study the impact of aggregation on two large-scale UC instances, one from the academic literature and another based on real-world operator data. Our computationalmore » tests demonstrate that when present, identical generators can negatively affect the performance of modern MILP solvers on UC formulations. Further, we show that our reformation of the UC MILP through aggregation is an effective method for mitigating this source of computational difficulty.« less

Projects for increasing job satisfaction and creating a healthy work environment.

PubMed

Brunges, Michele; Foley-Brinza, Christine

2014-12-01

Workplace culture is one of the biggest factors driving employee commitment and engagement. Multiple studies have shown that hospitals will perform better over time if employees are committed to their jobs and engaged in what they do. By creating and implementing multiple projects during a three-year period, a team at the University of Florida Health Shands Hospital, Gainesville, increased job satisfaction. Projects included ensuring meal breaks were offered, creating a serenity area, developing the patient ambassador role, actively addressing bullying and unprofessional behavior, assigning a student mentee to work with staff members on culture change, offering regular fun activities, redesigning the unit, reorganizing schedules to reduce stress, implementing education and training initiatives, establishing a Unit Practice Council, and implementing reward and recognition programs. Survey results and anecdotal evidence suggest that these projects combined to increase employee satisfaction and employee retention rates. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Revenue cycle management, Part II.

PubMed

Crew, Matt

2007-01-01

The proper management of your revenue cycle requires the application of "best practices" and the continual monitoring and measuring of the entire cycle. The correct technology will enable you to gain the insight and efficiencies needed in the ever-changing healthcare economy. The revenue cycle is a process that begins when you negotiate payor contracts, set fees, and schedule appointments and continues until claims are paid in full. Every single step in the cycle carries equal importance. Monitoring all phases and a commitment to continually communicating the results will allow you to achieve unparalleled success. In part I of this article, we explored the importance of contracting, scheduling, and case management as well as coding and clinical documentation. We will now take a closer look at the benefits charge capture, claim submission, payment posting, accounts receivable follow-up, and reporting can mean to your practice.

Strengthened MILP formulation for certain gas turbine unit commitment problems

DOE PAGES

Pan, Kai; Guan, Yongpei; Watson, Jean -Paul; ...

2015-05-22

In this study, we derive a strengthened MILP formulation for certain gas turbine unit commitment problems, in which the ramping rates are no smaller than the minimum generation amounts. This type of gas turbines can usually start-up faster and have a larger ramping rate, as compared to the traditional coal-fired power plants. Recently, the number of this type of gas turbines increases significantly due to affordable gas prices and their scheduling flexibilities to accommodate intermittent renewable energy generation. In this study, several new families of strong valid inequalities are developed to help reduce the computational time to solve these typesmore » of problems. Meanwhile, the validity and facet-defining proofs are provided for certain inequalities. Finally, numerical experiments on a modified IEEE 118-bus system and the power system data based on recent studies verify the effectiveness of applying our formulation to model and solve this type of gas turbine unit commitment problems, including reducing the computational time to obtain an optimal solution or obtaining a much smaller optimality gap, as compared to the default CPLEX, when the time limit is reached with no optimal solutions obtained.« less

"Like the Fish Not in Water": How Language and Race Mediate the Social and Economic Inclusion of Women Migrants to Australia

ERIC Educational Resources Information Center

Butorac, Donna

2014-01-01

Learning English is an important aspect of post-migration settlement in Australia, and new migrants with beginner to intermediate proficiency are strongly encouraged to attend government-subsidised English language classes. Underpinning the framing and delivery of these classes is a commitment to the discursive construction of Australia as an…

Widening Participation in Higher Education: The Role of Professional and Social Class Identities and Commitments

ERIC Educational Resources Information Center

Wilkins, Andrew; Burke, Penny Jane

2015-01-01

Since the neoliberal reforms to British education in the 1980s, education debates have been saturated with claims to the efficacy of the market as a mechanism for improving the content and delivery of state education. In recent decades with the expansion and "massification" of higher education, widening participation (WP) has acquired an…

Requirements for sustainable schistosomiasis control.

PubMed

Traoré, M

1996-01-01

In Mali the increased transmission of schistosomiasis following the construction of numerous reservoirs and irrigation schemes, together with experience gained in tackling the disease, have led to a major effort to train personnel in control methods, to achieve decentralized delivery and management, and to foster self-reliance in this field. The author outlines the essential components of a sound national control programme requiring long-term commitment.

Validity and Reliability of the 3-E Tool for Evaluating the Curriculum Support Intervention in Uganda

ERIC Educational Resources Information Center

Mutto, Milton; Mukasa, Immaculate; Avasi, Victor; Kilibo, Charles; Kamwesigye, Charles; Duku, Tom

2015-01-01

This study determined psychometric properties of 3-ET, an instrument specifically designed to track the effects of a curriculum support intervention created to enhance the delivery of the national curriculum in a war zone in Uganda. The instrument was developed through brain storm and expert review before being committed to structural and…

Magnetic Resonance Imaging-Guided Adaptive Radiation Therapy: A "Game Changer" for Prostate Treatment?

PubMed

Pathmanathan, Angela U; van As, Nicholas J; Kerkmeijer, Linda G W; Christodouleas, John; Lawton, Colleen A F; Vesprini, Danny; van der Heide, Uulke A; Frank, Steven J; Nill, Simeon; Oelfke, Uwe; van Herk, Marcel; Li, X Allen; Mittauer, Kathryn; Ritter, Mark; Choudhury, Ananya; Tree, Alison C

2018-02-01

Radiation therapy to the prostate involves increasingly sophisticated delivery techniques and changing fractionation schedules. With a low estimated α/β ratio, a larger dose per fraction would be beneficial, with moderate fractionation schedules rapidly becoming a standard of care. The integration of a magnetic resonance imaging (MRI) scanner and linear accelerator allows for accurate soft tissue tracking with the capacity to replan for the anatomy of the day. Extreme hypofractionation schedules become a possibility using the potentially automated steps of autosegmentation, MRI-only workflow, and real-time adaptive planning. The present report reviews the steps involved in hypofractionated adaptive MRI-guided prostate radiation therapy and addresses the challenges for implementation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Impact of Feed Delivery Pattern on Aerial Particulate Matter and Behavior of Feedlot Cattle.

PubMed

Mitloehner, Frank M; Dailey, Jeff W; Morrow, Julie L; McGlone, John J

2017-03-01

Fine particulate matter with less than 2.5 microns diameter (PM 2.5 ) generated by cattle in feedlots is an environmental pollutant and a potential human and animal health issue. The objective of this study was to determine if a feeding schedule affects cattle behaviors that promote PM 2.5 in a commercial feedlot. The study used 2813 crossbred steers housed in 14 adjacent pens at a large-scale commercial West Texas feedlot. Treatments were conventional feeding at 0700, 1000, and 1200 (CON) or feeding at 0700, 1000, and 1830 (ALT), the latter feeding time coincided with dusk. A mobile behavior lab was used to quantify behaviors of steers that were associated with generation of PM 2.5 (e.g., fighting, mounting of peers, and increased locomotion). PM 2.5 samplers measured respirable particles with a mass median diameter ≤2.5 μm (PM 2.5 ) every 15 min over a period of 7 d in April and May. Simultaneously, the ambient temperature, humidity, wind speed and direction, precipitation, air pressure, and solar radiation were measured with a weather station. Elevated downwind PM 2.5 concentrations were measured at dusk, when cattle that were fed according to the ALT vs. the CON feeding schedule, demonstrated less PM 2.5 -generating behaviors ( p < 0.05). At dusk, steers on ALT vs. CON feeding schedules ate or were waiting to eat (standing in second row behind feeding cattle) at much greater rates ( p < 0.05). Upwind PM 2.5 concentrations were similar between the treatments. Downwind PM 2.5 concentrations averaged over 24 h were lower from ALT compared with CON pens (0.072 vs. 0.115 mg/m³, p < 0.01). However, dry matter intake (DMI) was less ( p < 0.05), and average daily gain (ADG) tended to be less ( p < 0.1) in cattle that were fed according to the ALT vs. the CON feeding schedules, whereas feed efficiency (aka gain to feed, G:F) was not affected. Although ALT feeding may pose a challenge in feed delivery and labor scheduling, cattle exhibited fewer PM 2.5 -generating behaviors and reduced generation of PM 2.5 when feed delivery times matched the natural desires of cattle to eat in a crepuscular pattern.

Uptake of Mobile ICT Health Services: Has the Time Come to become Commodity?

NASA Astrophysics Data System (ADS)

Angelidis, Pantelis A.

Personalized healthcare (pHealth) is a collective term aiming to reflect all modes of patient-centric healthcare delivery via advanced technology means. Personalized health involves the utilization of micro and nanotechnology advances, molecular biology, implantable sensors, textile innovations and mobile information & communication technology (mICT) to create individualized monitoring and treatment plans. pHealth proactively endorses the sense of “one-to-one” communication to elevate healthcare delivery, optimize patient services and ensure seamless from the patient point of view information exchange. Patient awareness, policy planning and technology progress are favoring phealth market penetration, while financing issues, political commitment, and unavailability of technology infrastructures are fundamentally prohibiting its expansion. This paper explores the drivers and barriers to the adoption of phealth delivery schemes, including a discussion on interoperability issues. It also presents case study results.

A Cross-Layer Duty Cycle MAC Protocol Supporting a Pipeline Feature for Wireless Sensor Networks

PubMed Central

Tong, Fei; Xie, Rong; Shu, Lei; Kim, Young-Chon

2011-01-01

Although the conventional duty cycle MAC protocols for Wireless Sensor Networks (WSNs) such as RMAC perform well in terms of saving energy and reducing end-to-end delivery latency, they were designed independently and require an extra routing protocol in the network layer to provide path information for the MAC layer. In this paper, we propose a new cross-layer duty cycle MAC protocol with data forwarding supporting a pipeline feature (P-MAC) for WSNs. P-MAC first divides the whole network into many grades around the sink. Each node identifies its grade according to its logical hop distance to the sink and simultaneously establishes a sleep/wakeup schedule using the grade information. Those nodes in the same grade keep the same schedule, which is staggered with the schedule of the nodes in the adjacent grade. Then a variation of the RTS/CTS handshake mechanism is used to forward data continuously in a pipeline fashion from the higher grade to the lower grade nodes and finally to the sink. No extra routing overhead is needed, thus increasing the network scalability while maintaining the superiority of duty-cycling. The simulation results in OPNET show that P-MAC has better performance than S-MAC and RMAC in terms of packet delivery latency and energy efficiency. PMID:22163895

Emerging frontiers in healthcare research and delivery.: the 16th Annual HMO Research Network Conference, March 21-24, 2010, Austin, Texas.

PubMed

Stevens, Alan B; Sanghi, Sandhya

2010-12-01

The Health Maintenance Organization Research Network (HMORN), a consortium of 16 healthcare delivery systems with integrated research centers, held their 16(th) annual conference in Austin, Texas from March 21-24, 2010. The conference was hosted by Scott & White Healthcare. Its theme "Emerging Frontiers in Healthcare Research and Delivery" reflected the objective of the conference which was to build synergy among scientists and clinicians to influence the health of the nation; to demonstrate the network's commitment to reach beyond traditional collaborators; discuss tools and technologies; and to expand opportunities for public-private partnerships in cutting-edge healthcare research and delivery. More than 320 researchers and healthcare professionals, representing each of the member HMOs, participated in this conference. Representatives from the AHRQ, CDC, NCI and NIH met with researchers to advance the quality and breadth of public domain research in HMOs. The objective of this article is to provide information about the HMORN and its 16(th) annual conference.

KSC-04pd1975

NASA Image and Video Library

2004-09-22

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers conduct a post-delivery verification test on a Control Moment Gyro (CMG) that is scheduled to fly on mission STS-114. The CMG will replace another on the International Space Station, which will require a spacewalk.

KSC-04pd1977

NASA Image and Video Library

2004-09-22

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers conduct a post-delivery verification test on a Control Moment Gyro (CMG) that is scheduled to fly on mission STS-114. The CMG will replace another on the International Space Station, which will require a spacewalk.

KSC-04pd1976

NASA Image and Video Library

2004-09-22

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers conduct a post-delivery verification test on a Control Moment Gyro (CMG) that is scheduled to fly on mission STS-114. The CMG will replace another on the International Space Station, which will require a spacewalk.

36 CFR 902.82 - Fee schedule.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., an institution of graduate higher education, an institution of undergraduate higher education, an institution of professional education, and an institution of vocational education, which operates a program or... examples are not intended to be all-inclusive. Moreover, as traditional methods of news delivery evolve (e...

48 CFR 11.403 - Supplies or services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Supplies or services. 11.403 Section 11.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING DESCRIBING AGENCY NEEDS Delivery or Performance Schedules 11.403 Supplies or services. (a) The...

48 CFR 42.302 - Contract administration functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... delivery schedules. (32) Perform preaward surveys (see Subpart 9.1). (33) Advise and assist contractors... performance in the areas of design, development, and production. (41) Evaluate for adequacy and perform surveillance of contractor engineering efforts and management systems that relate to design, development...

Obstetrician call schedule and obstetric outcomes among women eligible for a trial of labor after cesarean.

PubMed

Yee, Lynn M; Liu, Lilly Y; Grobman, William A

2017-01-01

Reducing cesarean deliveries is a major public health goal. The low rate of vaginal birth after cesarean has been attributed largely to a decrease in the likelihood of choosing a trial of labor after cesarean, despite evidence suggesting a majority of women with 1 prior low transverse cesarean are trial of labor after cesarean candidates. Although a number of reasons for this decrease have been explored, it remains unclear how systems issues such as physician call schedules influence delivery approach and mode in this context. The objective of the study was to investigate the relationship between obstetricians' call schedule and obstetric outcomes among women eligible for a trial of labor after cesarean. This is a retrospective cohort study of the likelihood of attempting a trial of labor after cesarean and achieving vaginal birth after cesarean among women with 1 prior low transverse cesarean delivery and a term, cephalic singleton gestation based on the delivering provider's call schedule. Attending obstetrician call schedules were classified as traditional or night float call. Night float call was defined as a schedule in which the provider had clinical responsibilities only for a day or night shift, without other clinical responsibilities before or after the period of responsibility for laboring patients. Call schedules are determined by individual provider groups. Bivariable analyses and random-effects logistic regression were used to examine the relationship between obstetricians' call schedule and the frequency of trial of labor after cesarean. Secondary outcomes including frequency of vaginal birth after cesarean and maternal and neonatal outcomes also were assessed. Of 1502 eligible patients, 556 (37%) were delivered by physicians in a night float call system. A total of 22.6% underwent a trial of labor after cesarean and 12.8% achieved vaginal birth after cesarean; the vaginal birth after cesarean rate for women attempting a trial of labor after cesarean was 56.5%. Women were more likely to undergo a trial of labor after cesarean (33.1% vs 16.5%, P < .001) and achieve vaginal birth after cesarean (18.7% vs 9.3%, P < .001) when cared for by physicians with a night float call schedule. Regression analyses demonstrated physicians with a night float call schedule remained significantly more likely to have patients undergo trial of labor after cesarean (adjusted odds ratio, 2.64, 95% confidence interval, 1.65-4.25) and experience vaginal birth after cesarean (adjusted odds ratio, 2.17, 95% confidence interval, 1.36-3.45) after adjusting for potential confounders. However, the likelihood of achieving vaginal birth after cesarean if a trial of labor after cesarean was attempted was not different based on provider call type (adjusted odds ratio, 0.96, 95% confidence interval, 0.57-1.62). Although women delivered by providers with a night float schedule were more likely to experience uterine rupture (1.8% vs 0.6%, P = .03), chorioamnionitis (4.3% vs 1.7%, P = .002), postpartum hemorrhage (7.6% vs 4.8%, P = .03), and neonates admitted to the neonatal intensive care unit (6.8% vs 3.9%, P = .01), these associations did not persist when the population was limited to women attempting trial of labor after cesarean. Although physicians working on a night float call system were significantly more likely to have patients with a prior cesarean undergo trial of labor after cesarean and achieve vaginal birth after cesarean, their patients also were more likely to experience maternal and neonatal morbidity. However, these differences did not persist when limiting analyses to women attempting a trial of labor after cesarean. Using a night float call schedule may be an effective measure to promote a trial of labor after cesarean and vaginal birth after cesarean. Copyright © 2016 Elsevier Inc. All rights reserved.

What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India.

PubMed

Nair, M; Ariana, P; Webster, P

2012-01-01

Despite continuing efforts to promote skilled institutional delivery, eight women die every hour in India due to causes related to pregnancy and child birth. The objectives of this study were to assess the prevalence and the determinants of institutional delivery by skilled birth attendants in a rural population in Andhra Pradesh, India. This cross-sectional study used data from 'Young Lives', a longitudinal study on childhood poverty, and the study population was a cohort of 1419 rural, economically deprived women (from the Young Lives study) in Andhra Pradesh, India. The data are from round-1 of Young Lives younger cohort recruited in 2002 and followed until 2015. The participation rate of households was 99.5%. Prevalence of skilled institutional delivery was 36.8%. Women's education (odds ratio [OR] for secondary education 2.06; 95% confidence interval [95%CI] 1.33-3.19), desire to be pregnant (OR 1.89; 95% CI 1.12-3.22) and adequate prenatal care (OR 1.69; 95% CI 1.30-2.21) were found to be the positive determinants of skilled institutional delivery. High birth order (OR for second birth 0.44; 95% CI 0.32-0.60, OR for third birth 0.47; 95% CI 0.30-0.72 and OR for ≥fourth 0.47; 95% CI 0.27-0.81), schedule caste/schedule tribe social background (OR 0.70; 95% CI 0.53-0.93) and poor economic status of the household (OR for the poorest households 0.67; 95% CI 0.46-0.99) were negatively associated with skilled institutional delivery. Despite existence of supporting schemes, the utilisation of skilled institutional delivery services was low in the study population. Educated women and women with adequate prenatal care who have a desired pregnancy were more likely to utilise health institutions and skilled delivery care. There is a need for integrated approaches through maternal health, family planning and education programs, and a focus on uneducated, poor women belonging to disadvantaged social groups.

A time scheduling model of logistics service supply chain based on the customer order decoupling point: a perspective from the constant service operation time.

PubMed

Liu, Weihua; Yang, Yi; Xu, Haitao; Liu, Xiaoyan; Wang, Yijia; Liang, Zhicheng

2014-01-01

In mass customization logistics service, reasonable scheduling of the logistics service supply chain (LSSC), especially time scheduling, is benefit to increase its competitiveness. Therefore, the effect of a customer order decoupling point (CODP) on the time scheduling performance should be considered. To minimize the total order operation cost of the LSSC, minimize the difference between the expected and actual time of completing the service orders, and maximize the satisfaction of functional logistics service providers, this study establishes an LSSC time scheduling model based on the CODP. Matlab 7.8 software is used in the numerical analysis for a specific example. Results show that the order completion time of the LSSC can be delayed or be ahead of schedule but cannot be infinitely advanced or infinitely delayed. Obtaining the optimal comprehensive performance can be effective if the expected order completion time is appropriately delayed. The increase in supply chain comprehensive performance caused by the increase in the relationship coefficient of logistics service integrator (LSI) is limited. The relative concern degree of LSI on cost and service delivery punctuality leads to not only changes in CODP but also to those in the scheduling performance of the LSSC.

A Time Scheduling Model of Logistics Service Supply Chain Based on the Customer Order Decoupling Point: A Perspective from the Constant Service Operation Time

PubMed Central

Yang, Yi; Xu, Haitao; Liu, Xiaoyan; Wang, Yijia; Liang, Zhicheng

2014-01-01

In mass customization logistics service, reasonable scheduling of the logistics service supply chain (LSSC), especially time scheduling, is benefit to increase its competitiveness. Therefore, the effect of a customer order decoupling point (CODP) on the time scheduling performance should be considered. To minimize the total order operation cost of the LSSC, minimize the difference between the expected and actual time of completing the service orders, and maximize the satisfaction of functional logistics service providers, this study establishes an LSSC time scheduling model based on the CODP. Matlab 7.8 software is used in the numerical analysis for a specific example. Results show that the order completion time of the LSSC can be delayed or be ahead of schedule but cannot be infinitely advanced or infinitely delayed. Obtaining the optimal comprehensive performance can be effective if the expected order completion time is appropriately delayed. The increase in supply chain comprehensive performance caused by the increase in the relationship coefficient of logistics service integrator (LSI) is limited. The relative concern degree of LSI on cost and service delivery punctuality leads to not only changes in CODP but also to those in the scheduling performance of the LSSC. PMID:24715818

Efficient Project Delivery Using Lean Principles - An Indian Case Study

NASA Astrophysics Data System (ADS)

Kovvuri, P. Ramachandra Reddy; Sawhney, Anil; Ahuja, Ritu; Sreekumar, Aiswarya

2016-03-01

Construction industry in India is growing at a rapid pace. Along with this growth, the industry is facing numerous challenges that are making delivery of projects inefficient. Experts believe that capacity constraints in the industry need to be addressed immediately. Government has recommended `introduction of efficient technologies and modern management techniques' to increase the productivity of the industry. In this context, lean principles can act as a lever to make project delivery more efficient and provide the much needed impetus to the Indian construction sector. Around the globe lean principles are showing positive results on the projects. Project teams are reporting improvements in construction time, cost and quality along with softer benefits of enhanced collaboration, coordination and trust in project teams. Can adoption of lean principles provide similar benefits in the Indian construction sector? This research was conducted to answer this question. Using an action research approach a key lean construction tool called Last Planner System (LPS) was tested on a large Indian construction project. The work described in this work investigates the improvements achieved in project delivery by adopting LPS in Indian construction sector. Comparison in pre- and post-implementation data demonstrates increase in the certainty of work-flow and improves schedule compliance. This is measured through a simple LPS metric called percent plan complete. Explicit improvements in schedule performance are seen during 8 week LPS implementation along with implicit improvements in coordination, collaboration and trust in the project team. This work reports the findings of LPS implementation on the case study project outlining the barriers and drivers to adoption, strategies needed to ensure successful implementation and roadmap for implementation. Based on the findings the authors envision that lean construction can make project delivery more efficient in India.

Self-balancing dynamic scheduling of electrical energy for energy-intensive enterprises

NASA Astrophysics Data System (ADS)

Gao, Yunlong; Gao, Feng; Zhai, Qiaozhu; Guan, Xiaohong

2013-06-01

Balancing production and consumption with self-generation capacity in energy-intensive enterprises has huge economic and environmental benefits. However, balancing production and consumption with self-generation capacity is a challenging task since the energy production and consumption must be balanced in real time with the criteria specified by power grid. In this article, a mathematical model for minimising the production cost with exactly realisable energy delivery schedule is formulated. And a dynamic programming (DP)-based self-balancing dynamic scheduling algorithm is developed to obtain the complete solution set for such a multiple optimal solutions problem. For each stage, a set of conditions are established to determine whether a feasible control trajectory exists. The state space under these conditions is partitioned into subsets and each subset is viewed as an aggregate state, the cost-to-go function is then expressed as a function of initial and terminal generation levels of each stage and is proved to be a staircase function with finite steps. This avoids the calculation of the cost-to-go of every state to resolve the issue of dimensionality in DP algorithm. In the backward sweep process of the algorithm, an optimal policy is determined to maximise the realisability of energy delivery schedule across the entire time horizon. And then in the forward sweep process, the feasible region of the optimal policy with the initial and terminal state at each stage is identified. Different feasible control trajectories can be identified based on the region; therefore, optimising for the feasible control trajectory is performed based on the region with economic and reliability objectives taken into account.

Schedule-induced polydipsia in the spontaneously hypertensive rat and its relation to impulsive behaviour.

PubMed

Ibias, Javier; Pellón, Ricardo

2011-09-30

Eight Spontaneously Hypertensive Rat (SHR), 8 Wistar-Kyoto (WKY) and 8 Wistar rats, all male, maintained at 80-85% of their free-feeding weight by controlled access to food, were exposed to a series of fixed time (FT) schedules whereby food pellets were regularly delivered regardless of the animals' behaviour. The FT values used were 9, 15, 30, 60, 120 and 180 s, with the order of presentation of the schedules among the animals being counterbalanced (except under the FT 120-s and 180-s schedules, which were successively presented as the last two of the series). Due to freely available access to water, the animals developed schedule-induced drinking under all FT schedules, marked by the characteristic bitonic function that relates the number of licks and amount of water drunk to the length of the inter-food interval. Wistar and WKY rats displayed maximum drinking under an FT 15-s schedule, with WKY rats registering lower quantities across all FT values. Among SHR rats, maximum schedule-induced polydipsia was observed under the FT 30-s schedule, with a rightward shift in the bitonic function compared to controls. For long FT values, the temporal distribution of licks within inter-food intervals was shifted slightly towards the right in the SHR rats. In a subsequent study, only the SHR and Wistar rats were used, and the animals were exposed to a delay-discounting procedure. The rats were faced with successive choices, in which they could choose between an immediate reward of one food pellet and another of four food pellets at a delay of 3, 6, 12 or 24s. In the case of the longer delays, SHR rats chose the immediate reward of lower magnitude more often than did their Wistar counterparts, and also committed a greater number of omissions during the forced-choice trials of the procedure. The results indicate that differences in schedule-induced polydipsia are related to indexes of cognitive rather than motor impulsivity, a finding in line with the theoretical idea that adjunctive behaviour is linked to operant reinforcement processes. Copyright © 2011 Elsevier B.V. All rights reserved.

Gaining and maintaining commitment to large-scale change in healthcare organizations.

PubMed

Narine, L; Persaud, D D

2003-08-01

Healthcare administrators have sought to improve the quality of healthcare services by using organizational change as a lever. Unfortunately, evaluations of organizational change efforts in areas such as total quality management (TQM), continuous quality improvement (CQI), and organizational restructuring have indicated that these change programmes have not fulfilled their promise in improving service delivery. Furthermore, there are no easy answers as to why so many large-scale change programmes are unsuccessful. The aim of this analysis is to provide insights into practices that may be utilized to improve the chances of successful change management. It is proposed that in order to effect change, implementers must first gain commitment to the change. This is done by ensuring organizational readiness for change, surfacing dissatisfaction with the present state, communicating a clear vision of the proposed change, promoting participation in the change effort, and developing a clear and consistent communication plan. However gaining commitment is not enough. Many change programmes have been initially perceived as being successful but long-term success has been elusive. Therefore, maintaining commitment during the uncertainty associated with the transition period is imperative. This can be done by successfully managing the transition using action steps such as consolidating change using feedback mechanisms and making the change a permanent part of the organization's culture.

Improving Software Engineering on NASA Projects

NASA Technical Reports Server (NTRS)

Crumbley, Tim; Kelly, John C.

2010-01-01

Software Engineering Initiative: Reduces risk of software failure -Increases mission safety. More predictable software cost estimates and delivery schedules. Smarter buyer of contracted out software. More defects found and removed earlier. Reduces duplication of efforts between projects. Increases ability to meet the challenges of evolving software technology.

Measuring and Reducing College Students' Procrastination

ERIC Educational Resources Information Center

Perrin, Christopher J.; Miller, Neal; Haberlin, Alayna T.; Ivy, Jonathan W.; Meindl, James N.; Neef, Nancy A.

2011-01-01

We examined college students' procrastination when studying for weekly in-class quizzes. Two schedules of online practice quiz delivery were compared using a multiple baseline design. When online study material was made available noncontingently, students usually procrastinated. When access to additional study material was contingent on completing…

Thermal energy storage subsystems. A collection of quarterly reports

NASA Technical Reports Server (NTRS)

1978-01-01

The design, development, and progress toward the delivery of three subsystems is discussed. The subsystem used a salt hydrate mixture for thermal energy storage. The program schedules, technical data, and other program activities from October 1, 1976, through December 31, 1977 are presented.

Research Perspectives for Material Requirements Planning Systems. Paper No. 434.

ERIC Educational Resources Information Center

Berry, W. L.; Whybark, D. Clay

Material requirements planning (MRP) systems are described as management tools for planning and controlling production operations. A wide variety of industries and production organizations are credited as reporting significant operating improvements in such areas as inventory control, production scheduling, delivery performance, and production…

Randomized controlled trial of intravenous acetaminophen for postcesarean delivery pain control.

PubMed

Altenau, Brie; Crisp, Catrina C; Devaiah, C Ganga; Lambers, Donna S

2017-09-01

Cesarean delivery is a common surgery in the United States, with 1.3 million performed during 2009. 1 Obstetricians must balance the growing concern with opioid abuse, dependence, and side effects with optimal postoperative pain control. Intravenous acetaminophen may represent an additional method to decrease the reliance on opioid medications and improve postoperative pain following cesarean delivery. The objective of the study was to determine whether the administration of intravenous acetaminophen following routine scheduled cesarean delivery would decrease the need for narcotic medications to control postoperative pain. This was an institutional review board-approved, double-blind, placebo-controlled, randomized trial, registered on clinicaltrials.gov (number 02046382). Women scheduled to undergo cesarean delivery with regional anesthesia at term were recruited. All perioperative and postpartum care was standardized via study order sets. Study patients were given all medications in a standardized manner receiving either acetaminophen 1000 mg intravenously or 100 mL saline (placebo) every 8 hours for 48 hours for a total of 6 doses. The pharmacy prepared intravenous acetaminophen and saline in identical administration bags labeled study drug to ensure blinding. The initial dose of study drug was given within 60 minutes of skin incision. Quantity of breakthrough and scheduled analgesic medications and self-reported pain levels on the Faces Pain Scale (0-10) before and after study drug administration were collected. Patient demographics were extracted from the chart. Power calculation determined that 45 patients per arm were required to detect a 30% reduction in postcesarean narcotic requirement with 80% power and a significance level of P = .05. A total of 133 patients were consented for the study. Twenty-nine were excluded and 104 patients completed the study: 57 received intravenous acetaminophen and 47 received placebo. There were no differences in baseline demographic characteristics including patient age, body mass index, gravidity, parity, race, comorbidities, or number of prior cesarean deliveries. There were no differences between groups in estimated blood loss or length of stay. The total amount of oral narcotic medications consumed by patients receiving intravenous acetaminophen was significantly reduced when compared with the placebo group (47 mg vs 65 mg of oxycodone; P = .034). The total amount of ibuprofen used between groups was not different. There was no difference in pain scores between groups before and after study dose administration. There was no significant difference in narcotic side effects (nausea/emesis, respiratory depression, constipation) in either study arm. Intravenous acetaminophen in the postoperative period following cesarean delivery resulted in a significant decrease in oral narcotic consumption for pain control. Copyright © 2017 Elsevier Inc. All rights reserved.

The Ukrainian Crisis and European Security: Implications for the United States and U.S. Army

DTIC Science & Technology

2015-01-01

Finland . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 New Uncertainties in the Black Sea Region...increas- ing pressure if Putin is successful in destabilizing eastern Ukraine. Putin’s Increasing Commitment to the Pro -Russian Separatists Since the...downing of the MH17 commercial airliner in July 2014, Russia has increased weapon deliveries to the pro -Russian rebels, as well as the firepower of

Hippi Care Hospital: Towards Proactive Business Processes in Emergency Room Services. Teaching Case

ERIC Educational Resources Information Center

Tan, Kar Way; Shankararaman, Venky

2014-01-01

It was 2:35 am on a Saturday morning. Wiki Lim, process specialist from the Process Innovation Centre (PIC) of Hippi Care Hospital (HCH), desperately doodling on her notepad for ideas to improve service delivery at HCH's Emergency Department (ED). HCH has committed to the public that its ED would meet the service quality criterion of serving 90%…

Quantifying the effects of antiangiogenic and chemotherapy drug combinations on drug delivery and treatment efficacy

PubMed Central

Yιlmaz, Defne; Phipps, Colin; Kohandel, Mohammad

2017-01-01

Tumor-induced angiogenesis leads to the development of leaky tumor vessels devoid of structural and morphological integrity. Due to angiogenesis, elevated interstitial fluid pressure (IFP) and low blood perfusion emerge as common properties of the tumor microenvironment that act as barriers for drug delivery. In order to overcome these barriers, normalization of vasculature is considered to be a viable option. However, insight is needed into the phenomenon of normalization and in which conditions it can realize its promise. In order to explore the effect of microenvironmental conditions and drug scheduling on normalization benefit, we build a mathematical model that incorporates tumor growth, angiogenesis and IFP. We administer various theoretical combinations of antiangiogenic agents and cytotoxic nanoparticles through heterogeneous vasculature that displays a similar morphology to tumor vasculature. We observe differences in drug extravasation that depend on the scheduling of combined therapy; for concurrent therapy, total drug extravasation is increased but in adjuvant therapy, drugs can penetrate into deeper regions of tumor. PMID:28922358

The effects of variable-time delivery of food items and praise on problem behavior reinforced by escape.

PubMed

Lomas, Joanna E; Fisher, Wayne W; Kelley, Michael E

2010-01-01

Prior research indicates that reinforcement of an appropriate response (e.g., compliance) can produce concomitant reductions in problem behavior reinforced by escape when problem behavior continues to produce negative reinforcement (e.g., Lalli et al., 1999). These effects may be due to a preference for positive over negative reinforcement or to positive reinforcement acting as an abolishing operation, rendering demands less aversive and escape from demands less effective as negative reinforcement. In the current investigation, we delivered a preferred food item and praise on a variable-time 15-s schedule while providing escape for problem behavior on a fixed-ratio 1 schedule in a demand condition for 3 participants with problem behavior maintained by negative reinforcement. Results for all 3 participants showed that variable-time delivery of preferred edible items reduced problem behavior even though escape continued to be available for these responses. These findings are discussed in the context of motivating operations.

Time-scheduled delivery of computer health animations: "Installing" healthy habits of computer use.

PubMed

Wang, Sy-Chyi; Chern, Jin-Yuan

2013-06-01

The development of modern technology brings convenience to our lives but removes physical activity from our daily routines, thereby putting our lives at risk. Extended computer use may contribute to symptoms such as visual impairment and musculoskeletal disorders. To help reduce the risk of physical inactivity and promote healthier computer use, this study developed a time-scheduled delivery of health-related animations for users sitting in front of computers for prolonged periods. In addition, we examined the effects that the program had on the computer-related health behavior intentions and actions of participants. Two waves of questionnaires were implemented for data collection before and after intervention. The results showed that the animation program indeed had a positive effect on participants' healthy computer use actions in terms of breathtaking, body massages, and body stretches. It also helped to bridge the intention-action gap of the health behaviors. The development and evaluation were documented, and users' experiences/suggestions were discussed at the end.

Quantifying the effects of antiangiogenic and chemotherapy drug combinations on drug delivery and treatment efficacy.

PubMed

Yonucu, Sirin; Yιlmaz, Defne; Phipps, Colin; Unlu, Mehmet Burcin; Kohandel, Mohammad

2017-09-01

Tumor-induced angiogenesis leads to the development of leaky tumor vessels devoid of structural and morphological integrity. Due to angiogenesis, elevated interstitial fluid pressure (IFP) and low blood perfusion emerge as common properties of the tumor microenvironment that act as barriers for drug delivery. In order to overcome these barriers, normalization of vasculature is considered to be a viable option. However, insight is needed into the phenomenon of normalization and in which conditions it can realize its promise. In order to explore the effect of microenvironmental conditions and drug scheduling on normalization benefit, we build a mathematical model that incorporates tumor growth, angiogenesis and IFP. We administer various theoretical combinations of antiangiogenic agents and cytotoxic nanoparticles through heterogeneous vasculature that displays a similar morphology to tumor vasculature. We observe differences in drug extravasation that depend on the scheduling of combined therapy; for concurrent therapy, total drug extravasation is increased but in adjuvant therapy, drugs can penetrate into deeper regions of tumor.

Ecosystem objectives to support the UK vision for the marine environment.

PubMed

Rogers, S I; Tasker, M L; Earll, R; Gubbay, S

2007-02-01

European Maritime States already have commitments to protect species and habitats and maintain quality standards in coastal and offshore waters. These are a direct response to environmental legislation in Europe and commitments made to biodiversity conservation in OSPAR and at the World Summit on Sustainable Development. An integrated approach to management requires that these are consistent with the requirements for sustainable development, and include wider social considerations and active stakeholder participation. This review describes a hierarchical framework that incorporates the marine objectives and delivery statements of ecological, social and economic sectors. The framework leads from the UK's guiding principles for sustainable development, through visionary statements and strategic goals for high level delivery, to operational objectives and statements of action which deliver management. Parts of this hierarchy can already be populated for the UK, especially those at the higher levels. At the operational level, however, there is less clarity. The review shows that, despite some gaps, existing commitments for ecological components of the ecosystem are transparent and generally conform to this framework, due largely to high profile government funding of environmental protection and science and a single national vision for the marine environment. Specific objectives for six components of the ecosystem were developed; benthic habitats, seabirds and mammals, phytoplankton and zooplankton, fish, and physical/chemical quality of the water and atmosphere. The objectives included some that avoided limits and others that aimed to achieve targets, and for management to be effective it will be important to have a common understanding of how these can together be interpreted and made operational. In a review of 13 social and economic sectors, few provided a clear breakdown of objectives leading from a high level vision or a sustainable development principle. Six sectors did not have high level government targets for production or other measures of sectoral performance. Such commercial operations generally determine their own operational delivery targets based on market forces. Recent proposals in Europe to create an integrated framework for social, economic and environmental activities will need to carefully balance the development of a strong and competitive marine economy with existing international obligations to environmental protection.

Revisiting Bevacizumab + Cytotoxics Scheduling Using Mathematical Modeling: Proof of Concept Study in Experimental Non-Small Cell Lung Carcinoma.

PubMed

Imbs, Diane-Charlotte; El Cheikh, Raouf; Boyer, Arnaud; Ciccolini, Joseph; Mascaux, Céline; Lacarelle, Bruno; Barlesi, Fabrice; Barbolosi, Dominique; Benzekry, Sébastien

2018-01-01

Concomitant administration of bevacizumab and pemetrexed-cisplatin is a common treatment for advanced nonsquamous non-small cell lung cancer (NSCLC). Vascular normalization following bevacizumab administration may transiently enhance drug delivery, suggesting improved efficacy with sequential administration. To investigate optimal scheduling, we conducted a study in NSCLC-bearing mice. First, experiments demonstrated improved efficacy when using sequential vs. concomitant scheduling of bevacizumab and chemotherapy. Combining this data with a mathematical model of tumor growth under therapy accounting for the normalization effect, we predicted an optimal delay of 2.8 days between bevacizumab and chemotherapy. This prediction was confirmed experimentally, with reduced tumor growth of 38% as compared to concomitant scheduling, and prolonged survival (74 vs. 70 days). Alternate sequencing of 8 days failed in achieving a similar increase in efficacy, thus emphasizing the utility of modeling support to identify optimal scheduling. The model could also be a useful tool in the clinic to personally tailor regimen sequences. © 2017 The Authors CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

Cognitive overload and communication in two healthcare settings.

PubMed

Cicourel, Aaron V

2004-01-01

The confluence of organizational social interaction and cognitive information processing constraints create 'noisy' conditions in institutionalized settings. Attentional and memory limitations always influence the ability of participants to comprehend each other's communication. Two organizational settings (a medical specialty clinic and periodontal office) will be used to explore a few features of healthcare delivery that are often ignored in studies of such systems. Scheduling appointments, for example, creates stress for both patients and healthcare personnel but is often an unexamined aspect of healthcare delivery that has become both challenging and often irritating for all concerned. For example, when patients call, someone at a general scheduling center or the particular clinic or office of an individual physician or dentist or a group practice will answer the call with a menu of options, or the caller may be asked to leave message. When a patient leaves a clinic or surgery office after a visit, they may be allowed to make a new appointment. The term 'cognitive overload' is a ubiquitous element of all healthcare systems and refers to organizationally induced and constrained limited capacity processing inherent in the way improvised discourse practices, and annotative devices or artifacts (such as written notes or some related strategy) become an integral part of everyday healthcare delivery.

Dynamic Routing for Delay-Tolerant Networking in Space Flight Operations

NASA Technical Reports Server (NTRS)

Burleigh, Scott C.

2008-01-01

Contact Graph Routing (CGR) is a dynamic routing system that computes routes through a time-varying topology composed of scheduled, bounded communication contacts in a network built on the Delay-Tolerant Networking (DTN) architecture. It is designed to support operations in a space network based on DTN, but it also could be used in terrestrial applications where operation according to a predefined schedule is preferable to opportunistic communication, as in a low-power sensor network. This paper will describe the operation of the CGR system and explain how it can enable data delivery over scheduled transmission opportunities, fully utilizing the available transmission capacity, without knowing the current state of any bundle protocol node (other than the local node itself) and without exhausting processing resources at any bundle router.

Decision Model for Planning and Scheduling of Seafood Product Considering Traceability

NASA Astrophysics Data System (ADS)

Agustin; Mawengkang, Herman; Mathelinea, Devy

2018-01-01

Due to the global challenges, it is necessary for an industrial company to integrate production scheduling and distribution planning, in order to be more efficient and to get more economics advantages. This paper presents seafood production planning and scheduling of a seafood manufacture company which produces simultaneously multi kind of seafood products, located at Aceh Province, Indonesia. The perishability nature of fish highly restricts its storage duration and delivery conditions. Traceability is a tracking requirement to check whether the quality of the product is satisfied. The production and distribution planning problem aims to meet customer demand subject to traceability of the seafood product and other restrictions. The problem is modeled as a mixed integer linear program, and then it is solved using neighborhood search approach.

Efficient bounding schemes for the two-center hybrid flow shop scheduling problem with removal times.

PubMed

Hidri, Lotfi; Gharbi, Anis; Louly, Mohamed Aly

2014-01-01

We focus on the two-center hybrid flow shop scheduling problem with identical parallel machines and removal times. The job removal time is the required duration to remove it from a machine after its processing. The objective is to minimize the maximum completion time (makespan). A heuristic and a lower bound are proposed for this NP-Hard problem. These procedures are based on the optimal solution of the parallel machine scheduling problem with release dates and delivery times. The heuristic is composed of two phases. The first one is a constructive phase in which an initial feasible solution is provided, while the second phase is an improvement one. Intensive computational experiments have been conducted to confirm the good performance of the proposed procedures.

Efficient Bounding Schemes for the Two-Center Hybrid Flow Shop Scheduling Problem with Removal Times

PubMed Central

2014-01-01

We focus on the two-center hybrid flow shop scheduling problem with identical parallel machines and removal times. The job removal time is the required duration to remove it from a machine after its processing. The objective is to minimize the maximum completion time (makespan). A heuristic and a lower bound are proposed for this NP-Hard problem. These procedures are based on the optimal solution of the parallel machine scheduling problem with release dates and delivery times. The heuristic is composed of two phases. The first one is a constructive phase in which an initial feasible solution is provided, while the second phase is an improvement one. Intensive computational experiments have been conducted to confirm the good performance of the proposed procedures. PMID:25610911

Implementing a Cardiac Skills Orientation and Simulation Program.

PubMed

Hemingway, Maureen W; Osgood, Patrice; Mannion, Mildred

2018-02-01

Patients with cardiac morbidities admitted for cardiac surgical procedures require perioperative nurses with a high level of complex nursing skills. Orienting new cardiac team members takes commitment and perseverance in light of variable staffing levels, high-acuity patient populations, an active cardiac surgical schedule, and the unpredictability of scheduling patients undergoing cardiac transplantation. At an academic medical center in Boston, these issues presented opportunities to orient new staff members to the scrub person role, but hampered efforts to provide active learning opportunities in a safe environment. As a result, facility personnel created a program to increase new staff members' skills, confidence, and proficiency, while also increasing the number of staff members who were proficient at scrubbing complex cardiac procedures. To address the safe learning requirement, personnel designed a simulation program to provide scrubbing experience, decrease orientees' supervision time, and increase staff members' confidence in performing the scrub person role. © AORN, Inc, 2018.

Report of the 90-day study on human exploration of the Moon and Mars

NASA Technical Reports Server (NTRS)

1989-01-01

The basic mission sequence to achieve the President's goal is clear: begin with Space Station Freedom in the 1990's, return to the Moon to stay early in the Next century, and then journey to Mars. Five reference approaches are modeled building on past programs and recent studies to reflect wide-ranging strategies that incorporate varied program objectives, schedules, technologies, and resource availabilities. The reference approaches are (1) balance and speed; (2) the earliest possible landing on Mars; (3) reduce logistics from Earth; (4) schedule adapted to Space Station Freedom; and (5) reduced scales. The study and programmatic assessment have shown that the Human Exploration Initiative is indeed a feasible approach to achieving the President's goals. Several reasonable alternatives exist, but a long-range commitment and significant resources will be required. However, the value of the program and the benefits to the Nation are immeasurable.

Communication in health care delivery in developing countries: which way out?

PubMed

Olutimayin, Jide

2002-09-01

Most governments in developing countries have adopted frameworks for health development which stressed community based initiatives and intervention at all levels of the health pyramid (WHO, 1992). But even today, most of the rural communities in these countries are still not developed in terms of available health facilities. What then is/are responsible for these failures? Various authors have come up with various reasons, principal amongst which are inadequate resources, lack of planning, insincerity/non-commitment of the governments, lack of modern information technology, etc. This paper examines some of these factors in relation to how they accentuate or hamper healthcare delivery in developing countries, using African rural communities as a study field. The resultant suggestions are a consortium of varying factors, some of which are economic in nature, policy changes, human resources development, and re-orientation of social and government attitudes towards achieving meaningful results in healthcare delivery, particularly in the rural communities.

Hydrogel microfluidics for the patterning of pluripotent stem cells

NASA Astrophysics Data System (ADS)

Cosson, S.; Lutolf, M. P.

2014-03-01

Biomolecular signaling is of utmost importance in governing many biological processes such as the patterning of the developing embryo where biomolecules regulate key cell-fate decisions. In vivo, these factors are presented in a spatiotemporally tightly controlled fashion. Although state-of-the-art microfluidic technologies allow precise biomolecule delivery in time and space, long-term (stem) cell culture at the micro-scale is often far from ideal due to medium evaporation, limited space for cell growth or shear stress. To overcome these challenges, we here introduce a concept based on hydrogel microfluidics for decoupling conventional, macro-scale cell culture from precise biomolecule delivery through a gel layer. We demonstrate the spatiotemporally controlled neuronal commitment of mouse embryonic stem cells via delivery of retinoic acid gradients. This technique should be useful for testing the effect of dose and timing of biomolecules, singly or in combination, on stem cell fate.

Patient Populations, Clinical Associations, and System Efficiency in Healthcare Delivery System

NASA Astrophysics Data System (ADS)

Liu, Yazhuo

The efforts to improve health care delivery usually involve studies and analysis of patient populations and healthcare systems. In this dissertation, I present the research conducted in the following areas: identifying patient groups, improving treatments for specific conditions by using statistical as well as data mining techniques, and developing new operation research models to increase system efficiency from the health institutes' perspective. The results provide better understanding of high risk patient groups, more accuracy in detecting disease' correlations and practical scheduling tools that consider uncertain operation durations and real-life constraints.

7 CFR 274.2 - Providing benefits to participants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... throughout the month, or for a shorter period. When staggering benefit delivery, however, State agencies... household participating longer than two consecutive, complete months. Regardless of the issuance schedule... resumes through the end of the month or over a five-day period following the resumption of issuance, even...

7 CFR 274.2 - Providing benefits to participants.

Code of Federal Regulations, 2011 CFR

2011-01-01

... throughout the month, or for a shorter period. When staggering benefit delivery, however, State agencies... household participating longer than two consecutive, complete months. Regardless of the issuance schedule... resumes through the end of the month or over a five-day period following the resumption of issuance, even...

7 CFR 274.2 - Providing benefits to participants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... throughout the month, or for a shorter period. When staggering benefit delivery, however, State agencies... household participating longer than two consecutive, complete months. Regardless of the issuance schedule... resumes through the end of the month or over a five-day period following the resumption of issuance, even...

Gaps in the Body of Knowledge of Systems Engineering

DTIC Science & Technology

2012-07-01

practices, agile development, Kanban , risk management, and decision management. This focus is being driven by the need to reduce time for delivery of...to incorporate Kanban approaches to scheduling the SE activities based on value. Rapid Fielding. In this situation, there is a short time to

An Academic Library's Experience with Fee-Based Services.

ERIC Educational Resources Information Center

Hornbeck, Julia W.

1983-01-01

Profile of fee-based information services offered by the Information Exchange Center of Georgia Institute of Technology notes history and background, document delivery to commercial clients and on-campus faculty, online and manual literature searching, staff, cost analysis, fee schedule, operating methods, client relations, marketing, and current…

KSC-01pp1362

NASA Image and Video Library

2001-07-19

KENNEDY SPACE CENTER, Fla. -- The P5 truss rolls into the Spaceport Florida hangar just before a rain storm. The truss eventually will be transported to the Space Station Processing Facility. The P5 is scheduled for delivery to the International Space Station on mission 12A.1 in April 2003

75 FR 28612 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... Agency Information Collection Activities; Comment Request AGENCIES: Office of the Comptroller of the..., Mailstop 2-3, Attention: 1557-0081, 250 E Street, SW., Washington, DC 20219. In addition, comments may be... 20552, Attention: ``1550-0023 (TFR: Schedule DI Revisions).'' Hand Delivery/Courier: Guard's Desk, East...

48 CFR 52.232-30 - Installment Payments for Commercial Items.

Code of Federal Regulations, 2011 CFR

2011-10-01

... contract line item. For example, if the first scheduled delivery of any separately priced unit of a... REGULATION (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and... financing payments. The Contractor may request, and the Government shall pay, a contract financing...

Alternative Classroom Management and Instructional Delivery Systems in Business Education.

ERIC Educational Resources Information Center

Smith, Douglas C.; Davis, Diane C.; Everett, Donna R.; Kruger, Diane; McLaren, Constance H.; Morse, H. Pauletta; Nelson, Sandra J.; Smith, Gloria Jean; Yacht, Carol; Yohon, Teresa

Identifies and assesses various nontraditional approaches to business education in high school, university, and graduate school. "Block Scheduling: Considerations for Business Education" (Gloria Jean Smith, Douglas C. Smith) describes ways to maximize learning for high school students by restructuring class time. "Distance Learning: Challenges and…

Comprehensive analysis of a Radiology Operations Management computer system.

PubMed

Arenson, R L; London, J W

1979-11-01

The Radiology Operations Management computer system at the Hospital of the University of Pennsylvania is discussed. The scheduling and file room modules are based on the system at Massachusetts General Hospital. Patient delays are indicated by the patient tracking module. A reporting module allows CRT/keyboard entry by transcriptionists, entry of standard reports by radiologists using bar code labels, and entry by radiologists using a specialty designed diagnostic reporting terminal. Time-flow analyses demonstrate a significant improvement in scheduling, patient waiting, retrieval of radiographs, and report delivery. Recovery of previously lost billing contributes to the proved cost effectiveness of this system.

Multiplexing Low and High QoS Workloads in Virtual Environments

NASA Astrophysics Data System (ADS)

Verboven, Sam; Vanmechelen, Kurt; Broeckhove, Jan

Virtualization technology has introduced new ways for managing IT infrastructure. The flexible deployment of applications through self-contained virtual machine images has removed the barriers for multiplexing, suspending and migrating applications with their entire execution environment, allowing for a more efficient use of the infrastructure. These developments have given rise to an important challenge regarding the optimal scheduling of virtual machine workloads. In this paper, we specifically address the VM scheduling problem in which workloads that require guaranteed levels of CPU performance are mixed with workloads that do not require such guarantees. We introduce a framework to analyze this scheduling problem and evaluate to what extent such mixed service delivery is beneficial for a provider of virtualized IT infrastructure. Traditionally providers offer IT resources under a guaranteed and fixed performance profile, which can lead to underutilization. The findings of our simulation study show that through proper tuning of a limited set of parameters, the proposed scheduling algorithm allows for a significant increase in utilization without sacrificing on performance dependability.

Costs of vaccine programs across 94 low- and middle-income countries.

PubMed

Portnoy, Allison; Ozawa, Sachiko; Grewal, Simrun; Norman, Bryan A; Rajgopal, Jayant; Gorham, Katrin M; Haidari, Leila A; Brown, Shawn T; Lee, Bruce Y

2015-05-07

While new mechanisms such as advance market commitments and co-financing policies of the GAVI Alliance are allowing low- and middle-income countries to gain access to vaccines faster than ever, understanding the full scope of vaccine program costs is essential to ensure adequate resource mobilization. This costing analysis examines the vaccine costs, supply chain costs, and service delivery costs of immunization programs for routine immunization and for supplemental immunization activities (SIAs) for vaccines related to 18 antigens in 94 countries across the decade, 2011-2020. Vaccine costs were calculated using GAVI price forecasts for GAVI-eligible countries, and assumptions from the PAHO Revolving Fund and UNICEF for middle-income countries not supported by the GAVI Alliance. Vaccine introductions and coverage levels were projected primarily based on GAVI's Adjusted Demand Forecast. Supply chain costs including costs of transportation, storage, and labor were estimated by developing a mechanistic model using data generated by the HERMES discrete event simulation models. Service delivery costs were abstracted from comprehensive multi-year plans for the majority of GAVI-eligible countries and regression analysis was conducted to extrapolate costs to additional countries. The analysis shows that the delivery of the full vaccination program across 94 countries would cost a total of $62 billion (95% uncertainty range: $43-$87 billion) over the decade, including $51 billion ($34-$73 billion) for routine immunization and $11 billion ($7-$17 billion) for SIAs. More than half of these costs stem from service delivery at $34 billion ($21-$51 billion)-with an additional $24 billion ($13-$41 billion) in vaccine costs and $4 billion ($3-$5 billion) in supply chain costs. The findings present the global costs to attain the goals envisioned during the Decade of Vaccines to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all communities. By projecting the full costs of immunization programs, our findings may aid to garner greater country and donor commitments toward adequate resource mobilization and efficient allocation. As service delivery costs have increasingly become the main driver of vaccination program costs, it is essential to pay additional consideration to health systems strengthening. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessment & Commitment Tracking System (ACTS)

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

Bryant, Robert A.; Childs, Teresa A.; Miller, Michael A.

2004-12-20

The ACTS computer code provides a centralized tool for planning and scheduling assessments, tracking and managing actions associated with assessments or that result from an event or condition, and "mining" data for reporting and analyzing information for improving performance. The ACTS application is designed to work with the MS SQL database management system. All database interfaces are written in SQL. The following software is used to develop and support the ACTS application: Cold Fusion HTML JavaScript Quest TOAD Microsoft Visual Source Safe (VSS) HTML Mailer for sending email Microsoft SQL Microsoft Internet Information Server

Evaluating alternative refrigerants for high ambient temperature environments

DOE PAGES

Abdelaziz, Omar; Shrestha, Som S.

2016-01-01

According to the Montreal Protocol, developing countries have started the phase out schedule of the ozone depleting substances, including HCFC refrigerants, in 2015 and expect them to reach 35% reduction in 2020. This commitment to the start the phase out of HCFC refrigerants, especially R-22, in developing countries is seen as an opportunity to introduce lower Global Warming Potential (GWP) refrigerants. Furthermore, this paper summarizes an investigation into the performance of lower GWP refrigerants in high ambient temperature environments, experienced in some of the developed countries, in mini-split air conditioning units.

Ensuring the Reliable Operation of the Power Grid: State-Based and Distributed Approaches to Scheduling Energy and Contingency Reserves

NASA Astrophysics Data System (ADS)

Prada, Jose Fernando

Keeping a contingency reserve in power systems is necessary to preserve the security of real-time operations. This work studies two different approaches to the optimal allocation of energy and reserves in the day-ahead generation scheduling process. Part I presents a stochastic security-constrained unit commitment model to co-optimize energy and the locational reserves required to respond to a set of uncertain generation contingencies, using a novel state-based formulation. The model is applied in an offer-based electricity market to allocate contingency reserves throughout the power grid, in order to comply with the N-1 security criterion under transmission congestion. The objective is to minimize expected dispatch and reserve costs, together with post contingency corrective redispatch costs, modeling the probability of generation failure and associated post contingency states. The characteristics of the scheduling problem are exploited to formulate a computationally efficient method, consistent with established operational practices. We simulated the distribution of locational contingency reserves on the IEEE RTS96 system and compared the results with the conventional deterministic method. We found that assigning locational spinning reserves can guarantee an N-1 secure dispatch accounting for transmission congestion at a reasonable extra cost. The simulations also showed little value of allocating downward reserves but sizable operating savings from co-optimizing locational nonspinning reserves. Overall, the results indicate the computational tractability of the proposed method. Part II presents a distributed generation scheduling model to optimally allocate energy and spinning reserves among competing generators in a day-ahead market. The model is based on the coordination between individual generators and a market entity. The proposed method uses forecasting, augmented pricing and locational signals to induce efficient commitment of generators based on firm posted prices. It is price-based but does not rely on multiple iterations, minimizes information exchange and simplifies the market clearing process. Simulations of the distributed method performed on a six-bus test system showed that, using an appropriate set of prices, it is possible to emulate the results of a conventional centralized solution, without need of providing make-whole payments to generators. Likewise, they showed that the distributed method can accommodate transactions with different products and complex security constraints.

Incorporating Wind Power Forecast Uncertainties Into Stochastic Unit Commitment Using Neural Network-Based Prediction Intervals.

PubMed

Quan, Hao; Srinivasan, Dipti; Khosravi, Abbas

2015-09-01

Penetration of renewable energy resources, such as wind and solar power, into power systems significantly increases the uncertainties on system operation, stability, and reliability in smart grids. In this paper, the nonparametric neural network-based prediction intervals (PIs) are implemented for forecast uncertainty quantification. Instead of a single level PI, wind power forecast uncertainties are represented in a list of PIs. These PIs are then decomposed into quantiles of wind power. A new scenario generation method is proposed to handle wind power forecast uncertainties. For each hour, an empirical cumulative distribution function (ECDF) is fitted to these quantile points. The Monte Carlo simulation method is used to generate scenarios from the ECDF. Then the wind power scenarios are incorporated into a stochastic security-constrained unit commitment (SCUC) model. The heuristic genetic algorithm is utilized to solve the stochastic SCUC problem. Five deterministic and four stochastic case studies incorporated with interval forecasts of wind power are implemented. The results of these cases are presented and discussed together. Generation costs, and the scheduled and real-time economic dispatch reserves of different unit commitment strategies are compared. The experimental results show that the stochastic model is more robust than deterministic ones and, thus, decreases the risk in system operations of smart grids.

48 CFR 227.7103-2 - Acquisition of technical data.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Identify the type and quantity of the technical data to be delivered under the contract and the format and...-price type contract; (4) Include delivery schedules and acceptance criteria for each deliverable data... data. 227.7103-2 Section 227.7103-2 Federal Acquisition Regulations System DEFENSE ACQUISITION...

48 CFR 227.7103-2 - Acquisition of technical data.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Identify the type and quantity of the technical data to be delivered under the contract and the format and...-price type contract; (4) Include delivery schedules and acceptance criteria for each deliverable data... data. 227.7103-2 Section 227.7103-2 Federal Acquisition Regulations System DEFENSE ACQUISITION...

48 CFR 227.7103-2 - Acquisition of technical data.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Identify the type and quantity of the technical data to be delivered under the contract and the format and...-price type contract; (4) Include delivery schedules and acceptance criteria for each deliverable data... data. 227.7103-2 Section 227.7103-2 Federal Acquisition Regulations System DEFENSE ACQUISITION...

48 CFR 227.7103-2 - Acquisition of technical data.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Identify the type and quantity of the technical data to be delivered under the contract and the format and...-price type contract; (4) Include delivery schedules and acceptance criteria for each deliverable data... data. 227.7103-2 Section 227.7103-2 Federal Acquisition Regulations System DEFENSE ACQUISITION...

48 CFR 227.7103-2 - Acquisition of technical data.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Identify the type and quantity of the technical data to be delivered under the contract and the format and...-price type contract; (4) Include delivery schedules and acceptance criteria for each deliverable data... data. 227.7103-2 Section 227.7103-2 Federal Acquisition Regulations System DEFENSE ACQUISITION...

41 CFR 51-2.4 - Determination of suitability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Determination of suitability. 51-2.4 Section 51-2.4 Public Contracts and Property Management Other Provisions Relating to... performed and that it will have the capability to meet Government quality standards and delivery schedules...

20 CFR 628.420 - Job training plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Job training plan. 628.420 Section 628.420... THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.420 Job training plan. (a) The Governor shall issue instructions and schedules to assure that job training plans and plan modifications...

20 CFR 628.420 - Job training plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Job training plan. 628.420 Section 628.420... THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.420 Job training plan. (a) The Governor shall issue instructions and schedules to assure that job training plans and plan modifications...

77 FR 44721 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... Classification of Diseases IMRT Intensity Modulated Radiation Therapy IOM Internet-only Manual IPCI Indirect... RIA Regulatory impact analysis RVU Relative value unit SBRT Stereotactic body radiation therapy SGR... adjust the payment rates for two common radiation oncology treatment delivery methods, intensity...

41 CFR 51-2.4 - Determination of suitability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Determination of suitability. 51-2.4 Section 51-2.4 Public Contracts and Property Management Other Provisions Relating to... performed and that it will have the capability to meet Government quality standards and delivery schedules...

Boeing engineers perform air flow balance testing.

NASA Image and Video Library

2017-10-05

Boeing engineers, Chris Chapman, left, Greg Clark, center, and Ashesh Patel, right, perform air flow balance testing on NASA's new Basic Express Racks. The racks, developed at Marshall, will expand the capabilities for science research aboard the International Space Station. Delivery to the station is scheduled for late 2018.

Perpetual Enrollment Online Courses: Advantages, Administration, and Caveats

ERIC Educational Resources Information Center

Fekula, Michael J.

2010-01-01

Although the advent of online learning has revolutionized the delivery of education, from the average student's perspective there have been few radical innovations in the general administration of pure online courses since their inception. With some exceptions the scheduling of online courses generally aligns with the university calendar, while…

20 CFR 628.420 - Job training plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Job training plan. 628.420 Section 628.420... THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.420 Job training plan. (a) The Governor shall issue instructions and schedules to assure that job training plans and plan modifications...

Restructuring the Guidance Delivery System: Implications for High School Counselors.

ERIC Educational Resources Information Center

Greer, Richard M.; Richardson, Michael D.

1992-01-01

Notes that large portion of high school counselor's clientele, working parents, are not available during regular school hours. Suggests model program using flexible scheduling for high school counselors designed to address the issues of a changing clientele, a changing society, and changing expectation of counselors and schools. (NB)

The face of equipoise - delivering a structured education programme within a randomized controlled trial: qualitative study

PubMed Central

2014-01-01

Background In trials of behavioural interventions, the individuals who deliver the intervention are in a position of key influence on the success of the trial. Their fidelity to the intervention is crucial. Yet little is understood about the experiences of this group of trial personnel. This study aimed to investigate the views and experiences of educators who delivered a structured education intervention to people with type 2 diabetes, which incorporated training in self-monitoring of either blood glucose (SMBG) or urine glucose (SMUG) as part of a randomized controlled trial (RCT). Methods Educators’ views were explored through focus groups before and after training (N = 18) and approximately 1 year into the trial (N = 14), and semi-structured telephone interviews at approximately 2 years (N = 7). Analysis was based on the constant comparative method. Results Educators held preferences regarding the intervention variants; thus, they were not in individual equipoise. Training raised awareness of preferences and their potential to impact on delivery. Educators were confident in their unbiased delivery, but acknowledged the challenges involved. Concealing their preferences was helped by a sense of professionalism, the patient-centred nature of the intervention, and concessions in the trial protocol (enabling participants to swap monitoring methods if needed). Commitment to unbiased delivery was explained through a desire for evidence-based knowledge in the contentious area of SMBG. Conclusions The findings provide insight into a previously unexplored group of trial personnel - intervention deliverers in trials of behavioural interventions - which will be useful to those designing and running similar trials. Rather than individual equipoise, it is intervention deliverers’ awareness of personal preferences and their potential impact on the trial outcome that facilitates unbiased delivery. Further, awareness of community equipoise, the need for evidence, and relevance to the individual enhance commitment to the RCT. Trial registration ISRCTN95696668 PMID:24405854

An application of Extended Normalisation Process Theory in a randomised controlled trial of a complex social intervention: Process evaluation of the Strengthening Families Programme (10-14) in Wales, UK.

PubMed

Segrott, Jeremy; Murphy, Simon; Rothwell, Heather; Scourfield, Jonathan; Foxcroft, David; Gillespie, David; Holliday, Jo; Hood, Kerenza; Hurlow, Claire; Morgan-Trimmer, Sarah; Phillips, Ceri; Reed, Hayley; Roberts, Zoe; Moore, Laurence

2017-12-01

Process evaluations generate important data on the extent to which interventions are delivered as intended. However, the tendency to focus only on assessment of pre-specified structural aspects of fidelity has been criticised for paying insufficient attention to implementation processes and how intervention-context interactions influence programme delivery. This paper reports findings from a process evaluation nested within a randomised controlled trial of the Strengthening Families Programme 10-14 (SFP 10-14) in Wales, UK. It uses Extended Normalisation Process Theory to theorise how interaction between SFP 10-14 and local delivery systems - particularly practitioner commitment/capability and organisational capacity - influenced delivery of intended programme activities: fidelity (adherence to SFP 10-14 content and implementation requirements); dose delivered; dose received (participant engagement); participant recruitment and reach (intervention attendance). A mixed methods design was utilised. Fidelity assessment sheets (completed by practitioners), structured observation by researchers, and routine data were used to assess: adherence to programme content; staffing numbers and consistency; recruitment/retention; and group size and composition. Interviews with practitioners explored implementation processes and context. Adherence to programme content was high - with some variation, linked to practitioner commitment to, and understanding of, the intervention's content and mechanisms. Variation in adherence rates was associated with the extent to which multi-agency delivery team planning meetings were held. Recruitment challenges meant that targets for group size/composition were not always met, but did not affect adherence levels or family engagement. Targets for staffing numbers and consistency were achieved, though capacity within multi-agency networks reduced over time. Extended Normalisation Process Theory provided a useful framework for assessing implementation and explaining variation by examining intervention-context interactions. Findings highlight the need for process evaluations to consider both the structural and process components of implementation to explain whether programme activities are delivered as intended and why.

Home Visitations for Delivering an Early Childhood Obesity Intervention in Denver: Parent and Patient Navigator Perspectives.

PubMed

Knierim, Shanna Doucette; Moore, Susan L; Raghunath, Silvia Gutiérrez; Yun, Lourdes; Boles, Richard E; Davidson, Arthur J

2018-06-23

Objective This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. Methods Three patient navigators and 25 parents who participated in a home-based, childhood obesity program participated in focus groups or interviews. Emergent themes were identified through content analysis of qualitative data. Results Three overall themes were identified. Patient navigators and parents perceived: (1) enabling characteristics of home-based program delivery which facilitated family participation and/or behavior change (i.e., convenience, increased accountability, inclusion of household members, delivery in a familiar, intimate setting, and individualized pace and content); (2) logistic and cultural challenges to home-based delivery which reduced family participation and program reach (i.e., difficulties scheduling visits, discomfort with visitors in the home, and confusion about the patient navigator's role); and (3) remediable home-based delivery challenges which could be ameliorated by additional study staff (e.g., supervision of children, safety concerns) or through organized group sessions. Both patient navigators and participating parents discussed an interest in group classes with separate, supervised child-targeted programming and opportunities to engage with other families for social support. Conclusions for Practice A home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns. Conducting home visits in pairs, adding obesity prevention curriculum to existing home visiting programs, or pairing the convenience of home visits with group classes may be future strategies to explore.

Stock optimizing: maximizing reinforcers per session on a variable-interval schedule.

PubMed Central

Silberberg, A; Bauman, R; Hursh, S

1993-01-01

In Experiment 1, 2 monkeys earned their daily food ration by pressing a key that delivered food according to a variable-interval 3-min schedule. In Phases 1 and 4, sessions ended after 3 hr. In Phases 2 and 3, sessions ended after a fixed number of responses that reduced food intake and body weights from levels during Phases 1 and 4. Monkeys responded at higher rates and emitted more responses per food delivery when the food earned in a session was reduced. In Experiment 2, monkeys earned their daily food ration by depositing tokens into the response panel. Deposits delivered food according to a variable-interval 3-min schedule. When the token supply was unlimited (Phases 1, 3, and 5), sessions ended after 3 hr. In Phases 2 and 4, sessions ended after 150 tokens were deposited, resulting in a decrease in food intake and body weight. Both monkeys responded at lower rates and emitted fewer responses per food delivery when the food earned in a session was reduced. Experiment 1's results are consistent with a strength account, according to which the phases that reduced body weights increased food's value and therefore increased subjects' response rates. The results of Experiment 2 are consistent with an optimizing strategy, because lowering response rates when food is restricted defends body weight on variable-interval schedules. These contrasting results may be attributed to the discriminability of the contingency between response number and the end of a session being greater in Experiment 2 than in Experiment 1. In consequence, subjects lowered their response rates in order to increase the number of reinforcers per session (stock optimizing). PMID:8454960

Parallel Discrete Molecular Dynamics Simulation With Speculation and In-Order Commitment*†

PubMed Central

Khan, Md. Ashfaquzzaman; Herbordt, Martin C.

2011-01-01

Discrete molecular dynamics simulation (DMD) uses simplified and discretized models enabling simulations to advance by event rather than by timestep. DMD is an instance of discrete event simulation and so is difficult to scale: even in this multi-core era, all reported DMD codes are serial. In this paper we discuss the inherent difficulties of scaling DMD and present our method of parallelizing DMD through event-based decomposition. Our method is microarchitecture inspired: speculative processing of events exposes parallelism, while in-order commitment ensures correctness. We analyze the potential of this parallelization method for shared-memory multiprocessors. Achieving scalability required extensive experimentation with scheduling and synchronization methods to mitigate serialization. The speed-up achieved for a variety of system sizes and complexities is nearly 6× on an 8-core and over 9× on a 12-core processor. We present and verify analytical models that account for the achieved performance as a function of available concurrency and architectural limitations. PMID:21822327

Parallel Discrete Molecular Dynamics Simulation With Speculation and In-Order Commitment.

PubMed

Khan, Md Ashfaquzzaman; Herbordt, Martin C

2011-07-20

Discrete molecular dynamics simulation (DMD) uses simplified and discretized models enabling simulations to advance by event rather than by timestep. DMD is an instance of discrete event simulation and so is difficult to scale: even in this multi-core era, all reported DMD codes are serial. In this paper we discuss the inherent difficulties of scaling DMD and present our method of parallelizing DMD through event-based decomposition. Our method is microarchitecture inspired: speculative processing of events exposes parallelism, while in-order commitment ensures correctness. We analyze the potential of this parallelization method for shared-memory multiprocessors. Achieving scalability required extensive experimentation with scheduling and synchronization methods to mitigate serialization. The speed-up achieved for a variety of system sizes and complexities is nearly 6× on an 8-core and over 9× on a 12-core processor. We present and verify analytical models that account for the achieved performance as a function of available concurrency and architectural limitations.

Comprehensive Cancer Screening among Unmarried Women Aged 40–75 Years: Results from the Cancer Screening Project for Women

PubMed Central

Rogers, Michelle L.; Armstrong, Gene F.; Rakowski, William; Bowen, Deborah J.; Hughes, Tonda; McGarry, Kelly A.

2009-01-01

Abstract Objectives We explored self-reported rates of individual on-schedule breast, cervical, and colorectal cancer screenings, as well as an aggregate measure of comprehensive screenings, among unmarried women aged 40–75 years. We compared women who partner with women (WPW) or with women and men (WPWM) to women who partner exclusively with men (WPM). We also compared barriers to on-schedule cancer screenings between WPW/WPWM and WPM. Methods Comparable targeted and respondent-driven sampling methods were used to enroll 213 WPW/WPWM and 417 WPM (n = 630). Logistic regression models were computed to determine if partner gender was associated with each measure of on-schedule screening after controlling for demographic characteristics, health behaviors, and cancer-related experiences. Results Overall, 74.3% of women reported on-schedule breast screening, 78.3% reported on-schedule cervical screening, 66.5% reported on-schedule colorectal screening, and 56.7% reported being on-schedule for comprehensive screening. Partner gender was not associated with any of the measures of on-schedule screening in multivariable analyses. However, women who reported ever putting off, avoiding, or changing the place of screenings because of sexual orientation were less likely to be on-schedule for comprehensive screening. Women who reported barriers associated with taking time from work and body image concerns were also less likely to be on-schedule for comprehensive screening. Conclusions Barriers to cancer screening were comparable across types of examinations as well as between WPW/WPWM and WPM. Developing health promotion programs for unmarried women that address concomitant detection and prevention behaviors may improve the efficiency and effectiveness of healthcare delivery and ultimately assist in reducing multiple disease risks. PMID:19361311

Impact of primary healthcare providers' initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial.

PubMed

Keurhorst, M; Anderson, P; Heinen, M; Bendtsen, Preben; Baena, Begoña; Brzózka, Krzysztof; Colom, Joan; Deluca, Paolo; Drummond, Colin; Kaner, Eileen; Kłoda, Karolina; Mierzecki, Artur; Newbury-Birch, Dorothy; Okulicz-Kozaryn, Katarzyna; Palacio-Vieira, Jorge; Parkinson, Kathryn; Reynolds, Jillian; Ronda, Gaby; Segura, Lidia; Słodownik, Luiza; Spak, Fredrik; van Steenkiste, Ben; Wallace, Paul; Wolstenholme, Amy; Wojnar, Marcin; Gual, Antoni; Laurant, M; Wensing, M

2016-07-16

Brief interventions in primary healthcare are cost-effective in reducing drinking problems but poorly implemented in routine practice. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation. In a cluster randomised factorial trial, 120 primary healthcare units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design. Data from 746 providers from 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore, there were no significant interactions between these characteristics and allocated implementation groups. The extent to which providers changed their brief intervention delivery following experience of different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research, more attention is needed to unravel the causal relation between practitioners' attitudes, their actual behaviour and care improvement strategies to enhance implementation science. ClinicalTrials.gov: NCT01501552.

Improving adolescent pregnancy outcomes and maternal health:a case study of comprehensive case managed services.

PubMed

Bowman, Elizabeth K; Palley, Howard A

2003-01-01

Our findings indicate how health outcomes regarding adolescent pregnancy and maternal and infant health care are intertwined with a case management process that fosters measures that are social in nature-the provision of direct services, as well as the encouragement of informal social supports systems. They also show how case managed services in a small, nongovernmental organization (NGO) with a strong commitment to its clients may provide the spontaneity and caring which results in a "match" between client needs and the delivery of services-and positive outcomes for pregnant women, early maternal health and infant health. The delivery of such case managed services in a manner which is intensive, comprehensive, flexible and integrated contributes significantly to such improved health outcomes.

Characterization of the effect of hyperthermia on nanoparticle extravasation from tumor vasculature.

PubMed

Kong, G; Braun, R D; Dewhirst, M W

2001-04-01

The efficacy of novel cancer therapeutics can be hampered by inefficient delivery of agents to the tumor at effective concentrations. Liposomes have been used as a method to overcome some delivery issues and, in combination with hyperthermia, have been shown to increase drug delivery to tumors. This study investigates the effects of a range of temperatures (34-42 degrees C) and hyperthermia treatment scheduling (time between hyperthermia and drug administration as well as between consecutive hyperthermia treatments) on the extravasation of nanoparticles (100-nm liposomes) from tumor microvasculature in a human tumor (SKOV-3 ovarian carcinoma) xenograft grown in athymic nude mouse window chambers. Under normothermic conditions (34 degrees C) and at 39 degrees C, nanoparticles were unable to extravasate into the tumor interstitium. From 40 to 42 degrees C, nanoparticle extravasation increased with temperature, reaching maximal extravasation at 42 degrees C. Temperatures higher than 42 degrees C led to hemorrhage and stasis in tumor vessels. Enhanced nanoparticle extravasation was observed several hours after heating, decaying back to baseline at 6 h postheating. Reheating (42 degrees C for 1 h) 8 h after an initial heating (42 degrees C for 1 h) did not result in any increased nanoparticle extravasation, indicating development of vascular thermotolerance. The results of this study have implications for the application and scheduling of hyperthermia combined with other therapeutics (e.g., liposomes, antibodies, and viral vectors) for the treatment of cancer.

Reporting Guidelines for Music-based Interventions

PubMed Central

Robb, Sheri L.; Burns, Debra S.; Carpenter, Janet S.

2013-01-01

Music-based interventions are used to address a variety of problems experienced by individuals across the developmental lifespan (infants to elderly adults). In order to improve the transparency and specificity of reporting music-based interventions, a set of specific reporting guidelines is recommended. Recommendations pertain to reporting seven different components of music-based interventions including intervention theory, intervention content, intervention delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Recommendations are intended to support CONSORT and TREND statements for transparent reporting of interventions while taking into account the variety, complexity, and uniqueness of music-based interventions. PMID:23646227

A diagnostic approach to understanding entrepreneurship in health care.

PubMed

McCleary, Karl J; Rivers, Patrick A; Schneller, Eugene S

2006-01-01

Health care is quite different from other industries because of its organizational structure, service delivery, and financing of health services. Balancing costs, quality, and access presents unique challenges for each stakeholder group committed to promoting the health and healing of its citizens. Using the diagnostic approach to health care entrepreneurship, we created a framework from research in the field to understand the predisposing, enabling, and reinforcing factors most relevant to successful entrepreneurship.

Combining service marketing and strategic alliances in health care.

PubMed

Lazarus, I R

1993-11-01

With or without federal health care reform to impact the delivery of health care services in the U.S., hospitals must commit to service marketing and strategic alliances as a fundamental business strategy. Service marketing not only differentiates the provider, but with the proper programs in place, it may actually facilitate the formation of strategic alliances. The combination of these strategies will be particularly effective in preparing for any health care policy change.

Multi-objective group scheduling optimization integrated with preventive maintenance

NASA Astrophysics Data System (ADS)

Liao, Wenzhu; Zhang, Xiufang; Jiang, Min

2017-11-01

This article proposes a single-machine-based integration model to meet the requirements of production scheduling and preventive maintenance in group production. To describe the production for identical/similar and different jobs, this integrated model considers the learning and forgetting effects. Based on machine degradation, the deterioration effect is also considered. Moreover, perfect maintenance and minimal repair are adopted in this integrated model. The multi-objective of minimizing total completion time and maintenance cost is taken to meet the dual requirements of delivery date and cost. Finally, a genetic algorithm is developed to solve this optimization model, and the computation results demonstrate that this integrated model is effective and reliable.

77 FR 52697 - Federal Acquisition Regulation; Submission for OMB Review; Delivery Schedules

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... Paperwork Reduction Act, the Regulatory Secretariat will be submitting to the Office of Management and... collection would violate the fundamental purposes of the Paperwork Reduction Act because of the burden it... information is a fundamental requirement already being provided as a part of a solicitation by the contracting...

KSC-01pp1364

NASA Image and Video Library

2001-07-19

KENNEDY SPACE CENTER, Fla. -- As night approaches, the P5 truss rolls away from the Spaceport Florida hangar where it waited out a rain storm. The truss is being transported to the Space Station Processing Facility. The P5 is scheduled for delivery to the International Space Station on mission 12A.1 in April 2003

75 FR 68856 - Agency Information Collection Activities: Submission for OMB Review; Joint Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-09

... Information Collection Activities: Submission for OMB Review; Joint Comment Request AGENCY: Office of the..., Mailstop 2-3, Attention: 1557-0081, 250 E Street, SW., Washington, DC 20219. In addition, comments may be... 20552, Attention: ``1550-0023 (TFR: Schedule DI Revisions).'' Hand Delivery/Courier: Guard's Desk, East...

Impact of feed delivery pattern on aerial particulate matter and behavior of feedlot cattle

USDA-ARS?s Scientific Manuscript database

Fine particulate matter (PM) generated by cattle in feedlots is an environmental pollutant and a potential human and animal health issue. The objective of this study was to determine if a feeding schedule affects cattle behaviors that promote PM in a commercial feedlot. The study used 2,813 crossbre...

15 CFR 745.1 - Advance notification and annual report of all exports of Schedule 1 chemicals to other States...

Code of Federal Regulations, 2010 CFR

2010-01-01

... address: Information Technology Team, Treaty Compliance Division, Bureau of Industry and Security, U.S... courier delivery to the following address: Information Technology Team, Treaty Compliance Division, Bureau... Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND...

Online Psychology: Trial and Error in Course Development

ERIC Educational Resources Information Center

Harman, Marsha J.

2009-01-01

Online courses appear to be the future if colleges and universities choose to increase enrollments with students who need more flexibility in scheduling. The challenge has been to create a course that is rigorous with the limitations to physical presence of the instructor and the parameters inherent in technological delivery. This article relates…

Efficient Evaluation System for Learning Management Systems

ERIC Educational Resources Information Center

Cavus, Nadire

2009-01-01

A learning management system (LMS) provides the platform for web-based learning environment by enabling the management, delivery, tracking of learning, testing, communication, registration process and scheduling. There are many LMS systems on the market that can be obtained for free or through payment. It has now become an important task to choose…

A New Intelligent Tutoring System

ERIC Educational Resources Information Center

Ford, Lindsey

2008-01-01

Early in 1984, Logica started an ICAI research contract with MoD (Procurement Executive), which was to be undertaken in collaboration with the technical authority at the Royal Signals and Radar Establishment, Malvern. A prototype system, which has become known as TUTOR, was scheduled for delivery to the client later in 1985. Initially, and for…

Improving quality and patient satisfaction in a pediatric resident continuity clinic through advanced access scheduling.

PubMed

Tuli, Sanjeev Y; Thompson, Lindsay A; Ryan, Kathleen A; Srinivas, Ganga L; Fillipps, Donald J; Young, Christopher M; Tuli, Sonal S

2010-06-01

To evaluate the impact of advanced access scheduling in a pediatric residency clinic on resident and patient satisfaction, medical education, practice quality, and efficiency. Residents were assigned to either the advanced access template (10 appointments available to patients and 2 physician overbooks) or the prior template (5 available and 8 overbooks). Outcomes included resident and patient satisfaction, appointment availability, and continuity of care and clinic costs. Patient satisfaction improved in 7 areas (P < .001). Residents in either template did not report an impact on medical education experiences. Significant increases were realized with appointment availability and the number of patients seen. Continuity also increased as the overflow/acute visits decreased (P < .001). Overall costs per visit decreased 22%. Because of the significant improvements in access, continuity, and efficiency, all residents were switched to the advanced access template after completion of the study. Improvement in access to the primary physician has a significant impact on patient satisfaction with health care delivery. This model optimizes the limited time that residents have in continuity clinic, and it has implications for health care delivery quality improvement.

An ant colony optimization heuristic for an integrated production and distribution scheduling problem

NASA Astrophysics Data System (ADS)

Chang, Yung-Chia; Li, Vincent C.; Chiang, Chia-Ju

2014-04-01

Make-to-order or direct-order business models that require close interaction between production and distribution activities have been adopted by many enterprises in order to be competitive in demanding markets. This article considers an integrated production and distribution scheduling problem in which jobs are first processed by one of the unrelated parallel machines and then distributed to corresponding customers by capacitated vehicles without intermediate inventory. The objective is to find a joint production and distribution schedule so that the weighted sum of total weighted job delivery time and the total distribution cost is minimized. This article presents a mathematical model for describing the problem and designs an algorithm using ant colony optimization. Computational experiments illustrate that the algorithm developed is capable of generating near-optimal solutions. The computational results also demonstrate the value of integrating production and distribution in the model for the studied problem.

Increased impulsive choice for saccharin during PCP withdrawal in female monkeys: influence of menstrual cycle phase

PubMed Central

Carroll, Marilyn E.; Kohl, Emily A.; Johnson, Krista M.; LaNasa, Rachel M.

2013-01-01

Background In previous studies with male and female rhesus monkeys withdrawal of access to oral phencyclidine (PCP) self administration reduced responding for food under a high fixed-ratio (FR) schedule more in males than females and with a delay discounting (DD) task with saccharin (SACC) as the reinforcer. Impulsive choice for SACC increased during PCP withdrawal more than females. Objectives The goal of the present study was to examine the effect of PCP (0.25 or 0.5 mg/ml) withdrawal on impulsive choice for SACC in females during the follicular and luteal phases of the menstrual cycle. Materials and methods In Component 1 PCP and water were available from 2 drinking spouts for 1.5 h sessions under concurrent FR 16 schedules. In Component 2 a SACC solution was available for 45 min under a DD schedule. Monkeys had a choice of one immediate SACC delivery (0.6 ml) or 6 delayed SACC deliveries, and the delay was increased by 1 sec after a response on the delayed lever and decreased by 1 sec after a response on the immediate lever. There was then a 10-day water substitution phase, or PCP-withdrawal, that occurred during the mid-folllicular phase (Days 7–11) or the late-luteal (Days 24–28) phase of the menstrual cycle. Access to PCP and concurrent water was then restored, and the PCP withdrawal procedure was repeated over several follicular and luteal menstrual phases. Results PCP deliveries were higher during the luteal vs the follicular phase. Impulsive choice was greater during the luteal (vs follicular) phase during withdrawal of the higher PCP concentration. Conclusions PCP withdrawal was associated with elevated impulsive choice for SACC, especially in the luteal (vs follicular) phase of the menstrual cycle in female monkeys. PMID:23344553

Hypocretin/orexin antagonists decrease cocaine self-administration by female rhesus monkeys.

PubMed

Foltin, Richard W; Evans, Suzette M

2018-07-01

The hypocretin/orexin system is involved in regulating arousal, and much recent work demonstrates that decreasing hypocretin receptor-1 (HCRTr1) activity using antagonists decreases appetitive behavior, including stimulant drug self-administration and reinstatement. The present study determined the effects of hypocretin-1 and HCRTr1 antagonists on responding reinforced by intravenous (i.v.) cocaine self-administration (0.0125 - 0.05 mg/kg/infusion) in 5 female rhesus monkeys. Responding was examined using 3 schedules of reinforcement: 1) a Fixed interval 1 min, Fixed ratio 10 Chain schedule [FI 1-min (FR10:S)], 2) a Progressive Ratio (PR) schedule, and 3) a cocaine vs. candy. Choice schedule: the HCRTr1 antagonist SB-334867 (8-24 mg/kg, i.m.) decreased cocaine taking under the Chain schedule and PR schedule in all 5 monkeys and in 4 of the 5 monkeys under the Choice schedule. d- Amphetamine (0.06 - 0.25 mg/kg, i.m.), tested as a control manipulation, decreased cocaine taking in all 5 monkeys under the Chain schedule. The peptide hypocretin-1 (0.072 mg/kg, i.v.) increased cocaine taking in the monkeys with low rates of cocaine taking under the Chain (3/4) and Choice (4/5) schedules. Reinstatement of extinguished cocaine responding following response-independent delivery of a large dose of cocaine (0.3 mg/kg) was attenuated in 3 of the 5 monkeys by the HCRTr1 antagonist SB-334867. These data expand upon work accomplished in predominantly male rodents suggesting that the hypocretin system modulates the response to appetitive stimuli. A better understanding of this system offers promise as a novel approach in medication development for appetitive disorders. Copyright © 2018 Elsevier B.V. All rights reserved.

Default options and neonatal resuscitation decisions.

PubMed

Haward, Marlyse Frieda; Murphy, Ryan O; Lorenz, John M

2012-12-01

To determine whether presenting delivery room management options as defaults influences decisions to resuscitate extremely premature infants. Adult volunteers recruited from the world wide web were randomised to receive either resuscitation or comfort care as the delivery room management default option for a hypothetical delivery of a 23-week gestation infant. Participants were required to check a box to opt out of the default. The primary outcome measure was the proportion of respondents electing resuscitation. Data were analysed using χ(2) tests and multivariate logistic regression. Participants who were told the delivery room management default option was resuscitation were more likely to opt for resuscitation (OR 6.54 95% CI 3.85 to 11.11, p<0.001). This effect persisted on multivariate regression analysis (OR 7.00, 95% CI 3.97 to 12.36, p<0.001). Female gender, being married or in a committed relationship, being highly religious, experiences with prematurity, and favouring sanctity of life were significantly associated with decisions to resuscitate. Presenting delivery room options for extremely premature infants as defaults exert a significant effect on decision makers. The information structure of the choice task may act as a subtle form of manipulation. Further, this effect may operate in ways that a decision maker is not aware of and this raises questions of patient autonomy. Presenting delivery room options for extremely premature infants as defaults may compromise autonomous decision-making.

Surface-Satellite Measurements for Atmospheric Radiative Transfer (SMART)and Chemical, Optical and Microphysical Measurements of In-Situ Troposphere (COMMIT) Research Activities

NASA Technical Reports Server (NTRS)

Tsay, Si-Chee

2004-01-01

The GSFC SMART consists of a suite of remote sensing instruments, including many commercially available radiometers, spectrometer, interferometer, and three in-house developed inskuments: micro-pulse lidar (MPL), scanning microwave radiometer (SMiR), and sun-sky-surface photometer (S(sup 3)). SMART cover the spectral range from UV to microwave, and passive to active remote sensing. This is to enrich the EOS-like research activities (i.e., EOS validation, innovative investigations, and long-term local environmental observations). During past years, SMART has been deployed in many NASA supported field campaigns to collocate with satellite nadir overpass for intercomparisons, and for initializing model simulations. Built on the successful experience of SMART, we are currently developing a new ground-based in-situ sampling package, COMMIT, including measurements of trace gases (CO, SO2, NOx, and O3,) concentrations, fine/coarse particle sizers and chemical composition, single- and three-wavelength nephelometers, and surface meteorological probes. COMMIT is built for seeking a relationship between surface in-situ measurements and boundary layer characteristics. This is to enrich EOS-like research on removing boundary layer signal from the entire column from space observation - to deduce the stable (less variability) free-troposphere observations. The COMMIT will try its best to link the chemical, microphysical, and optical properties of the boundary layer with radiation. The next major activities for SMART-COMMIT are scheduled for 2004-2006 in BASE-ASIA and EAST-AIRE. The expected close collaboration of BASE-ASIA with various research projects in Asia (i.e., ABC in South Asia, led by Ramanathan et al.; EAST-AIRE in East Asia, led by Li et al.; and APEX in Northeast Asia, led by Nakajima et al.) will definitely provide a better understanding of the impact of the biomass burning and air pollutants on regional-to-global climate, hydrological and carbon cycles, and tropospheric chemistry in Asia.

HESTIA Commodities Exchange Pallet and Sounding Rocket Test Stand

NASA Technical Reports Server (NTRS)

Chaparro, Javier

2013-01-01

During my Spring 2016 internship, my two major contributions were the design of the Commodities Exchange Pallet and the design of a test stand for a 100 pounds-thrust sounding rocket. The Commodities Exchange Pallet is a prototype developed for the Human Exploration Spacecraft Testbed for Integration and Advancement (HESTIA) program. Under the HESTIA initiative the Commodities Exchange Pallet was developed as a method for demonstrating multi-system integration thru the transportation of In-Situ Resource Utilization produced oxygen and water to a human habitat. Ultimately, this prototype's performance will allow for future evaluation of integration, which may lead to the development of a flight capable pallet for future deep-space exploration missions. For HESTIA, my main task was to design the Commodities Exchange Pallet system to be used for completing an integration demonstration. Under the guidance of my mentor, I designed, both, the structural frame and fluid delivery system for the commodities pallet. The fluid delivery system includes a liquid-oxygen to gaseous-oxygen system, a water delivery system, and a carbon-dioxide compressors system. The structural frame is designed to meet safety and transportation requirements, as well as the ability to interface with the ER division's Portable Utility Pallet. The commodities pallet structure also includes independent instrumentation oxygen/water panels for operation and system monitoring. My major accomplishments for the commodities exchange pallet were the completion of the fluid delivery systems and the structural frame designs. In addition, parts selection was completed in order to expedite construction of the prototype, scheduled to begin in May of 2016. Once the commodities pallet is assembled and tested it is expected to complete a fully integrated transfer demonstration with the ISRU unit and the Environmental Control and Life Support System test chamber in September of 2016. In addition to the development of the Commodities Exchange Pallet, I also assisted in preparation for testing the upper stage of a sounding rocket developed as a Center Innovation Fund project. The main objective of this project is to demonstrate the integration between a propulsion system and a solid oxide fuel cell (SOFC). The upper stage and SOFC are scheduled to complete an integrated test in August of 2016. As part of preparation for scheduled testing, I was responsible for designing the upper stage's test stand/support structure and main engine plume deflector to be used during hot-fire testing (fig. 3). The structural components of the test stand need to meet safety requirements for operation of the propulsion system, which consist of a 100 pounds-thrust main engine and two 15 pounds-thrust reaction control thrusters. My main accomplishment for this project was the completion of the design and the parts selection for construction of the structure, scheduled to begin late April of 2016.

Associations Between Mistreatment by a Provider during Childbirth and Maternal Health Complications in Uttar Pradesh, India.

PubMed

Raj, Anita; Dey, Arnab; Boyce, Sabrina; Seth, Aparna; Bora, Siddhartha; Chandurkar, Dharmendra; Hay, Katherine; Singh, Kultar; Das, Arup Kumar; Chakraverty, Amit; Ramakrishnan, Aparajita; Shetye, Mrunal; Saggurti, Niranjan; Silverman, Jay G

2017-09-01

Objectives This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India. Methods Cross-sectional survey data were collected from women (N = 2639) who had delivered at 68 public health facilities in Uttar Pradesh, participating in a quality of care study. Participants were recruited from April to July 2015 and surveyed on demographics, mistreatment during childbirth (measure developed for this study, Cronbach's alpha = 0.70), and maternal health complications. Regression models assessed associations between mistreatment during childbirth and maternal complications, at delivery and postpartum, adjusting for demographics and pregnancy complications. Results Participants were aged 17-48 years, and 30.3% were scheduled caste/scheduled tribe. One in five (20.9%) reported mistreatment by their provider during childbirth, including discrimination and abuse; complications during delivery (e.g., obstructed labor) and postpartum (e.g., excessive bleeding) were reported by 45.8 and 41.5% of women, respectively. Health providers at delivery included staff nurses (81.8%), midwives (14.0%), and physicians (2.2%); Chi square analyses indicate that women were significantly more likely to report mistreatment when their provider was a nurse rather than a physician or midwife. Women reporting mistreatment by a provider during childbirth had higher odds of complications at delivery (AOR = 1.32; 95% CI 1.05-1.67) and postpartum (AOR = 2.12; 95% CI 1.67-2.68). Conclusions for Practice Mistreatment of women by their provider during childbirth is a pervasive health and human rights violation, and is associated with increased risk for maternal health complications in Uttar Pradesh. Efforts to improve quality of maternal care should include greater training and monitoring of providers to ensure respectful treatment of patients.

Willingness to participate in accountable care organizations: health care managers' perspective.

PubMed

Wan, Thomas T H; Demachkie Masri, Maysoun; Ortiz, Judith; Lin, Blossom Y J

2014-01-01

This study examines how health care managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors, and knowledge about ACOs as predictors. Propensity score matching and analysis are used to adjust the state and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, health care managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Health care managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACO participation. The perspective of health care managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of health care managers.

Who benefits from family support? Work schedule and family differences.

PubMed

Jennings, Kristen S; Sinclair, Robert R; Mohr, Cynthia D

2016-01-01

Prior research has demonstrated the benefits of family-supportive organization perceptions (FSOP) for reducing stress, increasing satisfaction, and increasing worker commitment; however, less research has studied health outcomes or possible differences in the effects of FSOP based on worker characteristics. The present study examined relationships between FSOP and health outcomes, as well as how those relationships may depend on work schedule and family differences. Using a sample of 330 acute care nurses, the findings indicated that FSOP predicted several health and well-being outcomes obtained 9 months later. Further, the relationships between FSOP and the outcome variables depended on some work schedule and family differences. In terms of family differences, FSOP was most strongly related to life satisfaction for those who cared for dependent adults. The relationship between FSOP and health outcomes of depression, musculoskeletal pain, and physical health symptoms were generally significant for workers with dependent children, but not significant for workers with no children. Regarding schedule differences, the relationship between FSOP and life satisfaction was significant for those on nonstandard (evening/night) shifts but not significant for standard day shift workers; however, there were no differences in FSOP relationships by number of hours worked per week. The findings demonstrate that FSOP may benefit some employees more than others. Such differences need to be incorporated into both future work-family theory development and into efforts to document the effectiveness of family-supportive policies, programs, and practices. (c) 2016 APA, all rights reserved).

A cross-domain communication resource scheduling method for grid-enabled communication networks

NASA Astrophysics Data System (ADS)

Zheng, Xiangquan; Wen, Xiang; Zhang, Yongding

2011-10-01

To support a wide range of different grid applications in environments where various heterogeneous communication networks coexist, it is important to enable advanced capabilities in on-demand and dynamical integration and efficient co-share with cross-domain heterogeneous communication resource, thus providing communication services which are impossible for single communication resource to afford. Based on plug-and-play co-share and soft integration with communication resource, Grid-enabled communication network is flexibly built up to provide on-demand communication services for gird applications with various requirements on quality of service. Based on the analysis of joint job and communication resource scheduling in grid-enabled communication networks (GECN), this paper presents a cross multi-domain communication resource cooperatively scheduling method and describes the main processes such as traffic requirement resolution for communication services, cross multi-domain negotiation on communication resource, on-demand communication resource scheduling, and so on. The presented method is to afford communication service capability to cross-domain traffic delivery in GECNs. Further research work towards validation and implement of the presented method is pointed out at last.

Accelerating the Whiteshell Laboratories Decommissioning Through the Implementation of a Projectized and Delivery-Focused Organization - 13074

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

Wilcox, Brian; Mellor, Russ; Michaluk, Craig

2013-07-01

Whiteshell Laboratories (WL) is a nuclear research site in Canada that was commissioned in 1964 by Atomic Energy of Canada Limited. It covers a total area of approximately 4,375 hectares (10,800 acres) and includes the main campus site, the Waste Management Area (WMA) and outer areas of land identified as not used for or impacted by nuclear development or operations. The WL site employed up to 1100 staff. Site activities included the successful operation of a 60 MW organic liquid-cooled research reactor from 1965 to 1985, and various research programs including reactor safety research, small reactor development, fuel development, biophysicsmore » and radiation applications, as well as work under the Canadian Nuclear Fuel Waste Management Program. In 1997, AECL made a business decision to discontinue research programs and operations at WL, and obtained government concurrence in 1998. The Nuclear Legacy Liabilities Program (NLLP) was established in 2006 by the Canadian Government to remediate nuclear legacy liabilities in a safe and cost effective manner, including the WL site. The NLLP is being implemented by AECL under the governance of a Natural Resources Canada (NRCan)/AECL Joint Oversight Committee (JOC). Significant progress has since been made, and the WL site currently holds the only Canadian Nuclear Safety Commission (CNSC) nuclear research site decommissioning license in Canada. The current decommissioning license is in place until the end of 2018. The present schedule planned for main campus decommissioning is 30 years (to 2037), followed by institutional control of the WMA until a National plan is implemented for the long-term management of nuclear waste. There is an impetus to advance work and complete decommissioning sooner. To accomplish this, AECL has added significant resources, reorganized and moved to a projectized environment. This presentation outlines changes made to the organization, the tools implemented to foster projectization, and the benefits and positive impacts on schedule and delivery. A revised organizational structure was implemented in two phases, starting 2011 April 1, to align WL staff with the common goal of decommissioning the site through the direction of the WL Decommissioning Project General Manager. On 2011 September 1, the second phase of the reorganization was implemented and WL Decommissioning staff was organized under five Divisions: Programs and Regulatory Compliance, General Site Services, Decommissioning Strategic Planning, Nuclear Facilities and Project Delivery. A new Mission, Vision and Objectives were developed for the project, and several productivity enhancements are being implemented. These include the use of an integrated and fully re-sourced Site Wide Schedule that is updated and reviewed at Plan-of-the-Week meetings, improved work distribution throughout the year, eliminating scheduling 'push' mentality, project scoreboards, work planning implementation, lean practices and various process improvement initiatives. A revised Strategic Plan is under development that reflects the improved project delivery capabilities. As a result of these initiatives, and a culture change towards a projectized approach, the decommissioning schedule will be advanced by approximately 10 years. (authors)« less

Failure mode and effects analysis as a performance improvement tool in trauma.

PubMed

Day, Suzanne; Dalto, Joseph; Fox, Jolene; Turpin, Melinda

2006-01-01

Performance improvement (PI) in the multiple systems injured patient frequently highlights areas for improvement in overall hospital care processes. Failure mode effects analysis (FMEA) is an effective tool to assess and prioritize areas of risk in clinical practice. Failure mode effects analysis is often initiated by a "near-miss" or concern for risk as opposed to a root cause analysis that is initiated solely after a sentinel event. In contrast to a root cause analysis, the FMEA looks more broadly at processes involved in the delivery of care. The purpose of this abstract was to demonstrate the usefulness of FMEA as a PI tool by describing an event and following the event through the healthcare delivery PI processes involved. During routine chart abstraction, a trauma registrar found that an elderly trauma patient admitted with a subdural hematoma inadvertently received heparin during the course of a dialysis treatment. Although heparin use was contraindicated in this patient, there were no sequelae as a result of the error. This case was reviewed by the trauma service PI committee and the quality improvement team, which initiated FMEA. An FMEA of inpatient dialysis process was conducted following this incident. The process included physician, nursing, and allied health representatives involved in dialysis. As part of the process, observations of dialysis treatments and staff interviews were conducted. Observation revealed that nurses generally left the patient's room and did not involve themselves in the dialysis process. A formal patient "pass-off" report was not done. Nurses did not review dialysis orders or reevaluate the treatment plan before treatment. We found that several areas of our current practice placed our patients at risk. 1. The nephrology consult/dialysis communication process was inconsistent. 2. Scheduling of treatments for chronic dialysis patients could occur without a formal consult or order. 3. RNs were not consistently involved in dialysis scheduling, setup, or treatment. 4. Dialysis technicians may exceed scope of practice (taking telephone orders) when scheduling of treatment occurred before consult and written orders. Near-miss events may be overlooked as opportunities for improvement in cases where no harm has come to the patient. As a result of our FMEA investigation, the following recommendations were made to improve hospital care delivery in those trauma patients who require inpatient dialysis: 1. Education of RNs about the dialysis process. 2. Implementation of a formal reporting process between the RN and the dialysis technician before the procedure is initiated. 3. RN supervision of dialysis treatments. 4. Use of a preprinted inpatient dialysis form. 5. Education of dialysis technicians regarding their scope of practice. 6. Improve notification process for scheduling dialysis procedures between units and dialysis coordinator (similar to x-ray scheduling). Our performance improvement focus has broadened to include all reported "near-miss" events in order to improve our healthcare delivery process before an event with sequelae occurs. We have found that using FMEA has greatly increased our ability to facilitate change across all services and departments within the hospital.

Physical therapy in preschool classrooms: successful integration of therapy into classroom routines.

PubMed

Sekerak, Darlene Massey; Kirkpatrick, Dana B; Nelson, Kristal C; Propes, June H

2003-01-01

This exploratory investigation identifies factors that contribute to success of physical therapy services delivered in the context of the daily routines in preschool classroom settings. Ten pediatric physical therapists from rural and urban communities across North Carolina served as informants during telephone interviews. Qualitative analysis of the data led to the identification of six major themes: interactions among classroom personnel, impact of the classroom environment, individual characteristics of the child, logistical considerations, administrative policies and practices, and service delivery options. All 10 informants shared the perception that the cooperation and commitment of the teacher was essential for successful incorporation of therapy activities in classroom routines. Furthermore, the informants agreed that multiple models of service delivery were necessary to meet the individual needs of children. These results lead the authors to question the wisdom of promoting any one service delivery model as "best practice" and suggest guidelines for successful integration of physical therapy in the preschool classroom.

Child-to-Child programme in the Philippine setting.

PubMed

Rabor, I F; Santos Ocampo, P D

1982-09-01

The Philippines is an archipelago with a growing population, largely rural, 50% of which is in the 0-14 years old age group. As noted by WHO (1978), the leading health problems are communicable diseases, malnutrition, poor environmental sanitation, malaria and schistosomiasis, rapid population growth, drug abuse and dependence. Health care delivery is hampered by insufficient number and maldistribution of personnel, health clinics and hospitals. The predominant attitude of curative rather than preventive approach to health problems shared by consumers and care givers alike, passive and meager participation if at all on the part of recipients also contribute to deficient health care delivery. Child-to-Child health programmes would be most useful in depressed areas of the country, especially in the rural setting and should be widely implemented if feasible. Data concerning the community involved will include resources, strengths and weaknesses, and degree of commitment from its members. We hope to have in the Philippines more experience in Child-to-Child programmes-health care delivery in the future.

Surfactant-based drug delivery systems for treating drug-resistant lung cancer.

PubMed

Kaur, Prabhjot; Garg, Tarun; Rath, Goutam; Murthy, R S R; Goyal, Amit K

2016-01-01

Among all cancers, lung cancer is the major cause of deaths. Lung cancer can be categorized into two classes for prognostic and treatment purposes: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Both categories of cancer are resistant to certain drugs. Various mechanisms behind drug resistance are over-expression of superficial membrane proteins [glycoprotein (P-gp)], lung resistance-associated proteins, aberration of the intracellular enzyme system, enhancement of the cell repair system and deregulation of cell apoptosis. Structure-performance relationships and chemical compatibility are consequently major fundamentals in surfactant-based formulations, with the intention that a great deal investigation is committed to this region. With the purpose to understand the potential of P-gp in transportation of anti-tumor drugs to cancer cells with much effectiveness and specificity, several surfactant-based delivery systems have been developed which may include microspheres, nanosized drug carriers (nanoparticles, nanoemulsions, stealth liposomes, nanogels, polymer-drug conjugates), novel powders, hydrogels and mixed micellar systems intended for systemic and/or localized delivery.

Applied Meteorology Unit (AMU)

NASA Technical Reports Server (NTRS)

Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Wheeler, Mark

2010-01-01

This report summarizes the Applied Meteorology Unit (AMU) activities for the first quarter of Fiscal Year 2010 (October - December 2009). A detailed project schedule is included in the Appendix. Included tasks are: (1) Peak Wind Tool for User Launch Commit Criteria (LCC), (2) Objective Lightning Probability Tool, Phase III, (3) Peak Wind Tool for General Forecasting, Phase II, (4) Upgrade Summer Severe Weather Tool in Meteorological Interactive Data Display System (MIDDS), (5) Advanced Regional Prediction System (ARPS) Data Analysis System (ADAS) Update and Maintainability, (5) Verify 12-km resolution North American Model (MesoNAM) Performance, and (5) Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) Graphical User Interface.

Assuring quality in high-consequence engineering

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

Hoover, Marcey L.; Kolb, Rachel R.

2014-03-01

In high-consequence engineering organizations, such as Sandia, quality assurance may be heavily dependent on staff competency. Competency-dependent quality assurance models are at risk when the environment changes, as it has with increasing attrition rates, budget and schedule cuts, and competing program priorities. Risks in Sandia's competency-dependent culture can be mitigated through changes to hiring, training, and customer engagement approaches to manage people, partners, and products. Sandia's technical quality engineering organization has been able to mitigate corporate-level risks by driving changes that benefit all departments, and in doing so has assured Sandia's commitment to excellence in high-consequence engineering and national service.

Models of education in medicine, public health, and engineering.

PubMed

Garcia, Patricia; Armstrong, Robert; Zaman, Muhammad H

2014-09-12

Discussion on global health in both the academic and the public domain has focused largely on research, capacity building, and service delivery. Although these efforts along with financial commitments from public and private partners have contributed to a broader appreciation and understanding of global health challenges, the reflection of global health in academic training has largely been lacking. However, integrative models are beginning to appear. Copyright © 2014, American Association for the Advancement of Science.

Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System.

PubMed

Foss Durant, Anne; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

2015-01-01

In early 2010, leaders within Kaiser Permanente (KP) Northern California's Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes.

Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System

PubMed Central

Durant, Anne Foss; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

2015-01-01

In early 2010, leaders within Kaiser Permanente (KP) Northern California’s Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes. PMID:26828076

The (political) economics of antiretroviral treatment in developing countries.

PubMed

Nattrass, Nicoli J

2008-12-01

Despite unprecedented international mobilisation to support universal provision of highly active antiretroviral therapy (HAART), national governments continue to play the key role in determining access to treatment. Whereas some AIDS-affected countries have performed as well as or better than expected given their level of development, institutional characteristics and demographic challenges (e.g. Thailand and Brazil), others (notably South Africa) have not. This article argues that the 'economics' of antiretroviral drug delivery is at heart a political-economy of access to treatment. It depends on commitment on the part of national governments to negotiate with pharmaceutical companies over patented antiretroviral drug prices, on their policy towards compulsory licensing, and on the approach they adopt to delivering HAART. Civil society has an important role to play in encouraging governments to become, and remain, committed to taking action to ensure sustainable and widespread access to HAART.

Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam.

PubMed

Levin, Carol E; Van Minh, Hoang; Odaga, John; Rout, Swampa Sarit; Ngoc, Diep Nguyen Thi; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D Scott

2013-08-01

To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Data were collected from a sample of facilities that participated in five demonstration projects for hpv vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services.

Stimulus Effects on Local Preference: Stimulus-Response Contingencies, Stimulus-Food Pairing, and Stimulus-Food Correlation

ERIC Educational Resources Information Center

Davison, Michael; Baum, William M.

2010-01-01

Four pigeons were trained in a procedure in which concurrent-schedule food ratios changed unpredictably across seven unsignaled components after 10 food deliveries. Additional green-key stimulus presentations also occurred on the two alternatives, sometimes in the same ratio as the component food ratio, and sometimes in the inverse ratio. In eight…

75 FR 19426 - Sunshine Act Meetings of the Board of Directors; Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-14

... LEGAL SERVICES CORPORATION Sunshine Act Meetings of the Board of Directors; Notice Date and Time: The Legal Services Corporation Board of Directors will meet on April 16-17, 2010. On Friday April 16... Schedule Time \\1\\ Friday, April 16, 2010 1. Promotion & Provision for the 1:30 p.m. Delivery of Legal...

75 FR 44018 - Sunshine Act Meetings of the Board of Directors; Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... LEGAL SERVICES CORPORATION Sunshine Act Meetings of the Board of Directors; Notice Date and Time: The Legal Services Corporation Board of Directors will meet on July 30-31, 2010. On Friday July 30... Schedule Time \\1\\ Friday, July 30, 2010: 1. Promotion & Provision for the Delivery 3:15 p.m. of Legal...

Claims and Counterclaims: Institutional Arrangements and Farmers' Response to the Delivery and Adoption of Innovations in the Okavango Delta, Botswana

ERIC Educational Resources Information Center

Noga, Sekondeko Ronnie; Kolawole, Oluwatoyin Dare; Thakadu, Olekae Tsompi; Masunga, Gaseitsiwe Smollie

2017-01-01

Purpose: This article examined how institutional factors influencing the promotion of two elephant crop-raiding deterrent innovations (ECDIs) introduced to farmers through a ministry-based extension system in the Okavango Delta, Botswana, have impacted farmers' adoption behaviour. Methodology: A standardised interview schedule was used to elicit…

Differentiating Delivery of Instruction with Online Learning Modules for Teacher Candidates

ERIC Educational Resources Information Center

Wilkinson, Colleen Ann

2013-01-01

Online learning has become a prevalent method of instruction in higher education. There are many reasons for this change in pedagogy, including rapid developments in technology, as well as the logistic challenges of enrolling in college, such as commuting and coordinating work schedules. The quality of online instruction and its impact on teacher…

76 FR 67526 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

..., order routing and market data delivery services to their customers while the User is co-located in the... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for...

76 FR 79242 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Approving a Proposed Rule Change Expanding...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

..., order routing and market data delivery services to their customers while the User is co-located in the... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant that Requests to Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for...

Graduate Program Scheduling Gains Flexibility through Container Courses: A Case Study

ERIC Educational Resources Information Center

Rose, Richard

2011-01-01

Online course delivery makes possible one innovation which can provide each student with greater program flexibility as well as some personal ownership of the direction and pace of his degree progress. This concept can be called the "container course." A container course is the offering of more than one course simultaneously under a single course…

Flipping an Agricultural Education Teaching Methods Course

ERIC Educational Resources Information Center

Conner, Nathan W.; Stripling, Christopher T.; Blythe, Jessica M.; Roberts, T. Grady; Stedman, Nicole L. P.

2014-01-01

Flipping or inverting a course is a relatively new approach to structuring a course. Using this method, the lectures traditionally delivered during regularly scheduled class time are converted to a media for delivery online, often in the form of videos. Learners are expected to view the online lectures prior to class. Then in turn, in-class time…

Maternal Nutrition and Four-Alternative Choice

ERIC Educational Resources Information Center

Davison, Michael; Krageloh, Christian U.; Fraser, Mhoyra; Breier, Bernhard H.

2007-01-01

Two groups of 10 male rats were trained to nose poke for food pellets at four alternatives that provided differing rates of pellet delivery on aperiodic schedules. After a fixed number of pellets had been delivered, 5, 10 or 20 in different conditions of the experiment, a 10-s blackout occurred, and the locations of the differing rates of pellet…

Building Up the Other Side of Sesame Street. Organizing and Administering Delivery of Off Campus Continuing Professional Education.

ERIC Educational Resources Information Center

Sarlos, Beatrice E.

Continuing professional education (CPE), defined as educational services offered to professionals (those who possess initial degrees required for practice) without the restrictions of traditional scheduling, credits, tuition, or instruction methods, is discussed. The importance of a uniform terminology to distinguish the specific area of CPE is…

77 FR 47079 - Notice of Availability of Draft Policy Document for Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-07

... Public Health Service Act (PHS Act) to support the delivery of preventive and primary care services to... section 1861(aa)(4) and section 1905(l)(2)(B) of the Social Security Act, FQHC Look-Alikes do not receive... support the fee and discount schedules based on an individual's ability to pay. When finalized, this PIN...

The effects of the mode of delivery on oxidative-antioxidative balance.

PubMed

Mutlu, Birgul; Aksoy, Nurten; Cakir, Hale; Celik, Hakim; Erel, Ozcan

2011-11-01

The purpose of this study was to investigate the effects of the mode of delivery on the oxidant and antioxidant systems in mothers and infants and to demonstrate which mode leads more oxidative stress. The participants were divided into two groups according to the mode of their labour and delivery: group 1 (n = 33) women with normal labour and delivery and group 2 (n = 33) with scheduled caesarean section (C/S) and delivery. The maternal, cord, and infant blood samples in both groups were collected. The serum total antioxidant capacity (TAC) and the total oxidant status (TOS) were evaluated by using an automated colorimetric measurement method. The parameters indicating oxidative stress (TOS, oxidative stress index, and lipid hydroperoxide) in maternal, cord, and newborn blood samples were higher in patients delivering with C/S than those normal spontaneous vaginal deliveries (NSVD) patient group, while it was vice versa for TAC. It may be concluded that both the mothers and neonates in C/S group are exposed to higher oxidative stress as compared with those in NSVD group and the antioxidant mechanisms are insufficient to cope with this stress during C/S. This result indicates that the normal delivery through the physiological route is healthier for the bodies of mothers and infants.

A qualitative descriptive study of the group prenatal care experience: perceptions of women with low-risk pregnancies and their midwives.

PubMed

McDonald, Sarah D; Sword, Wendy; Eryuzlu, Leyla E; Biringer, Anne B

2014-09-26

Group prenatal care (GPC) originated in 1994 as an innovative model of prenatal care delivery. In GPC, eight to twelve pregnant women of similar gestational age meet with a health care provider to receive their prenatal check-up and education in a group setting. GPC offers significant health benefits in comparison to traditional, one-on-one prenatal care. Women in GPC actively engage in their healthcare and experience a supportive network with one another. The purpose of this study was to better understand the GPC experience of women and care providers in a lower risk group of women than often has been previously studied. This qualitative descriptive study collected data through three focus group interviews--two with women who had completed GPC at a midwifery clinic in Ontario, Canada and one with the midwives at the clinic. Data was analyzed through open coding to identify themes. Nine women and five midwives participated in the focus groups, from which eight categories as well as further subcategories were identified: The women and midwives noted reasons for participating (connections, education, efficiency). Participants suggested both benefits (learning from the group, normalizing the pregnancy experience, preparedness for labour and delivery, and improved relationships as all contributing to positive health outcomes) and concerns with GPC (e.g. sufficient time with the midwife) which generally diminished with experience. Suggestions for change focused on content, environment, partners, and access to the midwives. Challenges to providing GPC included scheduling and systems-level issues such as funding and regulation. Flexibility and commitment to the model facilitated it. Comparison with other models of care identified less of a relationship with the midwife, but more information received. In promoting GPC, women would emphasize the philosophy of care to other women and the midwives would promote the reduction in workload and women's independence to colleagues. Overall, women and midwives expressed a high level of satisfaction with their GPC experience. This study gained insight into previously unexplored areas of the GPC experience, perceptions of processes that contribute to positive health outcomes, strategies to promote GPC and elements that enhance the feasibility of GPC.

Interdisciplinary Team Huddles for Fetal Heart Rate Tracing Review.

PubMed

Thompson, Lisa; Krening, Cynthia; Parrett, Dolores

2018-06-01

To address an increase in unexpected poor outcomes in term neonates, our team developed a goal of high reliability and improved fetal safety in the culture of the Labor and Delivery nursing department. We implemented interdisciplinary reviews of fetal heart rate, along with a Category II fetal heart rate management algorithm and a fetal heart rate assessment rapid response alert to call for unscheduled reviews when needed. Enhanced communication between nurses and other clinicians supported an interdisciplinary approach to fetal safety, and we observed an improvement in health outcomes for term neonates. We share our experience with the intention of making our methods available to any labor and delivery unit team committed to safe, high-quality care and service excellence. Copyright © 2018 AWHONN. Published by Elsevier Inc. All rights reserved.

AWAS: A dynamic work scheduling system

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

Lee, Y.; Hao, J.; Kocur, G.

1994-12-31

The Automated Work Administration System (AWAS) is an automated scheduling system developed at GTE. A typical work center has 1000 employees and processes 4000 jobs each day. Jobs are geographically distributed within the service area of the work center, require different skills, and have to be done within specified time windows. Each job can take anywhere from 12 minutes to several hours to complete. Each employee can have his/her individual schedule, skill, or working area. The jobs can enter and leave the system at any time The employees dial up to the system to request for their next job atmore » the beginning of a day or after a job is done. The system is able to respond to the changes dynamically and produce close to optimum solutions at real time. We formulate the real world problem as a minimum cost network flow problem. Both employees and jobs are formulated as nodes. Relationship between jobs and employees are formulated as arcs, and working hours contributed by employees and consumed by jobs are formulated as flow. The goal is to minimize missed commitments. We solve the problem with the successive shortest path algorithm. Combined with pre-processing and post-processing, the system produces reasonable outputs and the response time is very good.« less

The determination of the levels of burnout syndrome, organizational commitment, and job satisfaction of the health workers.

PubMed

Gorgulu, O; Akilli, A

2017-01-01

The concept of burnout is an important element for efficiency in occupational groups such as health and education, which necessitate constant communication with people and have a busy schedule. The determination of the levels of burnout syndrome, organizational commitment, and job satisfaction of the health workers. A questionnaire consisting of four parts was prepared so as to measure the levels of organizational commitment, job satisfaction, and burnout of the medical staff of the institution. The data for this research were gained by a questionnaire sent to 370 medical staff (doctors, nurses, contract staff, and other employees). Kolmogorov Smirnov test, t-test, ANOVA, Tukey multiple comparison test and Pearson's correlation analysis were used to this study. The average age of the employees taking part in the questionnaire was calculated as 34.30 years (min: 18 years, max: 59 years). The proportional value of the individuals with their 0-5 years working period in the institution was observed as 58.1%. An individual's interior work satisfaction, education level, hours worked at the hospital and their titles are also statistically important (P< 0.05). There is a positive correlation and significant relation between medical staffs' emotional exhaustion and desensitization (r = 0.573). There is a positive correlation and significant relation between normative commitment sub dimension, interior and exterior job satisfaction (r = 0.449, r = 0.472). Efforts to reduce the job burnout and psychological support for health care workers support motivation in order to provide better services to increase significantly. Thus, both personal productivity will be increased, and gain will be obtained in the institutional sense.

Career Commitment of Postprofessional Athletic Training Program Graduates

PubMed Central

Bowman, Thomas G.; Mazerolle, Stephanie M.; Goodman, Ashley

2015-01-01

Context: Choosing to pursue an advanced degree in athletic training appears to indicate professional commitment and passion for the profession. Currently, there is a paucity of information regarding why some athletic trainers pursue enrollment in a postprofessional athletic training program (PPATP), indicating commitment to the profession, but later depart for another primary role outside of athletic training. Objective: To understand why athletic trainers invested in advanced training via a PPATP but then decided to leave the profession. Design: Qualitative study. Setting: Online data collection. Patients or Other Participants: Twelve graduates (8 women [67%], 4 men [33%], age = 31.58 ± 3.06 years) from PPATPs who no longer had primary employment as an athletic trainer. Data Collection and Analysis: Recruits responded to an e-mail invitation to participate by completing a confidential online questionnaire. We analyzed data using a general inductive approach and secured trustworthiness using multiple-analyst triangulation, peer review, and member checks. Results: Two higher-order themes emerged regarding the career commitment of former athletic trainers who were PPATP graduates: (1) departure from an athletic training career and (2) partial continuance in athletic training. Two second-order themes emerged from the reasons for departure: (1) decreased recognition of value and (2) work-life imbalance. Finally, we identified 2 third-order themes from the participants' reasons for departure because of a perceived lack of value: (1) low salary and (2) long, inconsistent hours worked. Conclusions: Most of our participants intended to stay in the profession when they chose to attend a PPATP. However, during role inductance in either the clinical experience of the PPATP they attended or early in their careers, they began to have thoughts of leaving mainly because of inadequate financial compensation, challenging work schedules, or both. PMID:25343531

Career commitment of postprofessional athletic training program graduates.

PubMed

Bowman, Thomas G; Mazerolle, Stephanie M; Goodman, Ashley

2015-04-01

Choosing to pursue an advanced degree in athletic training appears to indicate professional commitment and passion for the profession. Currently, there is a paucity of information regarding why some athletic trainers pursue enrollment in a postprofessional athletic training program (PPATP), indicating commitment to the profession, but later depart for another primary role outside of athletic training. To understand why athletic trainers invested in advanced training via a PPATP but then decided to leave the profession. Qualitative study. Online data collection. Twelve graduates (8 women [67%], 4 men [33%], age = 31.58 ± 3.06 years) from PPATPs who no longer had primary employment as an athletic trainer. Recruits responded to an e-mail invitation to participate by completing a confidential online questionnaire. We analyzed data using a general inductive approach and secured trustworthiness using multiple-analyst triangulation, peer review, and member checks. Two higher-order themes emerged regarding the career commitment of former athletic trainers who were PPATP graduates: (1) departure from an athletic training career and (2) partial continuance in athletic training. Two second-order themes emerged from the reasons for departure: (1) decreased recognition of value and (2) work-life imbalance. Finally, we identified 2 third-order themes from the participants' reasons for departure because of a perceived lack of value: (1) low salary and (2) long, inconsistent hours worked. Most of our participants intended to stay in the profession when they chose to attend a PPATP. However, during role inductance in either the clinical experience of the PPATP they attended or early in their careers, they began to have thoughts of leaving mainly because of inadequate financial compensation, challenging work schedules, or both.

Permanent Habitats in Earth-Sol/Mars-Sol Orbit Positions

NASA Astrophysics Data System (ADS)

Greenspon, J.

Project Outpost is a manned Earth-Sol/Mars-Sol platform that enables permanent occupation in deep space. In order to develop the program elements for this complex mission, Project Outpost will rely primarily on existing/nearterm technology and hardware for the construction of its components. For the purposes of this study, four mission requirements are considered: 1. Outpost - Man's 1st purpose-produced effort of space engineering, in which astructure is developed/constructed in an environment completely alien to currentpractices for EVA guidelines. 2. Newton - a concept study developed at StarGate Research, for the development ofa modified Hohmann personnel orbital transport operating between Earth andMars. Newton would serve as the primary crew delivery apparatus throughrepeatable transfer scheduling for all Earth-Lpoint-Mars activities. Thispermanent "transit system" would establish the foundations for Solar systemcolonization. 3. Cruis - a concept study developed at StarGate Research, for the development of amodified Hohmann cargo orbital transport operating between Earth and Mars.Cruis would serve as the primary equipment delivery apparatus throughrepeatable transfer scheduling for all Earth-Lpoint-Mars activities. Thispermanent "transit system" would establish the foundations for Solar systemcolonization, and 4. Ares/Diana - a more conventional space platform configuration for Lunar andMars orbit is included as a construction baseline. The operations of these assetsare supported, and used for the support, of the outpost. Outpost would be constructed over a 27-year period of launch opportunities into Earth-Sol or Mars-Sol Lagrange orbit (E-S/M-S L1, 4 or 5). The outpost consists of an operations core with a self-contained power generation ability, a docking and maintenance structure, a Scientific Research complex and a Habitation Section. After achieving initial activation, the core will provide the support and energy required to operate the outpost in a 365 day orbit - with a resupply schedule of 120 days. The initial power grid, based on the ISS's solar array, provides energy during the initial start-up phases. The Operations Core serves as the backbone of the outpost, providing a centrally defined structural brace for other elements. After placement, the core is energized through the deployment of 2 ISS solar wings. Gravitation via rotation will occur approximately 450 days later, with the completion of the habitat elements, when the main reaction control engines are fired to provide an artificial gravity of 8.77 m/s. Station operations begin with deployment of the solar arrays and charging of the battery systems. Newton and Cruis assist in the transporting of supplies and personnel from Earth to Mars via the Outpost, and serve as a crucial component to a long term space exploration/colonization initiative. The cycling spacecraft means of travel has advantages in that it is readily repeatable, immediately demonstrating a long term commitment. The cycling spacecraft, however, represent a less than mature technology. The transportation system between Earth - Outpost - Mars will be perpetually on a duplicate development track with it's "stops". Ares/Diana is advantageous in that they are completely conventional mission profiles with modules and knowledge imported from the International Space Station. While Diana represents a logical next step from Earth, Ares will undoubtedly be developed alongside the Outpost itself.

Theory and interpretation in qualitative studies from general practice: Why and how?

PubMed

Malterud, Kirsti

2016-03-01

In this article, I want to promote theoretical awareness and commitment among qualitative researchers in general practice and suggest adequate and feasible theoretical approaches. I discuss different theoretical aspects of qualitative research and present the basic foundations of the interpretative paradigm. Associations between paradigms, philosophies, methodologies and methods are examined and different strategies for theoretical commitment presented. Finally, I discuss the impact of theory for interpretation and the development of general practice knowledge. A scientific theory is a consistent and soundly based set of assumptions about a specific aspect of the world, predicting or explaining a phenomenon. Qualitative research is situated in an interpretative paradigm where notions about particular human experiences in context are recognized from different subject positions. Basic theoretical features from the philosophy of science explain why and how this is different from positivism. Reflexivity, including theoretical awareness and consistency, demonstrates interpretative assumptions, accounting for situated knowledge. Different types of theoretical commitment in qualitative analysis are presented, emphasizing substantive theories to sharpen the interpretative focus. Such approaches are clearly within reach for a general practice researcher contributing to clinical practice by doing more than summarizing what the participants talked about, without trying to become a philosopher. Qualitative studies from general practice deserve stronger theoretical awareness and commitment than what is currently established. Persistent attention to and respect for the distinctive domain of knowledge and practice where the research deliveries are targeted is necessary to choose adequate theoretical endeavours. © 2015 the Nordic Societies of Public Health.

Health service delivery in China: a literature review.

PubMed

Eggleston, Karen; Ling, Li; Qingyue, Meng; Lindelow, Magnus; Wagstaff, Adam

2008-02-01

We report the results of a review of the Chinese- and English-language literatures on service delivery in China, asking how well China's health-care providers perform and what determines their performance. Although data and methodological limitations suggest caution in drawing conclusions, a critical reading of the available evidence suggests that current health service delivery in China leaves room for improvement, in terms of quality, responsiveness to patients, efficiency, cost escalation, and equity. The literature suggests that these problems will not be solved by simply shifting ownership to the private sector or by simply encouraging providers -- public and private -- to compete with one another for individual patients. By contrast, substantial improvements could be (and in some places have already been) made by changing the way providers are paid -- shifting away from fee-for-service and the distorted price schedule. Other elements of 'active purchasing' by insurers could further improve outcomes. Rigorous evaluations, based on richer micro-level data, could considerably strengthen the evidence base for service delivery policy in China.

A microstructural analysis of schedule-induced polydipsia reveals incentive-induced hyperactivity in an animal model of ADHD

PubMed Central

Íbias, Javier; Pellón, Ricardo; Sanabria, Federico

2014-01-01

Recent research has suggested that frequent short bursts of activity characterize hyperactivity associated with attention deficit hyperactivity disorder (ADHD). This study determined whether such pattern is also visible in schedule-induced polydipsia (SIP) in the spontaneously hypertensive rat (SHR), an animal model of ADHD. Male SHR, Wistar Kyoto (WKY) and Wistar rats were exposed to 40 sessions of SIP using a multiple fixed-time (FT) schedule of food delivery with FT 30-s and FT 90-s components. Stable performance was analysed to determine the extent to which SIP-associated drinking is organized in bouts. The Bi-Exponential Refractory Model (BERM) of free-operant performance was applied to schedule-induced licks. A model comparison analysis supported BERM as a description of SIP episodes: licks were not produced at a constant rate but organized into bouts within drinking episodes. FT 30-s induced similar overall licking rates, latencies to first licks and episode durations across strains; FT 90-s induced longer episode durations in SHRs and reduced licking rate in WKY and Wistar rats to nearly baseline levels. Across schedules, SHRs made more and shorter bouts when compared to the other strains. These results suggest an incentive-induced hyperactivity in SHR that has been observed in operant behavior and in children with ADHD. PMID:25447297

Combinations of response-reinforcer relations in periodic and aperiodic schedules.

PubMed

Kuroda, Toshikazu; Cançado, Carlos R X; Lattal, Kennon A; Elcoro, Mirari; Dickson, Chata A; Cook, James E

2013-03-01

Key pecking of 4 pigeons was studied under a two-component multiple schedule in which food deliveries were arranged according to a fixed and a variable interfood interval. The percentage of response-dependent food in each component was varied, first in ascending (0, 10, 30, 70 and 100%) and then in descending orders, in successive conditions. The change in response rates was positively related to the percentage of response-dependent food in each schedule component. Across conditions, positively accelerated and linear patterns of responding occurred consistently in the fixed and variable components, respectively. These results suggest that the response-food dependency determines response rates in periodic and aperiodic schedules, and that the temporal distribution of food determines response patterns independently of the response-food dependency. Running rates, but not postfood pauses, also were positively related to the percentage of dependent food in each condition, in both fixed and variable components. Thus, the relation between overall response rate and the percentage of dependent food was mediated by responding that occurred after postfood pausing. The findings together extend previous studies wherein the dependency was either always present or absent, and increase the generality of the effects of variations in the response-food dependency from aperiodic to periodic schedules. © Society for the Experimental Analysis of Behavior.

Investigations of timing during the schedule and reinforcement intervals with wheel-running reinforcement.

PubMed

Belke, Terry W; Christie-Fougere, Melissa M

2006-11-01

Across two experiments, a peak procedure was used to assess the timing of the onset and offset of an opportunity to run as a reinforcer. The first experiment investigated the effect of reinforcer duration on temporal discrimination of the onset of the reinforcement interval. Three male Wistar rats were exposed to fixed-interval (FI) 30-s schedules of wheel-running reinforcement and the duration of the opportunity to run was varied across values of 15, 30, and 60s. Each session consisted of 50 reinforcers and 10 probe trials. Results showed that as reinforcer duration increased, the percentage of postreinforcement pauses longer than the 30-s schedule interval increased. On probe trials, peak response rates occurred near the time of reinforcer delivery and peak times varied with reinforcer duration. In a second experiment, seven female Long-Evans rats were exposed to FI 30-s schedules leading to 30-s opportunities to run. Timing of the onset and offset of the reinforcement period was assessed by probe trials during the schedule interval and during the reinforcement interval in separate conditions. The results provided evidence of timing of the onset, but not the offset of the wheel-running reinforcement period. Further research is required to assess if timing occurs during a wheel-running reinforcement period.

Split delivery vehicle routing problem with time windows: a case study

NASA Astrophysics Data System (ADS)

Latiffianti, E.; Siswanto, N.; Firmandani, R. A.

2018-04-01

This paper aims to implement an extension of VRP so called split delivery vehicle routing problem (SDVRP) with time windows in a case study involving pickups and deliveries of workers from several points of origin and several destinations. Each origin represents a bus stop and the destination represents either site or office location. An integer linear programming of the SDVRP problem is presented. The solution was generated using three stages of defining the starting points, assigning busses, and solving the SDVRP with time windows using an exact method. Although the overall computational time was relatively lengthy, the results indicated that the produced solution was better than the existing routing and scheduling that the firm used. The produced solution was also capable of reducing fuel cost by 9% that was obtained from shorter total distance travelled by the shuttle buses.

Delivery performance of conventional aircraft by terminal-area, time-based air traffic control: A real-time simulation evaluation

NASA Technical Reports Server (NTRS)

Credeur, Leonard; Houck, Jacob A.; Capron, William R.; Lohr, Gary W.

1990-01-01

A description and results are presented of a study to measure the performance and reaction of airline flight crews, in a full workload DC-9 cockpit, flying in a real-time simulation of an air traffic control (ATC) concept called Traffic Intelligence for the Management of Efficient Runway-scheduling (TIMER). Experimental objectives were to verify earlier fast-time TIMER time-delivery precision results and obtain data for the validation or refinement of existing computer models of pilot/airborne performance. Experimental data indicated a runway threshold, interarrival-time-error standard deviation in the range of 10.4 to 14.1 seconds. Other real-time system performance parameters measured include approach speeds, response time to controller turn instructions, bank angles employed, and ATC controller message delivery-time errors.

Developing a framework of service convenience in health care: An exploratory study for a primary care provider.

PubMed

Tuzovic, Sven; Kuppelwieser, Volker

2016-01-01

From retail health clinics and online appointment scheduling to (mobile) kiosks that enable patient check-in and automate the collection of copays and open balances, convenience has become an important topic in the health care sector over the last few years. While service convenience has also gained much interest in academia, one common limitation is that authors have adopted a "goods-centered" perspective focusing primarily on retail settings. Results of this exploratory study reveal that health care service convenience encompasses seven different dimensions: decision, access, scheduling, registration and check-in, transaction, care delivery, and postconsultation convenience. Implications and future research suggestions are discussed.

Prioritization of Evidence-Based Preventive Health Services During Periodic Health Examinations

PubMed Central

Shires, Deirdre A.; Stange, Kurt C.; Divine, George; Ratliff, Scott; Vashi, Ronak; Tai-Seale, Ming; Lafata, Jennifer Elston

2011-01-01

Background Delivery of preventive services sometimes falls short of guideline recommendations. Purpose To evaluate the multilevel factors associated with evidence-based preventive service delivery during periodic health examinations (PHE). Methods Primary care physicians were recruited from an integrated delivery system in southeast Michigan. Office visit audio-recordings of PHE visits conducted from 2007–2009 were used to ascertain physician recommendation for or delivery of 19 guideline-recommended preventive services. Alternating logistic regression was used to evaluate factors associated with service delivery. Data analyses were completed in 2011. Results Among 484 PHE visits to 64 general internal medicine and family physicians by insured patients aged 50–80 years, there were 2662 services for which patients were due; 54% were recommended or delivered. Regression analyses indicated that the likelihood of service delivery decreased with patient age and with each concern the patient raised, and increased with increasing BMI and with each additional minute after scheduled appointment time the physician first presented. The likelihood was greater with patient/physician gender concordance and less if the physician used the electronic medical record in the exam room and had seen the patient in the past 12 months. Conclusions A combination of patient, physician, visit and contextual factors are associated with preventive service delivery. Additional studies are warranted to understand the complex interplay of factors that support and compromise preventive service delivery. PMID:22261213

Feasibility and acceptability of HIV self-testing among pre-exposure prophylaxis users in Kenya.

PubMed

Ngure, Kenneth; Heffron, Renee; Mugo, Nelly; Thomson, Kerry A; Irungu, Elizabeth; Njuguna, Njambi; Mwaniki, Lawrence; Celum, Connie; Baeten, Jared M

2017-02-10

HIV testing is key to the delivery of pre-exposure prophylaxis (PrEP): testing HIV-uninfected at-risk persons is the first step for PrEP initiation and ongoing HIV testing is an essential part of PrEP delivery. Thus, novel and cost-effective HIV-testing approaches to streamline delivery of PrEP are urgently needed. Within a demonstration project of PrEP for HIV prevention among high-risk HIV serodiscordant couples in Kenya (the Partners Demonstration Project), we conducted a pilot evaluation of HIV self-testing. Clinic visits were scheduled quarterly and included in-clinic HIV testing using fingerstick rapid HIV tests and refills of PrEP prescriptions. HIV oral fluid self-test kits were provided for participants to use in the two-month interval between scheduled quarterly clinic visits. Acceptability of HIV self-testing was assessed using both quantitative and qualitative methods. We found that 222 of 226 (98%) HIV-uninfected persons who were offered accepted self-testing. Nearly all (96.8%) reported that using the self-testing kit was easy. More than half (54.5%) reportedly did not share the HIV results from self-testing with anyone and almost all (98.7%) the participants did not share the HIV self-testing kits with anyone. Many participants reported that HIV self-testing was empowering and reduced anxiety associated with waiting between clinic HIV tests. HIV self-testing was highly acceptable and may therefore be a feasible strategy to efficiently permit routine HIV testing between PrEP refills.

Perspectives of host faculty and trainees on international visiting faculty to paediatric academic departments in East Africa

PubMed Central

Russ, Christiana M; Ganapathi, Lakshmi; Marangu, Diana; Silverman, Melanie; Kija, Edward; Bakeera-Kitaka, Sabrina; Laving, Ahmed

2016-01-01

Background Investments in faculty exchanges to build physician workforce capacity are increasing. Little attention has been paid to the expectations of host institution faculty and trainees. This prospective qualitative research study explored faculty and resident perspectives about guest faculty in paediatric departments in East Africa, asking (1) What are the benefits and challenges of hosting guest faculty, (2) What factors influence the effectiveness of faculty visits and (3) How do host institutions prepare for faculty visits? Methods We recruited 36 faculty members and residents from among four paediatric departments in East Africa to participate in semistructured interviews which were audio recorded and transcribed. Data were qualitatively analysed using principles of open coding and thematic analysis. We achieved saturation of themes. Results Benefits of faculty visits varied based on the size and needs of host institutions. Emergent themes included the importance of guest faculty time commitment, and mutual preparation to ensure that visit goals and scheduling met host needs. We documented conflicts that developed around guest emotional responses and ethical approaches to clinical resource limitations, which some hosts tried to prepare for and mitigate. Imbalance in resources led to power differentials; some hosts sought partnerships to re-establish control over the process of having guests. Conclusions We identified that guest faculty can assist paediatric institutions in building capacity; however, effective visits require: (1) mutually agreed on goals with appropriate scheduling, visit length and commitment to ensure that the visits meet the host's needs, (2) careful selection and preparation of guest faculty to meet the host's goals, (3) emotional preparation by prospective guests along with host orientation to clinical work in the host's setting and (4) attention to funding sources for the visit and mitigation of resulting power differentials. PMID:28588960

Disease management.

PubMed Central

Hunter, D. J.; Fairfield, G.

1997-01-01

The disease management approach to patient care seeks to coordinate resources across the healthcare delivery system. The growing interest in evidence based medicine and outcomes, and a commitment to integrated care across the primary, secondary, and community care sectors, all contribute to making disease management an attractive idea. A combination of patient education, provider use of practice guidelines, appropriate consultation, and supplies of drugs and ancillary services all come together in the disease management process. But its effectiveness is largely untested, so evaluation is essential. PMID:9233330

Determining the Value of Contractor Performance Assessment Reporting System (CPARS) Narratives for the Acquisition Process

DTIC Science & Technology

2014-06-01

sweep floors daily, mop floors with soap and water one time per week, wax floors one time per quarter, remove trash from garbage bins every Thursday...authority. The FAR specifically states that a COR “has no authority to make any commitments or changes that affect price, quality, quantity, delivery, or...to define key requirements to make sure everyone has the same view of the performance requirements. The customer states that they want the vendor

Two-stage stochastic unit commitment model including non-generation resources with conditional value-at-risk constraints

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

Huang, Yuping; Zheng, Qipeng P.; Wang, Jianhui

2014-11-01

tThis paper presents a two-stage stochastic unit commitment (UC) model, which integrates non-generation resources such as demand response (DR) and energy storage (ES) while including riskconstraints to balance between cost and system reliability due to the fluctuation of variable genera-tion such as wind and solar power. This paper uses conditional value-at-risk (CVaR) measures to modelrisks associated with the decisions in a stochastic environment. In contrast to chance-constrained modelsrequiring extra binary variables, risk constraints based on CVaR only involve linear constraints and con-tinuous variables, making it more computationally attractive. The proposed models with risk constraintsare able to avoid over-conservative solutions butmore » still ensure system reliability represented by loss ofloads. Then numerical experiments are conducted to study the effects of non-generation resources ongenerator schedules and the difference of total expected generation costs with risk consideration. Sen-sitivity analysis based on reliability parameters is also performed to test the decision preferences ofconfidence levels and load-shedding loss allowances on generation cost reduction.« less

A Service Portal for the Integrated SCaN Network

NASA Technical Reports Server (NTRS)

Marx, Sarah R.

2012-01-01

The Space Communication and Navigation (SCaN) program office owns the assets and services provided by the Deep Space Network (DSN), Near Earth Network (NEN), and Space Network (SN). At present, these individual networks are operated by different NASA centers--JPL for DSN--and Goddard Space Flight Center (GSFC) for NEN and SN--with separate commitments offices for each center. In the near future, SCaN's program office would like to deploy an integrated service portal which would merge the two commitments offices with the goal of easing the task of user planning for space missions requiring services of two or more of these networks. Following interviews with subject matter experts in this field, use cases were created to include the services and functionality mission users would like to see in this new integrated service portal. These use cases provide a guideline for a mock-up of the design of the user interface for the portal. The benefit of this work will ease the time required and streamline/standardize the process for planning and scheduling SCAN's services for future space missions.

Gamify and Recognize Prior Learning: How to Succeed in Educators' Further Professional Training with Open Badges

ERIC Educational Resources Information Center

Lius, Esko

2016-01-01

Traditional further professional training has been losing its position and importance in teacher upskilling. Traditional modes of training delivery do not work well in situations where much of the competences have been gained informally, or when teachers find it difficult to attend training days that fit poorly to their schedules or location. This…

The Student Storm Survey©: College Students' Thoughts on Their University's Response to a Natural Disaster

ERIC Educational Resources Information Center

Rosenthal, Gary T.; Boudreaux, Monique; Boudreaux, Dwight L.; Soignier, R. D.; Folse, Earl; Frias, Tracey; Soper, Barlow

2014-01-01

Hurricanes Gustav and Ike devastated the region that our University serves. Near the start of the semester, only one of the ten scheduled class days could be completed and administrators asked students and faculty to "continue the learning process" online via Blackboard©, our Electronic Delivery System (EDS). The Student Storm Survey©…

77 FR 38067 - Medicare Program; Public Meeting Regarding Inherent Reasonableness of Medicare Fee Schedule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

... forth in 42 CFR 414.402 will be used to determine what items will be included in the competitions. These..., regardless of the method of delivery. Non-Mail Order Item--Any item that a beneficiary or caregiver picks up... what Medicare pays for mail order supplies versus non-mail order supplies may encourage fraud and abuse...

Internal Drivers of External Flexibility: A Detailed Analysis

DTIC Science & Technology

2007-08-14

example, order processing within a supplier’s firm is a competence. Meeting customer demand by providing a consistent delivery schedule is a capability...Focus interview on the following logistics areas: a. order processing b. inventory c. transportation d. warehousing, materials handling...demands. In logistics, superior service depends upon order processing (Byrne and Markham 1991); quality of contact personnel (Innis and LaLonde 1994

Using Blended Learning as an Innovative Delivery Model for an In-House Language Program

ERIC Educational Resources Information Center

Gadbois, Manon; Quildon, Denise

2013-01-01

This paper reports on the development and implementation in 2012 of McGill University's French at Work program for McGill employees, using a blended learning model. The program is an example of how a reduction in face-to-face teaching presents one solution to employees' scheduling constraints and how this model might offer suggestions for the…

Space-based solar power conversion and delivery systems study. Volume 2: Engineering analysis of orbital systems

NASA Technical Reports Server (NTRS)

1976-01-01

Program plans, schedules, and costs are determined for a synchronous orbit-based power generation and relay system. Requirements for the satellite solar power station (SSPS) and the power relay satellite (PRS) are explored. Engineering analysis of large solar arrays, flight mechanics and control, transportation, assembly and maintenance, and microwave transmission are included.

An overview of the NASA electronic components information management system

NASA Technical Reports Server (NTRS)

Kramer, G.; Waterbury, S.

1991-01-01

The NASA Parts Project Office (NPPO) comprehensive data system to support all NASA Electric, Electronic, and Electromechanical (EEE) parts management and technical data requirements is described. A phase delivery approach is adopted, comprising four principal phases. Phases 1 and 2 support Space Station Freedom (SSF) and use a centralized architecture with all data and processing kept on a mainframe computer. Phases 3 and 4 support all NASA centers and projects and implement a distributed system architecture, in which data and processing are shared among networked database servers. The Phase 1 system, which became operational in February of 1990, implements a core set of functions. Phase 2, scheduled for release in 1991, adds functions to the Phase 1 system. Phase 3, to be prototyped beginning in 1991 and delivered in 1992, introduces a distributed system, separate from the Phase 1 and 2 system, with a refined semantic data model. Phase 4 extends the data model and functionality of the Phase 3 system to provide support for the NASA design community, including integration with Computer Aided Design (CAD) environments. Phase 4 is scheduled for prototyping in 1992 to 93 and delivery in 1994.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers confirm the Multi-Purpose Logistics Module Donatello is safely in place on a work stand. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello, is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

NASA Image and Video Library

2004-02-13

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers confirm the Multi-Purpose Logistics Module Donatello is safely in place on a work stand. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello, is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, the Multi-Purpose Logistics Module Donatello is slowly lowered toward a work stand. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

NASA Image and Video Library

2004-02-13

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, the Multi-Purpose Logistics Module Donatello is slowly lowered toward a work stand. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

KENNEDY SPACE CENTER, FLA. - All three Multi-Purpose Logistics Modules are on the floor of the Space Station Processing Facility. This is the first time the three - Leonardo, Raffaello and Donatello -- have been in one location. Donatello has been stored in the Operations and Checkout Building since its arrival at KSC and was brought into the SSPF for routine testing. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - All three Multi-Purpose Logistics Modules are on the floor of the Space Station Processing Facility. This is the first time the three - Leonardo, Raffaello and Donatello -- have been in one location. Donatello has been stored in the Operations and Checkout Building since its arrival at KSC and was brought into the SSPF for routine testing. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

KENNEDY SPACE CENTER, FLA. - The Multi-Purpose Logistics Module Donatello is moved away from the payload canister in the Space Station Processing Facility. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

NASA Image and Video Library

2004-02-13

KENNEDY SPACE CENTER, FLA. - The Multi-Purpose Logistics Module Donatello is moved away from the payload canister in the Space Station Processing Facility. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers help the Multi-Purpose Logistics Module Donatello settle onto a work stand. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello, is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

NASA Image and Video Library

2004-02-13

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers help the Multi-Purpose Logistics Module Donatello settle onto a work stand. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello, is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

KENNEDY SPACE CENTER, FLA. - The Multi-Purpose Logistics Module Donatello is suspended by cables over the payload canister in the Space Station Processing Facility. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

NASA Image and Video Library

2004-02-13

KENNEDY SPACE CENTER, FLA. - The Multi-Purpose Logistics Module Donatello is suspended by cables over the payload canister in the Space Station Processing Facility. Previously housed in the Operations and Checkout Building, Donatello was brought into the SSPF for routine testing. This is the first time all three MPLMs (Donatello, Raffaello and Leonardo) are in the SSPF. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. The third MPLM, Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

KENNEDY SPACE CENTER, FLA. - This view reveals all three Multi-Purpose Logistics Modules on the floor of the Space Station Processing Facility. This is the first time all three - Leonardo, Raffaello and Donatello -- have been in one location. Donatello has been stored in the Operations and Checkout Building since its arrival at KSC and was brought into the SSPF for routine testing. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - This view reveals all three Multi-Purpose Logistics Modules on the floor of the Space Station Processing Facility. This is the first time all three - Leonardo, Raffaello and Donatello -- have been in one location. Donatello has been stored in the Operations and Checkout Building since its arrival at KSC and was brought into the SSPF for routine testing. The MPLMs were built by the Italian Space Agency, to serve as reusable logistics carriers and the primary delivery system to resupply and return station cargo requiring a pressurized environment. Raffaello is scheduled to fly on Space Shuttle Atlantis on mission STS-114.

Operations research for resource planning and -use in radiotherapy: a literature review.

PubMed

Vieira, Bruno; Hans, Erwin W; van Vliet-Vroegindeweij, Corine; van de Kamer, Jeroen; van Harten, Wim

2016-11-25

The delivery of radiotherapy (RT) involves the use of rather expensive resources and multi-disciplinary staff. As the number of cancer patients receiving RT increases, timely delivery becomes increasingly difficult due to the complexities related to, among others, variable patient inflow, complex patient routing, and the joint planning of multiple resources. Operations research (OR) methods have been successfully applied to solve many logistics problems through the development of advanced analytical models for improved decision making. This paper presents the state of the art in the application of OR methods for logistics optimization in RT, at various managerial levels. A literature search was performed in six databases covering several disciplines, from the medical to the technical field. Papers included in the review were published in peer-reviewed journals from 2000 to 2015. Data extraction includes the subject of research, the OR methods used in the study, the extent of implementation according to a six-stage model and the (potential) impact of the results in practice. From the 33 papers included in the review, 18 addressed problems related to patient scheduling (of which 12 focus on scheduling patients on linear accelerators), 8 focus on strategic decision making, 5 on resource capacity planning, and 2 on patient prioritization. Although calculating promising results, none of the papers reported a full implementation of the model with at least a thorough pre-post performance evaluation, indicating that, apart from possible reporting bias, implementation rates of OR models in RT are probably low. The literature on OR applications in RT covers a wide range of approaches from strategic capacity management to operational scheduling levels, and shows that considerable benefits in terms of both waiting times and resource utilization are likely to be achieved. Various fields can be further developed, for instance optimizing the coordination between the available capacity of different imaging devices or developing scheduling models that consider the RT chain of operations as a whole rather than the treatment machines alone.

Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam

PubMed Central

Van Minh, Hoang; Odaga, John; Rout, Swampa Sarit; Ngoc, Diep Nguyen Thi; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D Scott

2013-01-01

Abstract Objective To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Methods Data were collected from a sample of facilities that participated in five demonstration projects for HPV vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. Findings The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). Conclusion The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services. PMID:23940406

Wind Energy Management System EMS Integration Project: Incorporating Wind Generation and Load Forecast Uncertainties into Power Grid Operations

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

Makarov, Yuri V.; Huang, Zhenyu; Etingov, Pavel V.

2010-01-01

The power system balancing process, which includes the scheduling, real time dispatch (load following) and regulation processes, is traditionally based on deterministic models. Since the conventional generation needs time to be committed and dispatched to a desired megawatt level, the scheduling and load following processes use load and wind and solar power production forecasts to achieve future balance between the conventional generation and energy storage on the one side, and system load, intermittent resources (such as wind and solar generation), and scheduled interchange on the other side. Although in real life the forecasting procedures imply some uncertainty around the loadmore » and wind/solar forecasts (caused by forecast errors), only their mean values are actually used in the generation dispatch and commitment procedures. Since the actual load and intermittent generation can deviate from their forecasts, it becomes increasingly unclear (especially, with the increasing penetration of renewable resources) whether the system would be actually able to meet the conventional generation requirements within the look-ahead horizon, what the additional balancing efforts would be needed as we get closer to the real time, and what additional costs would be incurred by those needs. To improve the system control performance characteristics, maintain system reliability, and minimize expenses related to the system balancing functions, it becomes necessary to incorporate the predicted uncertainty ranges into the scheduling, load following, and, in some extent, into the regulation processes. It is also important to address the uncertainty problem comprehensively by including all sources of uncertainty (load, intermittent generation, generators’ forced outages, etc.) into consideration. All aspects of uncertainty such as the imbalance size (which is the same as capacity needed to mitigate the imbalance) and generation ramping requirement must be taken into account. The latter unique features make this work a significant step forward toward the objective of incorporating of wind, solar, load, and other uncertainties into power system operations. Currently, uncertainties associated with wind and load forecasts, as well as uncertainties associated with random generator outages and unexpected disconnection of supply lines, are not taken into account in power grid operation. Thus, operators have little means to weigh the likelihood and magnitude of upcoming events of power imbalance. In this project, funded by the U.S. Department of Energy (DOE), a framework has been developed for incorporating uncertainties associated with wind and load forecast errors, unpredicted ramps, and forced generation disconnections into the energy management system (EMS) as well as generation dispatch and commitment applications. A new approach to evaluate the uncertainty ranges for the required generation performance envelope including balancing capacity, ramping capability, and ramp duration has been proposed. The approach includes three stages: forecast and actual data acquisition, statistical analysis of retrospective information, and prediction of future grid balancing requirements for specified time horizons and confidence levels. Assessment of the capacity and ramping requirements is performed using a specially developed probabilistic algorithm based on a histogram analysis, incorporating all sources of uncertainties of both continuous (wind and load forecast errors) and discrete (forced generator outages and start-up failures) nature. A new method called the “flying brick” technique has been developed to evaluate the look-ahead required generation performance envelope for the worst case scenario within a user-specified confidence level. A self-validation algorithm has been developed to validate the accuracy of the confidence intervals.« less

Mathematical Analysis of Vehicle Delivery Scale of Bike-Sharing Rental Nodes

NASA Astrophysics Data System (ADS)

Zhai, Y.; Liu, J.; Liu, L.

2018-04-01

Aiming at the lack of scientific and reasonable judgment of vehicles delivery scale and insufficient optimization of scheduling decision, based on features of the bike-sharing usage, this paper analyses the applicability of the discrete time and state of the Markov chain, and proves its properties to be irreducible, aperiodic and positive recurrent. Based on above analysis, the paper has reached to the conclusion that limit state (steady state) probability of the bike-sharing Markov chain only exists and is independent of the initial probability distribution. Then this paper analyses the difficulty of the transition probability matrix parameter statistics and the linear equations group solution in the traditional solving algorithm of the bike-sharing Markov chain. In order to improve the feasibility, this paper proposes a "virtual two-node vehicle scale solution" algorithm which considered the all the nodes beside the node to be solved as a virtual node, offered the transition probability matrix, steady state linear equations group and the computational methods related to the steady state scale, steady state arrival time and scheduling decision of the node to be solved. Finally, the paper evaluates the rationality and accuracy of the steady state probability of the proposed algorithm by comparing with the traditional algorithm. By solving the steady state scale of the nodes one by one, the proposed algorithm is proved to have strong feasibility because it lowers the level of computational difficulty and reduces the number of statistic, which will help the bike-sharing companies to optimize the scale and scheduling of nodes.

Attitudes, beliefs, and practices regarding electronic nicotine delivery systems in patients scheduled for elective surgery.

PubMed

Kadimpati, Sandeep; Nolan, Margaret; Warner, David O

2015-01-01

Smokers are at increased risk of postoperative complications. Electronic nicotine delivery systems (ENDS; or electronic cigarettes) could be a useful tool to reduce harm in the perioperative period. This pilot study examined the attitudes, beliefs, and practices of smokers scheduled for elective surgery regarding ENDS. This was a cross-sectional survey of current cigarette smokers who were evaluated in a preoperative clinic before elective surgery at Mayo Clinic. Measures included demographic characteristics, smoking history, 2 indices assessing the perception of how smoking affected health risks, ENDS use history, and 3 indices assessing interest in, perceived benefits of, and barriers to using ENDS in the perioperative period. Of the 112 smokers who completed the survey, 62 (55%) had tried ENDS and 24 (21%) reported current use. The most commonly stated reason for using ENDS was to quit smoking. Approximately 2 in 3 participants would be willing to use ENDS to help them reduce or eliminate perioperative cigarette use, and similar proportions perceived health benefits of doing so. Of the factors studied, only attempted to quit within the last year was significantly associated with increased interest in the perioperative use of ENDS (P=.03). Compared with participants who had tried ENDS (n=62), those who had never tried ENDS (n=50) had a significantly increased interest in the perioperative use of ENDS. A substantial proportion of patients scheduled for elective surgery had tried ENDS and would consider using ENDS to reduce perioperative use of cigarettes. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Using in situ simulation to evaluate operational readiness of a children's hospital-based obstetrics unit.

PubMed

Ventre, Kathleen M; Barry, James S; Davis, Deborah; Baiamonte, Veronica L; Wentworth, Allen C; Pietras, Michele; Coughlin, Liza; Barley, Gwyn

2014-04-01

Relocating obstetric (OB) services to a children's hospital imposes demands on facility operations, which must be met to ensure quality care and a satisfactory patient experience. We used in situ simulations to prospectively and iteratively evaluate operational readiness of a children's hospital-based OB unit before it opened for patient care. This project took place at a 314-bed, university-affiliated children's hospital. We developed 3 full-scale simulation scenarios depicting a concurrent maternal and neonatal emergency. One scenario began with a standardized patient experiencing admission; the mannequin portrayed a mother during delivery. We ran all 3 scenarios on 2 dates scheduled several weeks apart. We ran 2 of the scenarios on a third day to verify the reliability of key processes. During the simulations, content experts completed equipment checklists, and participants identified latent safety hazards. Each simulation involved a unique combination of scheduled participants who were supplemented by providers from responding ancillary services. The simulations involved 133 scheduled participants representing OB, neonatology, and anesthesiology. We exposed and addressed operational deficiencies involving equipment availability, staffing, interprofessional communication, and systems issues such as transfusion protocol failures and electronic order entry challenges. Process changes between simulation days 1 to 3 decreased the elapsed time between transfusion protocol activation and blood arrival to the operating room and labor/delivery/recovery/postpartum setting. In situ simulations identified multiple operational deficiencies on the OB unit, allowing us to take corrective action before its opening. This project may guide other children's hospitals regarding care processes likely to require significant focus and possible modification to accommodate an OB service.

Nurse managed occupational health services: a primary care model in practice.

PubMed

Childre, F

1997-10-01

1. Managed care focus on delivering health care which values prevention, early intervention, continuity of care, commitment to quality care, and outcomes, as well as client satisfaction. Occupational health nurses routinely integrate these values into their practice. 2. An on-site model of primary health care delivery, incorporating the fundamentals of occupational health nursing, can bring significant savings to the organization in health related costs. 3. Case management may provide the greatest potential for growth in occupational health nursing. It is a method that can be used together with managed care to maximize quality health care services. 4. Viewing health related costs as an investment as opposed to part of a benefit plan, influences employees to make positive choices. It also impacts the delivery of health care services on a systematic, global level, which affects total health care costs.

On Reducing Delay in Mesh-Based P2P Streaming: A Mesh-Push Approach

NASA Astrophysics Data System (ADS)

Liu, Zheng; Xue, Kaiping; Hong, Peilin

The peer-assisted streaming paradigm has been widely employed to distribute live video data on the internet recently. In general, the mesh-based pull approach is more robust and efficient than the tree-based push approach. However, pull protocol brings about longer streaming delay, which is caused by the handshaking process of advertising buffer map message, sending request message and scheduling of the data block. In this paper, we propose a new approach, mesh-push, to address this issue. Different from the traditional pull approach, mesh-push implements block scheduling algorithm at sender side, where the block transmission is initiated by the sender rather than by the receiver. We first formulate the optimal upload bandwidth utilization problem, then present the mesh-push approach, in which a token protocol is designed to avoid block redundancy; a min-cost flow model is employed to derive the optimal scheduling for the push peer; and a push peer selection algorithm is introduced to reduce control overhead. Finally, we evaluate mesh-push through simulation, the results of which show mesh-push outperforms the pull scheduling in streaming delay, and achieves comparable delivery ratio at the same time.

Asymptotically reliable transport of multimedia/graphics over wireless channels

NASA Astrophysics Data System (ADS)

Han, Richard Y.; Messerschmitt, David G.

1996-03-01

We propose a multiple-delivery transport service tailored for graphics and video transported over connections with wireless access. This service operates at the interface between the transport and application layers, balancing the subjective delay and image quality objectives of the application with the low reliability and limited bandwidth of the wireless link. While techniques like forward-error correction, interleaving and retransmission improve reliability over wireless links, they also increase latency substantially when bandwidth is limited. Certain forms of interactive multimedia datatypes can benefit from an initial delivery of a corrupt packet to lower the perceptual latency, as long as reliable delivery occurs eventually. Multiple delivery of successively refined versions of the received packet, terminating when a sufficiently reliable version arrives, exploits the redundancy inherently required to improve reliability without a traffic penalty. Modifications to acknowledgment-repeat-request (ARQ) methods to implement this transport service are proposed, which we term `leaky ARQ'. For the specific case of pixel-coded window-based text/graphics, we describe additional functions needed to more effectively support urgent delivery and asymptotic reliability. X server emulation suggests that users will accept a multi-second delay between a (possibly corrupt) packet and the ultimate reliably-delivered version. The relaxed delay for reliable delivery can be exploited for traffic capacity improvement using scheduling of retransmissions.

Schedule-induced drinking as functions of interpellet interval and draught size in the Java macaque1

PubMed Central

Allen, Joseph D.; Kenshalo, Dan R.

1978-01-01

Three Java monkeys received food pellets that were assigned by both ascending and descending series of fixed-time schedules whose values varied between 8 and 256 seconds. The draught size dispensed by a concurrently available water-delivery tube was systematically varied between 1.0 and 0.3 milliliter per lick at various fixed-time values during the second and third series determinations. Session water intake was bitonically related to the interpellet interval and was determined by the interaction of (1) the probability of initiating a drinking bout, which fell off at the highest interpellet intervals and, (2) the size of the bout, which increased directly with increases in interpellet interval. Variations in draught size had little effect on total session intakes, but reduced bout size at draught sizes of 0.5 milliliter and below. Thus, a volume-regulation process of schedule-induced drinking operated generally at the session-intake level, but was limited to higher draught sizes at the bout level. PMID:16812093

Schedule-induced drinking as functions of interpellet interval and draught size in the Java macaque.

PubMed

Allen, J D; Kenshalo, D R

1978-09-01

Three Java monkeys received food pellets that were assigned by both ascending and descending series of fixed-time schedules whose values varied between 8 and 256 seconds. The draught size dispensed by a concurrently available water-delivery tube was systematically varied between 1.0 and 0.3 milliliter per lick at various fixed-time values during the second and third series determinations. Session water intake was bitonically related to the interpellet interval and was determined by the interaction of (1) the probability of initiating a drinking bout, which fell off at the highest interpellet intervals and, (2) the size of the bout, which increased directly with increases in interpellet interval. Variations in draught size had little effect on total session intakes, but reduced bout size at draught sizes of 0.5 milliliter and below. Thus, a volume-regulation process of schedule-induced drinking operated generally at the session-intake level, but was limited to higher draught sizes at the bout level.

Patient-Centered Appointment Scheduling Using Agent-Based Simulation

PubMed Central

Turkcan, Ayten; Toscos, Tammy; Doebbeling, Brad N.

2014-01-01

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to better understand clinic workflow and key constraints. We then developed an agent-based simulation model that includes all access modalities (appointments, walk-ins, and after-hours access), incorporate resources and key constraints and determine the best appointment scheduling method that improves access and continuity of care. This paper demonstrates the value of simulation models to test a variety of alternative strategies to improve access to care through scheduling. PMID:25954423

Incomplete Markets and Imperfect Institutions: Some Challenges Posed by Trust for Contemporary Health Care and Health Policy.

PubMed

Schlesinger, Mark; Gray, Bradford H

2016-08-01

As contemporary health policy promotes evidence-based practices using targeted incentives, policy makers may lose track of vital aspects of care that are difficult to measure. For more than a half century, scholars have recognized that these latter aspects play a crucial role in high-quality care and equitable health system performance but depend on the potentially frail reed of providers' trustworthiness: that is, their commitment to facets and outcomes of care not easily assessed by external parties. More recently, early experience with pay for performance in health settings suggests that enhancing financial rewards for the measurable undermines providers' commitment to the unmeasurable, degrading the trustworthiness of their practices. Reformers have looked to revised professional norms or reorganized practice arrangements to bolster the intrinsic motivations required for trustworthiness. We suggest here that these responses are likely to prove inadequate. We propose that they be complemented by a renewed policy-making commitment to nonprofit ownership among health care providers, insurers, and integrated delivery systems. We identify some of the concerns raised in the past with ownership-based policies and propose a set of responses. If these are pursued in combination, they hold the promise of a sustainable ownership-based policy reform for the United States. Copyright © 2016 by Duke University Press.

Operating health analysis of electric power systems

NASA Astrophysics Data System (ADS)

Fotuhi-Firuzabad, Mahmud

The required level of operating reserve to be maintained by an electric power system can be determined using both deterministic and probabilistic techniques. Despite the obvious disadvantages of deterministic approaches there is still considerable reluctance to apply probabilistic techniques due to the difficulty of interpreting a single numerical risk index and the lack of sufficient information provided by a single index. A practical way to overcome difficulties is to embed deterministic considerations in the probabilistic indices in order to monitor the system well-being. The system well-being can be designated as healthy, marginal and at risk. The concept of system well-being is examined and extended in this thesis to cover the overall area of operating reserve assessment. Operating reserve evaluation involves the two distinctly different aspects of unit commitment and the dispatch of the committed units. Unit commitment health analysis involves the determination of which unit should be committed to satisfy the operating criteria. The concepts developed for unit commitment health, margin and risk are extended in this thesis to evaluate the response well-being of a generating system. A procedure is presented to determine the optimum dispatch of the committed units to satisfy the response criteria. The impact on the response wellbeing being of variations in the margin time, required regulating margin and load forecast uncertainty are illustrated. The effects on the response well-being of rapid start units, interruptible loads and postponable outages are also illustrated. System well-being is, in general, greatly improved by interconnection with other power systems. The well-being concepts are extended to evaluate the spinning reserve requirements in interconnected systems. The interconnected system unit commitment problem is decomposed into two subproblems in which unit scheduling is performed in each isolated system followed by interconnected system evaluation. A procedure is illustrated to determine the well-being indices of the overall interconnected system. Under normal operating conditions, the system may also be able to carry a limited amount of interruptible load on top of its firm load without violating the operating criterion. An energy based approach is presented to determine the optimum interruptible load carrying capability in both the isolated and interconnected systems. Composite system spinning reserve assessment and composite system well-being are also examined in this research work. The impacts on the composite well-being of operating reserve considerations such as stand-by units, interruptible loads and the physical locations of these resources are illustrated. It is expected that the well-being framework and the concepts developed in this research work will prove extremely useful in the new competitive utility environment.

Magazine approach during a signal for food depends on Pavlovian, not instrumental, conditioning.

PubMed

Harris, Justin A; Andrew, Benjamin J; Kwok, Dorothy W S

2013-04-01

In the conditioned magazine approach paradigm, rats are exposed to a contingent relationship between a conditioned stimulus (CS) and the delivery of food (the unconditioned stimulus, US). As the rats learn the CS-US association, they make frequent anticipatory head entries into the food magazine (the conditioned response, CR) during the CS. Conventionally, this is considered to be a Pavlovian paradigm because food is contingent on the CS and not on the performance of CRs during the CS. However, because magazine entries during the CS are reliably followed by food, the increase in frequency of those responses may involve adventitious ("superstitious") instrumental conditioning. The existing evidence, from experiments using an omission schedule to eliminate the possibility of instrumental conditioning (B. J. Farwell & J. J. Ayres, 1979, Stimulus-reinforcer and response-reinforcer relations in the control of conditioned appetitive headpoking (goal tracking) in rats. Learning and Motivation, 10, 295-312; P. C. Holland, 1979, Differential effects of omission contingencies on various components of Pavlovian appetitive conditioned responding in rats. Journal of Experimental Psychology: Animal Behavior Processes, 5, 178-193), is ambiguous: rats acquire magazine CRs despite the omission schedule, demonstrating that the response does not depend on instrumental conditioning, but the response rate is greatly depressed compared with that of rats trained on a yoked schedule, consistent with a contribution from instrumental conditioning under normal (nonomission) schedules. Here we describe experiments in which rats were trained on feature-positive or feature-negative type discriminations between trials that were reinforced on an omission schedule versus trials reinforced on a yoked schedule. The experiments show that the difference in responding between omission and yoked schedules is due to suppression of responding under the omission schedule rather than an elevation of responding under the yoked schedule. We conclude that magazine responses during the CS are largely or entirely Pavlovian CRs.

The Development of Patient Scheduling Groups for an Effective Appointment System

PubMed Central

2016-01-01

Summary Background Patient access to care and long wait times has been identified as major problems in outpatient delivery systems. These aspects impact medical staff productivity, service quality, clinic efficiency, and health-care cost. Objectives This study proposed to redesign existing patient types into scheduling groups so that the total cost of clinic flow and scheduling flexibility was minimized. The optimal scheduling group aimed to improve clinic efficiency and accessibility. Methods The proposed approach used the simulation optimization technique and was demonstrated in a Primary Care physician clinic. Patient type included, emergency/urgent care (ER/UC), follow-up (FU), new patient (NP), office visit (OV), physical exam (PE), and well child care (WCC). One scheduling group was designed for this physician. The approach steps were to collect physician treatment time data for each patient type, form the possible scheduling groups, simulate daily clinic flow and patient appointment requests, calculate costs of clinic flow as well as appointment flexibility, and find the scheduling group that minimized the total cost. Results The cost of clinic flow was minimized at the scheduling group of four, an 8.3% reduction from the group of one. The four groups were: 1. WCC, 2. OV, 3. FU and ER/UC, and 4. PE and NP. The cost of flexibility was always minimized at the group of one. The total cost was minimized at the group of two. WCC was considered separate and the others were grouped together. The total cost reduction was 1.3% from the group of one. Conclusions This study provided an alternative method of redesigning patient scheduling groups to address the impact on both clinic flow and appointment accessibility. Balance between them ensured the feasibility to the recognized issues of patient service and access to care. The robustness of the proposed method on the changes of clinic conditions was also discussed. PMID:27081406

Wicked problems: policy contradictions in publicly financed dental care.

PubMed

Quiñonez, Carlos

2012-01-01

To review two policy issues that define publicly financed dental care as a "wicked policy problem." Historical review. By demonstrating how governments have shifted their funding focus from direct delivery care, to public third-party financing arrangements in private dental offices, and by their willingness to fund composite restorations in public fee schedules, it is clear that the logic and sustainability of public programming needs reconsideration. The current contradictions in public dental care programs speak to the need for policy makers to reassess their goals, and ask whether decisions are based more on political necessity than on a logical evidence-informed approach to the delivery of publicly financed dental care. © 2012 American Association of Public Health Dentistry.

The perinatal quality collaborative of North Carolina's 39 weeks project: a quality improvement program to decrease elective deliveries before 39 weeks of gestation.

PubMed

Berrien, Kate; Devente, James; French, Amanda; Cochran, Keith M; McCaffrey, Marty; Horton, Bethany J; Chescheir, Nancy

2014-01-01

Despite long-standing guidelines from the American College of Obstetricians and Gynecologists that call for avoiding elective births prior to 39 weeks of gestation, elective deliveries make up almost one-third of US births occurring in weeks 36-38. Poor outcomes are more likely for infants born electively before 39 weeks than for those born at 39 weeks. The Perinatal Quality Collaborative of North Carolina (PQCNC) undertook the 39 Weeks Project in 2009-2010 with the aim of reducing the number of early-term elective deliveries in North Carolina hospitals. Participating hospitals (N = 33) provided retrospective data on all early-term deliveries and created new policies, or amended or enforced existing policies, to accomplish the project's goals. Project activities included in-person learning sessions, regional meetings, webinars, electronic newsletters, a secure extranet Web site where participating hospitals could share relevant materials, and individual leadership consultations with hospital teams. Hospitals submitted monthly data to PQCNC, which provided ongoing training and data analysis. Elective deliveries before 39 weeks of gestation decreased 45% over the project period, from 2% to 1.1% of all deliveries. The proportion of elective deliveries among all scheduled early-term deliveries also decreased, from 23.63% to 16.19%. There was an increase in the proportion of patients with documented evidence of medical indications for early delivery, from 62.4% to 88.2%. No data were collected to determine whether outcomes changed for patients whose deliveries were deferred. The project also depended on each hospital to code its own data. The PQCNC's 39 Weeks Project successfully decreased the rate of early-term elective deliveries in participating hospitals.

An academic-health service partnership in nursing: lessons from the field.

PubMed

Granger, Bradi B; Prvu-Bettger, Janet; Aucoin, Julia; Fuchs, Mary Ann; Mitchell, Pamela H; Holditch-Davis, Diane; Roth, Deborah; Califf, Robert M; Gilliss, Catherine L

2012-03-01

To describe the development of an academic-health services partnership undertaken to improve use of evidence in clinical practice. Academic health science schools and health service settings share common elements of their missions: to educate, participate in research, and excel in healthcare delivery, but differences in the business models, incentives, and approaches to problem solving can lead to differences in priorities. Thus, academic and health service settings do not naturally align their leadership structures or work processes. We established a common commitment to accelerate the appropriate use of evidence in clinical practice and created an organizational structure to optimize opportunities for partnering that would leverage shared resources to achieve our goal. A jointly governed and funded institute integrated existing activities from the academic and service sectors. Additional resources included clinical staff and student training and mentoring, a pilot research grant-funding program, and support to access existing data. Emergent developments include an appreciation for a wider range of investigative methodologies and cross-disciplinary teams with skills to integrate research in daily practice and improve patient outcomes. By developing an integrated leadership structure and commitment to shared goals, we developed a framework for integrating academic and health service resources, leveraging additional resources, and forming a mutually beneficial partnership to improve clinical outcomes for patients. Structurally integrated academic-health service partnerships result in improved evidence-based patient care delivery and in a stronger foundation for generating new clinical knowledge, thus improving patient outcomes. © 2012 Sigma Theta Tau International.

Methodology to Define Delivery Accuracy Under Current Day ATC Operations

NASA Technical Reports Server (NTRS)

Sharma, Shivanjli; Robinson, John E., III

2015-01-01

In order to enable arrival management concepts and solutions in a NextGen environment, ground- based sequencing and scheduling functions have been developed to support metering operations in the National Airspace System. These sequencing and scheduling algorithms as well as tools are designed to aid air traffic controllers in developing an overall arrival strategy. The ground systems being developed will support the management of aircraft to their Scheduled Times of Arrival (STAs) at flow-constrained meter points. This paper presents a methodology for determining the undelayed delivery accuracy for current day air traffic control operations. This new method analyzes the undelayed delivery accuracy at meter points in order to understand changes of desired flow rates as well as enabling definition of metrics that will allow near-future ground automation tools to successfully achieve desired separation at the meter points. This enables aircraft to meet their STAs while performing high precision arrivals. The research presents a possible implementation that would allow delivery performance of current tools to be estimated and delivery accuracy requirements for future tools to be defined, which allows analysis of Estimated Time of Arrival (ETA) accuracy for Time-Based Flow Management (TBFM) and the FAA's Traffic Management Advisor (TMA). TMA is a deployed system that generates scheduled time-of-arrival constraints for en- route air traffic controllers in the US. This new method of automated analysis provides a repeatable evaluation of the delay metrics for current day traffic, new releases of TMA, implementation of different tools, and across different airspace environments. This method utilizes a wide set of data from the Operational TMA-TBFM Repository (OTTR) system, which processes raw data collected by the FAA from operational TMA systems at all ARTCCs in the nation. The OTTR system generates daily reports concerning ATC status, intent and actions. Due to its availability, ease of use, and vast collection of data across several airspaces it was determined that the OTTR data set would be the best method to utilize moving forward with this analysis. The particular variables needed for further analysis were determined along with the necessary OTTR reports, by working closely with the repository team additional analysis reports were developed that provided key ETA and STA information at the freeze horizon. One major benefit of the OTTR data is that using the correct reports the data across several airports could be analyzed over large periods of time. The OTTR data processes the TBFM data daily and is stored in various formats across several airspaces. This allowed us to develop our own parsing methods and raw data processing that would not rely on other computationally expensive tools that perform more in depth analysis of similar sets of data. The majority of this work consisted of the development of the ability to filter flights to create a subset of flights that could be considered undelayed, which is defined as a flight at the freeze horizon with an ETA and STA difference that was minimal or close to zero. This was a broad method that allowed the consideration of a large data set which consisted of all the traffic across a two month period in 2013, the hottest and coldest months, arriving into four airports: George Bush Intercontinental, Denver International, Los Angeles International, and Phoenix Sky Harbor.

A microstructural analysis of schedule-induced polydipsia reveals incentive-induced hyperactivity in an animal model of ADHD.

PubMed

Íbias, Javier; Pellón, Ricardo; Sanabria, Federico

2015-02-01

Recent research has suggested that frequent short bursts of activity characterize hyperactivity associated with attention deficit hyperactivity disorder (ADHD). This study determined whether such pattern is also visible in schedule-induced polydipsia (SIP) in the spontaneously hypertensive rat (SHR), an animal model of ADHD. Male SHR, Wistar Kyoto (WKY) and Wistar rats were exposed to 40 sessions of SIP using a multiple fixed-time (FT) schedule of food delivery with FT 30-s and FT 90-s components. Stable performance was analyzed to determine the extent to which SIP-associated drinking is organized in bouts. The Bi-Exponential Refractory Model (BERM) of free-operant performance was applied to schedule-induced licks. A model comparison analysis supported BERM as a description of SIP episodes: licks were not produced at a constant rate but organized into bouts within drinking episodes. FT 30-s induced similar overall licking rates, latencies to first licks and episode durations across strains; FT 90-s induced longer episode durations in SHRs and reduced licking rate in WKY and Wistar rats to nearly baseline levels. Across schedules, SHRs made more and shorter bouts when compared to the other strains. These results suggest an incentive-induced hyperactivity in SHR that has been observed in operant behaviour and in children with ADHD. Copyright © 2014 Elsevier B.V. All rights reserved.

Segment scheduling method for reducing 360° video streaming latency

NASA Astrophysics Data System (ADS)

Gudumasu, Srinivas; Asbun, Eduardo; He, Yong; Ye, Yan

2017-09-01

360° video is an emerging new format in the media industry enabled by the growing availability of virtual reality devices. It provides the viewer a new sense of presence and immersion. Compared to conventional rectilinear video (2D or 3D), 360° video poses a new and difficult set of engineering challenges on video processing and delivery. Enabling comfortable and immersive user experience requires very high video quality and very low latency, while the large video file size poses a challenge to delivering 360° video in a quality manner at scale. Conventionally, 360° video represented in equirectangular or other projection formats can be encoded as a single standards-compliant bitstream using existing video codecs such as H.264/AVC or H.265/HEVC. Such method usually needs very high bandwidth to provide an immersive user experience. While at the client side, much of such high bandwidth and the computational power used to decode the video are wasted because the user only watches a small portion (i.e., viewport) of the entire picture. Viewport dependent 360°video processing and delivery approaches spend more bandwidth on the viewport than on non-viewports and are therefore able to reduce the overall transmission bandwidth. This paper proposes a dual buffer segment scheduling algorithm for viewport adaptive streaming methods to reduce latency when switching between high quality viewports in 360° video streaming. The approach decouples the scheduling of viewport segments and non-viewport segments to ensure the viewport segment requested matches the latest user head orientation. A base layer buffer stores all lower quality segments, and a viewport buffer stores high quality viewport segments corresponding to the most recent viewer's head orientation. The scheduling scheme determines viewport requesting time based on the buffer status and the head orientation. This paper also discusses how to deploy the proposed scheduling design for various viewport adaptive video streaming methods. The proposed dual buffer segment scheduling method is implemented in an end-to-end tile based 360° viewports adaptive video streaming platform, where the entire 360° video is divided into a number of tiles, and each tile is independently encoded into multiple quality level representations. The client requests different quality level representations of each tile based on the viewer's head orientation and the available bandwidth, and then composes all tiles together for rendering. The simulation results verify that the proposed dual buffer segment scheduling algorithm reduces the viewport switch latency, and utilizes available bandwidth more efficiently. As a result, a more consistent immersive 360° video viewing experience can be presented to the user.

PubMed Central

2012-01-01

The Walt Disney Company has never lost sight of its founder's edict: “Give the public everything you can give them.” From this simple statement, everyone at Disney strives to exceed customer expectations every day. For more than 80 years this singular pursuit of excellence in delivering consistent quality service has earned the Disney organization a world-renowned reputation and ongoing business success. Uncover some of the secrets behind the Disney service culture and processes. In this session, you will examine the time-tested model for delivering world-class Guest service and discover how attention to detail creates a consistent, successful environment for both employees and customers. You can then use these ideas to transform and improve your own organization's delivery of quality service. You will learn how to: Develop an organizational culture that supports consistent delivery of quality service.Evaluate the Disney approach and tailor it to your business.Design quality service standards and processes to raise the level of customer satisfaction.Create metrics to gauge the needs, perceptions and expectations of your customers.Enable employees, settings and processes to convey your quality service commitment.Implement a strategic plan for monitoring the delivery of seamless customer experiences.

Web-Based Medical Appointment Systems: A Systematic Review

PubMed Central

Zhao, Peng; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo

2017-01-01

Background Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. Objective The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. Methods In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. Results A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients’ reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Conclusions Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies. PMID:28446422

Web-Based Medical Appointment Systems: A Systematic Review.

PubMed

Zhao, Peng; Yoo, Illhoi; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo

2017-04-26

Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients' reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies. ©Peng Zhao, Illhoi Yoo, Jaie Lavoie, Beau James Lavoie, Eduardo Simoes. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.04.2017.

Bringing Lean Six Sigma to the Supply Chain Classroom: A Problem-Based Learning Case

ERIC Educational Resources Information Center

Miller, Keith E.; Hill, Craig; Miller, Antoinette R.

2016-01-01

The article describes a project that employs problem-based learning (PBL) to teach the Lean Six Sigma (LSS) methodology as part of an undergraduate or graduate business course. It is scalable to a variety of course delivery and schedule formats, and uses data sets that can create distinct problem-solving scenarios for up to 16 student teams. It…

JPRS Report, Science & Technology, Japan.

DTIC Science & Technology

1988-06-25

search for antibacterial substances, antitumor agents or biologically active substances such as toxins and other pharmacologically active substances from...total cost of ¥1.35 billion. Delivery is scheduled for March 1988. This helicopter will be used for various purposes, such as rescue activities , etc...long standing, has suddenly changed. Now, it is concentrating very effectively on development activities so as to be one of the pioneers in

Generating Ship-to-Shore Bulk Fuel Delivery Schedules for the Marine Expeditionary Unit

DTIC Science & Technology

2017-06-01

Amphibious Ready Group . . . . . . . . . . . . . . . . . . . . . 9 2.2 Amphibious Connectors . . . . . . . . . . . . . . . . . . . . . 11 2.3 Fuel Containers...ARG Amphibious Ready Group BLT Battalion Landing Team COMPHIBRON Commander, Amphibious Squadron CSV Comma Separated Values LCAC Landing Craft Air...in the world. The MEU and the Amphibious Ready Group (ARG) create a highly capable amphibious force able to strike and conduct operations from the sea

The pneumatic syringe: a simple apparatus for self-administration of drugs by rats.

PubMed

Weeks, J R

1977-12-01

Drug solution is delivered by a syringe operated by a pneumatic cylinder. Recommended delivery volumes are from 10 to 200 microliter. A solid-state control unit is described which can operate two syringes (drug injection and flush), has outputs for recording responses and injections, and can be programmed to provide several schedules of reinforcement. All components are readily commercially available.

Loglines. May - June 2011

DTIC Science & Technology

2011-06-01

chief of the Aerial Delivery and Textile Section. When orders for construction material peaked in 2010, the riggers helped pack about 200 air...ensures effective inspection programs and that SRM projects are scheduled to ensure critical defense missions can be fueled while the projects are...the Active Item Walk and Pick helps distribution workers quickly grab any of 8,000 items considered fast movers, such as washers and gaskets

75 FR 39322 - 30-Day Notice of Proposed Information Collection: Retail Price Schedule, DS-2020 Parts 1-4, DS...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

.... Originating Office: Bureau of Administration Office of Allowances (A/OPR/ALS). Form Number: DS-2020, DS-2020I...: [email protected] . Mail (paper, disk, or CD-ROM submissions): Office of Allowances (A/OPR/ALS), Room... Delivery or Courier: Office of Allowances (A/OPR/ ALS), Room L314, Department of State, 2401 E Street, NW...

75 FR 20873 - 60-Day Notice of Proposed Information Collection: DS-2020 Retail Price Schedule, Part 3 and Part...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-21

... Office: Bureau of Administration Office of Allowances (A/OPR/ALS). Form Number: DS-2020. Respondents... submissions): Office of Allowances (A/OPR/ALS), Room L314 SA-1, Department of State, Washington, DC 20522-0103 Fax: (202) 261-8707 or (202) 261-8708 Hand Delivery or Courier: Office of Allowances (A/OPR/ALS) Room...

Avoidance of Timeout from Response-Independent Food: Effects of Delivery Rate and Quality

ERIC Educational Resources Information Center

Richardson, Joseph V.; Baron, Alan

2008-01-01

In three experiments, a rat's lever presses could postpone timeouts from food pellets delivered on response-independent schedules. In Experiment 1, the pellets were delivered at variable-time (VT) rates ranging from VT 0.5 to VT 8 min. Experiment 2 replicated the VT 1 min and VT 8 min conditions of Experiment 1 with new subjects. Finally, subjects…

Integrated Advanced Microwave Sounding Unit-A (AMSU-A): Monthly Report for August

NASA Technical Reports Server (NTRS)

Nieto, A.

2000-01-01

Included in this report are Combined Program Delivery Schedules and Reports; a report from the Product Team Leaders on the status of all major program elements; Contract Data Requirements List (CDRL) 503, the Weight and Power Budgets; CDRL 204, reporting on the activities of Performance Assurance; CDRL 203, the Configuration Management Status Report; and the Documentation/Data Management Status Report.

Streamlining DOD Acquisitions: Balancing Schedule with Complexity

DTIC Science & Technology

2006-09-01

from them has a distinct industrial flavor: streamlined processes, benchmarking, and business models . The requirements generation com- munity led by... model ), and the Department of the Navy assumed program lead. [Stable Program Inputs (-)] By 1984, the program goals included delivery of 913 V-22...they subsequently specified a crew of two. [Stable Program Input (-)] The contractor team won in a “fly-off” solely via modeling and simulation

Resistance to Change and Relapse of Observing

PubMed Central

Thrailkill, Eric A; Shahan, Timothy A

2012-01-01

Four experiments examined relapse of extinguished observing behavior of pigeons using a two-component multiple schedule of observing-response procedures. In both components, unsignaled periods of variable-interval (VI) food reinforcement alternated with extinction and observing responses produced stimuli associated with the availability of the VI schedule (i.e., S+). The components differed in the rate of food arranged (Rich  = VI 30 s; Lean  =  VI 120 s). In Experiment 1, following baseline training, extinction of observing involved removal of both food and S+ deliveries, and reinstatement was examined by presenting either response-independent food or S+ deliveries. In Experiment 2, extinction involved removal of only food deliveries while observing responses continued to produce S+. Reinstatement was examined by delivering food contingent upon the first two food-key responses occurring in the presence of the S+. Experiment 3 assessed ABA renewal of observing by extinguishing food-key and observing responses in the presence of one contextual stimulus (i.e., B) and then returning to the original training context (i.e., A) during continued extinction. Experiment 4 examined resurgence by introducing food reinforcement for an alternative response during extinction, and subsequently removing that alternative source of food. Across experiments, relative resistance to extinction and relapse of observing tended to be greater in the component previously associated with the higher rate of primary reinforcement. Relapse of observing or attending to stimuli associated with primary reinforcement appears to be impacted by frequency of primary reinforcement in a manner similar to responding maintained directly by primary reinforcement. PMID:22693359

Microgrid optimal scheduling considering impact of high penetration wind generation

NASA Astrophysics Data System (ADS)

Alanazi, Abdulaziz

The objective of this thesis is to study the impact of high penetration wind energy in economic and reliable operation of microgrids. Wind power is variable, i.e., constantly changing, and nondispatchable, i.e., cannot be controlled by the microgrid controller. Thus an accurate forecasting of wind power is an essential task in order to study its impacts in microgrid operation. Two commonly used forecasting methods including Autoregressive Integrated Moving Average (ARIMA) and Artificial Neural Network (ANN) have been used in this thesis to improve the wind power forecasting. The forecasting error is calculated using a Mean Absolute Percentage Error (MAPE) and is improved using the ANN. The wind forecast is further used in the microgrid optimal scheduling problem. The microgrid optimal scheduling is performed by developing a viable model for security-constrained unit commitment (SCUC) based on mixed-integer linear programing (MILP) method. The proposed SCUC is solved for various wind penetration levels and the relationship between the total cost and the wind power penetration is found. In order to reduce microgrid power transfer fluctuations, an additional constraint is proposed and added to the SCUC formulation. The new constraint would control the time-based fluctuations. The impact of the constraint on microgrid SCUC results is tested and validated with numerical analysis. Finally, the applicability of proposed models is demonstrated through numerical simulations.