Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders.

PubMed

Roux, Paul; Passerieux, Christine; Fleury, Marie-Josée

2016-12-01

Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling. The structural equation model provided a good fit with the data. An increase in needs was associated with lower service performance and worse outcomes, whereas higher service performance was associated with better outcomes. Service performance partially mediated the effect of patient needs on outcomes. Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life. © The Royal College of Psychiatrists 2016.

Integration mechanisms and hospital efficiency in integrated health care delivery systems.

PubMed

Wan, Thomas T H; Lin, Blossom Yen-Ju; Ma, Allen

2002-04-01

This study analyzes integration mechanisms that affect system performances measured by indicators of efficiency in integrated delivery systems (IDSs) in the United States. The research question is, do integration mechanisms improve IDSs' efficiency in hospital care? American Hospital Association's Annual Survey (1998) and Dorenfest's Survey on Information Systems in Integrated Healthcare Delivery Systems (1998) were used to conduct the study, using IDS as the unit of analysis. A covariance structure equation model of the effects of system integration mechanisms on IDS performance was formulated and validated by an empirical examination of IDSs. The study sample includes 973 hospital-based integrated health care delivery systems operating in the United States, carried in the list of Dorenfests Survey on Information Systems in Integrated Health care Delivery Systems. The measurement indicators of system integration mechanisms are categorized into six related domains: informatic integration, case management, hybrid physician-hospital integration, forward integration, backward integration, and high tech medical services. The multivariate analysis reveals that integration mechanisms in system operation are positively correlated and positively affect IDSs' efficiency. The six domains of integration mechanisms account for 58.9% of the total variance in hospital performance. The service differentiation strategy such as having more high tech medical services have much stronger influences on efficiency than other integration mechanisms do. The beneficial effects of integration mechanisms have been realized in IDS performance. High efficiency in hospital care can be achieved by employing proper integration strategies in operations.

Performance analysis of CCSDS path service

NASA Technical Reports Server (NTRS)

Johnson, Marjory J.

1989-01-01

A communications service, called Path Service, is currently being developed by the Consultative Committee for Space Data Systems (CCSDS) to provide a mechanism for the efficient transmission of telemetry data from space to ground for complex space missions of the future. This is an important service, due to the large volumes of telemetry data that will be generated during these missions. A preliminary analysis of performance of Path Service is presented with respect to protocol-processing requirements and channel utilization.

Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis

PubMed Central

Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

2017-01-01

Objective Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. Setting The study focused on all 72 health districts of Zambia. Methods We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Results Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. Conclusions With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. PMID:28057650

Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis.

PubMed

Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

2017-01-05

Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. The study focused on all 72 health districts of Zambia. We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Assessing the implementation of a bedside service handoff on an academic hospitalist service.

PubMed

Wray, Charlie M; Arora, Vineet M; Hedeker, Donald; Meltzer, David O

2018-06-01

Inpatient service handoffs are a vulnerable transition during a patients' hospitalization. We hypothesized that performing the service handoff at the patients' bedside may be one mechanism to more efficiently transfer patient information between physicians, while further integrating the patient into their hospital care. We performed a 6-month prospective study of performing a bedside handoff (BHO) at the service transition on a non-teaching hospitalist service. On a weekly basis, transitioning hospitalists co-rounded at patient's bedsides. Post-handoff surveys assessed for completeness of handoff, communication, missed information, and adverse events. A control group who performed the handoff via email, phone or face-to-face was also surveyed. Chi-square and item-response theory (IRT) analysis assessed for differences between BHO and control groups. Narrative responses were elicited to qualitatively describe the BHO. In total, 21/31 (67%) scheduled BHOs were performed. On average, 4 out of 6 eligible patients experienced a BHO, with a total of 90 patients experiencing a BHO. Of those asked to perform the BHO, 52% stated the service transition took 31-60 min compared to 24% in the control group. Controlling for the nesting of observations within physicians, IRT analysis found that BHO respondents had statistically significant greater odds of: reporting increased patient awareness of the service handoff, more certainty in the plan for each patient, less discovery of missed information, and less time needed to learn about the patient on the first day compared to control methods. Narrative responses described a more patient-centered handoff with improved communication that was time-consuming and often logistically difficult to implement. Despite its time-intensive nature, performing the service handoff at the patient's bedside may lead to a more complete and efficient service transition. Published by Elsevier Inc.

Aircraft Energy Efficiency (ACEE) status report

NASA Technical Reports Server (NTRS)

Nored, D. L.; Dugan, J. F., Jr.; Saunders, N. T.; Ziemianski, J. A.

1979-01-01

Fuel efficiency in aeronautics, for fuel conservation in general as well as for its effect on commercial aircraft operating economics is considered. Projects of the Aircraft Energy Efficiency Program related to propulsion are emphasized. These include: (1) engine component improvement, directed at performance improvement and engine diagnostics for prolonged service life; (2) energy efficient engine, directed at proving the technology base for the next generation of turbofan engines; and (3) advanced turboprop, directed at advancing the technology of turboprop powered aircraft to a point suitable for commercial airline service. Progress in these technology areas is reported.

An Efficient Power Saving Mechanism for Delay-Guaranteed Services in IEEE 802.16e

NASA Astrophysics Data System (ADS)

Park, Yunju; Hwang, Gang Uk

As the IEEE 802.16e Wireless Metropolitan Access Network (WMAN) supports the mobility of a mobile station (MS), increasing MS power efficiency has become an important issue. In this paper, we analyze the sleep-mode operation for an efficient power saving mechanism for delay-guaranteed services in the IEEE 802.16e WMAN and observe the effects of the operating parameters related to this operation. For the analysis we use the M/GI/1/K queueing system with multiple vacations, exhaustive services and setup times. In the analysis, we consider the power consumption during the wake-mode period as well as the sleep-mode period. As a performance measure for the power consumption, we propose the power consumption per unit time per effective arrival which considers the power consumption and the packet blocking probability simultaneously. In addition, since we consider delay-guaranteed services, the average packet response delay is also considered as a performance measure. Based on the performance measures, we obtain the optimal sleep-mode operation which minimizes the power consumption per unit time per effective arrival with a given delay requirement. Numerical studies are also provided to investigate the system performance and to show how to achieve our objective.

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

PubMed

Coop, Colleen F

2006-05-01

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

Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups

PubMed Central

Jian, Weiyan; Huang, Yinmin; Hu, Mu; Zhang, Xiumei

2009-01-01

Background The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context. Methods Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals. Results Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals. Conclusion It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to improve the reliability of clinical information and the risk-adjustment ability of Case-Mix. PMID:19402913

Workflow as a Service in the Cloud: Architecture and Scheduling Algorithms.

PubMed

Wang, Jianwu; Korambath, Prakashan; Altintas, Ilkay; Davis, Jim; Crawl, Daniel

2014-01-01

With more and more workflow systems adopting cloud as their execution environment, it becomes increasingly challenging on how to efficiently manage various workflows, virtual machines (VMs) and workflow execution on VM instances. To make the system scalable and easy-to-extend, we design a Workflow as a Service (WFaaS) architecture with independent services. A core part of the architecture is how to efficiently respond continuous workflow requests from users and schedule their executions in the cloud. Based on different targets, we propose four heuristic workflow scheduling algorithms for the WFaaS architecture, and analyze the differences and best usages of the algorithms in terms of performance, cost and the price/performance ratio via experimental studies.

75 FR 55816 - Senior Executive Service Performance Review Board Membership

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-14

... DEPARTMENT OF THE INTERIOR Council of the Inspectors General on Integrity and Efficiency Senior..., each agency is required to establish one or more Senior Executive Service (SES) performance review boards. The purpose of these boards is to review and evaluate the initial appraisal of a senior executive...

Building the chronic kidney disease management team.

PubMed

Spry, Leslie

2008-01-01

The need to be efficient and the demands for performance-based service are changing how nephrologists deliver care. Chronic kidney disease (CKD) occurs in patients with complex medical and social problems. CKD management requires that multidisciplinary professionals provide patient education, disease management, and psychosocial support. To remain cost-efficient, many physicians are training and supervising midlevel practitioners in the delivery of specialized health care. Specialized care that meets present CKD patient needs is best delivered in a CKD clinic. Three models of CKD clinic are identified: (1) anemia management CKD clinic, (2) the basic CKD clinic, and (3) the comprehensive CKD clinic. Each clinic model is based on critical elements of staffing, billable services, and patient-focused health care. Billable services are anemia-management services, physician services that may be provided by midlevel practitioners, and medical nutrition therapy. In some cases, social worker services may be billable. Building a patient-focused clinic that offers CKD management requires planning, familiarity with federal regulations and statutes, and skillful practitioners. Making services cost-efficient and outcome oriented requires careful physician leadership, talented midlevel practitioners, and billing professionals who understand the goals of the CKD clinic. As Medicare payment reforms evolve, a well-organized CKD program can be well poised to meet the requirements of payers and congressional mandates for performance-based purchasing.

Benchmarking surgeon satisfaction at academic health centers: a nationwide comparative survey.

PubMed

Drachman, D A

1996-01-01

Forty-six academic health centers (AHCs) belonging to the University HealthSystem consortium joined forces to compare the efficiency of their surgical services and to identify best practices. In addition to measures of operational performance, surgeon satisfaction with the surgical services provided was measured by using a standardized questionnaire. From hospital records, indicators of the efficiency of surgical services were collected in three main areas: scheduling, preoperative testing and assessment, and the intraoperative process. Responding to a mail questionnaire, a sample of surgeons rated their satisfaction with key aspects of surgical services including scheduling, operating room staff, and equipment/supplies. On the basis of a review of the operational measures and the survey results, high performers were identified. Site visits were made to several of these high performers to uncover the critical factors responsible for their success. The survey revealed distinct variations in surgeon satisfaction across the participating institutions. Numerical benchmarks were obtained for surgeon satisfaction with each key component of surgical services. Scheduling was the most important component of overall surgeon satisfaction, explaining 71% of the variance in the rating of overall satisfaction with surgical services. High operational efficiency and high surgeon satisfaction were not incompatible. Several of the participating institutions were able to achieve both. These results were disseminated to all of the participants at a national meeting as well as in written form. The surgeon satisfaction survey allowed the participants to establish benchmarks for surgeon satisfaction for each key component of the surgical services they receive. The site visits revealed several common characteristics of highly efficient surgical services. Taken by themselves, the participating institutions might have been reluctant to consider adopting these best practices for fear of alienating the surgical staff. The availability of data on surgeon satisfaction showed the participants that these best practices can coexist with high levels of surgeon satisfaction. This has helped to promote their adoption by the other participating institutions.

R&D100: Lightweight Distributed Metric Service

ScienceCinema

Gentile, Ann; Brandt, Jim; Tucker, Tom; Showerman, Mike

2018-06-12

On today's High Performance Computing platforms, the complexity of applications and configurations makes efficient use of resources difficult. The Lightweight Distributed Metric Service (LDMS) is monitoring software developed by Sandia National Laboratories to provide detailed metrics of system performance. LDMS provides collection, transport, and storage of data from extreme-scale systems at fidelities and timescales to provide understanding of application and system performance with no statistically significant impact on application performance.

R&D100: Lightweight Distributed Metric Service

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

Gentile, Ann; Brandt, Jim; Tucker, Tom

2015-11-19

On today's High Performance Computing platforms, the complexity of applications and configurations makes efficient use of resources difficult. The Lightweight Distributed Metric Service (LDMS) is monitoring software developed by Sandia National Laboratories to provide detailed metrics of system performance. LDMS provides collection, transport, and storage of data from extreme-scale systems at fidelities and timescales to provide understanding of application and system performance with no statistically significant impact on application performance.

Joint Service Magazine Advertising Test. Spring 1978.

DTIC Science & Technology

1979-04-01

This is a test of the relative efficiency and effectiveness of joint Service advertising versus solo Service advertising of the Active Services...Subtests conducted were performance of page versus spread advertisements and four box versus three-line business reply cards. Call back research was conducted to validate findings of the major test. (Author)

Field Tests of In-Service Modifications to Improve Performance of An Icebreaker Main Diesel Engine

DOT National Transportation Integrated Search

1977-08-01

Field tests of in-service modifications to improve engine efficiency and lower the emissions were performed on the no. 3 main diesel engine of the USCGC Mackinaw (WAGB-83). This engine is a model 38D8-1/8 manufactured by Colt Industries, Fairbanks Mo...

Too Big, Too Small, or Just Right? Cost-Efficiency of Environmental Inspection Services in Connecticut.

PubMed

Cohen, Jeffrey P; Checko, Patricia J

2017-12-01

To assess optimal activity size/mix of Connecticut local public health jurisdictions, through estimating economies of scale/scope/specialization for environmental inspections/services. Connecticut's 74 local health jurisdictions (LHJs) must provide environmental health services, but their efficiency or reasons for wide cost variation are unknown. The public health system is decentralized, with variation in organizational structure/size. We develop/compile a longitudinal dataset covering all 74 LHJs, annually from 2005 to 2012. We estimate a public health services/inspections cost function, where inputs are translated into outputs. We consider separate estimates of economies of scale/scope/specialization for four mandated inspection types. We obtain data from Connecticut Department of Public Health databases, reports, and other publicly available sources. There has been no known previous utilization of this combined dataset. On average, regional districts, municipal departments, and part-time LHJs are performing fewer than the efficient number of inspections. The full-time municipal departments and regional districts are more efficient but still not at the minimum efficient scale. The regional districts' elasticities of scale are larger, implying they are more efficient than municipal health departments. Local health jurisdictions may enhance efficiency by increasing inspections and/or sharing some services. © Health Research and Educational Trust.

How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

PubMed

Pelone, Ferruccio; Kringos, Dionne S; Spreeuwenberg, Peter; De Belvis, Antonio G; Groenewegen, Peter P

2013-09-01

To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment models were run to compare the relative technical efficiency. A sensitivity analysis of the resulting efficiency scores was performed. PC systems in 22 European countries in 2009/2010. Model 1 included data on PC governance, workforce development and economic conditions as inputs and access, coordination, continuity and comprehensiveness of care as outputs. Model 2 included the previous process dimensions as inputs and quality indicators as outputs. There is relatively reasonable efficiency in all countries at delivering as many as possible PC processes at a given level of PC structure. It is particularly important to invest in economic conditions to achieve an efficient structure-process balance. Only five countries have fully efficient PC systems in turning their services delivery into high quality outcomes, using a similar combination of access, continuity and comprehensiveness, although they differ on the adoption of coordination of services. There is a large variation in efficiency levels obtained by countries with inefficient PC in turning their services delivery into quality outcomes. Maximizing the individual functions of PC without taking into account the coherence within the health-care system is not sufficient from a policymaker's point of view when aiming to achieve efficiency.

Workflow as a Service in the Cloud: Architecture and Scheduling Algorithms

PubMed Central

Wang, Jianwu; Korambath, Prakashan; Altintas, Ilkay; Davis, Jim; Crawl, Daniel

2017-01-01

With more and more workflow systems adopting cloud as their execution environment, it becomes increasingly challenging on how to efficiently manage various workflows, virtual machines (VMs) and workflow execution on VM instances. To make the system scalable and easy-to-extend, we design a Workflow as a Service (WFaaS) architecture with independent services. A core part of the architecture is how to efficiently respond continuous workflow requests from users and schedule their executions in the cloud. Based on different targets, we propose four heuristic workflow scheduling algorithms for the WFaaS architecture, and analyze the differences and best usages of the algorithms in terms of performance, cost and the price/performance ratio via experimental studies. PMID:29399237

Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan.

PubMed

Yamauchi, Yasuhiro

2015-07-12

Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care.

Green School--A Service Learning Instrument to Enhance School Society Relation

ERIC Educational Resources Information Center

Madhusoodanan, Harikrishnan; Vitus, Geetha Janet

2014-01-01

A Green school is energy efficient, higher performing school that can be environmentally beneficial. Importance of Green school lies in the environmental friendliness value it upholds. Service learning has emanated out of philosophies of progressiveness and pragmatism. Service learning enables students to grow and learn through active…

Privatization of solid waste collection services: Lessons from Gaborone.

PubMed

Bolaane, Benjamin; Isaac, Emmanuel

2015-06-01

Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Privatization of solid waste collection services: Lessons from Gaborone

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

Bolaane, Benjamin, E-mail: bolaaneb@mopipi.ub.bw; Isaac, Emmanuel, E-mail: eisaac300@gmail.com

Highlights: • We compared efficiency and effectiveness of waste collection by the public and private sector. • Public sector performs better than private sector in some areas and vice versa. • Outsourcing waste collection in developing countries is hindered by limited capacity on contractual issues. • Outsourcing collection in developing countries is hampered by inadequate waste information. • There is need to build capacity in the public sector of developing countries to support outsourcing. - Abstract: Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste managementmore » experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process.« less

Data Envelopment Analysis (DEA) Model in Operation Management

NASA Astrophysics Data System (ADS)

Malik, Meilisa; Efendi, Syahril; Zarlis, Muhammad

2018-01-01

Quality management is an effective system in operation management to develops, maintains, and improves quality from groups of companies that allow marketing, production, and service at the most economycal level as well as ensuring customer satisfication. Many companies are practicing quality management to improve their bussiness performance. One of performance measurement is through measurement of efficiency. One of the tools can be used to assess efficiency of companies performance is Data Envelopment Analysis (DEA). The aim of this paper is using Data Envelopment Analysis (DEA) model to assess efficiency of quality management. In this paper will be explained CCR, BCC, and SBM models to assess efficiency of quality management.

IoT Service Clustering for Dynamic Service Matchmaking.

PubMed

Zhao, Shuai; Yu, Le; Cheng, Bo; Chen, Junliang

2017-07-27

As the adoption of service-oriented paradigms in the IoT (Internet of Things) environment, real-world devices will open their capabilities through service interfaces, which enable other functional entities to interact with them. In an IoT application, it is indispensable to find suitable services for satisfying users' requirements or replacing the unavailable services. However, from the perspective of performance, it is inappropriate to find desired services from the service repository online directly. Instead, clustering services offline according to their similarity and matchmaking or discovering service online in limited clusters is necessary. This paper proposes a multidimensional model-based approach to measure the similarity between IoT services. Then, density-peaks-based clustering is employed to gather similar services together according to the result of similarity measurement. Based on the service clustering, the algorithms of dynamic service matchmaking, discovery, and replacement will be performed efficiently. Evaluating experiments are conducted to validate the performance of proposed approaches, and the results are promising.

IoT Service Clustering for Dynamic Service Matchmaking

PubMed Central

Yu, Le; Cheng, Bo; Chen, Junliang

2017-01-01

As the adoption of service-oriented paradigms in the IoT (Internet of Things) environment, real-world devices will open their capabilities through service interfaces, which enable other functional entities to interact with them. In an IoT application, it is indispensable to find suitable services for satisfying users’ requirements or replacing the unavailable services. However, from the perspective of performance, it is inappropriate to find desired services from the service repository online directly. Instead, clustering services offline according to their similarity and matchmaking or discovering service online in limited clusters is necessary. This paper proposes a multidimensional model-based approach to measure the similarity between IoT services. Then, density-peaks-based clustering is employed to gather similar services together according to the result of similarity measurement. Based on the service clustering, the algorithms of dynamic service matchmaking, discovery, and replacement will be performed efficiently. Evaluating experiments are conducted to validate the performance of proposed approaches, and the results are promising. PMID:28749431

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

Kurnik, Charles W.; Stoughton, Kate M; Figueroa, Jorge

This measurement and verification (M&V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings resulting from water conservation measures (WCMs) in energy performance contracts associated with outdoor irrigation efficiency projects. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M&V plan, and details the procedures to use to determine water savings.

Public Attitudes towards Socio-Cultural Aspects of Water Supply and Sanitation Services: Palestine as a Case Study

ERIC Educational Resources Information Center

Haddad, Marwan

2005-01-01

Identifying and considering public attitudes towards various aspects of water supply and sanitation services by planners and decision makers represent an important developmental element relating to the quality, efficiency, and performance of those services. A sample of 1000 Palestinian adults completed a questionnaire assessing attitudes towards…

Study of Core Competency Elements and Factors Affecting Performance Efficiency of Government Teachers in Northeastern Thailand

ERIC Educational Resources Information Center

Chansirisira, Pacharawit

2012-01-01

The research aimed to investigate the core competency elements and the factors affecting the performance efficiency of the civil service teachers in the northeastern region, Thailand. The research procedure consisted of two steps. In the first step, the data were collected using a questionnaire with the reliability (Cronbach's Alpha) of 0.90. The…

Strategic interaction among hospitals and nursing facilities: the efficiency effects of payment systems and vertical integration.

PubMed

Banks, D; Parker, E; Wendel, J

2001-03-01

Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by initiating prospective payments to nursing facilities, and are exploring the bundling of payments to hospitals. This paper develops a static profit-maximization model of the strategic interaction between the transferring hospital and a receiving nursing facility. This model suggests that the post-1984 system of prospective payment for hospital care, coupled with nursing facility payments that reimburse for services performed, induces inefficient under-provision of hospital services and encourages vertical integration. It further indicates that the extension of prospective payment to nursing facilities will not eliminate the incentive to vertically integrate, and will not result in efficient production unless such integration takes place. Bundling prospective payments for hospitals and nursing facilities will neither remove the incentive for vertical integration nor induce production efficiency without such vertical integration. However, bundled payment will induce efficient production, with or without vertical integration, if nursing facilities are reimbursed for services performed. Copyright 2001 John Wiley & Sons, Ltd.

Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan

PubMed Central

Yamauchi, Yasuhiro

2016-01-01

Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care. PMID:26493427

[Personality determinants of effectiveness in performing duties by soldiers in active service in the landing-shock brigade].

PubMed

Florkowski, A; Caban, Z; Szczesny, D; Zboralski, K

1996-01-01

After studies in the Brigade the authors identified and qualified personality traits which co-determine effectiveness in performing duties in active service. The efficiency of performing duties is determined by: high emotional resistance, high level of ability to logical conclusion, high level of self-control, low extroversion level, lack of antisocial tendencies. The authors worked out some indications concerning choice and selection for this military formation.

Efficient QoS-aware Service Composition

NASA Astrophysics Data System (ADS)

Alrifai, Mohammad; Risse, Thomas

Web service composition requests are usually combined with endto-end QoS requirements, which are specified in terms of non-functional properties (e.g. response time, throughput and price). The goal of QoS-aware service composition is to find the best combination of services such that their aggregated QoS values meet these end-to-end requirements. Local selection techniques are very efficient but fail short in handling global QoS constraints. Global optimization techniques, on the other hand, can handle global constraints, but their poor performance render them inappropriate for applications with dynamic and real-time requirements. In this paper we address this problem and propose a solution that combines global optimization with local selection techniques for achieving a better performance. The proposed solution consists of two steps: first we use mixed integer linear programming (MILP) to find the optimal decomposition of global QoS constraints into local constraints. Second, we use local search to find the best web services that satisfy these local constraints. Unlike existing MILP-based global planning solutions, the size of the MILP model in our case is much smaller and independent on the number of available services, yields faster computation and more scalability. Preliminary experiments have been conducted to evaluate the performance of the proposed solution.

How much can we gain from improved efficiency? An examination of performance of national HIV/AIDS programs and its determinants in low- and middle-income countries

PubMed Central

2012-01-01

Background The economic downturn exacerbates the inadequacy of resources for combating the worldwide HIV/AIDS pandemic and amplifies the need to improve the efficiency of HIV/AIDS programs. Methods We used data envelopment analysis (DEA) to evaluate efficiency of national HIV/AIDS programs in transforming funding into services and implemented a Tobit model to identify determinants of the efficiency in 68 low- and middle-income countries. We considered the change from the lowest quartile to the average value of a variable a "notable" increase. Results Overall, the average efficiency in implementing HIV/AIDS programs was moderate (49.8%). Program efficiency varied enormously among countries with means by quartile of efficiency of 13.0%, 36.4%, 54.4% and 96.5%. A country's governance, financing mechanisms, and economic and demographic characteristics influence the program efficiency. For example, if countries achieved a notable increase in "voice and accountability" (e.g., greater participation of civil society in policy making), the efficiency of their HIV/AIDS programs would increase by 40.8%. For countries in the lowest quartile of per capita gross national income (GNI), a notable increase in per capita GNI would increase the efficiency of AIDS programs by 45.0%. Conclusions There may be substantial opportunity for improving the efficiency of AIDS services, by providing more services with existing resources. Actions beyond the health sector could be important factors affecting HIV/AIDS service delivery. PMID:22443135

Managing for efficiency in health care: the case of Greek public hospitals.

PubMed

Mitropoulos, Panagiotis; Mitropoulos, Ioannis; Sissouras, Aris

2013-12-01

This paper evaluates the efficiency of public hospitals with two alternative conceptual models. One model targets resource usage directly to assess production efficiency, while the other model incorporates financial results to assess economic efficiency. Performance analysis of these models was conducted in two stages. In stage one, we utilized data envelopment analysis to obtain the efficiency score of each hospital, while in stage two we took into account the influence of the operational environment on efficiency by regressing those scores on explanatory variables that concern the performance of hospital services. We applied these methods to evaluate 96 general hospitals in the Greek national health system. The results indicate that, although the average efficiency scores in both models have remained relatively stable compared to past assessments, internal changes in hospital performances do exist. This study provides a clear framework for policy implications to increase the overall efficiency of general hospitals.

Assessment of community satisfaction index of population and civil registration office in Malang municipal

NASA Astrophysics Data System (ADS)

Hakim, A. N.

2017-06-01

The demands and needs of the community will be the quality of public services in Malang increased, so that the Government of Malang as organizers and executors of public services must meet these demands. The Municipal Government in its efforts to improve public service performance, forming the regional One Stop Operator (PPTSP) with the goal will be to simplify and improve efficiency in administrative proceedings. But the existence of the one stop service is still not optimal because of the persistence of public complaints about the performance of the one stop service. This study will discuss the performance of services in service counter of Population and Civil Registration through community satisfaction index to measure the service level and the perception of satisfaction and interest to determine which variables are less optimal and need to be improved using IPA method. The results showed that the level of service at the service counter of Population and Civil Registration quite good. Meanwhile, according the results of IPA analysis, there are two important variables for the community on the performance / quality was lacking, namely the service procedure and time.

Evaluating the Impact of Hospital Efficiency on Wellness in the Military Health System.

PubMed

Bastian, Nathaniel D; Kang, Hyojung; Swenson, Eric R; Fulton, Lawrence V; Griffin, Paul M

2016-08-01

Like all health care delivery systems, the U.S. Department of Defense Military Health System (MHS) strives to achieve top preventative care and population health outcomes for its members while operating at an efficient level and containing costs. The objective of this study is to understand the overall efficiency performance of military hospitals and investigate the relationship between efficiency and wellness. This study uses data envelopment analysis and stochastic frontier analysis to compare the efficiency of 128 military treatment facilities from the Army, Navy, and Air Force during the period of 2011 to 2013. Fixed effects panel regression is used to determine the association between the hospital efficiency and wellness scores. The results indicate that data envelopment analysis and stochastic frontier analysis efficiency scores are congruent in direction. Both results indicate that the majority of the MHS hospitals and clinics can potentially improve their productive efficiency by managing their input resources better. When comparing the performance of the three military branches of service, Army hospitals as a group outperformed their Navy and Air Force counterparts; thus, best practices from the Army should be shared across service components. The findings also suggest no statistically significant, positive association between efficiency and wellness over time in the MHS. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

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

Kurnik, Charles W.; Boyd, Brian; Stoughton, Kate M.

This measurement and verification (M and V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings resulting from water conservation measures (WCMs) in energy performance contracts associated with cooling tower efficiency projects. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M and V plan, and details the procedures to use to determine water savings.

High-performance web services for querying gene and variant annotation.

PubMed

Xin, Jiwen; Mark, Adam; Afrasiabi, Cyrus; Tsueng, Ginger; Juchler, Moritz; Gopal, Nikhil; Stupp, Gregory S; Putman, Timothy E; Ainscough, Benjamin J; Griffith, Obi L; Torkamani, Ali; Whetzel, Patricia L; Mungall, Christopher J; Mooney, Sean D; Su, Andrew I; Wu, Chunlei

2016-05-06

Efficient tools for data management and integration are essential for many aspects of high-throughput biology. In particular, annotations of genes and human genetic variants are commonly used but highly fragmented across many resources. Here, we describe MyGene.info and MyVariant.info, high-performance web services for querying gene and variant annotation information. These web services are currently accessed more than three million times permonth. They also demonstrate a generalizable cloud-based model for organizing and querying biological annotation information. MyGene.info and MyVariant.info are provided as high-performance web services, accessible at http://mygene.info and http://myvariant.info . Both are offered free of charge to the research community.

Parallel high-performance grid computing: capabilities and opportunities of a novel demanding service and business class allowing highest resource efficiency.

PubMed

Kepper, Nick; Ettig, Ramona; Dickmann, Frank; Stehr, Rene; Grosveld, Frank G; Wedemann, Gero; Knoch, Tobias A

2010-01-01

Especially in the life-science and the health-care sectors the huge IT requirements are imminent due to the large and complex systems to be analysed and simulated. Grid infrastructures play here a rapidly increasing role for research, diagnostics, and treatment, since they provide the necessary large-scale resources efficiently. Whereas grids were first used for huge number crunching of trivially parallelizable problems, increasingly parallel high-performance computing is required. Here, we show for the prime example of molecular dynamic simulations how the presence of large grid clusters including very fast network interconnects within grid infrastructures allows now parallel high-performance grid computing efficiently and thus combines the benefits of dedicated super-computing centres and grid infrastructures. The demands for this service class are the highest since the user group has very heterogeneous requirements: i) two to many thousands of CPUs, ii) different memory architectures, iii) huge storage capabilities, and iv) fast communication via network interconnects, are all needed in different combinations and must be considered in a highly dedicated manner to reach highest performance efficiency. Beyond, advanced and dedicated i) interaction with users, ii) the management of jobs, iii) accounting, and iv) billing, not only combines classic with parallel high-performance grid usage, but more importantly is also able to increase the efficiency of IT resource providers. Consequently, the mere "yes-we-can" becomes a huge opportunity like e.g. the life-science and health-care sectors as well as grid infrastructures by reaching higher level of resource efficiency.

FAST: A fully asynchronous and status-tracking pattern for geoprocessing services orchestration

NASA Astrophysics Data System (ADS)

Wu, Huayi; You, Lan; Gui, Zhipeng; Gao, Shuang; Li, Zhenqiang; Yu, Jingmin

2014-09-01

Geoprocessing service orchestration (GSO) provides a unified and flexible way to implement cross-application, long-lived, and multi-step geoprocessing service workflows by coordinating geoprocessing services collaboratively. Usually, geoprocessing services and geoprocessing service workflows are data and/or computing intensive. The intensity feature may make the execution process of a workflow time-consuming. Since it initials an execution request without blocking other interactions on the client side, an asynchronous mechanism is especially appropriate for GSO workflows. Many critical problems remain to be solved in existing asynchronous patterns for GSO including difficulties in improving performance, status tracking, and clarifying the workflow structure. These problems are a challenge when orchestrating performance efficiency, making statuses instantly available, and constructing clearly structured GSO workflows. A Fully Asynchronous and Status-Tracking (FAST) pattern that adopts asynchronous interactions throughout the whole communication tier of a workflow is proposed for GSO. The proposed FAST pattern includes a mechanism that actively pushes the latest status to clients instantly and economically. An independent proxy was designed to isolate the status tracking logic from the geoprocessing business logic, which assists the formation of a clear GSO workflow structure. A workflow was implemented in the FAST pattern to simulate the flooding process in the Poyang Lake region. Experimental results show that the proposed FAST pattern can efficiently tackle data/computing intensive geoprocessing tasks. The performance of all collaborative partners was improved due to the asynchronous mechanism throughout communication tier. A status-tracking mechanism helps users retrieve the latest running status of a GSO workflow in an efficient and instant way. The clear structure of the GSO workflow lowers the barriers for geospatial domain experts and model designers to compose asynchronous GSO workflows. Most importantly, it provides better support for locating and diagnosing potential exceptions.

Hybrid services efficient provisioning over the network coding-enabled elastic optical networks

NASA Astrophysics Data System (ADS)

Wang, Xin; Gu, Rentao; Ji, Yuefeng; Kavehrad, Mohsen

2017-03-01

As a variety of services have emerged, hybrid services have become more common in real optical networks. Although the elastic spectrum resource optimizations over the elastic optical networks (EONs) have been widely investigated, little research has been carried out on the hybrid services of the routing and spectrum allocation (RSA), especially over the network coding-enabled EON. We investigated the RSA for the unicast service and network coding-based multicast service over the network coding-enabled EON with the constraints of time delay and transmission distance. To address this issue, a mathematical model was built to minimize the total spectrum consumption for the hybrid services over the network coding-enabled EON under the constraints of time delay and transmission distance. The model guarantees different routing constraints for different types of services. The immediate nodes over the network coding-enabled EON are assumed to be capable of encoding the flows for different kinds of information. We proposed an efficient heuristic algorithm of the network coding-based adaptive routing and layered graph-based spectrum allocation algorithm (NCAR-LGSA). From the simulation results, NCAR-LGSA shows highly efficient performances in terms of the spectrum resources utilization under different network scenarios compared with the benchmark algorithms.

Overall ED efficiency is associated with decreased time to percutaneous coronary intervention for ST-segment elevation myocardial infarction.

PubMed

Jones, Christopher W; Sonnad, Seema S; Augustine, James J; Reese, Charles L

2014-10-01

Performance of percutaneous coronary intervention (PCI) within 90 minutes of hospital arrival for ST-segment elevation myocardial infarction patients is a commonly cited clinical quality measure. The Centers for Medicare and Medicaid Services use this measure to adjust hospital reimbursement via the Value-Based Purchasing Program. This study investigated the relationship between hospital performance on this quality measure and emergency department (ED) operational efficiency. Hospital-level data from Centers for Medicare and Medicaid Services on PCI quality measure performance was linked to information on operational performance from 272 US EDs obtained from the Emergency Department Benchmarking Alliance annual operations survey. Standard metrics of ED size, acuity, and efficiency were compared across hospitals grouped by performance on the door-to-balloon time quality measure. Mean hospital performance on the 90-minute arrival to PCI measure was 94.0% (range, 42-100). Among hospitals failing to achieve the door-to-balloon time performance standard, median ED length of stay was 209 minutes, compared with 173 minutes among those hospitals meeting the benchmark standard (P < .001). Similarly, median time from ED patient arrival to physician evaluation was 39 minutes for hospitals below the performance standard and 23 minutes for hospitals at the benchmark standard (P < .001). Markers of ED size and acuity, including annual patient volume, admission rate, and the percentage of patients arriving via ambulance did not vary with door-to-balloon time. Better performance on measures associated with ED efficiency is associated with more timely PCI performance. Copyright © 2014 Elsevier Inc. All rights reserved.

75 FR 41793 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... agencies for cooperative projects in marketing service and in marketing research to effectuate the purposes... encourage research and innovation aimed at improving the efficiency and performance of the U.S. marketing.... Agricultural Marketing Service Title: Federal-State Marketing Improvement Program (FSMIP). OMB Control Number...

Sustainable business models: systematic approach toward successful ambulatory care pharmacy practice.

PubMed

Sachdev, Gloria

2014-08-15

This article discusses considerations for making ambulatory care pharmacist services at least cost neutral and, ideally, generate a margin that allows for service expansion. The four pillars of business sustainability are leadership, staffing, information technology, and compensation. A key facet of leadership in ambulatory care pharmacy practice is creating and expressing a clear vision for pharmacists' services. Staffing considerations include establishing training needs, maximizing efficiencies, and minimizing costs. Information technology is essential for efficiency in patient care delivery and outcomes assessment. The three domains of compensation are cost savings, pay for performance, and revenue generation. The following eight steps for designing and implementing an ambulatory care pharmacist service are discussed: (1) prepare a needs assessment, (2) analyze existing strengths, weaknesses, opportunities, and threats, (3) analyze service gaps and feasibility, (4) consider financial opportunities, (5) consider stakeholders' interests, (6) develop a business plan, (7) implement the service, and (8) measure outcomes. Potential future changes in national healthcare policy (such as pharmacist provider status and expanded pay for performance) could enhance the opportunities for sustainable ambulatory care pharmacy practice. The key challenges facing ambulatory care pharmacists are developing sustainable business models, determining which services yield a positive return on investment, and demanding payment for value-added services. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Cooling Tower (Evaporative Cooling System) Measurement and Verification Protocol

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

Kurnik, Charles W.; Boyd, Brian; Stoughton, Kate M.

This measurement and verification (M and V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings resulting from water conservation measures (WCMs) in energy performance contracts associated with cooling tower efficiency projects. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M and V plan, and details the procedures to use to determine water savings.

Outdoor Irrigation Measurement and Verification Protocol

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

Kurnik, Charles W.; Stoughton, Kate M.; Figueroa, Jorge

This measurement and verification (M&V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings resulting from water conservation measures (WCMs) in energy performance contracts associated with outdoor irrigation efficiency projects. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M&V plan, and details the procedures to use to determine water savings.

Using a new incentive mechanism to improve wastewater sector performance: the case study of Italy.

PubMed

De Gisi, Sabino; Petta, Luigi; Farina, Roberto; De Feo, Giovanni

2014-01-01

The system of "Service Objectives", introduced by the Italian National Strategic Framework 2007-2013, is an innovative results-oriented programme concerning 4 thematic areas (education, care for the elderly and children, management of municipal solid wastes and integrated water service) in which the Ministry of Economic Development and eight Southern Italy districts are involved. The system was initially associated to an incentive mechanism which provided subsidies for a total amount of EUR 3 billion from the national Underdeveloped Areas Fund, according to the achievement of specific targets set for 11 service indicators in 2013. The indicators used for the integrated water service refer to the efficiency in water supply service as well as the coverage of wastewater treatment service. The aim of the study is to describe the activities carried out in Italy by the ENEA Agency in order to define a new performance indicator for wastewater treatment service taking into account the appropriateness and efficiency of existing plants equipment and, consequently, evaluating economic incentives. The proposed procedure takes into account both wastewater treatment demand and quality of wastewater treatment service offered to citizens. Input data, provided by the National Institute of Statistics (ISTAT), were elaborated in order to define appropriate parameters, with a multi-criteria analysis being used to define the new performance indicator. The applicability of the proposed procedure was verified considering all the 8 Southern Italy and Island districts (Abruzzo, Molise, Campania, Apulia, Basilicata, Calabria, Sicily and Sardinia) involved in the programme. The obtained results show that the quality of municipal wastewater may influence the calculation of the incentive amount. The performance indicators defined in this work might be conveniently extended to other contexts similar to the assessed geographical area (Southern Italy and Islands). Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessing the Sustainability Performance of Urban Plans based on Ecosystem Services

NASA Astrophysics Data System (ADS)

Menteşe, E. Y.; Tezer, A.

2017-12-01

Aiming at efficient and mindful use of natural resources while enabling social cohesion and economic development; sustainable development is one of the most emerging phenomenon in last decade. In this regard, role of urban development is critical by means of achieving sustainability since more than half of the world's population lives in cities. However, there is no solid and widely accepted approach for sustainability assessment in land use planning because there is not enough evidence on the relation between land use plans and environmental sustainability. With the basic aim of setting up relation between environmental sustainability and urban plans, this study utilizes ecosystem services phenomenon to define sustainability performance of a land use plan. Since ecosystem services can easily be related with land cover and land use they can be used as an efficient tool to act as indicators of sustainability. Meanwhile, while urban plans can provide ecosystem services and their level of service provision can be quantified, this is not solely enough for understanding its sustainability. Because it is also known that a land use plan mostly has negative impact on sustainability. Hence, this study embraces land use plans as a source of ecosystem services and environmental impacts. The difference between these entities are assumed to be the sustainability performance of a plan. The analysis relies on four parameters: ecosystem service capacity (environmental impact capacity), areal quantity of a land cover / use function, fragmantation level of the land use / cover and weight of ecosystem services / environmental impacts. Lastly, this approach is adopted for Istanbul's environmental master plan of 2009 and actual land cover of the same period. By calculating both data's environmental performance, the change of sustainability level sourced from environmental plan is analyzed.

[IMSS in numbers. Evaluation of the performance of health institutions in Mexico, 2004].

PubMed

2006-01-01

The evaluation of health institutions performance in Mexico during 2004 was done using 29 indicators that describe intra-hospital mortality rates, productivity of health services, availability of health resources, quality of care, security, investment and costs of health care and the satisfaction level by users of health services. This exercise describes the efficiency and organization of health services provided by the different health institutions and allows comparing and balancing the performance of each institution. Results indicate the differences in availability of resources, inequity in the financing health care services, and inefficiency in the use of resources but also describe the level of efficacy of certain institutions and the satisfaction level that different users have of health services. The evaluation of the performance of the entire health institutions should provide the means to improve all the process of health care and to increase the quality of care in all health institutions in the country.

A Comprehensive Optimization Strategy for Real-time Spatial Feature Sharing and Visual Analytics in Cyberinfrastructure

NASA Astrophysics Data System (ADS)

Li, W.; Shao, H.

2017-12-01

For geospatial cyberinfrastructure enabled web services, the ability of rapidly transmitting and sharing spatial data over the Internet plays a critical role to meet the demands of real-time change detection, response and decision-making. Especially for the vector datasets which serve as irreplaceable and concrete material in data-driven geospatial applications, their rich geometry and property information facilitates the development of interactive, efficient and intelligent data analysis and visualization applications. However, the big-data issues of vector datasets have hindered their wide adoption in web services. In this research, we propose a comprehensive optimization strategy to enhance the performance of vector data transmitting and processing. This strategy combines: 1) pre- and on-the-fly generalization, which automatically determines proper simplification level through the introduction of appropriate distance tolerance (ADT) to meet various visualization requirements, and at the same time speed up simplification efficiency; 2) a progressive attribute transmission method to reduce data size and therefore the service response time; 3) compressed data transmission and dynamic adoption of a compression method to maximize the service efficiency under different computing and network environments. A cyberinfrastructure web portal was developed for implementing the proposed technologies. After applying our optimization strategies, substantial performance enhancement is achieved. We expect this work to widen the use of web service providing vector data to support real-time spatial feature sharing, visual analytics and decision-making.

Service-Aware Clustering: An Energy-Efficient Model for the Internet-of-Things

PubMed Central

Bagula, Antoine; Abidoye, Ademola Philip; Zodi, Guy-Alain Lusilao

2015-01-01

Current generation wireless sensor routing algorithms and protocols have been designed based on a myopic routing approach, where the motes are assumed to have the same sensing and communication capabilities. Myopic routing is not a natural fit for the IoT, as it may lead to energy imbalance and subsequent short-lived sensor networks, routing the sensor readings over the most service-intensive sensor nodes, while leaving the least active nodes idle. This paper revisits the issue of energy efficiency in sensor networks to propose a clustering model where sensor devices’ service delivery is mapped into an energy awareness model, used to design a clustering algorithm that finds service-aware clustering (SAC) configurations in IoT settings. The performance evaluation reveals the relative energy efficiency of the proposed SAC algorithm compared to related routing algorithms in terms of energy consumption, the sensor nodes’ life span and its traffic engineering efficiency in terms of throughput and delay. These include the well-known low energy adaptive clustering hierarchy (LEACH) and LEACH-centralized (LEACH-C) algorithms, as well as the most recent algorithms, such as DECSA and MOCRN. PMID:26703619

Service-Aware Clustering: An Energy-Efficient Model for the Internet-of-Things.

PubMed

Bagula, Antoine; Abidoye, Ademola Philip; Zodi, Guy-Alain Lusilao

2015-12-23

Current generation wireless sensor routing algorithms and protocols have been designed based on a myopic routing approach, where the motes are assumed to have the same sensing and communication capabilities. Myopic routing is not a natural fit for the IoT, as it may lead to energy imbalance and subsequent short-lived sensor networks, routing the sensor readings over the most service-intensive sensor nodes, while leaving the least active nodes idle. This paper revisits the issue of energy efficiency in sensor networks to propose a clustering model where sensor devices' service delivery is mapped into an energy awareness model, used to design a clustering algorithm that finds service-aware clustering (SAC) configurations in IoT settings. The performance evaluation reveals the relative energy efficiency of the proposed SAC algorithm compared to related routing algorithms in terms of energy consumption, the sensor nodes' life span and its traffic engineering efficiency in terms of throughput and delay. These include the well-known low energy adaptive clustering hierarchy (LEACH) and LEACH-centralized (LEACH-C) algorithms, as well as the most recent algorithms, such as DECSA and MOCRN.

Structural relationships between work environment and service quality perceptions as a function of customer contact intensity: implications for human service strategy.

PubMed

Scotti, Dennis J; Harmon, Joel; Behson, Scott J

2009-01-01

This study assesses the importance of customer-contact intensity at the service encounter level as a determinant of service quality assessments. Using data from the U.S. Department of Veterans Affairs, it shows that performance-driven human resources practices play an important role as determinants of employee customer orientation and service capability in both high-contact (outpatient healthcare) and low-contact (benefits claim processing) human service contexts. However, there existed significant differences across service delivery settings in the salience of customer orientation and the congruence between employee and customer perceptions of service quality, depending on the intensity of customer contact. In both contexts, managerial attention to high-performance work systems and customer-orientation has the potential to favorably impact perceptions of service quality, amplify consumer satisfaction, and enhance operational efficiency.

Chip-set for quality of service support in passive optical networks

NASA Astrophysics Data System (ADS)

Ringoot, Edwin; Hoebeke, Rudy; Slabbinck, B. Hans; Verhaert, Michel

1998-10-01

In this paper the design of a chip-set for QoS provisioning in ATM-based Passive Optical Networks is discussed. The implementation of a general-purpose switch chip on the Optical Network Unit is presented, with focus on the design of the cell scheduling and buffer management logic. The cell scheduling logic supports `colored' grants, priority jumping and weighted round-robin scheduling. The switch chip offers powerful buffer management capabilities enabling the efficient support of GFR and UBR services. Multicast forwarding is also supported. In addition, the architecture of a MAC controller chip developed for a SuperPON access network is introduced. In particular, the permit scheduling logic and its implementation on the Optical Line Termination will be discussed. The chip-set enables the efficient support of services with different service requirements on the SuperPON. The permit scheduling logic built into the MAC controller chip in combination with the cell scheduling and buffer management capabilities of the switch chip can be used by network operators to offer guaranteed service performance to delay sensitive services, and to efficiently and fairly distribute any spare capacity to delay insensitive services.

A SOPC-BASED Evaluation of AES for 2.4 GHz Wireless Network

NASA Astrophysics Data System (ADS)

Ken, Cai; Xiaoying, Liang

In modern systems, data security is needed more than ever before and many cryptographic algorithms are utilized for security services. Wireless Sensor Networks (WSN) is an example of such technologies. In this paper an innovative SOPC-based approach for the security services evaluation in WSN is proposed that addresses the issues of scalability, flexible performance, and silicon efficiency for the hardware acceleration of encryption system. The design includes a Nios II processor together with custom designed modules for the Advanced Encryption Standard (AES) which has become the default choice for various security services in numerous applications. The objective of this mechanism is to present an efficient hardware realization of AES using very high speed integrated circuit hardware description language (Verilog HDL) and expand the usability for various applications. As compared to traditional customize processor design, the mechanism provides a very broad range of cost/performance points.

Performance Contracting: Taking School Technology Green

ERIC Educational Resources Information Center

Taival, Dane

2009-01-01

Energy efficiency makes fiscal and environmental sense, and so does energy savings performance contracting. Because an energy savings performance contract can create a self-funding package of products and services that reduce energy and operating costs, over time, school districts' sometimes-large initial investment in emerging technologies saves…

Energy efficient engine high-pressure turbine detailed design report

NASA Technical Reports Server (NTRS)

Thulin, R. D.; Howe, D. C.; Singer, I. D.

1982-01-01

The energy efficient engine high-pressure turbine is a single stage system based on technology advancements in the areas of aerodynamics, structures and materials to achieve high performance, low operating economics and durability commensurate with commercial service requirements. Low loss performance features combined with a low through-flow velocity approach results in a predicted efficiency of 88.8 for a flight propulsion system. Turbine airfoil durability goals are achieved through the use of advanced high-strength and high-temperature capability single crystal materials and effective cooling management. Overall, this design reflects a considerable extension in turbine technology that is applicable to future, energy efficient gas-turbine engines.

78 FR 6094 - Information Collection Request Submitted to OMB for Review and Approval; Comment Request; EPA's...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-29

... encompass organization-wide energy performance improvement, such as building technology upgrades, product... help EPA promote energy-efficient technologies by evaluating the efficiency of their buildings using... Leaders--Ineligible Facilities List (5900-20) ENERGY STAR Leaders--Leaders Story (5900-20) Service and...

A Comparative Analysis of the Efficiency of National Education Systems

ERIC Educational Resources Information Center

Thieme, Claudio; Gimenez, Victor; Prior, Diego

2012-01-01

The present study assesses the performance of 54 participating countries in PISA 2006. It employs efficiency indicators that relate result variables with resource variables used in the production of educational services. Desirable outputs of educational achievement and undesirable outputs of educational inequality are considered jointly as result…

A Framework and Improvements of the Korea Cloud Services Certification System.

PubMed

Jeon, Hangoo; Seo, Kwang-Kyu

2015-01-01

Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed.

A Framework and Improvements of the Korea Cloud Services Certification System

PubMed Central

Jeon, Hangoo

2015-01-01

Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed. PMID:26125049

Evaluation of performance and impacts of maternal and child health hospital services using Data Envelopment Analysis in Guangxi Zhuang Autonomous Region, China: a comparison study among poverty and non-poverty county level hospitals.

PubMed

Wang, Xuan; Luo, Hongye; Qin, Xianjin; Feng, Jun; Gao, Hongda; Feng, Qiming

2016-08-23

As the core of the county-level Maternal and Child Health Hospitals (MCHH) in rural areas of China, the service efficiency affects the fairness and availability of healthcare services. This study aims to identify the determinants of hospital efficiency and explore how to improve the performance of MCHH in terms of productivity and efficiency. Data was collected from a sample of 32 county-level MCHHs of Guangxi in 2014. Firstly, we specified and measured the indicators of the inputs and outputs which represent hospital resources expended and its profiles respectively. Then we estimated the efficiency scores using Data Envelopment Analysis (DEA) for each hospital. Efficiency scores were decomposed into technical, scale and congestion components, and the potential output increases and/or input reductions were also estimated in this model, which would make relatively inefficient hospitals more efficient. In the second stage, the estimated efficiency scores are regressed against hospital external and internal environment factors using a Tobit model. We used DEAP (V2.1) and R for data analysis. The average scores of technical efficiency, net technical efficiency (managerial efficiency) and scale efficiency of the hospitals were 0.875, 0.922 and 0.945, respectively. Half of the hospitals were efficient, and 9.4 % and 40.6 % were weakly efficient and inefficient, respectively. Among the low-productiveness hospitals, 61.1 % came from poor counties (Poor counties in this article are in the list of key poverty-stricken counties at the national level, published by The State Council Leading Group Office of Poverty Alleviation and Development, 2012). The total input indicated that redundant medical resources in poverty areas were significantly higher than those in non-poverty areas. The Tobit regression model showed that the technical efficiency was proportional to the total annual incomes, the number of discharge patients, and the number of outpatient and emergency visits, while it was inversely proportional to total expenditure and the actual number of open beds. Technical efficiency was not associated with number of health care workers. The overall operational efficiency of the county-level MCHHs in Guangxi was low and needs to be improved. Regional economic differences affect the performances of hospitals. Health administrations should adjust and optimize the resource investments for the different areas. For the hospitals in poverty areas, policy-makers should not only consider the hardware facilities investment, but also the introduction of advanced techniques and high-level medical personnel to improve their technical efficiency.

Improving outpatient phlebotomy service efficiency and patient experience using discrete-event simulation.

PubMed

Yip, Kenneth; Pang, Suk-King; Chan, Kui-Tim; Chan, Chi-Kuen; Lee, Tsz-Leung

2016-08-08

Purpose - The purpose of this paper is to present a simulation modeling application to reconfigure the outpatient phlebotomy service of an acute regional and teaching hospital in Hong Kong, with an aim to improve service efficiency, shorten patient queuing time and enhance workforce utilization. Design/methodology/approach - The system was modeled as an inhomogeneous Poisson process and a discrete-event simulation model was developed to simulate the current setting, and to evaluate how various performance metrics would change if switched from a decentralized to a centralized model. Variations were then made to the model to test different workforce arrangements for the centralized service, so that managers could decide on the service's final configuration via an evidence-based and data-driven approach. Findings - This paper provides empirical insights about the relationship between staffing arrangement and system performance via a detailed scenario analysis. One particular staffing scenario was chosen by manages as it was considered to strike the best balance between performance and workforce scheduled. The resulting centralized phlebotomy service was successfully commissioned. Practical implications - This paper demonstrates how analytics could be used for operational planning at the hospital level. The authors show that a transparent and evidence-based scenario analysis, made available through analytics and simulation, greatly facilitates management and clinical stakeholders to arrive at the ideal service configuration. Originality/value - The authors provide a robust method in evaluating the relationship between workforce investment, queuing reduction and workforce utilization, which is crucial for managers when deciding the delivery model for any outpatient-related service.

Two-dimensional priority-based dynamic resource allocation algorithm for QoS in WDM/TDM PON networks

NASA Astrophysics Data System (ADS)

Sun, Yixin; Liu, Bo; Zhang, Lijia; Xin, Xiangjun; Zhang, Qi; Rao, Lan

2018-01-01

Wavelength division multiplexing/time division multiplexing (WDM/TDM) passive optical networks (PON) is being viewed as a promising solution for delivering multiple services and applications. The hybrid WDM / TDM PON uses the wavelength and bandwidth allocation strategy to control the distribution of the wavelength channels in the uplink direction, so that it can ensure the high bandwidth requirements of multiple Optical Network Units (ONUs) while improving the wavelength resource utilization. Through the investigation of the presented dynamic bandwidth allocation algorithms, these algorithms can't satisfy the requirements of different levels of service very well while adapting to the structural characteristics of mixed WDM / TDM PON system. This paper introduces a novel wavelength and bandwidth allocation algorithm to efficiently utilize the bandwidth and support QoS (Quality of Service) guarantees in WDM/TDM PON. Two priority based polling subcycles are introduced in order to increase system efficiency and improve system performance. The fixed priority polling subcycle and dynamic priority polling subcycle follow different principles to implement wavelength and bandwidth allocation according to the priority of different levels of service. A simulation was conducted to study the performance of the priority based polling in dynamic resource allocation algorithm in WDM/TDM PON. The results show that the performance of delay-sensitive services is greatly improved without degrading QoS guarantees for other services. Compared with the traditional dynamic bandwidth allocation algorithms, this algorithm can meet bandwidth needs of different priority traffic class, achieve low loss rate performance, and ensure real-time of high priority traffic class in terms of overall traffic on the network.

Productivity Analysis of Public and Private Airports: A Causal Investigation

NASA Technical Reports Server (NTRS)

Vasigh, Bijan; Gorjidooz, Javad

2007-01-01

Around the world, airports are being viewed as enterprises, rather than public services, which are expected to be managed efficiently and provide passengers with courteous customer services. Governments are, increasingly, turning to the private sectors for their efficiency in managing the operation, financing, and development, as well as providing security for airports. Operational and financial performance evaluation has become increasingly important to airport operators due to recent trends in airport privatization. Assessing performance allows the airport operators to plan for human resources and capital investment as efficiently as possible. Productivity measurements may be used as comparisons and guidelines in strategic planning, in the internal analysis of operational efficiency and effectiveness, and in assessing the competitive position of an airport in transportation industry. The primary purpose of this paper is to investigate the operational and financial efficiencies of 22 major airports in the United States and Europe. These airports are divided into three groups based on private ownership (7 British Airport Authority airports), public ownership (8 major United States airports), and a mix of private and public ownership (7 major European Union airports. The detail ownership structures of these airports are presented in Appendix A. Total factor productivity (TFP) model was utilized to measure airport performance in terms of financial and operational efficiencies and to develop a benchmarking tool to identify the areas of strength and weakness. A regression model was then employed to measure the relationship between TFP and ownership structure. Finally a Granger causality test was performed to determine whether ownership structure is a Granger cause of TFP. The results of the analysis presented in this paper demonstrate that there is not a significant relationship between airport TFP and ownership structure. Airport productivity and efficiency is, however dependent upon the level of competition, choice of the market, and regulatory control.

Thermal Performance Data Services (TPDS)

NASA Technical Reports Server (NTRS)

French, Richard T.; Wright, Michael J.

2013-01-01

Initiated as a NASA Engineering and Safety Center (NESC) assessment in 2009, the Thermal Performance Database (TPDB) was a response to the need for a centralized thermal performance data archive. The assessment was renamed Thermal Performance Data Services (TPDS) in 2012; the undertaking has had two fronts of activity: the development of a repository software application and the collection of historical thermal performance data sets from dispersed sources within the thermal performance community. This assessment has delivered a foundational tool on which additional features should be built to increase efficiency, expand the protection of critical Agency investments, and provide new discipline-advancing work opportunities. This report contains the information from the assessment.

A comparison of operational performance : Washington state ferries to ferry operators worldwide.

DOT National Transportation Integrated Search

2010-06-01

This project compares eight measures of performance related to transit service quality (e.g. trip reliability, on-time departures) and cost-efficiency (e.g. farebox recovery, subsidy per passenger) between Washington State Ferries (WSF) and 23 ferry ...

Performance Contracting: Meeting the Challenge of Deferred Maintenance.

ERIC Educational Resources Information Center

Singer, Terry E.; Johnson, Mary E.

2001-01-01

Discusses the magnitude of the problem of deferred maintenance on today's university campuses and the solving this problem using performance-based energy efficiency retrofit as implemented by energy service companies (ESCO). Several case studies of ESCO designed retrofits are examined. (GR)

Voluntary medical male circumcision scale-up in Nyanza, Kenya: evaluating technical efficiency and productivity of service delivery.

PubMed

Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2015-01-01

Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya's context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350-5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959-4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of variations in VMMC service productivity, which are important for program planning.

Efficiently Selecting the Best Web Services

NASA Astrophysics Data System (ADS)

Goncalves, Marlene; Vidal, Maria-Esther; Regalado, Alfredo; Yacoubi Ayadi, Nadia

Emerging technologies and linking data initiatives have motivated the publication of a large number of datasets, and provide the basis for publishing Web services and tools to manage the available data. This wealth of resources opens a world of possibilities to satisfy user requests. However, Web services may have similar functionality and assess different performance; therefore, it is required to identify among the Web services that satisfy a user request, the ones with the best quality. In this paper we propose a hybrid approach that combines reasoning tasks with ranking techniques to aim at the selection of the Web services that best implement a user request. Web service functionalities are described in terms of input and output attributes annotated with existing ontologies, non-functionality is represented as Quality of Services (QoS) parameters, and user requests correspond to conjunctive queries whose sub-goals impose restrictions on the functionality and quality of the services to be selected. The ontology annotations are used in different reasoning tasks to infer service implicit properties and to augment the size of the service search space. Furthermore, QoS parameters are considered by a ranking metric to classify the services according to how well they meet a user non-functional condition. We assume that all the QoS parameters of the non-functional condition are equally important, and apply the Top-k Skyline approach to select the k services that best meet this condition. Our proposal relies on a two-fold solution which fires a deductive-based engine that performs different reasoning tasks to discover the services that satisfy the requested functionality, and an efficient implementation of the Top-k Skyline approach to compute the top-k services that meet the majority of the QoS constraints. Our Top-k Skyline solution exploits the properties of the Skyline Frequency metric and identifies the top-k services by just analyzing a subset of the services that meet the non-functional condition. We report on the effects of the proposed reasoning tasks, the quality of the top-k services selected by the ranking metric, and the performance of the proposed ranking techniques. Our results suggest that the number of services can be augmented by up two orders of magnitude. In addition, our ranking techniques are able to identify services that have the best values in at least half of the QoS parameters, while the performance is improved.

Research on Holographic Evaluation of Service Quality in Power Data Network

NASA Astrophysics Data System (ADS)

Wei, Chen; Jing, Tao; Ji, Yutong

2018-01-01

With the rapid development of power data network, the continuous development of the Power data application service system, more and more service systems are being put into operation. Following this, the higher requirements for network quality and service quality are raised, in the actual process for the network operation and maintenance. This paper describes the electricity network and data network services status. A holographic assessment model was presented to achieve a comprehensive intelligence assessment on the power data network and quality of service in the operation and maintenance on the power data network. This evaluation method avoids the problems caused by traditional means which performs a single assessment of network performance quality. This intelligent Evaluation method can improve the efficiency of network operation and maintenance guarantee the quality of real-time service in the power data network..

Improving client-centred care and services: the role of front/back-office configurations.

PubMed

Broekhuis, Manda; de Blok, Carolien; Meijboom, Bert

2009-05-01

This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfare and domestic services. Front/back-office configurations reflect a neglected domain of design decisions in the development of more client-centred processes and structures without incurring major cost increases. Based on a literature search, a framework of four front/back-office configurations was constructed. To illustrate the usefulness of this framework, a single, longitudinal case study was performed in a large organization, which provides home care, welfare and domestic services for a sustained period (2005-2006). The case study illustrates how front/back-office design decisions are related to the complexity of the clients' demands and the strategic objectives of an organization. The constructed framework guides the practical development of front/back-office designs, and shows how each design contributes differently to such performance objectives as quality, speed and efficiency. The front/back-office configurations presented comprise an important first step in elaborating client-centred care and service provision to the operational level. It helps healthcare organizations to become more responsive and to provide efficient client-centred care and services when approaching demand in a well-tuned manner. In addition to its applicability in home care, we believe that a deliberate front/back-office configuration also has potential in other fields of health care.

Re-Framing Pacific Regional Service Delivery: Opportunity Spaces for "Together" and "Apart"

ERIC Educational Resources Information Center

Sanga, Kabini

2011-01-01

Regionalism is a common development strategy in the Pacific region. Through it, numerous services are delivered to countries, communities and organisations. While some see regionalism as an effective and efficient strategy for the Pacific region, others point to its dismal performance. Using the experience of the Rethinking Pacific Education…

7 CFR Appendix B to Subpart B of... - Technical Reports for Projects With Total Eligible Project Costs of Greater Than $200,000

Code of Federal Regulations, 2014 CFR

2014-01-01

... maintenance of the renewable energy system or energy efficiency improvement will operate or perform as..., and maintenance. Authoritative evidence that project team service providers have the necessary... and shakedown, warranties, insurance, financing, professional services, and operations and maintenance...

7 CFR Appendix B to Subpart B of... - Technical Reports for Projects With Total Eligible Project Costs of Greater Than $200,000

Code of Federal Regulations, 2013 CFR

2013-01-01

... maintenance of the renewable energy system or energy efficiency improvement will operate or perform as..., and maintenance. Authoritative evidence that project team service providers have the necessary... and shakedown, warranties, insurance, financing, professional services, and operations and maintenance...

7 CFR Appendix B to Subpart B of... - Technical Reports for Projects With Total Eligible Project Costs of Greater Than $200,000

Code of Federal Regulations, 2012 CFR

2012-01-01

... maintenance of the renewable energy system or energy efficiency improvement will operate or perform as..., and maintenance. Authoritative evidence that project team service providers have the necessary... and shakedown, warranties, insurance, financing, professional services, and operations and maintenance...

Reactome graph database: Efficient access to complex pathway data

PubMed Central

Korninger, Florian; Viteri, Guilherme; Marin-Garcia, Pablo; Ping, Peipei; Wu, Guanming; Stein, Lincoln; D’Eustachio, Peter

2018-01-01

Reactome is a free, open-source, open-data, curated and peer-reviewed knowledgebase of biomolecular pathways. One of its main priorities is to provide easy and efficient access to its high quality curated data. At present, biological pathway databases typically store their contents in relational databases. This limits access efficiency because there are performance issues associated with queries traversing highly interconnected data. The same data in a graph database can be queried more efficiently. Here we present the rationale behind the adoption of a graph database (Neo4j) as well as the new ContentService (REST API) that provides access to these data. The Neo4j graph database and its query language, Cypher, provide efficient access to the complex Reactome data model, facilitating easy traversal and knowledge discovery. The adoption of this technology greatly improved query efficiency, reducing the average query time by 93%. The web service built on top of the graph database provides programmatic access to Reactome data by object oriented queries, but also supports more complex queries that take advantage of the new underlying graph-based data storage. By adopting graph database technology we are providing a high performance pathway data resource to the community. The Reactome graph database use case shows the power of NoSQL database engines for complex biological data types. PMID:29377902

Reactome graph database: Efficient access to complex pathway data.

PubMed

Fabregat, Antonio; Korninger, Florian; Viteri, Guilherme; Sidiropoulos, Konstantinos; Marin-Garcia, Pablo; Ping, Peipei; Wu, Guanming; Stein, Lincoln; D'Eustachio, Peter; Hermjakob, Henning

2018-01-01

Reactome is a free, open-source, open-data, curated and peer-reviewed knowledgebase of biomolecular pathways. One of its main priorities is to provide easy and efficient access to its high quality curated data. At present, biological pathway databases typically store their contents in relational databases. This limits access efficiency because there are performance issues associated with queries traversing highly interconnected data. The same data in a graph database can be queried more efficiently. Here we present the rationale behind the adoption of a graph database (Neo4j) as well as the new ContentService (REST API) that provides access to these data. The Neo4j graph database and its query language, Cypher, provide efficient access to the complex Reactome data model, facilitating easy traversal and knowledge discovery. The adoption of this technology greatly improved query efficiency, reducing the average query time by 93%. The web service built on top of the graph database provides programmatic access to Reactome data by object oriented queries, but also supports more complex queries that take advantage of the new underlying graph-based data storage. By adopting graph database technology we are providing a high performance pathway data resource to the community. The Reactome graph database use case shows the power of NoSQL database engines for complex biological data types.

Improving Efficiency While Improving Patient Care in a Student-Run Free Clinic.

PubMed

Lee, Jason S; Combs, Kristen; Pasarica, Magdalena

2017-01-01

Student-run free clinics (SRFCs) have the capacity to decrease health care inequity in underserved populations. These facilities can benefit from improved patient experience and outcomes. We implemented a series of quality improvement interventions with the objectives to decrease patient wait times and to increase the variety of services provided. A needs assessment was performed. Problems related to time management, communication between staff and providers, clinic resources, and methods for assessing clinic performance were identified as targets to reduce wait times and improve the variety of services provided. Seventeen interventions were designed and implemented over a 2-month period. The interventions resulted in improved efficiency for clinic operations and reduced patient wait times. The number of specialty providers, patient visits for specialty care, lifestyle education visits for disease prevention and treatment, free medications, and free laboratory investigations increased to achieve the goal of improving the availability and the variety of services provided. We demonstrated that it is feasible to implement successful quality improvement interventions in SRFCs to decrease patient wait times and to increase the variety of services provided. We believe that the changes we implemented can serve as a model for other SRFCs to improve their performance. © Copyright 2017 by the American Board of Family Medicine.

The role of environmental variables on the efficiency of water and sewerage companies: a case study of Chile.

PubMed

Molinos-Senante, María; Sala-Garrido, Ramón; Lafuente, Matilde

2015-07-01

This paper evaluates the efficiency of water and sewerage companies (WaSCs) by introducing the lack of service quality as undesirable outputs. It also investigates whether the production frontier of WaSCs is overall constant returns to scale (CRS) or variable returns to scale (VRS) by using two different data envelopment analysis models. In a second-stage analysis, we study the influence of exogenous and endogenous variables on WaSC performance by applying non-parametric hypothesis tests. In a pioneering approach, the analysis covers 18 WaSCs from Chile, representing about 90% of the Chilean urban population. The results evidence that the technology of the sample studied is characterized overall by CRS. Peak water demand, the percentage of external workers, and the percentage of unbilled water are the factors affecting the efficiency of WaSCs. From a policy perspective, the integration of undesirable outputs into the assessment of WaSC performance is crucial not to penalize companies that provide high service quality to customers.

A Technical Survey on Optimization of Processing Geo Distributed Data

NASA Astrophysics Data System (ADS)

Naga Malleswari, T. Y. J.; Ushasukhanya, S.; Nithyakalyani, A.; Girija, S.

2018-04-01

With growing cloud services and technology, there is growth in some geographically distributed data centers to store large amounts of data. Analysis of geo-distributed data is required in various services for data processing, storage of essential information, etc., processing this geo-distributed data and performing analytics on this data is a challenging task. The distributed data processing is accompanied by issues in storage, computation and communication. The key issues to be dealt with are time efficiency, cost minimization, utility maximization. This paper describes various optimization methods like end-to-end multiphase, G-MR, etc., using the techniques like Map-Reduce, CDS (Community Detection based Scheduling), ROUT, Workload-Aware Scheduling, SAGE, AMP (Ant Colony Optimization) to handle these issues. In this paper various optimization methods and techniques used are analyzed. It has been observed that end-to end multiphase achieves time efficiency; Cost minimization concentrates to achieve Quality of Service, Computation and reduction of Communication cost. SAGE achieves performance improvisation in processing geo-distributed data sets.

Second law analysis of advanced power generation systems using variable temperature heat sources

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

Bliem, C.J.; Mines, G.L.

1990-01-01

Many systems produce power using variable temperature (sensible) heat sources. The Heat Cycle Research Program is currently investigating the potential improvements to such power cycles utilizing moderate temperature geothermal resources to produce electrical power. It has been shown that mixtures of saturated hydrocarbons (alkanes) or halogenated hydrocarbons operating with a supercritical Rankine cycle gave improved performance over boiling Rankine cycles with the pure working fluids for typical applications. Recently, in addition to the supercritical Rankine Cycle, other types of cycles have been proposed for binary geothermal service. This paper explores the limits on efficiency of a feasible plant and discussesmore » the methods used in these advanced concept plants to achieve the maximum possible efficiency. The advanced plants considered appear to be approaching the feasible limit of performance so that the designer must weigh all considerations to fine the best plant for a given service. These results would apply to power systems in other services as well as to geothermal power plants. 17 refs., 15 figs.« less

Efficiency in Vocational Rehabilitation Program Service Delivery: The Impact of Socioeconomic Context

ERIC Educational Resources Information Center

Gere, Bryan O.; Burnett, Royce D.; Flowers, Carl R.; Akaaboune, Ouadie

2017-01-01

Background: State-federal (VR) program efficiency is the focus of empirical research because of increases in the magnitude and types of program requests, possibly funding cuts and class for models to more appropriately measure and evaluate performance. Objective: The purpose of this study was to examine the impact socioeconomic diversity has on…

48 CFR 22.1603 - Exceptions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... or subcontracts for work performed exclusively outside the United States. (b) Exemptions granted by... ability of the Government to procure goods and services on an economical and efficient basis or if special...

Importance of awareness in improving performance of emergency medical services (EMS) systems in enhancing traffic safety: A lesson from India.

PubMed

Vasudevan, Vinod; Singh, Preeti; Basu, Samyajit

2016-10-02

India has been slow in implementing a central emergency medical services (EMS) system across the country. "108 services" is one of the most popular services that is functional under the public-private partnership model. Limited available literature shows that despite access to services, many traffic crash victims are transported using private vehicles. The objective of this study is to understand the effectiveness of 108 services from a traffic safety perspective. A questionnaire survey is conducted to understand the awareness of EMS and their function. Using traffic-related fatalities as the dependent variable, a fixed effect panel data model is developed to analyze the effectiveness of the 108 services in improving the traffic safety. The results from the survey show that, in general, people are not aware of the 108 services. A majority of the population prefers taking victims to the hospital using their personal vehicles or any other vehicles available compared to calling an ambulance. Results from panel data analysis show that despite having an efficient system, these services failed to make significant improvement in the safety of road users in the states in which their services were subscribed. The lack of awareness of an important safety service is alarming. This could be a major reason for lower utilization of 108 services for transporting victims of traffic crashes. This article shows the importance of having efficient awareness campaigns to improve the efficiency of any similar programs that are aimed to enhance the safety of a region.

Latency of TCP applications over the ATM-WAN using the GFR service category

NASA Astrophysics Data System (ADS)

Chen, Kuo-Hsien; Siliquini, John F.; Budrikis, Zigmantas

1998-10-01

The GFR service category has been proposed for data services in ATM networks. Since users are ultimately interested in data service that provide high efficiency and low latency, it is important to study the latency performance for data traffic of the GFR service category in an ATM network. Today much of the data traffic utilizes the TCP/IP protocol suite and in this paper we study through simulation the latency of TCP applications running over a wide-area ATM network utilizing the GFR service category using a realistic TCP traffic model. From this study, we find that during congestion periods the reserved bandwidth in GFR can improve the latency performance for TCP applications. However, due to TCP 'Slow Start' data segment generation dynamics, we show that a large proportion of TCP segments are discarded under network congestion even when the reserved bandwidth is equal to the average generated rate of user data. Therefore, a user experiences worse than expected latency performance when the network is congested. In this study we also examine the effects of segment size on the latency performance of TCP applications using the GFR service category.

Energy efficiency in U.K. shopping centres

NASA Astrophysics Data System (ADS)

Mangiarotti, Michela

Energy efficiency in shopping centres means providing comfortable internal environment and services to the occupants with minimum energy use in a cost-effective and environmentally sensitive manner. This research considers the interaction of three factors affecting the energy efficiency of shopping centres: i) performance of the building fabric and services ii) management of the building in terms of operation, control, maintenance and replacement of the building fabric and services, and company's energy policy iii) occupants' expectation for comfort and awareness of energy efficiency. The aim of the investigation is to determine the role of the above factors in the energy consumption and carbon emissions of shopping centres and the scope for reducing this energy usage by changing one or all the three factors. The study also attempts to prioritize the changes in the above factors that are more cost-effective at reducing that energy consumption and identify the benefits and main economic and legal drivers for energy efficiency in shopping centres. To achieve these targets, three case studies have been analysed. Using energy data from bills, the performance of the selected case studies has been assessed to establish trends and current energy consumption and carbon emissions of shopping centres and their related causes. A regression analysis has attempted to break down the energy consumption of the landlords' area by end-use to identify the main sources of energy usage and consequently introduce cost-effective measures for saving energy. A monitoring and occupants' survey in both landlords' and tenants' areas have been carried out at the same time to compare the objective data of the environmental conditions with the subjective impressions of shoppers and shopkeepers. In particular, the monitoring aimed at assessing the internal environment to identify possible causes of discomfort and opportunities for introducing energy saving measures. The survey looked at determining the occupants' expectation for comfort and awareness of energy efficiency in shopping centres. The results show the complexity of prioritizing the three factors affecting energy efficiency in shopping centres, highlighting the relationships between those factors, and the role of different actors, involved in the life of shopping centres, in the energy and environmental performance of these buildings.

Performance Analysis of the NAS Y-MP Workload

NASA Technical Reports Server (NTRS)

Bergeron, Robert J.; Kutler, Paul (Technical Monitor)

1997-01-01

This paper describes the performance characteristics of the computational workloads on the NAS Cray Y-MP machines, a Y-MP 832 and later a Y-MP 8128. Hardware measurements indicated that the Y-MP workload performance matured over time, ultimately sustaining an average throughput of 0.8 GFLOPS and a vector operation fraction of 87%. The measurements also revealed an operation rate exceeding 1 per clock period, a well-balanced architecture featuring a strong utilization of vector functional units, and an efficient memory organization. Introduction of the larger memory 8128 increased throughput by allowing a more efficient utilization of CPUs. Throughput also depended on the metering of the batch queues; low-idle Saturday workloads required a buffer of small jobs to prevent memory starvation of the CPU. UNICOS required about 7% of total CPU time to service the 832 workloads; this overhead decreased to 5% for the 8128 workloads. While most of the system time went to service I/O requests, efficient scheduling prevented excessive idle due to I/O wait. System measurements disclosed no obvious bottlenecks in the response of the machine and UNICOS to the workloads. In most cases, Cray-provided software tools were- quite sufficient for measuring the performance of both the machine and operating, system.

Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

PubMed

Rosenberg, Christian; Kroos, Kristin; Rosenberg, Britta; Hosten, Norbert; Flessa, Steffen

2013-08-01

Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.

Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery

PubMed Central

Omondi Aduda, Dickens S.; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2015-01-01

Background Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya’s context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. Objective To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Design Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Results Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350–5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959–4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Conclusions Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of variations in VMMC service productivity, which are important for program planning. PMID:25706119

A cost and performance comparison of Public Private Partnership and public hospitals in Spain.

PubMed

Caballer-Tarazona, Maria; Clemente-Collado, Antonio; Vivas-Consuelo, David

2016-12-01

Public-private partnership (PPP) initiatives are extending around the world, especially in Europe, as an innovation to traditional public health systems, with the intention of making them more efficient.There is a varied range of PPP models with different degrees of responsibility from simple public sector contracts with the private, up to the complete privatisation of the service. As such, we may say the involvement of the private sector embraces the development, financing and provision of public infrastructures and delivery services.In this paper, one of the oldest PPP initiatives developed in Spain and transferred to other European and Latin American countries is evaluated for first time: the integrated healthcare delivery Alzira model.Through a comparison of public and PPP hospital performance, cost and quality indicators, the efficiency of the PPP experience in five hospitals is evaluated to identify the influence of private management in the results.Regarding the performance and efficiency analysis, it is seen that the PPP group obtains good results, above the average, but not always better than those directly managed. It is necessary to conduct studies with a greater number of PPP hospitals to obtain conclusive results.

Assessing the relative efficiency of water companies in the English and Welsh water industry: a metafrontier approach.

PubMed

Molinos-Senante, María; Maziotis, Alexandros; Sala-Garrido, Ramon

2015-11-01

The assessment of relative efficiency of water companies is essential for managers and authorities. This is evident in the UK water sector where there are companies with different services such as water and sewerage companies (WaSCs) and water-only companies (WoCs). Therefore, it is a critical limitation to estimate a common production frontier for both types of companies, as it might lead to biased efficiency estimates. In this paper, a robust and reliable methodology, the metafrontier model, is applied to compare the efficiency of water companies providing different services. The results illustrate the superior performance of WaSCs compared to WoCs. It also confirms the presence of economies of scope in the UK water industry. The methodology and results of this study are of great interest for both regulators and water utility managers to make informed decisions.

Efficient Assignment of Multiple E-MBMS Sessions towards LTE

NASA Astrophysics Data System (ADS)

Alexiou, Antonios; Bouras, Christos; Kokkinos, Vasileios

One of the major prerequisites for Long Term Evolution (LTE) networks is the mass provision of multimedia services to mobile users. To this end, Evolved - Multimedia Broadcast/Multicast Service (E-MBMS) is envisaged to play an instrumental role during LTE standardization process and ensure LTE’s proliferation in mobile market. E-MBMS targets at the economic delivery, in terms of power and spectral efficiency, of multimedia data from a single source entity to multiple destinations. This paper proposes a novel mechanism for efficient radio bearer selection during E-MBMS transmissions in LTE networks. The proposed mechanism is based on the concept of transport channels combination in any cell of the network. Most significantly, the mechanism manages to efficiently deliver multiple E-MBMS sessions. The performance of the proposed mechanism is evaluated and compared with several radio bearer selection mechanisms in order to highlight the enhancements that it provides.

Trends Among the States in Governance and Coordination of Higher Education.

ERIC Educational Resources Information Center

Chambers, M. M.

There has been a trend in state government toward tighter and tighter centralization that, though done in the name of greater economy and efficiency, is in large part a reach for political power. Not all services of the state can be performed well if integrated into a single monolithic administrative pyramid with all other state services and…

Achieving Efficient Spectrum Usage in Passive and Active Sensing

NASA Astrophysics Data System (ADS)

Wang, Huaiyi

Increasing demand for supporting more wireless services with higher performance and reliability within the frequency bands that are most conducive to operating cost-effective cellular and mobile broadband is aggravating current electromagnetic spectrum congestion. This situation motivates technology and management innovation to increase the efficiency of spectral use. If primary-secondary spectrum sharing can be shown possible without compromising (or while even improving) performance in an existing application, opportunities for efficiency may be realizable by making the freed spectrum available for commercial use. While both active and passive sensing systems are vitally important for many public good applications, opportunities for increasing the efficiency of spectrum use can be shown to exist for both systems. This dissertation explores methods and technologies for remote sensing systems that enhance spectral efficiency and enable dynamic spectrum access both within and outside traditionally allocated bands.

Disaster Coverage Predication for the Emerging Tethered Balloon Technology: Capability for Preparedness, Detection, Mitigation, and Response.

PubMed

Alsamhi, Saeed H; Samar Ansari, Mohd; Rajput, Navin S

2018-04-01

A disaster is a consequence of natural hazards and terrorist acts, which have significant potential to disrupt the entire wireless communication infrastructure. Therefore, the essential rescue squads and recovery operations during a catastrophic event will be severely debilitated. To provide efficient communication services, and to reduce casualty mortality and morbidity during the catastrophic events, we proposed the Tethered Balloon technology for disaster preparedness, detection, mitigation, and recovery assessment. The proposed Tethered Balloon is applicable to any type of disaster except for storms. The Tethered Balloon is being actively researched and developed as a simple solution to improve the performance of rescues, facilities, and services of emergency medical communication in the disaster area. The most important requirement for rescue and relief teams during or after the disaster is a high quality of service of delivery communication services to save people's lives. Using our proposed technology, we report that the Tethered Balloon has a large disaster coverage area. Therefore, the rescue and research teams are given higher priority, and their performance significantly improved in the particular coverage area. Tethered Balloon features made it suitable for disaster preparedness, mitigation, and recovery. The performance of rescue and relief teams was effective and efficient before and after the disaster as well as can be continued to coordinate the relief teams until disaster recovery. (Disaster Med Public Health Preparedness. 2018;12:222-231).

Privacy-Preserving Location-Based Service Scheme for Mobile Sensing Data.

PubMed

Xie, Qingqing; Wang, Liangmin

2016-11-25

With the wide use of mobile sensing application, more and more location-embedded data are collected and stored in mobile clouds, such as iCloud, Samsung cloud, etc. Using these data, the cloud service provider (CSP) can provide location-based service (LBS) for users. However, the mobile cloud is untrustworthy. The privacy concerns force the sensitive locations to be stored on the mobile cloud in an encrypted form. However, this brings a great challenge to utilize these data to provide efficient LBS. To solve this problem, we propose a privacy-preserving LBS scheme for mobile sensing data, based on the RSA (for Rivest, Shamir and Adleman) algorithm and ciphertext policy attribute-based encryption (CP-ABE) scheme. The mobile cloud can perform location distance computing and comparison efficiently for authorized users, without location privacy leakage. In the end, theoretical security analysis and experimental evaluation demonstrate that our scheme is secure against the chosen plaintext attack (CPA) and efficient enough for practical applications in terms of user side computation overhead.

Privacy-Preserving Location-Based Service Scheme for Mobile Sensing Data †

PubMed Central

Xie, Qingqing; Wang, Liangmin

2016-01-01

With the wide use of mobile sensing application, more and more location-embedded data are collected and stored in mobile clouds, such as iCloud, Samsung cloud, etc. Using these data, the cloud service provider (CSP) can provide location-based service (LBS) for users. However, the mobile cloud is untrustworthy. The privacy concerns force the sensitive locations to be stored on the mobile cloud in an encrypted form. However, this brings a great challenge to utilize these data to provide efficient LBS. To solve this problem, we propose a privacy-preserving LBS scheme for mobile sensing data, based on the RSA (for Rivest, Shamir and Adleman) algorithm and ciphertext policy attribute-based encryption (CP-ABE) scheme. The mobile cloud can perform location distance computing and comparison efficiently for authorized users, without location privacy leakage. In the end, theoretical security analysis and experimental evaluation demonstrate that our scheme is secure against the chosen plaintext attack (CPA) and efficient enough for practical applications in terms of user side computation overhead. PMID:27897984

Design of price incentives for adjunct policy goals in formula funding for hospitals and health services

PubMed Central

Duckett, Stephen J

2008-01-01

Background Hospital policy involves multiple objectives: efficiency of service delivery, pursuit of high quality care, promoting access. Funding policy based on hospital casemix has traditionally been considered to be only about promoting efficiency. Discussion Formula-based funding policy can be (and has been) used to pursue a range of policy objectives, not only efficiency. These are termed 'adjunct' goals. Strategies to incorporate adjunct goals into funding design must, implicitly or explicitly, address key decision choices outlined in this paper. Summary Policy must be clear and explicit about the behaviour to be rewarded; incentives must be designed so that all facilities with an opportunity to improve have an opportunity to benefit; the reward structure is stable and meaningful; and the funder monitors performance and gaming. PMID:18384694

Health resources management and physician control in a San Francisco, California, hospital.

PubMed Central

Rosenstein, A. H.; Stier, M. M.

1991-01-01

The continued escalation in health care spending has caused money to become an increasingly limited resource, which may eventually affect the ability of health professionals to provide complete health care services. Health care payers have stressed efficiency and the appropriateness of health care measures and are putting greater financial pressures on health professionals by making them more accountable for services provided. Hospitals and physicians must take a more active role in monitoring health care delivery and work together to improve performance efficiency. Efficiency can be gained through a comprehensive program that emphasizes high-quality care and the effective use of health care resources. The Health Resource Management Program is a model for carrying out this function that integrates data analysis and physician input and education. Images PMID:2006564

Measuring technical efficiency of output quality in intensive care units.

PubMed

Junoy, J P

1997-01-01

Presents some examples of the implications derived from imposing the objective of maximizing social welfare, subject to limited resources, on ethical care patients management in respect of quality performance of health services. Conventional knowledge of health economics points out that critically ill patients are responsible for increased use of technological resources and that they receive a high proportion of health care resources. Attempts to answer, from the point of view of microeconomics, the question: how do we measure comparative efficiency in the management of intensive care units? Analyses this question through data from an international empirical study using micro-economic measures of productive efficiency in public services (data envelopment analysis). Results show a 28.8 per cent level of technical inefficiency processing data from 25 intensive care units in the USA.

Impact of Financial Liberalization on Banking Sectors Performance from Central and Eastern European Countries

PubMed Central

Andries, Alin Marius; Capraru, Bogdan

2013-01-01

In this paper we analyse the impact of financial liberalization and reforms on the banking performance in 17 countries from CEE for the period 2004–2008 using a two-stage empirical model that involves estimating bank performance in the first stage and assessing its determinants in the second one. From our analysis it results that banks from CEE countries with higher level of liberalization and openness are able to increase cost efficiency and eventually to offer cheaper services to clients. Banks from non-member EU countries are less cost efficient but experienced much higher total productivity growth level, and large sized banks are much more cost efficient than medium and small banks, while small sized banks show the highest growth in terms of productivity. PMID:23555745

Impact of financial liberalization on banking sectors performance from central and eastern European countries.

PubMed

Andries, Alin Marius; Capraru, Bogdan

2013-01-01

In this paper we analyse the impact of financial liberalization and reforms on the banking performance in 17 countries from CEE for the period 2004-2008 using a two-stage empirical model that involves estimating bank performance in the first stage and assessing its determinants in the second one. From our analysis it results that banks from CEE countries with higher level of liberalization and openness are able to increase cost efficiency and eventually to offer cheaper services to clients. Banks from non-member EU countries are less cost efficient but experienced much higher total productivity growth level, and large sized banks are much more cost efficient than medium and small banks, while small sized banks show the highest growth in terms of productivity.

The influence of institutions and organizations on urban waste collection systems: an analysis of waste collection system in Accra, Ghana (1985-2000).

PubMed

Fobil, Julius N; Armah, Nathaniel A; Hogarh, Jonathan N; Carboo, Derick

2008-01-01

Urban waste collection system is a pivotal component of all waste management schemes around the world. Therefore, the efficient performance and the success of these schemes in urban pollution control rest on the ability of the collection systems to fully adapt to the prevailing cultural and social contexts within which they operate. Conceptually, institutions being the rules guiding the conduct of public service provision and routine social interactions, waste collection systems embedded in institutions can only realize their potentials if they fully evolve continuously to reflect evolving social and technical matrices underlying the cultures, organizations, institutions and social conditions they are designed to address. This paper is a product of an analysis of waste collection performance in Ghana under two different institutional and/or organizational regimes; from an initial entirely public sector dependence to a current mix of public-private sector participation drawing on actual planning data from 1985 to 2000. The analysis found that the overall performance of waste collection services in Ghana increased under the coupled system, with efficiency (in terms of total waste clearance and coverage of service provision) increasing rapidly with increased private-sector controls and levels of involvement, e.g. for solid waste, collection rate and disposal improved from 51% in 1998 to about 91% in the year 2000. However, such an increase in performance could not be sustained beyond 10 years of public-private partnerships. This analysis argues that the sustainability of improved waste collection efficiency is a function of the franchise and lease arrangements between private sector group on the one hand and public sector group (local authorities) on the other hand. The analysis therefore concludes that if such franchise and lease arrangements are not conceived out of an initial transparent process, such a provision could undermine the overall sustainability of private sector initiatives in collection services delivery in the long term, as in the case of the Accra example.

The moderating effect of leadership on the relationship between personality and performance.

PubMed

Yeh, Shu-Chuan Jennifer; Yuan, Kuo-Shu; Chen, Shih-Hua Sarah; Lo, Ying-Ying; Chou, Hsueh-Chih; Huang, Shan; Chiu, Herng-Chia; Wan, Thomas T H

2016-10-01

To examine how personality and leadership influence efficiency in the nursing service environment. Leadership and personality contribute to the success and failure of a unit. However, how they interact to influence performance is still understudied. We used matched pairs sample design to survey 135 head nurses and 1353 registered nurses on validated instruments of demographic characteristics, leadership styles and personality during June and July of 2014. Efficiency was calculated using Data Envelopment Analysis. Tobit regression was used for analysis. High conscientiousness and low neuroticism were significantly associated with higher efficiency. Particularly, under the initiating structure leadership style, high conscientiousness, high extraversion, high agreeableness, high openness and low neuroticism were related to higher efficiency. Openness would improve efficiency under a low consideration leadership style. Most personality traits were related to higher efficiency under the initiating leadership style. Only openness would improve leaders' efficiency under a high initiating structure and a low consideration leadership style. Considering personality as one factor of selecting head nurses, selecting the right person can improve the fit between individuals and organisations, which in turn, improves job performance. Training head nurses to develop better leadership styles in nurses is another way to enhance efficiency. © 2016 John Wiley & Sons Ltd.

Development of modelling algorithm of technological systems by statistical tests

NASA Astrophysics Data System (ADS)

Shemshura, E. A.; Otrokov, A. V.; Chernyh, V. G.

2018-03-01

The paper tackles the problem of economic assessment of design efficiency regarding various technological systems at the stage of their operation. The modelling algorithm of a technological system was performed using statistical tests and with account of the reliability index allows estimating the level of machinery technical excellence and defining the efficiency of design reliability against its performance. Economic feasibility of its application shall be determined on the basis of service quality of a technological system with further forecasting of volumes and the range of spare parts supply.

Simulation and Performance of Data Communication using AMSS

NASA Technical Reports Server (NTRS)

Ripamonti, Claudio; Konangi, Vijay K.; Kerczewski, Robert J.

2006-01-01

This paper reports the findings of a simulation of the Aeronautical Mobile Satellite Service (AMSS) to be used in the ATN (Aeronautical Telecommunications Network). The models of the protocols used in this simulation were designed to be compliant with the International Civil Aviation Organization (ICAO) Standards and Recommended Practices (SARP). The focus of this research is on the data communication capabilities of the AMSS. The simulated performance characteristics for a region of the AMSS are presented. The results are analyzed to determine the efficiency, limitations, and behavior of this service for the foreseen data communication

NASA Marshall Space Flight Center Improves Cooling System Performance: Best Management Practice Case Study #10: Cooling Towers (Fact Sheet)

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

Not Available

National Aeronautics and Space Administration's (NASA) Marshall Space Flight Center (MSFC) has a longstanding sustainability program that revolves around energy and water efficiency as well as environmental protection. MSFC identified a problematic cooling loop with six separate compressor heat exchangers and a history of poor efficiency. The facility engineering team at MSFC partnered with Flozone Services, Incorporated to implement a comprehensive water treatment platform to improve the overall efficiency of the system.

Energy Efficiency, Water Efficiency, and Renewable Energy Site Assessment: Seneca Rocks Discovery Center, Seneca Rocks, West Virginia

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

Kiatreungwattana, Kosol; Salasovich, James; Kandt, Alicen

As part of ongoing efforts by the U.S. Forest Service to reduce energy use and incorporate renewable energy technologies into its facilities, the Department of Energy's National Renewable Energy Laboratory performed an energy efficiency and renewable energy site assessment of the Seneca Rocks Discovery Center in Seneca Rocks, West Virginia. This report documents the findings of this assessment, and provides site-specific information for the implementation of energy and water conservation measures, and renewable energy measures.

Coordination between airway facilities specialists and air traffic personnel.

DOT National Transportation Integrated Search

2002-04-01

Airway Facilities (AF) is responsible for providing services and conducting operations that deliver the highest possible levels of National Airspace System (NAS) safety and efficiency. To accomplish this, AF specialists perform maintenance tasks for ...

Efficient Authorization of Rich Presence Using Secure and Composed Web Services

NASA Astrophysics Data System (ADS)

Li, Li; Chou, Wu

This paper presents an extended Role-Based Access Control (RBAC) model for efficient authorization of rich presence using secure web services composed with an abstract presence data model. Following the information symmetry principle, the standard RBAC model is extended to support context sensitive social relations and cascaded authority. In conjunction with the extended RBAC model, we introduce an extensible presence architecture prototype using WS-Security and WS-Eventing to secure rich presence information exchanges based on PKI certificates. Applications and performance measurements of our presence system are presented to show that the proposed RBAC framework for presence and collaboration is well suited for real-time communication and collaboration.

Service Quality Assessment for NASA's Deep Space Network: No Longer a Luxury

NASA Technical Reports Server (NTRS)

Barkley, Erik; Wolgast, Paul; Zendejas, Silvino

2010-01-01

When NASA's Deep Space Network (DSN) was established almost a half century ago, the concept of computer-based service delivery was impractical or infeasible due to the state of information technology As a result, the interface the DSN exposes to its customers tends to be equipment-centric, lacking a clear demarcation between the DSN and the mission operation systems (MOS) of its customers. As the number of customers has continued to increase, the need to improve efficiency and minimize costs has grown. This growth has been the impetus for a DSN transformation from an equipment-forrent provider to a provider of standard services. Service orientation naturally leads to requirements for service management, including proactive measurement of service quality and service levels as well as the efficiency of internal processes and the performance of service provisioning systems. DSN System Engineering has surveyed industry offerings to determine if commercial successes in decision support and Business Intelligence (BI) solutions can be applied to the DSN. A pilot project was initiated, and subsequently executed to determine the feasibility of repurposing a commercial Business Intelligence platform for engineering analysis in conjunction with the platform's intended business reporting and analysis functions.

Longitudinal analysis of high-technology medical services and hospital financial performance.

PubMed

Zengul, Ferhat D; Weech-Maldonado, Robert; Ozaydin, Bunyamin; Patrician, Patricia A; OʼConnor, Stephen J

U.S. hospitals have been investing in high-technology medical services as a strategy to improve financial performance. Despite the interest in high-tech medical services, there is not much information available about the impact of high-tech services on financial performance. The aim of this study was to examine the impact of high-tech medical services on financial performance of U.S. hospitals by using the resource-based view of the firm as a conceptual framework. Fixed-effects regressions with 2 years lagged independent variables using a longitudinal panel sample of 3,268 hospitals (2005-2010). It was hypothesized that hospitals with rare or large numbers (breadth) of high-tech medical services will experience better financial performance. Fixed effects regression results supported the link between a larger breadth of high-tech services and total margin, but only among not-for-profit hospitals. Both breadth and rareness of high-tech services were associated with high total margin among not-for-profit hospitals. Neither breadth nor rareness of high-tech services was associated with operating margin. Although breadth and rareness of high-tech services resulted in lower expenses per inpatient day among not-for-profit hospitals, these lower costs were offset by lower revenues per inpatient day. Enhancing the breadth of high-tech services may be a legitimate organizational strategy to improve financial performance, especially among not-for-profit hospitals. Hospitals may experience increased productivity and efficiency, and therefore lower inpatient operating costs, as a result of newer technologies. However, the negative impact on operating revenue should caution hospital administrators about revenue reducing features of these technologies, which may be related to the payer mix that these technologies may attract. Therefore, managers should consider both the cost and revenue implications of these technologies.

Data envelopment analysis in service quality evaluation: an empirical study

NASA Astrophysics Data System (ADS)

Najafi, Seyedvahid; Saati, Saber; Tavana, Madjid

2015-09-01

Service quality is often conceptualized as the comparison between service expectations and the actual performance perceptions. It enhances customer satisfaction, decreases customer defection, and promotes customer loyalty. Substantial literature has examined the concept of service quality, its dimensions, and measurement methods. We introduce the perceived service quality index (PSQI) as a single measure for evaluating the multiple-item service quality construct based on the SERVQUAL model. A slack-based measure (SBM) of efficiency with constant inputs is used to calculate the PSQI. In addition, a non-linear programming model based on the SBM is proposed to delineate an improvement guideline and improve service quality. An empirical study is conducted to assess the applicability of the method proposed in this study. A large number of studies have used DEA as a benchmarking tool to measure service quality. These models do not propose a coherent performance evaluation construct and consequently fail to deliver improvement guidelines for improving service quality. The DEA models proposed in this study are designed to evaluate and improve service quality within a comprehensive framework and without any dependency on external data.

Optimizing the Reliability and Performance of Service Composition Applications with Fault Tolerance in Wireless Sensor Networks

PubMed Central

Wu, Zhao; Xiong, Naixue; Huang, Yannong; Xu, Degang; Hu, Chunyang

2015-01-01

The services composition technology provides flexible methods for building service composition applications (SCAs) in wireless sensor networks (WSNs). The high reliability and high performance of SCAs help services composition technology promote the practical application of WSNs. The optimization methods for reliability and performance used for traditional software systems are mostly based on the instantiations of software components, which are inapplicable and inefficient in the ever-changing SCAs in WSNs. In this paper, we consider the SCAs with fault tolerance in WSNs. Based on a Universal Generating Function (UGF) we propose a reliability and performance model of SCAs in WSNs, which generalizes a redundancy optimization problem to a multi-state system. Based on this model, an efficient optimization algorithm for reliability and performance of SCAs in WSNs is developed based on a Genetic Algorithm (GA) to find the optimal structure of SCAs with fault-tolerance in WSNs. In order to examine the feasibility of our algorithm, we have evaluated the performance. Furthermore, the interrelationships between the reliability, performance and cost are investigated. In addition, a distinct approach to determine the most suitable parameters in the suggested algorithm is proposed. PMID:26561818

Public services for distribution of drinking water and liquid sanitation in urban zones in Morocco Relevance of introduction the performance indicators for preservation water resources.

NASA Astrophysics Data System (ADS)

Habib, Akka; Abdelhamid, Bouzidi; Said, Housni

2018-05-01

Because of the absence of regulations and specific national norms, the unilaterally applied indicators for performance evaluation of water distribution management services are insufficient. This does not pave the way for a clear visibility of water resources. The indicators are also so heterogeneous that they are not in equilibrium with the applied management patterns. In fact: 1- The performance (yield and Linear loss index) of drinking water networks presents a discrepancy between operators and lack of homogeneity in terms of parameters put in its equation. Hence, It these indicators lose efficiency and reliability; 2- Liquid sanitation service has to go beyond the quantitative evaluation target in order to consider the qualitative aspects of water. To reach this aim, a reasonable enlargement of performance indicators is of paramount importance in order to better manage water resource which is becoming scarce and insufficient.

Organisation and features of hospital, intermediate care and social services in English sites with low rates of delayed discharge.

PubMed

Baumann, Matt; Evans, Sherrill; Perkins, Margaret; Curtis, Lesley; Netten, Ann; Fernandez, Jose-Luis; Huxley, Peter

2007-07-01

In recent years, there has been significant concern, and policy activity, in relation to the problem of delayed discharges from hospital. Key elements of policy to tackle delays include new investment, the establishment of the Health and Social Care Change Agent Team, and the implementation of the Community Care (Delayed Discharge) Act 2003. Whilst the problem of delays has been widespread, some authorities have managed to tackle delays successfully. The aim of the qualitative study reported here was to investigate discharge practice and the organisation of services at sites with consistently low rates of delay, in order to identify factors supporting such good performance. Six 'high performing' English sites (each including a hospital trust, a local authority, and a primary care trust) were identified using a statistical model, and 42 interviews were undertaken with health and social services staff involved in discharge arrangements. Additionally, the authors set out to investigate the experiences of patients in the sites to examine whether there was a cost to patient care and outcomes of discharge arrangements in these sites, but unfortunately, it was not possible to secure sufficient patient participation. Whilst acknowledging the lack of patient experience and outcome data, a range of service elements was identified at the sites that contribute to the avoidance of delays, either through supporting efficiency within individual agencies or enabling more efficient joint working. Sites still struggling with delays should benefit from knowledge of this range. The government's reimbursement scheme appears to have been largely helpful in the study sites, prompting efficiency-driven changes to the organisation of services and discharge systems, but further focused research is required to provide clear evidence of its impact nationally, and in particular, how it impacts on staff, and patients and their families.

Health care service provision in Europe and regional diversity: a stochastic metafrontier approach.

PubMed

Schley, Katharina

2018-05-31

■■■: In the last decades, demographic change coupled with new and expensive medical innovations have put most health care systems in developed countries under financial pressure. Therefore, ensuring efficient service provision is essential for a sustainable health care system. This paper investigates the performance of regional health care services in six West European countries between 2005 and 2014. We apply a stochastic metafrontier model to capture the different conditions in the health care systems in the countries within the European Union. By means of this approach, it is possible to detect performance differences in the European health care systems subject to different conditions and technologies relative to the potential technology available. The results indicate that regional deprivation plays a key role for the efficiency of health care provision. Furthermore, a pooled model which assumes a similar technology for all countries cannot sufficiently account for differences between countries. Surprisingly, the Scandinavian regions lag behind other regions with respect to the metafrontier. C23, D61, I12, I18, R10.

Opportunities for Improved Management Efficiency of the Head Start Program: Performance Evaluation and High Risk Determination.

ERIC Educational Resources Information Center

Gall, Mary Sheila

This report provides results of a review of the methodology used by the Office of Human Development Services (HDS) to measure Head Start performance and to control high risk Head Start agencies. The review was performed at HDS headquarters and regional locations nationwide. The review was based on a sample of 200 Head Start agencies and focused on…

Technical developments in international satellite business services

NASA Astrophysics Data System (ADS)

Tan, P. P.

At the conception of International Satellite Business Services (ISBS), it was a primary objective to provide flexibility for accommodating a variety of service requirements which might be established by mutual agreement between users. The design guidelines are to ensure that the space segment is efficiently utilized, while other satellite services are protected from interference. Other considerations are related to an acceptable earth segment cost, maximum connectivity in worldwide services, the capability of growth and a reasonably smooth transition into future systems, and the maintenance of high performance objectives. Attention is given to a system overview, the characteristics of satellites for ISBS, and technological developments with some application possibilities for ISBS.

Rural and urban transit district benchmarking : effectiveness and efficiency guidance document.

DOT National Transportation Integrated Search

2011-05-01

Rural and urban transit systems have sought ways to compare performance across agencies, : identifying successful service delivery strategies and applying these concepts to achieve : successful results within their agency. Benchmarking is a method us...

SLA-based optimisation of virtualised resource for multi-tier web applications in cloud data centres

NASA Astrophysics Data System (ADS)

Bi, Jing; Yuan, Haitao; Tie, Ming; Tan, Wei

2015-10-01

Dynamic virtualised resource allocation is the key to quality of service assurance for multi-tier web application services in cloud data centre. In this paper, we develop a self-management architecture of cloud data centres with virtualisation mechanism for multi-tier web application services. Based on this architecture, we establish a flexible hybrid queueing model to determine the amount of virtual machines for each tier of virtualised application service environments. Besides, we propose a non-linear constrained optimisation problem with restrictions defined in service level agreement. Furthermore, we develop a heuristic mixed optimisation algorithm to maximise the profit of cloud infrastructure providers, and to meet performance requirements from different clients as well. Finally, we compare the effectiveness of our dynamic allocation strategy with two other allocation strategies. The simulation results show that the proposed resource allocation method is efficient in improving the overall performance and reducing the resource energy cost.

Rethinking Lean Service

NASA Astrophysics Data System (ADS)

Seddon, John; O'Donovan, Brendan; Zokaei, Keivan

Ever since Levitt's influential Harvard Business Review article 'Production-Line Approach to Service' was published in 1972, it has been common for services to be treated like production lines in both the academic literature and more widely in management practice. The belief that achieving economies of scale will reduce unit costs is a common feature of management decision-making. As technological advancement has produced ever more sophisticated IT and telephony, it has become increasingly easier for firms to standardise and off-shore services. The development of the 'lean' literature has only helped to emphasise the same underlying management assumptions: by managing cost and workers' activity, organisational performance is expected to improve. This chapter argues that through misinterpretation of the core paradigm 'lean' has become subsumed into the 'business as usual' of conventional service management. As a result, 'lean' has become synonymous with 'process efficiency' and the opportunity for significant performance improvement - as exemplified by Toyota - has been missed.

An End of Service Life Assessment of PMMA Lenses from Veteran Concentrator Photovoltaic Systems

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

Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebecca

The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. Molecular weight was compared between the incident and faceted surfaces of the lenses.« less

The health professions and the performance of future health systems in low-income countries: support or obstacle?

PubMed

Dussault, Gilles

2008-05-01

This paper discusses the present and future role of the health professions in health services delivery systems in low-income countries. Unlike richer countries, most low-income countries do not have a tradition of labour market regulation and the capacity of the professions themselves to regulate the provision of health services by their members tends to be weak. The paper looks at the impact of professional monopolies on the performance of health services delivery systems, e.g. equity of access, effectiveness of services, efficiency in the use of scarce resources, responsiveness to users' needs, including protection against the financial impact of utilising health services. It identifies issues which policy-makers face in relation to opening the health labour market while guaranteeing the safety and security of services provided by professionals. The suggestion is made that a "social contract", granting privileges of practice in exchange of a commitment to actively maintain and enhance the quality of their services, may be a viable course of action. This would require that the actors in the policy process collaborate in strengthening the capacity of regulatory agencies to perform their role.

Assessing the Relative Performance of Nurses Using Data Envelopment Analysis Matrix (DEAM).

PubMed

Vafaee Najar, Ali; Pooya, Alireza; Alizadeh Zoeram, Ali; Emrouznejad, Ali

2018-05-31

Assessing employee performance is one of the most important issue in healthcare management services. Because of their direct relationship with patients, nurses are also the most influential hospital staff who play a vital role in providing healthcare services. In this paper, a novel Data Envelopment Analysis Matrix (DEAM) approach is proposed for assessing the performance of nurses based on relative efficiency. The proposed model consists of five input variables (including type of employment, work experience, training hours, working hours and overtime hours) and eight output variables (the outputs are amount of hours each nurse spend on each of the eight activities including documentation, medical instructions, wound care and patient drainage, laboratory sampling, assessment and control care, follow-up and counseling and para-clinical measures, attendance during visiting and discharge suction) have been tested on 30 nurses from the heart department of a hospital in Iran. After determining the relative efficiency of each nurse based on the DEA model, the nurses' performance were evaluated in a DEAM format. As results the nurses were divided into four groups; superstars, potential stars, those who are needed to be trained effectively and question marks. Finally, based on the proposed approach, we have drawn some recommendations to policy makers in order to improve and maintain the performance of each of these groups. The proposed approach provides a practical framework for hospital managers so that they can assess the relative efficiency of nurses, plan and take steps to improve the quality of healthcare delivery.

Population-centered Risk- and Evidence-based Dental Interprofessional Care Team (PREDICT): study protocol for a randomized controlled trial.

PubMed

Cunha-Cruz, Joana; Milgrom, Peter; Shirtcliff, R Michael; Bailit, Howard L; Huebner, Colleen E; Conrad, Douglas; Ludwig, Sharity; Mitchell, Melissa; Dysert, Jeanne; Allen, Gary; Scott, JoAnna; Mancl, Lloyd

2015-06-20

To improve the oral health of low-income children, innovations in dental delivery systems are needed, including community-based care, the use of expanded duty auxiliary dental personnel, capitation payments, and global budgets. This paper describes the protocol for PREDICT (Population-centered Risk- and Evidence-based Dental Interprofessional Care Team), an evaluation project to test the effectiveness of new delivery and payment systems for improving dental care and oral health. This is a parallel-group cluster randomized controlled trial. Fourteen rural Oregon counties with a publicly insured (Medicaid) population of 82,000 children (0 to 21 years old) and pregnant women served by a managed dental care organization are randomized into test and control counties. In the test intervention (PREDICT), allied dental personnel provide screening and preventive services in community settings and case managers serve as patient navigators to arrange referrals of children who need dentist services. The delivery system intervention is paired with a compensation system for high performance (pay-for-performance) with efficient performance monitoring. PREDICT focuses on the following: 1) identifying eligible children and gaining caregiver consent for services in community settings (for example, schools); 2) providing risk-based preventive and caries stabilization services efficiently at these settings; 3) providing curative care in dental clinics; and 4) incentivizing local delivery teams to meet performance benchmarks. In the control intervention, care is delivered in dental offices without performance incentives. The primary outcome is the prevalence of untreated dental caries. Other outcomes are related to process, structure and cost. Data are collected through patient and staff surveys, clinical examinations, and the review of health and administrative records. If effective, PREDICT is expected to substantially reduce disparities in dental care and oral health. PREDICT can be disseminated to other care organizations as publicly insured clients are increasingly served by large practice organizations. ClinicalTrials.gov NCT02312921 6 December 2014. The Robert Wood Johnson Foundation and Advantage Dental Services, LLC, are supporting the evaluation.

[Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services].

PubMed

Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee

2015-10-01

The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

Applying operations management in client-oriented and cost-efficient provision of care, welfare and housing services

PubMed Central

de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

2008-01-01

Purpose In all Western countries, ageing populations cause the demand for elderly care services to increase dramatically. In addition, elderly clients are getting more demanding about the services they require to fulfil their widely varying and multiple needs. Besides, cost reductions have been the focus of governmental policies and organisational practices for many years. Health care providers increasingly see operations management as a promising approach to align both client-orientation and cost-efficiency in their day-to-day practices. Theory The paper starts from operations management literature on front office—back office design and modular production. Organisations have several options for deciding which activities need to be performed by FO, BO, or the client himself, and in deciding which employees need to perform these activities. By applying modular production, organisations can differentiate care and related services to a high degree without major cost increases. Method A literature review will be presented leading to a theoretical framework. This formed the basis for explorative case studies in the elderly care sector. Results and conclusions It will be argued how insights provided with the framework may enhance a client-orientation in integrated care delivery without major cost increases. Although case studies need to be interpreted with caution, interesting implications for organisational structures and inter-organisational cooperation can be seen. We will discuss how combined supply of care services can be made transparent to enhance choice options in service products, and what is required at the level of professionals for providing care and service packages based on client demand.

Strategic plans open for comment

NASA Astrophysics Data System (ADS)

Under the Government Performance and Results Act (the Results Act), agencies of the U.S. government are required to submit a 5-year strategic plan to the U.S. Congress by September 30, 1997 explaining how, when, and why they are spending tax dollars.Enacted in 1993, the Results Act is in tended to "improve efficiency and effective ness of Federal programs by establishing a system to set goals for program performance and to measure results." Thus according to the U.S. House of Representatives Committee on Science, the aim is for agencies to measure their performances by the results of their task and services, not by the number of tasks and services performed. Toward that goal, the Act requires that federal entities complete the following 3-step process:

Expanded Transportation Performance Measures to Supplement Level of Service (LOS) for Growth Management and Transportation Impact Analysis

DOT National Transportation Integrated Search

2012-10-01

Floridas transportation infrastructure must continually evolve to meet the demands of its growing population. Many jurisdictions are moving toward multimodal transportation systems that utilize existing infrastructure more efficiently, providing u...

Austin's Home Performance with Energy Star Program: Making a Compelling Offer to a Financial Institution Partner

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

Zimring, Mark

2011-03-18

Launched in 2006, over 8,700 residential energy upgrades have been completed through Austin Energy's Home Performance with Energy Star (HPwES) program. The program's lending partner, Velocity Credit Union (VCU) has originated almost 1,800 loans, totaling approximately $12.5 million. Residential energy efficiency loans are typically small, and expensive to originate and service relative to larger financing products. National lenders have been hesitant to deliver attractive loan products to this small, but growing, residential market. In response, energy efficiency programs have found ways to partner with local and regional banks, credit unions, community development finance institutions (CDFIs) and co-ops to deliver energymore » efficiency financing to homeowners. VCU's experience with the Austin Energy HPwES program highlights the potential benefits of energy efficiency programs to a lending partner.« less

Agent Based Fault Tolerance for the Mobile Environment

NASA Astrophysics Data System (ADS)

Park, Taesoon

This paper presents a fault-tolerance scheme based on mobile agents for the reliable mobile computing systems. Mobility of the agent is suitable to trace the mobile hosts and the intelligence of the agent makes it efficient to support the fault tolerance services. This paper presents two approaches to implement the mobile agent based fault tolerant service and their performances are evaluated and compared with other fault-tolerant schemes.

Intelligent distributed medical image management

NASA Astrophysics Data System (ADS)

Garcia, Hong-Mei C.; Yun, David Y.

1995-05-01

The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

Performance evaluation of a health insurance in Nigeria using optimal resource use: health care providers perspectives

PubMed Central

2014-01-01

Background Performance measures are often neglected during the transition period of national health insurance scheme implementation in many low and middle income countries. These measurements evaluate the extent to which various aspects of the schemes meet their key objectives. This study assesses the implementation of a health insurance scheme using optimal resource use domains and examines possible factors that influence each domain, according to providers’ perspectives. Methods A retrospective, cross-sectional survey was done between August and December 2010 in Kaduna state, and 466 health care provider personnel were interviewed. Optimal-resource-use was defined in four domains: provider payment mechanism (capitation and fee-for-service payment methods), benefit package, administrative efficiency, and active monitoring mechanism. Logistic regression analysis was used to identify provider factors that may influence each domain. Results In the provider payment mechanism domain, capitation payment method (95%) performed better than fee-for-service payment method (62%). Benefit package domain performed strongly (97%), while active monitoring mechanism performed weakly (37%). In the administrative efficiency domain, both promptness of referral system (80%) and prompt arrival of funds (93%) performed well. At the individual level, providers with fewer enrolees encountered difficulties with reimbursement. Other factors significantly influenced each of the optimal-resource-use domains. Conclusions Fee-for-service payment method and claims review, in the provider payment and active monitoring mechanisms, respectively, performed weakly according to the providers’ (at individual-level) perspectives. A short-fall on the supply-side of health insurance could lead to a direct or indirect adverse effect on the demand-side of the scheme. Capitation payment per enrolees should be revised to conform to economic circumstances. Performance indicators and providers’ characteristics and experiences associated with resource use can assist policy makers to monitor and evaluate health insurance implementation. PMID:24628889

NaradaBrokering as Middleware Fabric for Grid-based Remote Visualization Services

NASA Astrophysics Data System (ADS)

Pallickara, S.; Erlebacher, G.; Yuen, D.; Fox, G.; Pierce, M.

2003-12-01

Remote Visualization Services (RVS) have tended to rely on approaches based on the client server paradigm. The simplicity in these approaches is offset by problems such as single-point-of-failures, scaling and availability. Furthermore, as the complexity, scale and scope of the services hosted on this paradigm increase, this approach becomes increasingly unsuitable. We propose a scheme based on top of a distributed brokering infrastructure, NaradaBrokering, which comprises a distributed network of broker nodes. These broker nodes are organized in a cluster-based architecture that can scale to very large sizes. The broker network is resilient to broker failures and efficiently routes interactions to entities that expressed an interest in them. In our approach to RVS, services advertise their capabilities to the broker network, which manages these service advertisements. Among the services considered within our system are those that perform graphic transformations, mediate access to specialized datasets and finally those that manage the execution of specified tasks. There could be multiple instances of each of these services and the system ensures that load for a given service is distributed efficiently over these service instances. Among the features provided in our approach are efficient discovery of services and asynchronous interactions between services and service requestors (which could themselves be other services). Entities need not be online during the execution of the service request. The system also ensures that entities can be notified about task executions, partial results and failures that might have taken place during service execution. The system also facilitates specification of task overrides, distribution of execution results to alternate devices (which were not used to originally request service execution) and to multiple users. These RVS services could of course be either OGSA (Open Grid Services Architecture) based Grid services or traditional Web services. The brokering infrastructure will manage the service advertisements and the invocation of these services. This scheme ensures that the fundamental Grid computing concept is met - provide computing capabilities of those that are willing to provide it to those that seek the same. {[1]} The NaradaBrokering Project: http://www.naradabrokering.org

Technology’s present situation and the development prospects of energy efficiency monitoring as well as performance testing & analysis for process flow compressors

NASA Astrophysics Data System (ADS)

Li, L.; Zhao, Y.; Wang, L.; Yang, Q.; Liu, G.; Tang, B.; Xiao, J.

2017-08-01

In this paper, the background of performance testing of in-service process flow compressors set in user field are introduced, the main technique barriers faced in the field test are summarized, and the factors that result in real efficiencies of most process flow compressors being lower than the guaranteed by manufacturer are analysed. The authors investigated the present operational situation of process flow compressors in China and found that low efficiency operation of flow compressors is because the compressed gas is generally forced to flow back into the inlet pipe for adapting to the process parameters variety. For example, the anti-surge valve is always opened for centrifugal compressor. To improve the operation efficiency of process compressors the energy efficiency monitoring technology was overviewed and some suggestions are proposed in the paper, which is the basis of research on energy efficiency evaluation and/or labelling of process compressors.

Advanced binary geothermal power plants: Limits of performance

NASA Astrophysics Data System (ADS)

Bliem, C. J.; Mines, G. L.

1991-01-01

The Heat Cycle Research Program is investigating potential improvements to power cycles utilizing moderate temperature geothermal resources to produce electrical power. Investigations have specifically examined Rankine cycle binary power systems. Binary Rankine cycles are more efficient than the flash steam cycles at moderate resource temperature, achieving a higher net brine effectiveness. At resource conditions similar to those at the Heber binary plant, it has been shown that mixtures of saturated hydrocarbons (alkanes) or halogenated hydrocarbons operating in a supercritical Rankine cycle gave improved performance over Rankine cycles with the pure working fluids executing single or dual boiling cycles or supercritical cycles. Recently, other types of cycles have been proposed for binary geothermal service. The feasible limits on efficiency of a plant given practical limits on equipment performance is explored and the methods used in these advanced concept plants to achieve the maximum possible efficiency are discussed. (Here feasible is intended to mean reasonably achievable and not cost effective.) No direct economic analysis was made because of the sensitivity of economic results to site specific input. The limit of performance of three advanced plants were considered. The performance predictions were taken from the developers of each concept. The advanced plants considered appear to be approaching the feasible limit of performance. Ultimately, the plant designer must weigh the advantages and disadvantages of the the different cycles to find the best plant for a given service. In addition, a standard is presented of comparison of the work which has been done in the Heat Cycle Research Program and in the industrial sector by Exergy, Inc. and Polythermal Technologies.

Coverage-maximization in networks under resource constraints.

PubMed

Nandi, Subrata; Brusch, Lutz; Deutsch, Andreas; Ganguly, Niloy

2010-06-01

Efficient coverage algorithms are essential for information search or dispersal in all kinds of networks. We define an extended coverage problem which accounts for constrained resources of consumed bandwidth B and time T . Our solution to the network challenge is here studied for regular grids only. Using methods from statistical mechanics, we develop a coverage algorithm with proliferating message packets and temporally modulated proliferation rate. The algorithm performs as efficiently as a single random walker but O(B(d-2)/d) times faster, resulting in significant service speed-up on a regular grid of dimension d . The algorithm is numerically compared to a class of generalized proliferating random walk strategies and on regular grids shown to perform best in terms of the product metric of speed and efficiency.

Transforming Public Health Systems: Using Data to Drive Organizational Capacity for Quality Improvement and Efficiency

PubMed Central

Steinwachs, Donald M.

2014-01-01

Introduction: This paper examines the organization, services, and priorities of public health agencies and their capacity to be learning public health systems (LPHS). An LPHS uses data to measure population health and health risks and to evaluate its services and programs, and then integrates its own research with advances in scientific knowledge to innovate and improve its efficiency and effectiveness. Public Health Agencies and Impact for LPHS: Public health agencies’ (PHA) organizational characteristics vary across states, as does their funding per capita. Variations in organization, services provided, and expenditures per capita may reflect variations in community needs or may be associated with unmet needs. The status of legal statutes defining responsibilities and authorities and their relationships to other public and private agencies also vary. Little information is available on the efficiency and effectiveness of state and local PHAs, in part due to a lack of information infrastructure to capture uniform data on services provided. There are almost no data on the relationship of quality of services, staff performance, and resources to population health outcomes. By building a capacity to collect and analyze data on population health within and across communities, and by becoming a continuous learning PHA, the allocation of resources can more closely match population health needs and improve health outcomes. Accreditation of every PHA is an important first step toward becoming a learning PHA. Conclusions: Public Health Services and Systems Research (PHSSR) is beginning to shed light on some of these issues, particularly by investigating variation across PHAs. As this emerging discipline grows, there is a need to enhance the collection and use of data in support of building organized, effective, and efficient LPHSs with the PHA capacity to continually improve the public’s health. PMID:25995990

Improving the Efficiency of Physical Examination Services

PubMed Central

Chih, Mingchang; Bair, Aaron E.

2009-01-01

The objective of our project was to improve the efficiency of the physical examination screening service of a large hospital system. We began with a detailed simulation model to explore the relationships between four performance measures and three decision factors. We then attempted to identify the optimal physician inquiry starting time by solving a goal-programming problem, where the objective function includes multiple goals. One of our simulation results shows that the proposed optimal physician inquiry starting time decreased patient wait times by 50% without increasing overall physician utilization. Electronic supplementary material  The online version of this article (doi:10.1007/s10916-009-9271-z) contains supplementary material, which is available to authorized users. PMID:20703912

Integrating policy-based management and SLA performance monitoring

NASA Astrophysics Data System (ADS)

Liu, Tzong-Jye; Lin, Chin-Yi; Chang, Shu-Hsin; Yen, Meng-Tzu

2001-10-01

Policy-based management system provides the configuration capability for the system administrators to focus on the requirements of customers. The service level agreement performance monitoring mechanism helps system administrators to verify the correctness of policies. However, it is difficult for a device to process the policies directly because the policies are the management concept. This paper proposes a mechanism to decompose a policy into rules that can be efficiently processed by a device. Thus, the device may process the rule and collect the performance statistics information efficiently; and the policy-based management system may collect these performance statistics information and report the service-level agreement performance monitoring information to the system administrator. The proposed policy-based management system achieves both the policy configuration and service-level agreement performance monitoring requirements. A policy consists of a condition part and an action part. The condition part is a Boolean expression of a source host IP group, a destination host IP group, etc. The action part is the parameters of services. We say that an address group is compact if it only consists of a range of IP address that can be denoted by a pair of IP address and corresponding IP mask. If the condition part of a policy only consists of the compact address group, we say that the policy is a rule. Since a device can efficiently process a compact address and a system administrator prefers to define a range of IP address, the policy-based management system has to translate policy into rules and supplements the gaps between policy and rules. The proposed policy-based management system builds the relationships between VPN and policies, policy and rules. Since the system administrator wants to monitor the system performance information of VPNs and policies, the proposed policy-based management system downloads the relationships among VPNs, policies and rules to the SNMP agents. The SNMP agents build the management information base (MIB) of all VPNs, policies and rules according to the relationships obtained from the management server. Thus, the proposed policy-based management system may get all performance monitoring information of VPNs and policies from agents. The proposed policy-based manager achieves two goals: a) provide a management environment for the system administrator to configure their network only considering the policy requirement issues and b) let the device have only to process the packet and then collect the required performance information. These two things make the proposed management system satisfy both the user and device requirements.

Performance Contracting and Energy Efficiency in the State Government Market

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

Bharvirkar, Ranjit; Goldman, Charles; Gilligan, Donald

There is growing interest in energy efficiency (EE) among state policymakers as a result of increasing environmental concerns, rising electricity and natural gas prices, and lean economic times that motivate states to look more aggressively for cost-saving opportunities in public sector buildings. One logical place for state policymakers to demonstrate their commitment to energy efficiency is to 'lead by example' by developing and implementing strategies to reduce the energy consumption of state government facilities through investments in energy efficient technologies. Traditionally, energy efficiency improvements at state government facilities are viewed as a subset in the general category of building maintenancemore » and construction. These projects are typically funded through direct appropriations. However, energy efficiency projects are often delayed or reduced in scope whereby not all cost-effective measures are implemented because many states have tight capital budgets. Energy Savings Performance Contracting (ESPC) offers a potentially useful strategy for state program and facility managers to proactively finance and develop energy efficiency projects. In an ESPC project, Energy Service Companies (ESCOs) typically guarantee that the energy and cost savings produced by the project will equal or exceed all costs associated with implementing the project over the term of the contract. ESCOs typically provide turnkey design, installation, and maintenance services and also help arrange project financing. Between 1990 and 2006, U.S. ESCOs reported market activity of {approx}$28 Billion, with about {approx}75-80% of that activity concentrated in the institutional markets (K-12 schools, colleges/universities, state/local/federal government and hospitals). In this study, we review the magnitude of energy efficiency investment in state facilities and identify 'best practices' while employing performance contracting in the state government sector. The state government market is defined to include state offices, state universities, correctional facilities, and other state facilities. This study is part of a series of reports prepared by Lawrence Berkeley National Laboratory (LBNL) and the National Association of Energy Services Companies (NAESCO) on the ESCO market and industry trends. The scope of previous reports was much broader: Goldman et al. (2002) analyzed ESCO project costs and savings in public and private sector facilities, Hopper et al. (2005) focused on ESCO project activity in all public and institutional sectors, while Hopper et al (2007) provided aggregate results of a comprehensive survey of ESCOs on current industry activity and future prospects. We decided to focus the current study on ESCO and energy efficiency activity and potential market barriers in the state government market because previous studies suggested that this institutional sector has significant remaining energy efficiency opportunities. Moreover, ESCO activity in the state government market has lagged behind other institutional markets (e.g., K-12 schools, local governments, and the federal market). Our primary objectives were as follows: (1) Assess existing state agency energy information and data sources that could be utilized to develop performance metrics to assess progress among ESPC programs in states; (2) Conduct a comparative review of the performance of selected state ESPC programs in reducing energy usage and costs in state government buildings; and (3) Delineate the extent to which state government sector facilities are implementing energy efficiency projects apart from ESPC programs using other strategies (e.g. utility ratepayer-funded energy efficiency programs, loan funds).« less

Governance and Purchasing Function under Social Health Insurance in Nepal: Looking Back and Moving Forward.

PubMed

Sapkota, V P; Bhusal, U P

2017-01-01

Nepal is pursuing Social Health Insurance as a way of mobilizing revenues to achieve Universal Health Coverage. The Social Health Insurance governance encourages service providers to maintain quality and efficiency in services provision by practicing strategic purchasing. Social Health Security Programme is a social protection program which aspires to achieve the goals of Social Health Insurance. Social Health Security Development Committee needs to consider following experiences to function as a strategic purchaser. The Social Health Security Development Committee need to be an independent body instead of falling under Ministry of Health. Similarly, purchasing of health services needs to be made strategic, i.e., Social Health Security Development Committee should use its financial power to guide the provider behavior that will eventually contribute to achieving the goals of quality and efficiency in service provision. The other social health security funds should be merged with Social Health Security Development Committee and develop a single national fund. Finally, the state has to regulate and monitor the performance of the SHI agency.

Future-oriented maintenance strategy based on automated processes is finding its way into large astronomical facilities at remote observing sites

NASA Astrophysics Data System (ADS)

Silber, Armin; Gonzalez, Christian; Pino, Francisco; Escarate, Patricio; Gairing, Stefan

2014-08-01

With expanding sizes and increasing complexity of large astronomical observatories on remote observing sites, the call for an efficient and recourses saving maintenance concept becomes louder. The increasing number of subsystems on telescopes and instruments forces large observatories, like in industries, to rethink conventional maintenance strategies for reaching this demanding goal. The implementation of full-, or semi-automatic processes for standard service activities can help to keep the number of operating staff on an efficient level and to reduce significantly the consumption of valuable consumables or equipment. In this contribution we will demonstrate on the example of the 80 Cryogenic subsystems of the ALMA Front End instrument, how an implemented automatic service process increases the availability of spare parts and Line Replaceable Units. Furthermore how valuable staff recourses can be freed from continuous repetitive maintenance activities, to allow focusing more on system diagnostic tasks, troubleshooting and the interchanging of line replaceable units. The required service activities are decoupled from the day-to-day work, eliminating dependencies on workload peaks or logistic constrains. The automatic refurbishing processes running in parallel to the operational tasks with constant quality and without compromising the performance of the serviced system components. Consequentially that results in an efficiency increase, less down time and keeps the observing schedule on track. Automatic service processes in combination with proactive maintenance concepts are providing the necessary flexibility for the complex operational work structures of large observatories. The gained planning flexibility is allowing an optimization of operational procedures and sequences by considering the required cost efficiency.

Performance of rural health clinics: an examination of efficiency and Medicare beneficiary outcomes.

PubMed

Ortiz, J; Wan, T H

2012-01-01

In 2011, some 3800 Rural Health Clinics (RHCs) delivered primary care in underserved rural areas throughout the USA. To date, little research has been conducted to identify the variability in RHC performance. In an effort to address the knowledge gaps, a national, longitudinal study was conducted of a panel of 3565 RHCs. The goals of the study were to determine: (1) the relationship between two aspects of performance: efficiency and effectiveness; and (2) the factors that influence variation in RHC performance. A non-experimental study of RHC performance was conducted using 2 years of secondary data from multiple sources. A study panel of RHCs was formed. This panel was composed of all RHCs continuously in operation during the period 2006-2007. The study panel was divided into two subsets - one for the provider-based clinics; another for the independent clinics. The individual RHC was the unit of analysis throughout the study. Descriptive statistics were calculated for each subset. Bivariate analyses was conducted of the relationships between the clinic characteristics and the performance outcome measures, as well as the interrelationships between various clinic characteristics using χ², t-tests, Cramer's V, Pearson correlation, and Spearman correlation statistics. Next, using covariance structure analysis, the interrelationships were examined among the context (community or demographic factors), design (organizational structure and other mediating factors), and performance (efficiency and effectiveness) of RHCs. Three hypotheses were tested: (1) the effectiveness of RHCs is positively influenced by efficiency; (2) there is a reciprocal relationship between RHC efficiency and effectiveness; and (3) large RHCs are more efficient than small RHCs. To test the hypotheses that effectiveness of RHCs is positively influenced by efficiency and that there is a reciprocal relationship between efficiency and effectiveness, two covariance structure models were developed and revised: one for independent and one for provider-based RHCs. However, the revised models were not supported by the data. To test the hypothesis that large RHCs are more efficient than small ones, two additional efficiency-based structural equation models were constructed (one for independent RHCs and another for provider-based RHCs). Both of these models were supported by the data (independent model: χ² = 13.8, df = 8, p = 0.088, relative χ² = 1.723, adjusted goodness of fit index [AGFI] = .981, root mean square error of approximation [RMSEA] = .034; provider-based model: χ² = 19.011, df = 8, p = 0.015, relative χ² = 2.376, AGFI = .978, RMSEA = .043). This study examined the relationship between efficiency and effectiveness of RHCs. In addition, it identified several factors that influence the variation in RHC performance. The study has implications for optimizing RHC performance, providing quality services to rural populations, and enhancing the value of RHC data. The present is a critical time in the history of RHCs as they transition to meet the goals and expectations of the US health system reform. Additional research is needed to quantify and trend RHCs' contribution to the rural health delivery system in order to optimize their service to rural populations.

Exploiting New Data Sources to Quantify Arterial Congestion and Performance Measures.

DOT National Transportation Integrated Search

2017-01-01

Transit travel time, operating speed and reliability all influence service attractiveness, operating cost and system efficiency. These metrics have a long-term impact on system effectiveness through a change in ridership. As part of its bus dispatch ...

Self Evaluation of Organizations.

ERIC Educational Resources Information Center

Pooley, Richard C.

Evaluation within human service organizations is defined in terms of accepted evaluation criteria, with reasonable expectations shown and structured into a model of systematic evaluation practice. The evaluation criteria of program effort, performance, adequacy, efficiency and process mechanisms are discussed, along with measurement information…

OCICATS (Online Community Input Classification to Advance Transportation Services) - a GIS-based decision-support tool.

DOT National Transportation Integrated Search

2016-09-02

Public transportation agencies can obtain large amounts of information regarding timeliness, efficiency, cleanliness, ridership, and other : performance measures. However, these metrics are based on the interests of these agencies and do not necessar...

Understanding the Models of Community Hospital rehabilitation Activity (MoCHA): a mixed-methods study

PubMed Central

Gladman, John; Buckell, John; Young, John; Smith, Andrew; Hulme, Clare; Saggu, Satti; Godfrey, Mary; Enderby, Pam; Teale, Elizabeth; Longo, Roberto; Gannon, Brenda; Holditch, Claire; Eardley, Heather; Tucker, Helen

2017-01-01

Introduction To understand the variation in performance between community hospitals, our objectives are: to measure the relative performance (cost efficiency) of rehabilitation services in community hospitals; to identify the characteristics of community hospital rehabilitation that optimise performance; to investigate the current impact of community hospital inpatient rehabilitation for older people on secondary care and the potential impact if community hospital rehabilitation was optimised to best practice nationally; to examine the relationship between the configuration of intermediate care and secondary care bed use; and to develop toolkits for commissioners and community hospital providers to optimise performance. Methods and analysis 4 linked studies will be performed. Study 1: cost efficiency modelling will apply econometric techniques to data sets from the National Health Service (NHS) Benchmarking Network surveys of community hospital and intermediate care. This will identify community hospitals' performance and estimate the gap between high and low performers. Analyses will determine the potential impact if the performance of all community hospitals nationally was optimised to best performance, and examine the association between community hospital configuration and secondary care bed use. Study 2: a national community hospital survey gathering detailed cost data and efficiency variables will be performed. Study 3: in-depth case studies of 3 community hospitals, 2 high and 1 low performing, will be undertaken. Case studies will gather routine hospital and local health economy data. Ward culture will be surveyed. Content and delivery of treatment will be observed. Patients and staff will be interviewed. Study 4: co-designed web-based quality improvement toolkits for commissioners and providers will be developed, including indicators of performance and the gap between local and best community hospitals performance. Ethics and dissemination Publications will be in peer-reviewed journals, reports will be distributed through stakeholder organisations. Ethical approval was obtained from the Bradford Research Ethics Committee (reference: 15/YH/0062). PMID:28242766

Assessing the efficiency of hospital pharmacy services in Thai public district hospitals.

PubMed

Rattanachotphanit, Thananan; Limwattananon, Chulaporn; Limwattananon, Supon; Johns, Jeff R; Schommer, Jon C; Brown, Lawrence M

2008-07-01

The purpose of this study was to assess the efficiency of hospital pharmacy services and to determine the environmental factors affecting pharmacy service efficiency. The technical efficiency of a hospital pharmacy was assessed to evaluate the hospital's ability to use pharmacy manpower in order to produce the maximum output of the pharmacy service. Data Envelopment Analysis (DEA) was used as an efficiency measurement. The two labor inputs were pharmacists and support personnel and the ten outputs were from four pharmacy activities: drug dispensing, drug purchasing and inventory control, patient-oriented activities, and health consumer protection services. This was used to estimate technical efficiency. A Tobit regression model was used to determine the effect of the hospital size, location, input mix of pharmacy staff, working experience of pharmacists at the study hospitals, and use of technology on the pharmacy service efficiency. Data for pharmacy service input and output quantities were obtained from 155 respondents. Nineteen percent were found to have full efficiency with a technical efficiency score of 1.00. Thirty-six percent had a technical efficiency score of 0.80 or above and 27% had a low technical efficiency score (< 0.60). The average TE score increased in respect to the hospital size (0.60, 0.71, 0.75, and 0.83 in 10, 30, 60, and 90-120 bed hospitals, respectively). Hospital size and geographic location were significantly associated with pharmacy service efficiency.

Performance evaluation of nonhomogeneous hospitals: the case of Hong Kong hospitals.

PubMed

Li, Yongjun; Lei, Xiyang; Morton, Alec

2018-02-14

Throughout the world, hospitals are under increasing pressure to become more efficient. Efficiency analysis tools can play a role in giving policymakers insight into which units are less efficient and why. Many researchers have studied efficiencies of hospitals using data envelopment analysis (DEA) as an efficiency analysis tool. However, in the existing literature on DEA-based performance evaluation, a standard assumption of the constant returns to scale (CRS) or the variable returns to scale (VRS) DEA models is that decision-making units (DMUs) use a similar mix of inputs to produce a similar set of outputs. In fact, hospitals with different primary goals supply different services and provide different outputs. That is, hospitals are nonhomogeneous and the standard assumption of the DEA model is not applicable to the performance evaluation of nonhomogeneous hospitals. This paper considers the nonhomogeneity among hospitals in the performance evaluation and takes hospitals in Hong Kong as a case study. An extension of Cook et al. (2013) [1] based on the VRS assumption is developed to evaluated nonhomogeneous hospitals' efficiencies since inputs of hospitals vary greatly. Following the philosophy of Cook et al. (2013) [1], hospitals are divided into homogeneous groups and the product process of each hospital is divided into subunits. The performance of hospitals is measured on the basis of subunits. The proposed approach can be applied to measure the performance of other nonhomogeneous entities that exhibit variable return to scale.

Low cost and high performance GPON, GEPON and RFoG optical network pentaplexer module design using diffractive grating approach

NASA Astrophysics Data System (ADS)

Chen, I.-Ju; Chi, Chang-Chia; Tarn, Chen-Wen

2016-01-01

A new architecture of a pentaplexer transceiver module which can be used in GPON/GEPON and RFoG triple play optical networks with supporting of the multiple optical wavelengths of 1310 nm, 1490 nm, 1550 nm, 1610 nm, and 1650 nm, is proposed. By using diffractive grating elements combing with market readily available GRIN (Gradient-Index) lens, grating, mirrors, beamsplitter, LDs (Laser Diodes), and PDs (Photodetectors), the proposed design have the advantages of low cost, high efficiency/performance, easy design and manufacturing, over the contemporary triplex transceivers which are made of multilayer filters or waveguides that increase the complexity of manufacturing and reduce the performance efficiency. With the proposed design, a pentaplexer system can accommodate GPON/GEPON, RFoG, and monitoring integration services, total five optical wavelength channels into a hybrid-integrated TO-CAN package platform with sufficient efficiency.

Land use efficiency: anticipating future demand for land-sector greenhouse gas emissions abatement and managing trade-offs with agriculture, water, and biodiversity.

PubMed

Bryan, Brett A; Crossman, Neville D; Nolan, Martin; Li, Jing; Navarro, Javier; Connor, Jeffery D

2015-11-01

Competition for land is increasing, and policy needs to ensure the efficient supply of multiple ecosystem services from land systems. We modelled the spatially explicit potential future supply of ecosystem services in Australia's intensive agricultural land in response to carbon markets under four global outlooks from 2013 to 2050. We assessed the productive efficiency of greenhouse gas emissions abatement, agricultural production, water resources, and biodiversity services and compared these to production possibility frontiers (PPFs). While interacting commodity markets and carbon markets produced efficient outcomes for agricultural production and emissions abatement, more efficient outcomes were possible for water resources and biodiversity services due to weak price signals. However, when only two objectives were considered as per typical efficiency assessments, efficiency improvements involved significant unintended trade-offs for the other objectives and incurred substantial opportunity costs. Considering multiple objectives simultaneously enabled the identification of land use arrangements that were efficient over multiple ecosystem services. Efficient land use arrangements could be selected that meet society's preferences for ecosystem service provision from land by adjusting the metric used to combine multiple services. To effectively manage competition for land via land use efficiency, market incentives are needed that effectively price multiple ecosystem services. © 2015 John Wiley & Sons Ltd.

Ambulatory surgery centers best practices for the 90s.

PubMed

Hoover, J A

1994-05-01

Outpatient surgery will be the driving force in the continued growth of ambulatory care in the 1990s. Providing efficient, high-quality ambulatory surgical services should therefore be a priority among healthcare providers. Arthur Andersen conducted a survey to discover best practices in ambulatory surgical service. General success characteristics of best performers were business-focused relationships with physicians, the use of clinical protocols, patient convenience, cost management, strong leadership, teamwork, streamlined processes and efficient design. Other important factors included scheduling to maximize OR room use; achieving surgical efficiencies through reduced case pack assembly errors and equipment availability; a focus on cost capture rather than charge capture; sound materiel management practices, such as standardization and vendor teaming; and the appropriate use of automated systems. It is important to evaluate whether the best practices are applicable to your environment and what specific changes to your current processes would be necessary to adopt them.

Energy Efficiency and Renewable Energy Network (EREN): Customer satisfaction survey

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

Anderson, A.V.; Henderson, D.P.

1996-04-22

The Energy Efficiency and Renewable Energy Network (EREN) Customer Satisfaction Survey was developed and executed in support of EREN`s continuous quality improvement (CQI) plan. The study was designed to provide information about the demographic make up of EREN users, the value or benefits they derive from EREN, the kinds and quality of services they want, their levels of satisfaction with existing services, their preferences in both the sources of service and the means of delivery, and to provide benchmark data for the establishment of continuous quality improvement measures. The survey was performed by soliciting voluntary participation from members of themore » EREN Users Group. It was executed in two phases; the first being conducted by phone using a randomly selected group; and the second being conducted electronically and which was open to all of the remaining members of the Users Group. The survey results are described.« less

[Evaluation of financial performance of health services: reflections of operational policies in the hospital sector].

PubMed

Bonacim, Carlos Alberto Grespan; de Araujo, Adriana Maria Procópio

2011-01-01

Discussions about management manners and procedures has been relevant among organization managers in the health services. The health services economic evaluation approaches this theme and is taking an important role around the world, demanding the manager new challenges concerning the continuous search of activities efficiency and efficacy. The objective is to describe the consequences of operational changes in the economic-financial indicators of a Public Hospital. The methodology applied included besides the literature research, a case study in the "Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto--USP". The values found confirm the context of the hospital. One concludes that the average costs present similar behaviors with trend to stabilization, thus confirming improvements in efficiency. The importance of the rendering of accounts for the society related to the use of public resources and how this study can help in this way.

Traffic Management in ATM Networks Over Satellite Links

NASA Technical Reports Server (NTRS)

Goyal, Rohit; Jain, Raj; Goyal, Mukul; Fahmy, Sonia; Vandalore, Bobby; vonDeak, Thomas

1999-01-01

This report presents a survey of the traffic management Issues in the design and implementation of satellite Asynchronous Transfer Mode (ATM) networks. The report focuses on the efficient transport of Transmission Control Protocol (TCP) traffic over satellite ATM. First, a reference satellite ATM network architecture is presented along with an overview of the service categories available in ATM networks. A delay model for satellite networks and the major components of delay and delay variation are described. A survey of design options for TCP over Unspecified Bit Rate (UBR), Guaranteed Frame Rate (GFR) and Available Bit Rate (ABR) services in ATM is presented. The main focus is on traffic management issues. Several recommendations on the design options for efficiently carrying data services over satellite ATM networks are presented. Most of the results are based on experiments performed on Geosynchronous (GEO) latencies. Some results for Low Earth Orbits (LEO) and Medium Earth Orbit (MEO) latencies are also provided.

Parametric scramjet analysis

NASA Astrophysics Data System (ADS)

Choi, Jongseong

The performance of a hypersonic flight vehicle will depend on existing materials and fuels; this work presents the performance of the ideal scramjet engine for three different combustion chamber materials and three different candidate fuels. Engine performance is explored by parametric cycle analysis for the ideal scramjet as a function of material maximum service temperature and the lower heating value of jet engine fuels. The thermodynamic analysis is based on the Brayton cycle as similarly employed in describing the performance of the ramjet, turbojet, and fanjet ideal engines. The objective of this work is to explore material operating temperatures and fuel possibilities for the combustion chamber of a scramjet propulsion system to show how they relate to scramjet performance and the seven scramjet engine parameters: specific thrust, fuel-to-air ratio, thrust-specific fuel consumption, thermal efficiency, propulsive efficiency, overall efficiency, and thrust flux. The information presented in this work has not been done by others in the scientific literature. This work yields simple algebraic equations for scramjet performance which are similar to that of the ideal ramjet, ideal turbojet and ideal turbofan engines.

Guidance and Navigation for Rendezvous and Proximity Operations with a Non-Cooperative Spacecraft at Geosynchronous Orbit

NASA Technical Reports Server (NTRS)

Barbee, Brent William; Carpenter, J. Russell; Heatwole, Scott; Markley, F. Landis; Moreau, Michael; Naasz, Bo J.; VanEepoel, John

2010-01-01

The feasibility and benefits of various spacecraft servicing concepts are currently being assessed, and all require that the servicer spacecraft perform rendezvous, proximity, and capture operations with the target spacecraft to be serviced. Many high-value spacecraft, which would be logical targets for servicing from an economic point of view, are located in geosynchronous orbit, a regime in which autonomous rendezvous and capture operations are not commonplace. Furthermore, existing GEO spacecraft were not designed to be serviced. Most do not have cooperative relative navigation sensors or docking features, and some servicing applications, such as de-orbiting of a non-functional spacecraft, entail rendezvous and capture with a spacecraft that may be non-functional or un-controlled. Several of these challenges have been explored via the design of a notional mission in which a nonfunctional satellite in geosynchronous orbit is captured by a servicer spacecraft and boosted into super-synchronous orbit for safe disposal. A strategy for autonomous rendezvous, proximity operations, and capture is developed, and the Orbit Determination Toolbox (ODTBX) is used to perform a relative navigation simulation to assess the feasibility of performing the rendezvous using a combination of angles-only and range measurements. Additionally, a method for designing efficient orbital rendezvous sequences for multiple target spacecraft is utilized to examine the capabilities of a servicer spacecraft to service multiple targets during the course of a single mission.

25 CFR 63.11 - What is a determination of suitability for employment and efficiency of service?

Code of Federal Regulations, 2011 CFR

2011-04-01

... efficiency of service? 63.11 Section 63.11 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR... efficiency of service? (a) Determinations of suitability measure the fitness or eligibility of an applicant... create an immediate or long-term risk for any Indian child. (b) Efficiency of service is the employer's...

25 CFR 63.17 - How does an employer determine suitability for employment and efficiency of service?

Code of Federal Regulations, 2011 CFR

2011-04-01

... and efficiency of service? 63.17 Section 63.17 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... and efficiency of service? (a) Adjudication is the process employers use to determine suitability for employment and efficiency of service. The adjudication process protects the interests of the employer and the...

Technical Efficiency and Organ Transplant Performance: A Mixed-Method Approach

PubMed Central

de-Pablos-Heredero, Carmen; Fernández-Renedo, Carlos; Medina-Merodio, Jose-Amelio

2015-01-01

Mixed methods research is interesting to understand complex processes. Organ transplants are complex processes in need of improved final performance in times of budgetary restrictions. As the main objective a mixed method approach is used in this article to quantify the technical efficiency and the excellence achieved in organ transplant systems and to prove the influence of organizational structures and internal processes in the observed technical efficiency. The results show that it is possible to implement mechanisms for the measurement of the different components by making use of quantitative and qualitative methodologies. The analysis show a positive relationship between the levels related to the Baldrige indicators and the observed technical efficiency in the donation and transplant units of the 11 analyzed hospitals. Therefore it is possible to conclude that high levels in the Baldrige indexes are a necessary condition to reach an increased level of the service offered. PMID:25950653

Custodial Prowess

ERIC Educational Resources Information Center

Knopp, Alan

2005-01-01

Education administrators always are trying to get better performance from their custodial-services department. When schools use more efficient and cost-effective methods, administrators can focus on more pressing issues and worry less about routine problems. In this article, the author discusses some basics to consider: (1) site safety…

Project UCARE : Uniform Commuter Assistance Reporting and Evaluation for transportation demand management programs.

DOT National Transportation Integrated Search

2013-09-01

Moving Ahead for Progress in the 21st Century Act (MAP-21) places emphasis upon results and better management of programs for effective and efficient service delivery. With an increased focus on measuring performance, the transportation demand manage...

Robust multiperson detection and tracking for mobile service and social robots.

PubMed

Li, Liyuan; Yan, Shuicheng; Yu, Xinguo; Tan, Yeow Kee; Li, Haizhou

2012-10-01

This paper proposes an efficient system which integrates multiple vision models for robust multiperson detection and tracking for mobile service and social robots in public environments. The core technique is a novel maximum likelihood (ML)-based algorithm which combines the multimodel detections in mean-shift tracking. First, a likelihood probability which integrates detections and similarity to local appearance is defined. Then, an expectation-maximization (EM)-like mean-shift algorithm is derived under the ML framework. In each iteration, the E-step estimates the associations to the detections, and the M-step locates the new position according to the ML criterion. To be robust to the complex crowded scenarios for multiperson tracking, an improved sequential strategy to perform the mean-shift tracking is proposed. Under this strategy, human objects are tracked sequentially according to their priority order. To balance the efficiency and robustness for real-time performance, at each stage, the first two objects from the list of the priority order are tested, and the one with the higher score is selected. The proposed method has been successfully implemented on real-world service and social robots. The vision system integrates stereo-based and histograms-of-oriented-gradients-based human detections, occlusion reasoning, and sequential mean-shift tracking. Various examples to show the advantages and robustness of the proposed system for multiperson tracking from mobile robots are presented. Quantitative evaluations on the performance of multiperson tracking are also performed. Experimental results indicate that significant improvements have been achieved by using the proposed method.

NASA's Aeronautics Vision

NASA Technical Reports Server (NTRS)

Tenney, Darrel R.

2004-01-01

Six long-term technology focus areas are: 1. Environmentally Friendly, Clean Burning Engines. Focus: Develop innovative technologies to enable intelligent turbine engines that significantly reduce harmful emissions while maintaining high performance and increasing reliability. 2. New Aircraft Energy Sources and Management. Focus: Discover new energy sources and intelligent management techniques directed towards zero emissions and enable new vehicle concepts for public mobility and new science missions. 3. Quiet Aircraft for Community Friendly Service. Focus: Develop and integrate noise reduction technology to enable unrestricted air transportation service to all communities. 4. Aerodynamic Performance for Fuel Efficiency. Focus: Improve aerodynamic efficiency,structures and materials technologies, and design tools and methodologies to reduce fuel burn and minimize environmental impact and enable new vehicle concepts and capabilities for public mobility and new science missions. 5. Aircraft Weight Reduction and Community Access. Focus: Develop ultralight smart materials and structures, aerodynamic concepts, and lightweight subsystems to increase vehicle efficiency, leading to high altitude long endurance vehicles, planetary aircraft, advanced vertical and short takeoff and landing vehicles and beyond. 6. Smart Aircraft and Autonomous Control. Focus: Enable aircraft to fly with reduced or no human intervention, to optimize flight over multiple regimes, and to provide maintenance on demand towards the goal of a feeling, seeing, sensing, sentient air vehicle.

Evaluation of the influence of economic groups on the efficiency and quality of service of water companies: an empirical approach for Chile.

PubMed

Molinos-Senante, María; Farías, Rodrigo

2018-06-04

The privatization of water and sewerage services (WSS) has led to the foundation of water economic groups, which integrate several water companies and have gained notable importance at the global level. In the framework of benchmarking studies, there are no prior studies exploring the impact that economic groups have on the efficiency and quality of service provided by water companies. This study investigates, for the first time, whether the membership of water companies in an economic group influences their performance. Quantity- and quality-adjusted efficiency scores were computed using data envelopment analysis models. An empirical application was developed for the Chilean water industry since most of their water companies are private and belong to an economic group. The results show that independent water companies provide WSS with better quality than do water companies that belong to an economic group. From a statistical point of view, it was evident that membership in an economic group impacts both the quantity- and quality-adjusted efficiency scores of water companies. The results of this study illustrate that applying the model-firm regulation to the Chilean water industry has significant drawbacks that should be addressed by the water regulator to promote the long-term sustainability of the water industry.

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

PubMed

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

2011-07-01

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

Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

PubMed

Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

2018-03-01

Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

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.

Improving the effectiveness of service delivery in the public healthcare sector: the case of ophthalmology services in Malaysia.

PubMed

Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin

2015-08-28

Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy makers and service managers to intuitively visualise the overall performance of resource use in an otherwise difficult to assess scenario. The considerable potential output gain estimated indicates that effort should be invested to understand what drove the performance variation and optimise them. Similar performance assessment should be undertaken for other healthcare services in the country in order to work towards a sustainable health system.

[Methodology for the comprehensive evaluation of the quality of performance of activities of medical and social experts].

PubMed

Moskalenko, V F; Gorban', Ie M; Marunich, V V; Ipatov, A V; Sergiieni, O V

2001-01-01

The paper scientifically substantiates methodology, approaches, criteria, and control indices for assessment of activities of establishments of medical-and-social performance. Most indices for efficiency and certain indices for week points in the work of establishments of the service depend on interaction thereof with curative- and prophylactic institutions; the best results with the problem of prevention of disability and rehabilitation of invalids are supposed to be achieved through collaborative efforts. Other criteria and intermediate indices having an effect on the quality of activities reflect the resource- and trained personnel supplies of establishments of the service, amount of work, organizational measures designed to raise the quality of medical-and-social expert performance.

Corporate governance of public health services: lessons from New Zealand for the state sector.

PubMed

Perkins, R; Barnett, P; Powell, M

2000-01-01

New Zealand public hospitals and related services were grouped into 23 Crown Health Enterprises and registered as companies in 1993. Integral to this change was the introduction of corporate governance. New directors, largely from the business sector, were appointed to govern these organisations as efficient and effective businesses. This article presents the results of a survey of directors of New Zealand publicly-owned health provider organisations. Although directors thought they performed well in business systems development, they acknowledged their shortcomings in meeting government expectations in respect to financial performance and social responsibility. Changes in public health sector provider performance indicators have resulted in a mixed report card for the sector six years after corporate governance was instituted.

BlueDetect: An iBeacon-Enabled Scheme for Accurate and Energy-Efficient Indoor-Outdoor Detection and Seamless Location-Based Service

PubMed Central

Zou, Han; Jiang, Hao; Luo, Yiwen; Zhu, Jianjie; Lu, Xiaoxuan; Xie, Lihua

2016-01-01

The location and contextual status (indoor or outdoor) is fundamental and critical information for upper-layer applications, such as activity recognition and location-based services (LBS) for individuals. In addition, optimizations of building management systems (BMS), such as the pre-cooling or heating process of the air-conditioning system according to the human traffic entering or exiting a building, can utilize the information, as well. The emerging mobile devices, which are equipped with various sensors, become a feasible and flexible platform to perform indoor-outdoor (IO) detection. However, power-hungry sensors, such as GPS and WiFi, should be used with caution due to the constrained battery storage on mobile device. We propose BlueDetect: an accurate, fast response and energy-efficient scheme for IO detection and seamless LBS running on the mobile device based on the emerging low-power iBeacon technology. By leveraging the on-broad Bluetooth module and our proposed algorithms, BlueDetect provides a precise IO detection service that can turn on/off on-board power-hungry sensors smartly and automatically, optimize their performances and reduce the power consumption of mobile devices simultaneously. Moreover, seamless positioning and navigation services can be realized by it, especially in a semi-outdoor environment, which cannot be achieved by GPS or an indoor positioning system (IPS) easily. We prototype BlueDetect on Android mobile devices and evaluate its performance comprehensively. The experimental results have validated the superiority of BlueDetect in terms of IO detection accuracy, localization accuracy and energy consumption. PMID:26907295

A case study of the counterpart technical support policy to improve rural health services in Beijing

PubMed Central

2012-01-01

Background There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Methods Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural–urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Results Significant reductions in rural–urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural–urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural–urban gap in hospital efficiency. Conclusions The strategy for reducing urban–rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated. PMID:23272703

A case study of the counterpart technical support policy to improve rural health services in Beijing.

PubMed

Jian, Weiyan; Chan, Kit Yee; Tang, Shunv; Reidpath, Daniel D

2012-12-29

There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural-urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Significant reductions in rural-urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural-urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural-urban gap in hospital efficiency. The strategy for reducing urban-rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated.

School Solutions. Special Report: IAQ and Energy.

ERIC Educational Resources Information Center

Birr, Dave

1999-01-01

Discusses how energy service companies (ESCO) can help schools upgrade their indoor air quality and make them environmentally sound. How ESCO's help in arranging funding for indoor environmental improvements through energy performance contracts is discussed. Tips on energy-efficiency measures for improving indoor environmental quality are…

Teleoperator system man-machine interface requirements for satellite retrieval and satellite servicing. Volume 1: Requirements

NASA Technical Reports Server (NTRS)

Malone, T. B.

1972-01-01

Requirements were determined analytically for the man machine interface for a teleoperator system performing on-orbit satellite retrieval and servicing. Requirements are basically of two types; mission/system requirements, and design requirements or design criteria. Two types of teleoperator systems were considered: a free flying vehicle, and a shuttle attached manipulator. No attempt was made to evaluate the relative effectiveness or efficiency of the two system concepts. The methodology used entailed an application of the Essex Man-Systems analysis technique as well as a complete familiarization with relevant work being performed at government agencies and by private industry.

Eavesdropping-aware routing and spectrum allocation based on multi-flow virtual concatenation for confidential information service in elastic optical networks

NASA Astrophysics Data System (ADS)

Bai, Wei; Yang, Hui; Yu, Ao; Xiao, Hongyun; He, Linkuan; Feng, Lei; Zhang, Jie

2018-01-01

The leakage of confidential information is one of important issues in the network security area. Elastic Optical Networks (EON) as a promising technology in the optical transport network is under threat from eavesdropping attacks. It is a great demand to support confidential information service (CIS) and design efficient security strategy against the eavesdropping attacks. In this paper, we propose a solution to cope with the eavesdropping attacks in routing and spectrum allocation. Firstly, we introduce probability theory to describe eavesdropping issue and achieve awareness of eavesdropping attacks. Then we propose an eavesdropping-aware routing and spectrum allocation (ES-RSA) algorithm to guarantee information security. For further improving security and network performance, we employ multi-flow virtual concatenation (MFVC) and propose an eavesdropping-aware MFVC-based secure routing and spectrum allocation (MES-RSA) algorithm. The presented simulation results show that the proposed two RSA algorithms can both achieve greater security against the eavesdropping attacks and MES-RSA can also improve the network performance efficiently.

City of San Antonio, Texas Better Buildings Program

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

Meyer, Liza C.; Hammer, Mary C.

2014-06-30

The San Antonio Better Buildings Program is a unified single-point-of-service energy efficiency delivery mechanism targeting residential, commercial, institutional, industrial and public buildings. This comprehensive and replicable energy efficiency program is designed to be an effective demand side management initiative to provide a seamless process for program participants to have turn-key access to expert analysis, support and incentives to improve the performance of their in-place energy using systems, while reducing electrical energy use and demand.

Evaluation of AL-FEC performance for IP television services QoS

NASA Astrophysics Data System (ADS)

Mammi, E.; Russo, G.; Neri, A.

2010-01-01

The IP television services quality is a critical issue because of the nature of transport infrastructure. Packet loss is the main cause of service degradation in such kind of network platforms. The use of forward error correction (FEC) techniques in the application layer (AL-FEC), between the source of TV service (video server) and the user terminal, seams to be an efficient strategy to counteract packet losses alternatively or in addiction to suitable traffic management policies (only feasible in "managed networks"). A number of AL-FEC techniques have been discussed in literature and proposed for inclusion in TV over IP international standards. In this paper a performance evaluation of the AL-FEC defined in SMPTE 2022-1 standard is presented. Different typical events occurring in IP networks causing different types (in terms of statistic distribution) of IP packet losses have been studied and AL-FEC performance to counteract these kind of losses have been evaluated. The performed analysis has been carried out in view of fulfilling the TV services QoS requirements that are usually very demanding. For managed networks, this paper envisages a strategy to combine the use of AL-FEC with the set-up of a transport quality based on FEC packets prioritization. Promising results regard this kind of strategy have been obtained.

On scheduling task systems with variable service times

NASA Astrophysics Data System (ADS)

Maset, Richard G.; Banawan, Sayed A.

1993-08-01

Several strategies have been proposed for developing optimal and near-optimal schedules for task systems (jobs consisting of multiple tasks that can be executed in parallel). Most such strategies, however, implicitly assume deterministic task service times. We show that these strategies are much less effective when service times are highly variable. We then evaluate two strategies—one adaptive, one static—that have been proposed for retaining high performance despite such variability. Both strategies are extensions of critical path scheduling, which has been found to be efficient at producing near-optimal schedules. We found the adaptive approach to be quite effective.

Financing for public veterinary services to ensure that they meet international standards.

PubMed

Stemshorn, B; Zussman, D

2012-08-01

It is vital that public Veterinary Services develop the skills to address the challenging questions posed by national Treasury officials, who exercise an important mandate to ensure that expenditures are efficient and effective in serving the public interest. Examples of such questions are considered in this paper, along with systems and strategies for preparing for such reviews, including the use of the Performance of Veterinary Services (PVS) evaluation tools of the World Organisation for Animal Health. Some lessons and observations are drawn from PVS Evaluation and PVS Gap Analysis missions in nine countries.

Dynamic SLA Negotiation in Autonomic Federated Environments

NASA Astrophysics Data System (ADS)

Rubach, Pawel; Sobolewski, Michael

Federated computing environments offer requestors the ability to dynamically invoke services offered by collaborating providers in the virtual service network. Without an efficient resource management that includes Dynamic SLA Negotiation, however, the assignment of providers to customer's requests cannot be optimized and cannot offer high reliability without relevant SLA guarantees. We propose a new SLA-based SERViceable Metacomputing Environment (SERVME) capable of matching providers based on QoS requirements and performing autonomic provisioning and deprovisioning of services according to dynamic requestor needs. This paper presents the SLA negotiation process that includes on-demand provisioning and uses an object-oriented SLA model for large-scale service-oriented systems supported by SERVME. An initial reference implementation in the SORCER environment is also described.

How different are hospitals' responses to a financial reform? The impact on efficiency of activity-based financing.

PubMed

Biørn, Erik; Hagen, Terje P; Iversen, Tor; Magnussen, Jon

2010-03-01

For policy-makers the heterogeneity of hospital response to reforms is of crucial concern. Even though a reform may entail a positive effect on average efficiency, policy-makers will consider the reform as less attractive if the variation in hospital efficiency increases. The reason is that increased variance of efficiency across hospitals is likely to increase the impact of geography on access to hospital services. This paper examines the heterogeneity with respect to the impact of a financial reform-Activity Based Financing (ABF)-on hospital efficiency in Norway. From a theoretical model we find an ambiguous effect of hospital heterogeneity on the effect of ABF on efficiency. The data set is from a contiguous 10-year panel of 47 hospitals covering both pre-ABF years and years after its imposition. Substantial heterogeneity in the responses, as measured by both estimated and predicted coefficients, is found. We did not find any significant correlation between pre-ABF measures of efficiency and the effect of ABF on efficiency. We did however find a strongly significant correlation between the effect of ABF and post-ABF efficiency. Thus, the analysis confirms the impression that, whereas pre-ABF efficiency did not play any role in how hospitals responded to ABF, those responding generally ended up as better-performing hospitals. Hence, for the type of reform studied in this article we find that policy-makers do not need to worry about the impact of location on patients' access to hospital services.

Impacts of market and organizational characteristics on hospital efficiency and uncompensated care.

PubMed

Hsieh, Hui-Min; Clement, Dolores G; Bazzoli, Gloria J

2010-01-01

Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.

Current and planned shared service arrangements in Wisconsin local and tribal health departments.

PubMed

Madamala, Kusuma; Young, Nancy; Young, Dustin; Giese, Lieske; Brandenberg, Terry; Zahner, Susan

2014-01-01

The objective of this study was to explore current and future use of shared service arrangements as a management strategy to increase capacity to provide public health essential services in Wisconsin. An online cross-sectional survey of 99 local and tribal health departments in Wisconsin was conducted. Select variables from the 2010 Wisconsin Local Health Department Survey were merged. Other data sources included results from a Board of Health governance analysis and the Wisconsin Department of Health Services region data. Descriptive analysis was performed of current and future shared service arrangements and the characteristics of the types of arrangements and agreements in place. Ninety-one of 99 Wisconsin local and tribal health departments responded, yielding a 92% response rate. Seventy-one percent of respondents currently share services with 1 or more other health departments. More frequent arrangements were present in programmatic areas than in departmental operations. Most frequently reported motivators include making better use of resources, providing better services, and responding to program requirements. Extensive qualitative comments indicate arrangements accomplished what the local health department hoped it would with perceived gains in efficiency and effectiveness. There is widespread use of shared services among health departments in Wisconsin. Extensive qualitative comments suggest participant satisfaction with what the arrangements have accomplished. Motivating factors in developing the arrangements and limited mention of expiration dates suggest continued study of how these arrangements may evolve. Further examination of shared services as a potential mechanism to advance service effectiveness and efficiency is needed.

Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method.

PubMed

Sultan, Wasim I M; Crispim, José

2018-05-29

While health needs and expenditure in the Occupied Palestinian Territories (OPT) are growing, the international donations are declining and the economic situation is worsening. The purpose of this paper is twofold, to evaluate the productive efficiency of public hospitals in West Bank and to study contextual factors contributing to efficiency differences. This study examined technical efficiency among 11 public hospitals in West Bank from 2010 through 2015 targeting a total of 66 observations. Nationally representative data were extracted from the official annual health reports. We applied input-oriented Data Envelopment Analysis (DEA) models to estimate efficiency scores. To elaborate further on performance, we used Tobit regression to identify contextual factors whose impact on inefficient performance is statistically significant. Despite the increase in efficiency mean scores by 4% from 2010 to 2015, findings show potential savings of 14.5% of resource consumption without reducing the volume of the provided services. The significant Tobit model showed four predictors explaining the inefficient performance of a hospital (p <  0.01) are: bed occupancy rate (BOR); the outpatient-inpatient ratio (OPIPR); hospital's size (SIZE); and the availability of primary healthcare centers within the hospital's catchment area (PRC). There is a strong effect of OPIPR on efficiency differences between hospitals: A one unit increase in OPIPR will lead a decrease of 19.7% in the predicted inefficiency level holding all other factors constant. To date, no previous studies have examined the efficiency of public hospitals in the OPT. Our work identified their efficiency levels for potential improvements and the determinants of efficient performance. Based on the measurement of efficiency, the generated information may guide hospitals' managers, policymakers, and international donors improving the performance of the main national healthcare provider. The scope of this study is limited to public hospitals in West Bank. For a better understanding of the Palestinian market, further research on private hospitals and hospitals in Gaza Strip will be useful.

41 CFR 51-4.4 - Subcontracting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Subcontracting. 51-4.4 Section 51-4.4 Public Contracts and Property Management Other Provisions Relating to Public Contracts... both with efficient performance in furnishing commodities or services under the JWOD Act and maximizing...

Analysis of integrated healthcare networks' performance: a contingency-strategic management perspective.

PubMed

Lin, B Y; Wan, T T

1999-12-01

Few empirical analyses have been done in the organizational researches of integrated healthcare networks (IHNs) or integrated healthcare delivery systems. Using a contingency derived contact-process-performance model, this study attempts to explore the relationships among an IHN's strategic direction, structural design, and performance. A cross-sectional analysis of 100 IHNs suggests that certain contextual factors such as market competition and network age and tax status have statistically significant effects on the implementation of an IHN's service differentiation strategy, which addresses coordination and control in the market. An IHN's service differentiation strategy is positively related to its integrated structural design, which is characterized as integration of administration, patient care, and information system across different settings. However, no evidence supports that the development of integrated structural design may benefit an IHN's performance in terms of clinical efficiency and financial viability.

A Study on the Effect on Scheduling and Management of Surgeries with the Introduction of Excellent Medical Information.

PubMed

Mei, Tsai Ching

2016-01-01

The services of OR play an important role in the medical business for department of surgery. The most important issue for OR is about the scheduling and management of surgeries. Good surgery schedule could elevate the utilization efficiency of OR. Therefore, the introduction of excellent medical information can both dramatically elevate the work efficiency of health care employees and reduce workload to reach win-win benefits in both management and performance.

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

Kurnik, Charles W.; Stoughton, Kate M.; Figueroa, Jorge

This measurement and verification (M and V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings as a result of water conservation measures (WCMs) in energy performance contracts associated with converting turfgrass or other water-intensive plantings to water-wise and sustainable landscapes. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M and V plan, and details the procedures to use to determine water savings.

Fire, Aim… Ready? Alberta's Big Bang Approach to Healthcare Disintegration.

PubMed

Donaldson, Cam

2010-08-01

Alberta's abolition in 2008 of its health regions and the creation of Alberta Health Services (AHS) was a bold move, but the reasons for the change remain hazy. The stated goals were to "help make Alberta's … system more effective and efficient" and to "provide equitable access to health services and long-term sustainability." Data show, however, that Alberta's health regions were already performing well on these goals relative to other provinces, and where changes have since occurred, they cannot necessarily be attributed to AHS.

Modelling a radiology department service using a VDL integrated approach.

PubMed

Guglielmino, Maria Gabriella; Celano, Giovanni; Costa, Antonio; Fichera, Sergio

2009-01-01

The healthcare industry is facing several challenges such as the reduction of costs and quality improvement of the provided services. Engineering studies could be very useful in supporting organizational and management processes. Healthcare service efficiency depends on a strong collaboration between clinical and engineering experts, especially when it comes to analyzing the system and its constraints in detail and subsequently, when it comes to deciding on the reengineering of some key activities. The purpose of this paper is to propose a case study showing how a mix of representation tools allow a manager of a radiology department to solve some human and technological resource re-organizational issues, which have to be faced due to the introduction of a new technology and a new portfolio of services. In order to simulate the activities within the radiology department and examine the relationship between human and technological resources, different visual diagrammatic language (VDL) techniques have been implemented to get knowledge about the heterogeneous factors related to the healthcare service delivery. In particular, flow charts, IDEFO diagrams and Petri nets have been integrated each other with success as a modelisation tools. The simulation study performed through the application of the aforementioned VDL techniques suggests the opportunity of re-organizing the nurse activities within the radiology department. The re-organization of a healthcare service and in particular of a radiology department by means of joint flow charts, IDEF0 diagrams and Petri nets is a poorly investigated topic in literature. This paper demonstrates how flow charts and IDEF0 can help people working within the department to understand the weak points of their organization and constitute an efficient base of knowledge for the implementation of a Petri net aimed at improving the departmental performance.

A better gauge of corporate performance.

PubMed

Weber, D O

2001-01-01

Traditional methods of measuring organizational value aren't working very well. Instead, an organization's viability should be gauged from four perspectives, according to Robert S. Kaplan and David P. Norton, co-creators of the Balanced Scorecard. These perspectives--financial strength, customer service and satisfaction, internal operating efficiency, and learning and growth--become the underpinnings of a "balanced" tool with which leaders can assess corporate performance in the knowledge-based marketplace.

Heterogeneous concurrent computing with exportable services

NASA Technical Reports Server (NTRS)

Sunderam, Vaidy

1995-01-01

Heterogeneous concurrent computing, based on the traditional process-oriented model, is approaching its functionality and performance limits. An alternative paradigm, based on the concept of services, supporting data driven computation, and built on a lightweight process infrastructure, is proposed to enhance the functional capabilities and the operational efficiency of heterogeneous network-based concurrent computing. TPVM is an experimental prototype system supporting exportable services, thread-based computation, and remote memory operations that is built as an extension of and an enhancement to the PVM concurrent computing system. TPVM offers a significantly different computing paradigm for network-based computing, while maintaining a close resemblance to the conventional PVM model in the interest of compatibility and ease of transition Preliminary experiences have demonstrated that the TPVM framework presents a natural yet powerful concurrent programming interface, while being capable of delivering performance improvements of upto thirty percent.

An end of service life assessment of PMMA lenses from veteran concentrator photovoltaic systems

DOE PAGES

Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebeca; ...

2017-04-04

The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. The optimal focal distance of the lenses was quantified using the Solar Simulator, and then correlated to lens curvature using a recently developed measurement technique. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. As a result, molecular weight was compared between the incident and faceted surfaces of the lenses.« less

An end of service life assessment of PMMA lenses from veteran concentrator photovoltaic systems

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

Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebeca

The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. The optimal focal distance of the lenses was quantified using the Solar Simulator, and then correlated to lens curvature using a recently developed measurement technique. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. As a result, molecular weight was compared between the incident and faceted surfaces of the lenses.« less

Move Your Continuing Education Unit from Function to Performance-Based.

ERIC Educational Resources Information Center

Kodgis, Damian

This document explores the policies and practices essential for maintaining a profitable, efficient, and productive continuing education program. A continuing education organizational structure must produce results (sales) and services (delivery), and organizational roles must be clearly defined so that income is linked to expenses. Sales and…

Evaluating Eco-Innovation of OECD Countries with Data Envelopment Analysis

ERIC Educational Resources Information Center

Mavi, Reza Kiani; Standing, Craig

2016-01-01

Government regulations require businesses to improve their processes and products/services in a green and sustainable manner. For being environmentally friendly, businesses should invest more on eco-innovation practices. Firms eco-innovate to promote eco-efficiency and sustainability. This paper evaluates the eco-innovation performance of…

Can performance-based financing help reaching the poor with maternal and child health services? The experience of rural Rwanda.

PubMed

Lannes, Laurence; Meessen, Bruno; Soucat, Agnes; Basinga, Paulin

2016-07-01

More than 20 countries in Africa are scaling up performance-based financing (PBF), but its impact on equity in access to health services remains to be documented. This paper draws on evidence from Rwanda to examine the capacity of PBF to ensure equal access to key health interventions especially in rural areas where most of the poor live. Specifically, it focuses on maternal and child health services, distinguishing two wealth groups, and uses data from a rigorous impact evaluation. Difference-in-difference technique is used, and different model specifications are tested: control for unobserved heterogeneity and common random error using linear probability model, seemingly unrelated regression equations, and clustering and fixed effects. Results suggest that in Rwanda, PBF improved efficiency rather than equity for most health services. We find that PBF achieved efficiency gains by improving access to health services for those easier to reach, generally the relatively more affluent. It turns out to be less effective in reaching the poorest. Our results illustrate the advantages of rigorous randomized impact evaluation data as results published earlier using a nationally representative survey (Demographic and Health Survey) were not able to capture the pro-rich nature of the PBF scheme in Rwanda. Our paper advocates for building mechanisms targeting the vulnerable groups in PBF strategies. It also highlights the need to understand the impact of PBF together with the specific development of health insurance coverage and the organization of the health system. Copyright © 2015 John Wiley & Sons, Ltd.

On evaluating health centers groups in Lisbon and Tagus Valley: efficiency, equity and quality

PubMed Central

2013-01-01

Background Bearing in mind the increasing health expenses and their weight in the Portuguese gross domestic product, it is of the utmost importance to evaluate the performance of Primary Health Care providers taking into account both efficiency, quality and equity. This paper aims to contribute to a better understanding of the performance of Primary Health Care by measuring it in a Portuguese region (Lisbon and Tagus Valley) and identifying best practices. It also intends to evaluate the quality and equity provided. Methods For the purpose of measuring the efficiency of the health care centers (ACES) the non-parametric full frontier technique of data envelopment analysis (DEA) was adopted. The recent partial frontier method of order-m was also used to estimate the influence of exogenous variables on the efficiency of the ACES. The horizontal equity was investigated by applying the non-parametric Kruskal-Wallis test with multiple comparisons. Moreover, the quality of service was analyzed by using the ratio between the complaints and the total activity of the ACES. Results On the whole, a significant level of inefficiency was observed, although there was a general improvement in efficiency between 2009 and 2010. It was found that nursing was the service with the lowest scores. Concerning the horizontal equity, the analysis showed that there is no evidence of relevant disparities between the different subregions(NUTS III). Concerning the exogenous variables, the purchasing power, the percentage of patients aged 65 years old or older and the population size affect the efficiency negatively. Conclusions This research shows that better usage of the available resources and the creation of a learning network and dissemination of best practices will contribute to improvements in the efficiency of the ACES while maintaining or even improving quality and equity. It was also proved that the market structure does matter when efficiency measurement is addressed. PMID:24359014

Resource allocation in shared spectrum access communications for operators with diverse service requirements

NASA Astrophysics Data System (ADS)

Kibria, Mirza Golam; Villardi, Gabriel Porto; Ishizu, Kentaro; Kojima, Fumihide; Yano, Hiroyuki

2016-12-01

In this paper, we study inter-operator spectrum sharing and intra-operator resource allocation in shared spectrum access communication systems and propose efficient dynamic solutions to address both inter-operator and intra-operator resource allocation optimization problems. For inter-operator spectrum sharing, we present two competent approaches, namely the subcarrier gain-based sharing and fragmentation-based sharing, which carry out fair and flexible allocation of the available shareable spectrum among the operators subject to certain well-defined sharing rules, traffic demands, and channel propagation characteristics. The subcarrier gain-based spectrum sharing scheme has been found to be more efficient in terms of achieved throughput. However, the fragmentation-based sharing is more attractive in terms of computational complexity. For intra-operator resource allocation, we consider resource allocation problem with users' dissimilar service requirements, where the operator supports users with delay constraint and non-delay constraint service requirements, simultaneously. This optimization problem is a mixed-integer non-linear programming problem and non-convex, which is computationally very expensive, and the complexity grows exponentially with the number of integer variables. We propose less-complex and efficient suboptimal solution based on formulating exact linearization, linear approximation, and convexification techniques for the non-linear and/or non-convex objective functions and constraints. Extensive simulation performance analysis has been carried out that validates the efficiency of the proposed solution.

XML-based data model and architecture for a knowledge-based grid-enabled problem-solving environment for high-throughput biological imaging.

PubMed

Ahmed, Wamiq M; Lenz, Dominik; Liu, Jia; Paul Robinson, J; Ghafoor, Arif

2008-03-01

High-throughput biological imaging uses automated imaging devices to collect a large number of microscopic images for analysis of biological systems and validation of scientific hypotheses. Efficient manipulation of these datasets for knowledge discovery requires high-performance computational resources, efficient storage, and automated tools for extracting and sharing such knowledge among different research sites. Newly emerging grid technologies provide powerful means for exploiting the full potential of these imaging techniques. Efficient utilization of grid resources requires the development of knowledge-based tools and services that combine domain knowledge with analysis algorithms. In this paper, we first investigate how grid infrastructure can facilitate high-throughput biological imaging research, and present an architecture for providing knowledge-based grid services for this field. We identify two levels of knowledge-based services. The first level provides tools for extracting spatiotemporal knowledge from image sets and the second level provides high-level knowledge management and reasoning services. We then present cellular imaging markup language, an extensible markup language-based language for modeling of biological images and representation of spatiotemporal knowledge. This scheme can be used for spatiotemporal event composition, matching, and automated knowledge extraction and representation for large biological imaging datasets. We demonstrate the expressive power of this formalism by means of different examples and extensive experimental results.

High Performance Flat Plate Solar Thermal Collector Evaluation

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

Rockenbaugh, Caleb; Dean, Jesse; Lovullo, David

2016-09-01

This report was prepared for the General Services Administration by the National Renewable Energy Laboratory. The Honeycomb Solar Thermal Collector (HSTC) is a flat plate solar thermal collector that shows promising high efficiencies over a wide range of climate zones. The technical objectives of this study are to: 1) verify collector performance, 2) compare that performance to other market-available collectors, 3) verify overheat protection, and 4) analyze the economic performance of the HSTC both at the demonstration sites and across a matrix of climate zones and utility markets.

1-RAAP: An Efficient 1-Round Anonymous Authentication Protocol for Wireless Body Area Networks

PubMed Central

Liu, Jingwei; Zhang, Lihuan; Sun, Rong

2016-01-01

Thanks to the rapid technological convergence of wireless communications, medical sensors and cloud computing, Wireless Body Area Networks (WBANs) have emerged as a novel networking paradigm enabling ubiquitous Internet services, allowing people to receive medical care, monitor health status in real-time, analyze sports data and even enjoy online entertainment remotely. However, because of the mobility and openness of wireless communications, WBANs are inevitably exposed to a large set of potential attacks, significantly undermining their utility and impeding their widespread deployment. To prevent attackers from threatening legitimate WBAN users or abusing WBAN services, an efficient and secure authentication protocol termed 1-Round Anonymous Authentication Protocol (1-RAAP) is proposed in this paper. In particular, 1-RAAP preserves anonymity, mutual authentication, non-repudiation and some other desirable security properties, while only requiring users to perform several low cost computational operations. More importantly, 1-RAAP is provably secure thanks to its design basis, which is resistant to the anonymous in the random oracle model. To validate the computational efficiency of 1-RAAP, a set of comprehensive comparative studies between 1-RAAP and other authentication protocols is conducted, and the results clearly show that 1-RAAP achieves the best performance in terms of computational overhead. PMID:27213384

From Energy Audits to Home Performance: 30 Years of Articles in Home Energy Magazine

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

Meier, Alan

Home Energy Magazine has been publishing articles about residential energy efficiency for 30 years. Its goal has been to disseminate technically reliable and neutral information to the practitioners, that is, professionals in the business of home energy efficiency. The articles, editorials, letters, and advertisements are a kind of window on the evolution of energy conservation technologies, policies, and organizations. Initially, the focus was on audits and simple retrofits, such as weatherstripping and insulation. Instrumentation was sparse sometimes limited to a ruler to measure depth of attic insulation and a blower door was exotic. CFLs were heavy, awkward bulbs which might,more » or might not, fit in a fixture. Saving air conditioning energy was not a priority. Solar energy was only for the most adventurous. Thirty years on, the technologies and business have moved beyond just insulating attics to the larger challenge of delivering home performance and achieving zero net energy. This shift reflects the success in reducing space heating energy and the need to create a profitable industry by providing more services. The leading edge of the residential energy services market is becoming much more sophisticated, offering both efficiency and solar systems. The challenge is to continue providing relevant and reliable information in a transformed industry and a revolutionized media landscape.« less

1-RAAP: An Efficient 1-Round Anonymous Authentication Protocol for Wireless Body Area Networks.

PubMed

Liu, Jingwei; Zhang, Lihuan; Sun, Rong

2016-05-19

Thanks to the rapid technological convergence of wireless communications, medical sensors and cloud computing, Wireless Body Area Networks (WBANs) have emerged as a novel networking paradigm enabling ubiquitous Internet services, allowing people to receive medical care, monitor health status in real-time, analyze sports data and even enjoy online entertainment remotely. However, because of the mobility and openness of wireless communications, WBANs are inevitably exposed to a large set of potential attacks, significantly undermining their utility and impeding their widespread deployment. To prevent attackers from threatening legitimate WBAN users or abusing WBAN services, an efficient and secure authentication protocol termed 1-Round Anonymous Authentication Protocol (1-RAAP) is proposed in this paper. In particular, 1-RAAP preserves anonymity, mutual authentication, non-repudiation and some other desirable security properties, while only requiring users to perform several low cost computational operations. More importantly, 1-RAAP is provably secure thanks to its design basis, which is resistant to the anonymous in the random oracle model. To validate the computational efficiency of 1-RAAP, a set of comprehensive comparative studies between 1-RAAP and other authentication protocols is conducted, and the results clearly show that 1-RAAP achieves the best performance in terms of computational overhead.

Clinical laboratory: bigger is not always better.

PubMed

Plebani, Mario

2018-06-27

Laboratory services around the world are undergoing substantial consolidation and changes through mechanisms ranging from mergers, acquisitions and outsourcing, primarily based on expectations to improve efficiency, increasing volumes and reducing the cost per test. However, the relationship between volume and costs is not linear and numerous variables influence the end cost per test. In particular, the relationship between volumes and costs does not span the entire platter of clinical laboratories: high costs are associated with low volumes up to a threshold of 1 million test per year. Over this threshold, there is no linear association between volumes and costs, as laboratory organization rather than test volume more significantly affects the final costs. Currently, data on laboratory errors and associated diagnostic errors and risk for patient harm emphasize the need for a paradigmatic shift: from a focus on volumes and efficiency to a patient-centered vision restoring the nature of laboratory services as an integral part of the diagnostic and therapy process. Process and outcome quality indicators are effective tools to measure and improve laboratory services, by stimulating a competition based on intra- and extra-analytical performance specifications, intermediate outcomes and customer satisfaction. Rather than competing with economic value, clinical laboratories should adopt a strategy based on a set of harmonized quality indicators and performance specifications, active laboratory stewardship, and improved patient safety.

Contracts and management services site support program plan WBS 6.10.14

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

Knoll, J.M. Jr.

1994-09-01

Contracts and Management Services is recognized as the central focal point for programs having company or sitewide application in pursuit of the Hanford Missions`s financial and operational objectives. Contracts and Management Services actively pursues cost savings and operational efficiencies through: Management Standards by ensuring all employees have an accessible, integrated system of clear, complete, accurate, timely, and useful management control policies and procedures; Contract Reform by restructuring the contract, organization, and cost accounting systems to refocus Hanford contract activities on output products; Systems and Operations Evaluation by directing the Cost Reduction program, Great Ideas, and Span of Management activities; Programmore » Administration by enforcing conditions of Accountability (whether DEAR-based or FAR-based) for WHC, BCSR, ICF KH, and BHI; Contract Performance activities; chairing the WHC Cost Reduction Review Board; and analyzing companywide Performance Measures; Data Standards and Administration by establishing and directing the company data management program; giving direction to the major RL programs and mission areas for implementation of cost-effective and efficient data management practices; directing all operations, application, and interfaces contained within the Hanford PeopleCore System; directing accomplishment and delivery of TPA data management milestones; and directing the sitewide data management processes for Data Standards and the Data Directory.« less

Hospitalist time usage and cyclicality: opportunities to improve efficiency.

PubMed

Kim, Christopher S; Lovejoy, William; Paulsen, Michael; Chang, Robert; Flanders, Scott A

2010-01-01

Academic medical centers (AMCs) have a constrained resident work force. Many AMCs have increased the use of nonresident service hospitalists to manage continued growth in clinical volume. To optimize their time in the hospital, it is important to understand hospitalists' work flow. We performed a time-motion study of hospitalists carrying the admission pager throughout the 3 types of shifts we have at our hospital (day shift, swing shift, and night shift). Tertiary academic medical center in the Midwest. Hospitalists spend about 15% of their time on direct patient care, and two-thirds of their time on indirect patient care. Of the indirect activities, communication and documentation dominate. Travel demands make up over 7% of a hospitalists' time. There are spikes in indirect patient care, followed closely by spikes in direct patient care, at shift changes. At our AMC, indirect patient care activities accounted for the majority of the admitting hospitalists' time spent in the hospital, with documentation and communication dominating this time. Travel takes a significant fraction of hospitalists' time. There is also a cyclical nature to activities performed throughout the day, which can cause patient delays and impose variability on support services. There is a need for both service-specific and systemic improvements for AMCs to efficiently manage further growth in their inpatient volume. (c) 2010 Society of Hospital Medicine.

A secure biometrics-based authentication scheme for telecare medicine information systems.

PubMed

Yan, Xiaopeng; Li, Weiheng; Li, Ping; Wang, Jiantao; Hao, Xinhong; Gong, Peng

2013-10-01

The telecare medicine information system (TMIS) allows patients and doctors to access medical services or medical information at remote sites. Therefore, it could bring us very big convenient. To safeguard patients' privacy, authentication schemes for the TMIS attracted wide attention. Recently, Tan proposed an efficient biometrics-based authentication scheme for the TMIS and claimed their scheme could withstand various attacks. However, in this paper, we point out that Tan's scheme is vulnerable to the Denial-of-Service attack. To enhance security, we also propose an improved scheme based on Tan's work. Security and performance analysis shows our scheme not only could overcome weakness in Tan's scheme but also has better performance.

Commercial Building Energy Asset Score

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

This software (Asset Scoring Tool) is designed to help building owners and managers to gain insight into the as-built efficiency of their buildings. It is a web tool where users can enter their building information and obtain an asset score report. The asset score report consists of modeled building energy use (by end use and by fuel type), building systems (envelope, lighting, heating, cooling, service hot water) evaluations, and recommended energy efficiency measures. The intended users are building owners and operators who have limited knowledge of building energy efficiency. The scoring tool collects minimum building data (~20 data entries) frommore » users and build a full-scale energy model using the inference functionalities from Facility Energy Decision System (FEDS). The scoring tool runs real-time building energy simulation using EnergyPlus and performs life-cycle cost analysis using FEDS. An API is also under development to allow the third-party applications to exchange data with the web service of the scoring tool.« less

An Efficient Searchable Encryption Against Keyword Guessing Attacks for Sharable Electronic Medical Records in Cloud-based System.

PubMed

Wu, Yilun; Lu, Xicheng; Su, Jinshu; Chen, Peixin

2016-12-01

Preserving the privacy of electronic medical records (EMRs) is extremely important especially when medical systems adopt cloud services to store patients' electronic medical records. Considering both the privacy and the utilization of EMRs, some medical systems apply searchable encryption to encrypt EMRs and enable authorized users to search over these encrypted records. Since individuals would like to share their EMRs with multiple persons, how to design an efficient searchable encryption for sharable EMRs is still a very challenge work. In this paper, we propose a cost-efficient secure channel free searchable encryption (SCF-PEKS) scheme for sharable EMRs. Comparing with existing SCF-PEKS solutions, our scheme reduces the storage overhead and achieves better computation performance. Moreover, our scheme can guard against keyword guessing attack, which is neglected by most of the existing schemes. Finally, we implement both our scheme and a latest medical-based scheme to evaluate the performance. The evaluation results show that our scheme performs much better performance than the latest one for sharable EMRs.

Towards building high performance medical image management system for clinical trials

NASA Astrophysics Data System (ADS)

Wang, Fusheng; Lee, Rubao; Zhang, Xiaodong; Saltz, Joel

2011-03-01

Medical image based biomarkers are being established for therapeutic cancer clinical trials, where image assessment is among the essential tasks. Large scale image assessment is often performed by a large group of experts by retrieving images from a centralized image repository to workstations to markup and annotate images. In such environment, it is critical to provide a high performance image management system that supports efficient concurrent image retrievals in a distributed environment. There are several major challenges: high throughput of large scale image data over the Internet from the server for multiple concurrent client users, efficient communication protocols for transporting data, and effective management of versioning of data for audit trails. We study the major bottlenecks for such a system, propose and evaluate a solution by using a hybrid image storage with solid state drives and hard disk drives, RESTfulWeb Services based protocols for exchanging image data, and a database based versioning scheme for efficient archive of image revision history. Our experiments show promising results of our methods, and our work provides a guideline for building enterprise level high performance medical image management systems.

Performance improvement of optical CDMA networks with stochastic artificial bee colony optimization technique

NASA Astrophysics Data System (ADS)

Panda, Satyasen

2018-05-01

This paper proposes a modified artificial bee colony optimization (ABC) algorithm based on levy flight swarm intelligence referred as artificial bee colony levy flight stochastic walk (ABC-LFSW) optimization for optical code division multiple access (OCDMA) network. The ABC-LFSW algorithm is used to solve asset assignment problem based on signal to noise ratio (SNR) optimization in OCDM networks with quality of service constraints. The proposed optimization using ABC-LFSW algorithm provides methods for minimizing various noises and interferences, regulating the transmitted power and optimizing the network design for improving the power efficiency of the optical code path (OCP) from source node to destination node. In this regard, an optical system model is proposed for improving the network performance with optimized input parameters. The detailed discussion and simulation results based on transmitted power allocation and power efficiency of OCPs are included. The experimental results prove the superiority of the proposed network in terms of power efficiency and spectral efficiency in comparison to networks without any power allocation approach.

Tethered Balloon Technology in Design Solutions for Rescue and Relief Team Emergency Communication Services.

PubMed

Alsamhi, Saeed Hamood; Ansari, Mohd Samar; Ma, Ou; Almalki, Faris; Gupta, Sachin Kumar

2018-05-23

The actions taken at the initial times of a disaster are critical. Catastrophe occurs because of terrorist acts or natural hazards which have the potential to disrupt the infrastructure of wireless communication networks. Therefore, essential emergency functions such as search, rescue, and recovery operations during a catastrophic event will be disabled. We propose tethered balloon technology to provide efficient emergency communication services and reduce casualty mortality and morbidity for disaster recovery. The tethered balloon is an actively developed research area and a simple solution to support the performance, facilities, and services of emergency medical communication. The most critical requirement for rescue and relief teams is having a higher quality of communication services which enables them to save people's lives. Using our proposed technology, it has been reported that the performance of rescue and relief teams significantly improved. OPNET Modeler 14.5 is used for a network simulated with the help of ad hoc tools (Disaster Med Public Health Preparedness. 2018;page 1 of 8).

A service based adaptive U-learning system using UX.

PubMed

Jeong, Hwa-Young; Yi, Gangman

2014-01-01

In recent years, traditional development techniques for e-learning systems have been changing to become more convenient and efficient. One new technology in the development of application systems includes both cloud and ubiquitous computing. Cloud computing can support learning system processes by using services while ubiquitous computing can provide system operation and management via a high performance technical process and network. In the cloud computing environment, a learning service application can provide a business module or process to the user via the internet. This research focuses on providing the learning material and processes of courses by learning units using the services in a ubiquitous computing environment. And we also investigate functions that support users' tailored materials according to their learning style. That is, we analyzed the user's data and their characteristics in accordance with their user experience. We subsequently applied the learning process to fit on their learning performance and preferences. Finally, we demonstrate how the proposed system outperforms learning effects to learners better than existing techniques.

A Service Based Adaptive U-Learning System Using UX

PubMed Central

Jeong, Hwa-Young

2014-01-01

In recent years, traditional development techniques for e-learning systems have been changing to become more convenient and efficient. One new technology in the development of application systems includes both cloud and ubiquitous computing. Cloud computing can support learning system processes by using services while ubiquitous computing can provide system operation and management via a high performance technical process and network. In the cloud computing environment, a learning service application can provide a business module or process to the user via the internet. This research focuses on providing the learning material and processes of courses by learning units using the services in a ubiquitous computing environment. And we also investigate functions that support users' tailored materials according to their learning style. That is, we analyzed the user's data and their characteristics in accordance with their user experience. We subsequently applied the learning process to fit on their learning performance and preferences. Finally, we demonstrate how the proposed system outperforms learning effects to learners better than existing techniques. PMID:25147832

Implementation of QoSS (Quality-of-Security Service) for NoC-Based SoC Protection

NASA Astrophysics Data System (ADS)

Sepúlveda, Johanna; Pires, Ricardo; Strum, Marius; Chau, Wang Jiang

Many of the current electronic systems embedded in a SoC (System-on-Chip) are used to capture, store, manipulate and access critical data, as well as to perform other key functions. In such a scenario, security is considered as an important issue. The Network-on-chip (NoC), as the foreseen communication structure of next-generation SoC devices, can be used to efficiently incorporate security. Our work proposes the implementation of QoSS (Quality of Security Service) to overcome present SoC vulnerabilities. QoSS is a novel concept for data protection that introduces security as a dimension of QoS. In this paper, we present the implementation of two security services (access control and authentication), that may be configured to assume one from several possible levels, the implementation of a technique to avoid denial-of-service (DoS) attacks, evaluate their effectiveness and estimate their impact on NoC performance.

Time-aware service-classified spectrum defragmentation algorithm for flex-grid optical networks

NASA Astrophysics Data System (ADS)

Qiu, Yang; Xu, Jing

2018-01-01

By employing sophisticated routing and spectrum assignment (RSA) algorithms together with a finer spectrum granularity (namely frequency slot) in resource allocation procedures, flex-grid optical networks can accommodate diverse kinds of services with high spectrum-allocation flexibility and resource-utilization efficiency. However, the continuity and the contiguity constraints in spectrum allocation procedures may always induce some isolated, small-sized, and unoccupied spectral blocks (known as spectrum fragments) in flex-grid optical networks. Although these spectrum fragments are left unoccupied, they can hardly be utilized by the subsequent service requests directly because of their spectral characteristics and the constraints in spectrum allocation. In this way, the existence of spectrum fragments may exhaust the available spectrum resources for a coming service request and thus worsens the networking performance. Therefore, many reactive defragmentation algorithms have been proposed to handle the fragmented spectrum resources via re-optimizing the routing paths and the spectrum resources for the existing services. But the routing-path and the spectrum-resource re-optimization in reactive defragmentation algorithms may possibly disrupt the traffic of the existing services and require extra components. By comparison, some proactive defragmentation algorithms (e.g. fragmentation-aware algorithms) were proposed to suppress spectrum fragments from their generation instead of handling the fragmented spectrum resources. Although these proactive defragmentation algorithms induced no traffic disruption and required no extra components, they always left the generated spectrum fragments unhandled, which greatly affected their efficiency in spectrum defragmentation. In this paper, by comprehensively considering the characteristics of both the reactive and the proactive defragmentation algorithms, we proposed a time-aware service-classified (TASC) spectrum defragmentation algorithm, which simultaneously employed proactive and reactive mechanisms in suppressing spectrum fragments with the awareness of services' types and their duration times. By dividing the spectrum resources into several flexible groups according to services' types and limiting both the spectrum allocation and the spectrum re-tuning for a certain service inside one specific spectrum group according to its type, the proposed TASC defragmentation algorithm cannot only suppress spectrum fragments from generation inside each spectrum group, but also handle the fragments generated between two adjacent groups. In this way, the proposed TASC algorithm gains higher efficiency in suppressing spectrum fragments than both the reactive and the proactive defragmentation algorithms. Additionally, as the generation of spectrum fragments is retrained between spectrum groups and the defragmentation procedure is limited inside each spectrum group, the induced traffic disruption for the existing services can be possibly reduced. Besides, the proposed TASC defragmentation algorithm always re-tunes the spectrum resources of the service with the maximum duration time first in spectrum defragmentation procedure, which can further reduce spectrum fragments because of the fact that the services with longer duration times always have higher possibility in inducing spectrum fragments than the services with shorter duration times. The simulation results show that the proposed TASC defragmentation algorithm can significantly reduce the number of the generated spectrum fragments while improving the service blocking performance.

Quality initiatives: lean approach to improving performance and efficiency in a radiology department.

PubMed

Kruskal, Jonathan B; Reedy, Allen; Pascal, Laurie; Rosen, Max P; Boiselle, Phillip M

2012-01-01

Many hospital radiology departments are adopting "lean" methods developed in automobile manufacturing to improve operational efficiency, eliminate waste, and optimize the value of their services. The lean approach, which emphasizes process analysis, has particular relevance to radiology departments, which depend on a smooth flow of patients and uninterrupted equipment function for efficient operation. However, the application of lean methods to isolated problems is not likely to improve overall efficiency or to produce a sustained improvement. Instead, the authors recommend a gradual but continuous and comprehensive "lean transformation" of work philosophy and workplace culture. Fundamental principles that must consistently be put into action to achieve such a transformation include equal involvement of and equal respect for all staff members, elimination of waste, standardization of work processes, improvement of flow in all processes, use of visual cues to communicate and inform, and use of specific tools to perform targeted data collection and analysis and to implement and guide change. Many categories of lean tools are available to facilitate these tasks: value stream mapping for visualizing the current state of a process and identifying activities that add no value; root cause analysis for determining the fundamental cause of a problem; team charters for planning, guiding, and communicating about change in a specific process; management dashboards for monitoring real-time developments; and a balanced scorecard for strategic oversight and planning in the areas of finance, customer service, internal operations, and staff development. © RSNA, 2012.

Assessing the technical efficiency of health posts in rural Guatemala: a data envelopment analysis.

PubMed

Hernández, Alison R; San Sebastián, Miguel

2014-01-01

Strengthening health service delivery to the rural poor is an important means of redressing inequities. Meso-level managers can help enhance efficiency in the utilization of existing resources through the application of practical tools to analyze routinely collected data reflecting inputs and outputs. This study aimed to assess the efficiency and change in productivity of health posts over two years in a rural department of Guatemala. Data envelopment analysis was used to measure health posts' technical efficiency and productivity change for 2008 and 2009. Input/output data were collected from the regional health office of Alta Verapaz for 34 health posts from the 19 districts comprising the health region. Technical efficiency varied widely across health posts, with mean scores of 0.78 (SD=0.24) and 0.75 (SD=0.21) in 2008 and 2009, respectively. Overall, productivity increased by 4%, though 47% of health posts experienced a decline in productivity. Results were combined on a bivariate plot to identify health posts at the high and low extremes of efficiency, which should be followed up to determine how and why their production processes are operating differently. Assessing efficiency using the data that are available at the meso-level can serve as a first step in strengthening performance. Further work is required to support managers in the routine application of efficiency analysis and putting the results to use in guiding efforts to improve service delivery and increase utilization.

Assessing the technical efficiency of health posts in rural Guatemala: a data envelopment analysis

PubMed Central

Hernández, Alison R.; Sebastián, Miguel San

2014-01-01

Introduction Strengthening health service delivery to the rural poor is an important means of redressing inequities. Meso-level managers can help enhance efficiency in the utilization of existing resources through the application of practical tools to analyze routinely collected data reflecting inputs and outputs. This study aimed to assess the efficiency and change in productivity of health posts over two years in a rural department of Guatemala. Methods Data envelopment analysis was used to measure health posts’ technical efficiency and productivity change for 2008 and 2009. Input/output data were collected from the regional health office of Alta Verapaz for 34 health posts from the 19 districts comprising the health region. Results Technical efficiency varied widely across health posts, with mean scores of 0.78 (SD=0.24) and 0.75 (SD=0.21) in 2008 and 2009, respectively. Overall, productivity increased by 4%, though 47% of health posts experienced a decline in productivity. Results were combined on a bivariate plot to identify health posts at the high and low extremes of efficiency, which should be followed up to determine how and why their production processes are operating differently. Conclusions Assessing efficiency using the data that are available at the meso-level can serve as a first step in strengthening performance. Further work is required to support managers in the routine application of efficiency analysis and putting the results to use in guiding efforts to improve service delivery and increase utilization. PMID:24461356

Exploring Infiniband Hardware Virtualization in OpenNebula towards Efficient High-Performance Computing

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

Pais Pitta de Lacerda Ruivo, Tiago; Bernabeu Altayo, Gerard; Garzoglio, Gabriele

2014-11-11

has been widely accepted that software virtualization has a big negative impact on high-performance computing (HPC) application performance. This work explores the potential use of Infiniband hardware virtualization in an OpenNebula cloud towards the efficient support of MPI-based workloads. We have implemented, deployed, and tested an Infiniband network on the FermiCloud private Infrastructure-as-a-Service (IaaS) cloud. To avoid software virtualization towards minimizing the virtualization overhead, we employed a technique called Single Root Input/Output Virtualization (SRIOV). Our solution spanned modifications to the Linux’s Hypervisor as well as the OpenNebula manager. We evaluated the performance of the hardware virtualization on up to 56more » virtual machines connected by up to 8 DDR Infiniband network links, with micro-benchmarks (latency and bandwidth) as well as w a MPI-intensive application (the HPL Linpack benchmark).« less

The challenge of corporatisation: the experience of Portuguese public hospitals.

PubMed

Rego, Guilhermina; Nunes, Rui; Costa, José

2010-08-01

The inability of traditional state organisations to respond to new economic, technological and social challenges and the associated emerging problems has made it necessary to adopt new methods of health management. As a result, new directions have emerged in the reform of Public Administration together with the introduction of innovative models. The aim is to achieve a type of management that focuses on results as well as on effort and efficiency. We intend to analyse to what extent the adoption of business management models by hospital healthcare units can improve their performance, mainly in terms of standards of efficiency. Data envelopment analysis (DEA) was used to investigate the efficiency of a set of public Portuguese hospitals. The aim was to evaluate the impact of business management in Portuguese public hospitals with regards to efficiency, specifically taking into account the fact that lack of resources and increased health care needs are a present and future reality. From a total of 83 public hospitals, a sample of 59 hospitals was chosen, of which 21 are state-owned hospital enterprises (SA) and 38 are traditional public administration sector hospitals (SPA). This study evaluates hospital performance by calculating two efficiency measures associated with two categories of inputs. The first efficiency measures the costs associated with hospital production lines and the number of beds (representing fixed capacity) as inputs. The annual costs generated by the hospitals in the consumption of capital and work (direct and indirect costs) are used. A second measure of efficiency is calculated separately. This measure includes in the inputs the number of beds as well as the human resources available (number of doctors, number of nurses and other personnel) in each hospital. With regard to output, the variables that best reflect the hospital services rendered were considered: number of inpatient days, patients discharged, outpatient visits, emergencies services, sessions in hospital day care services and the number of surgeries. The results seem to suggest that the introduction of market processes and changes in organisational structure--such as managerial autonomy and corporatisation of public hospitals--have had a positive impact on Portuguese public hospitals. This positive evolution was particularly evident in SA hospitals, but further studies are needed to confirm these preliminary results.

Dynamic Online Bandwidth Adjustment Scheme Based on Kalai-Smorodinsky Bargaining Solution

NASA Astrophysics Data System (ADS)

Kim, Sungwook

Virtual Private Network (VPN) is a cost effective method to provide integrated multimedia services. Usually heterogeneous multimedia data can be categorized into different types according to the required Quality of Service (QoS). Therefore, VPN should support the prioritization among different services. In order to support multiple types of services with different QoS requirements, efficient bandwidth management algorithms are important issues. In this paper, I employ the Kalai-Smorodinsky Bargaining Solution (KSBS) for the development of an adaptive bandwidth adjustment algorithm. In addition, to effectively manage the bandwidth in VPNs, the proposed control paradigm is realized in a dynamic online approach, which is practical for real network operations. The simulations show that the proposed scheme can significantly improve the system performances.

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

PubMed Central

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

2011-01-01

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

Performance-based financing and changing the district health system: experience from Rwanda.

PubMed Central

Soeters, Robert; Habineza, Christian; Peerenboom, Peter Bob

2006-01-01

Evidence from low-income Asian countries shows that performance-based financing (as a specific form of contracting) can improve health service delivery more successfully than traditional input financing mechanisms. We report a field experience from Rwanda demonstrating that performance-based financing is a feasible strategy in sub-Saharan Africa too. Performance-based financing requires at least one new actor, an independent well equipped fundholder organization in the district health system separating the purchasing, service delivery as well as regulatory roles of local health authorities from the technical role of contract negotiation and fund disbursement. In Rwanda, local community groups, through patient surveys, verified the performance of health facilities and monitored consumer satisfaction. A precondition for the success of performance-based financing is that authorities must respect the autonomous management of health facilities competing for public subsidies. These changes are an opportunity to redistribute roles within the health district in a more transparent and efficient fashion. PMID:17143462

Restructuring Big Data to Improve Data Access and Performance in Analytic Services Making Research More Efficient for the Study of Extreme Weather Events and Application User Communities

NASA Astrophysics Data System (ADS)

Ostrenga, D.; Shen, S.; Vollmer, B.; Meyer, D. L.

2017-12-01

NASA climate reanalysis dataset from MERRA-2 contains numerous data for atmosphere, land, and ocean, that are grouped into 95 products of archived volume over 300 TB. The data files are saved as hourly-file, day-file (hourly time interval) and month-file containing up to 125 parameters. Due to the large number of data files and the sheer data volumes, it is a challenging for users, especially those in the application research community, to handle dealing with the original data files. Most of these researchers prefer to focus on a small region or single location using the hourly data for long time periods to analyze extreme weather events or say winds for renewable energy applications. At the GES DISC, we have been working closely with the science teams and the application user community to create several new value added data products and high quality services to facilitate the use of the model data for various types of research. We have tested converting hourly data from one-day per file into different data cubes, such as one-month, one-year, or whole-mission and then continued to analyze the efficiency of the accessibility of this newly structured data through various services. Initial results have shown that compared to the original file structure, the new data has significantly improved the performance for accessing long time series. It is noticed that the performance is associated to the cube size and structure, the compression method, and how the data are accessed. The optimized data cube structure will not only improve the data access, but also enable better online analytic services for doing statistical analysis and extreme events mining. Two case studies will be presented using the newly structured data and value added services, the California drought and the extreme drought of the Northeastern states of Brazil. Furthermore, data access and analysis through cloud storage capabilities will be investigated.

Review: Using artificial insemination v. natural service in beef herds.

PubMed

Baruselli, P S; Ferreira, R M; Sá Filho, M F; Bó, G A

2018-03-20

The aim of this review is to compare the performance of different reproductive programs using natural service, estrus synchronization treatment before natural service (timed natural breeding (TNB)), artificial insemination (AI) following estrus detection and timed artificial insemination (TAI) in beef herds. It is well known that after parturition the beef cow undergoes a period of anestrous, when they do not exhibit estrus, eliminating the opportunity to become pregnant in the early postpartum by natural mating or by AI after detection of estrus. Hormonal stimulation is already a consistent and well-proven strategy used to overcome postpartum anestrus in beef herds. Basically, hormones that normally are produced during the estrous cycle of the cow can be administered in physiological doses to induce cyclicity and to precisely synchronize follicular growth, estrus and ovulation. Furthermore, two options of mating may be used after hormonal stimulation: natural service (i.e. utilization of bull service after synchronization, referred to as TNB) and TAI. These strategies improve the reproductive efficiency of the herds compared with natural service without estrus induction or synchronization. After the first synchronized service, the most common strategy adopted to get non-pregnant cows pregnant soon is the introduction of clean-up bulls until the end of the breeding season. However, methods to resynchronize non-pregnant cows after the first service are already well established and offer a potential tool to reduce the time for subsequent inseminations. Thus, the use of these technologies enable to eliminate the use of bulls by using resynchronization programs (i.e. two, three or four sequential TAI procedures). The dissemination of efficient reproductive procedures, such as TNB, TAI and Resynch programs, either isolated or in combination, enables the production of a greater quantity (obtaining increased pregnancy rates early in the breeding season) and quality (maximization of the use of AI with superior genetic sires) of beef calves. These technologies can contribute to improve the production efficiency, and consequently, improve livestock profitability.

Efficiency and factors influencing efficiency of Community Health Strategy in providing Maternal and Child Health services in Mwingi District, Kenya: an expert opinion perspective

PubMed Central

Nzioki, Japheth Mativo; Onyango, Rosebella Ogutu; Ombaka, James Herbert

2015-01-01

Introduction Community Health Strategy (CHS) is a new Primary Health Care (PHC) model in Kenya, designed to provide PHC services in Kenya. In 2011, CHS was initiated in Mwingi district as one of the components of APHIA plus kamili program. The objectives of this study was to evaluate the efficiency of the CHS in providing MCH services in Mwingi district and to establish the factors influencing efficiency of the CHS in providing MCH services in the district. Methods This was a qualitative study. Fifteen Key informants were sampled from key stakeholders. Sampling was done using purposive and maximum variation sampling methods. Semi-structured in-depth interviews were used for data collection. Data was managed and analyzed using NVIVO. Framework analysis and quasi statistics were used in data analysis. Results Expert opinion data indicated that the CHS was efficient in providing MCH services. Factors influencing efficiency of the CHS in provision of MCH services were: challenges facing Community Health Workers (CHWs), Social cultural and economic factors influencing MCH in the district, and motivation among CHWs. Conclusion Though CHS was found to be efficient in providing MCH services, this was an expert opinion perspective, a quantitative Cost Effectiveness Analysis (CEA) to confirm these findings is recommended. To improve efficiency of the CHS in the district, challenges facing CHWs and Social cultural and economic factors that influence efficiency of the CHS in the district need to be addressed. PMID:26090046

78 FR 52933 - Strengthening the Operating Framework and Furthering the Objectives of Coalition for Accelerating...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0972... Therapies Initiative (U24) AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and... more efficiently perform efficacy analysis of potential new drugs in therapeutic areas that are...

University and Polytechnic Objectives, Resource Allocation and Performance Indices in the Central Services. Program on Institutional Management in Higher Education.

ERIC Educational Resources Information Center

Norris, Graeme, Ed.

Research progress by member institutions is reviewed with regard to university administration, computing, committees, libraries, and student welfare. Consideration is given to effectiveness and efficiency, management information, management by objectives, periodic review of objectives, strategy, and analytic resource allocation. Two research…

Assessment of public vs private MSW management: a case study.

PubMed

Massoud, M A; El-Fadel, M; Abdel Malak, A

2003-09-01

Public-private partnerships in urban environmental services have witnessed increased interest in recent years primarily to reform the weak performance of the public sector, reduce cost, improve efficiency, and ensure environmental protection. In this context, successful public-private partnerships require a thorough analysis of opportunities, a deliberate attention to process details, and a continuous examination of services to determine whether they are more effectively performed by the private sector. A comparative assessment of municipal solid waste collection services in the two largest cities in Lebanon where until recently municipal solid waste collection is private in one and public in the other is conducted. While quality of municipal solid waste collection improved, due to private sector participation, the corresponding cost did not, due to monopoly and an inadequate organizational plan defining a proper division of responsibilities between the private and the public sector.

From serological to computer cross-matching in nine hospitals.

PubMed

Georgsen, J; Kristensen, T

1998-01-01

In 1991 it was decided to reorganise the transfusion service of the County of Funen. The aims were to standardise and improve the quality of blood components, laboratory procedures and the transfusion service and to reduce the number of outdated blood units. Part of the efficiency gains was reinvested in a dedicated computer system making it possible--among other things--to change the cross-match procedures from serological to computer cross-matching according to the ABCD-concept. This communication describes how this transition was performed in terms of laboratory techniques, education of personnel as well as implementation of the computer system and indicates the results obtained. The Funen Transfusion Service has by now performed more than 100.000 red cell transfusions based on ABCD-cross-matching and has not encountered any problems. Major results are the significant reductions of cross-match procedures, blood grouping as well as the number of outdated blood components.

On a simulation study of cyber attacks on vehicle-to-infrastructure communication (V2I) in Intelligent Transportation System (ITS)

NASA Astrophysics Data System (ADS)

Ekedebe, Nnanna; Yu, Wei; Song, Houbing; Lu, Chao

2015-05-01

An intelligent transportation system (ITS) is one typical cyber-physical system (CPS) that aims to provide efficient, effective, reliable, and safe driving experiences with minimal congestion and effective traffic flow management. In order to achieve these goals, various ITS technologies need to work synergistically. Nonetheless, ITS's reliance on wireless connectivity makes it vulnerable to cyber threats. Thus, it is critical to understand the impact of cyber threats on ITS. In this paper, using real-world transportation dataset, we evaluated the consequences of cyber threats - attacks against service availability by jamming the communication channel of ITS. In this way, we can have a better understanding of the importance of ensuring adequate security respecting safety and life-critical ITS applications before full and expensive real-world deployments. Our experimental data shows that cyber threats against service availability could adversely affect traffic efficiency and safety performances evidenced by exacerbated travel time, fuel consumed, and other evaluated performance metrics as the communication network is compromised. Finally, we discuss a framework to make ITS secure and more resilient against cyber threats.

Is there scope for cost savings and efficiency gains in HIV services? A systematic review of the evidence from low- and middle-income countries

PubMed Central

Siapka, Mariana; Remme, Michelle; Obure, Carol Dayo; Maier, Claudia B; Dehne, Karl L

2014-01-01

Abstract Objective To synthesize the data available – on costs, efficiency and economies of scale and scope – for the six basic programmes of the UNAIDS Strategic Investment Framework, to inform those planning the scale-up of human immunodeficiency virus (HIV) services in low- and middle-income countries. Methods The relevant peer-reviewed and “grey” literature from low- and middle-income countries was systematically reviewed. Search and analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Findings Of the 82 empirical costing and efficiency studies identified, nine provided data on economies of scale. Scale explained much of the variation in the costs of several HIV services, particularly those of targeted HIV prevention for key populations and HIV testing and treatment. There is some evidence of economies of scope from integrating HIV counselling and testing services with several other services. Cost efficiency may also be improved by reducing input prices, task shifting and improving client adherence. Conclusion HIV programmes need to optimize the scale of service provision to achieve efficiency. Interventions that may enhance the potential for economies of scale include intensifying demand-creation activities, reducing the costs for service users, expanding existing programmes rather than creating new structures, and reducing attrition of existing service users. Models for integrated service delivery – which is, potentially, more efficient than the implementation of stand-alone services – should be investigated further. Further experimental evidence is required to understand how to best achieve efficiency gains in HIV programmes and assess the cost–effectiveness of each service-delivery model. PMID:25110375

42 CFR 440.370 - Economy and efficiency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Economy and efficiency. 440.370 Section 440.370 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.370 Economy and efficiency....

Health services analysis as a tool for evidence-based policy decisions: the case of the Ministry of Health and Social Security in Mexico.

PubMed

Kroeger, Axel; Hernandez, Juan Manuel

2003-12-01

To describe the strengths and weaknesses of two Mexican health care providers for poor populations [Ministry of Health (MoH) and Social Security (SS)] in order to facilitate policy decisions about the future of the two systems. In four Mexican states we conducted (i) a household interview survey in 10 724 households; (ii) a user satisfaction survey in 1319 households; (iii) a satisfaction survey of 236 health workers; (iv) in-depth interviews with 190 health workers; (v) 188 focus-group discussions with different population groups; (vi) a document analysis. Both systems serve populations with similar characteristics of poverty. The availability of resources was better in the MoH system; SS care was better concerning process indicators (family planning, antenatal care; in-service delivery of drugs, staff productivity, user satisfaction and staff motivation), efficiency and effectiveness (reduction of morbidity and mortality). Possible explanatory factors for the better performance of the SS system were strong supervision, regular communication, joint data analysis and annual population surveys. Better service organization makes a difference regarding efficiency and effectiveness. Policy-makers, deciding on which kind of health services are best for the poor, should take into account health services' analyses.

Graph Databases for Large-Scale Healthcare Systems: A Framework for Efficient Data Management and Data Services

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

Park, Yubin; Shankar, Mallikarjun; Park, Byung H.

Designing a database system for both efficient data management and data services has been one of the enduring challenges in the healthcare domain. In many healthcare systems, data services and data management are often viewed as two orthogonal tasks; data services refer to retrieval and analytic queries such as search, joins, statistical data extraction, and simple data mining algorithms, while data management refers to building error-tolerant and non-redundant database systems. The gap between service and management has resulted in rigid database systems and schemas that do not support effective analytics. We compose a rich graph structure from an abstracted healthcaremore » RDBMS to illustrate how we can fill this gap in practice. We show how a healthcare graph can be automatically constructed from a normalized relational database using the proposed 3NF Equivalent Graph (3EG) transformation.We discuss a set of real world graph queries such as finding self-referrals, shared providers, and collaborative filtering, and evaluate their performance over a relational database and its 3EG-transformed graph. Experimental results show that the graph representation serves as multiple de-normalized tables, thus reducing complexity in a database and enhancing data accessibility of users. Based on this finding, we propose an ensemble framework of databases for healthcare applications.« less

Space-assisted irrigation management: an operational perspective

NASA Astrophysics Data System (ADS)

Calera Belmonte, Alfonso; Jochum, Anne M.; Cuesta Garcia, Andres

2004-10-01

Irrigation Advisory Services (IAS) are the natural management instruments to achieve a better efficiency in the use of water for irrigation. IAS help farmers to apply water according to the actual crop water requirements and thus, to optimize production and cost-effectiveness. The project DEMETER (DEMonstration of Earth observation TEchnologies in Routine irrigation advisory services) aims at assessing and demonstrating how the performance and cost-effectiveness of IAS is substantially improved by the incorporation of Earth observation (EO) techniques and Information Society Technology (IT) into their day-to-day operations. EO allows for efficiently monitoring crop water requirements of each field in extended areas. The incorporation of IT in the generation and distribution of information makes that information easily available to IAS and to its associated farmers (the end-users) in a personalized way. This paper describes the methodology and selected results.

Bandwidth Efficient Modulation and Coding Techniques for NASA's Existing Ku/Ka-Band 225 MHz Wide Service

NASA Technical Reports Server (NTRS)

Gioannini, Bryan; Wong, Yen; Wesdock, John

2005-01-01

The National Aeronautics and Space Administration (NASA) has recently established the Tracking and Data Relay Satellite System (TDRSS) K-band Upgrade Project (TKUP), a project intended to enhance the TDRSS Ku-band and Ka-band Single Access Return 225 MHz (Ku/KaSAR-225) data service by adding the capability to process bandwidth efficient signal design and to replace the White Sand Complex (WSC) KSAR high data rate ground equipment and high rate switches which are nearing obsolescence. As a precursor to this project, a modulation and coding study was performed to identify signal structures which maximized the data rate through the Ku/KaSAR-225 channel, minimized the required customer EIRP and ensured acceptable hardware complexity on the customer platform. This paper presents the results and conclusions of the TKUP modulation and coding study.

Volt-VAR Optimization on American Electric Power Feeders in Northeast Columbus

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

Schneider, Kevin P.; Weaver, T. F.

2012-05-10

In 2007 American Electric Power launched the gridSMART® initiative with the goals of increasing efficiency of the electricity delivery system and improving service to the end-use customers. As part of the initiative, a coordinated Volt-VAR system was deployed on eleven distribution feeders at five substations in the Northeast Columbus Ohio Area. The goal of the coordinated Volt-VAR system was to decrease the amount of energy necessary to provide end-use customers with the same quality of service. The evaluation of the Volt-VAR system performance was conducted in two stages. The first stage was composed of simulation, analysis, and estimation, while themore » second stage was composed of analyzing collected field data. This panel paper will examine the analysis conducted in both stages and present the estimated improvements in system efficiency.« less

Memory Management of Multimedia Services in Smart Homes

NASA Astrophysics Data System (ADS)

Kamel, Ibrahim; Muhaureq, Sanaa A.

Nowadays there is a wide spectrum of applications that run in smart home environments. Consequently, home gateway, which is a central component in the smart home, must manage many applications despite limited memory resources. OSGi is a middleware standard for home gateways. OSGi models services as dependent components. Moreover, these applications might differ in their importance. Services collaborate and complement each other to achieve the required results. This paper addresses the following problem: given a home gateway that hosts several applications with different priorities and arbitrary dependencies among them. When the gateway runs out of memory, which application or service will be stopped or kicked out of memory to start a new service. Note that stopping a given service means that all the services that depend on it will be stopped too. Because of the service dependencies, traditional memory management techniques, in the operating system literatures might not be efficient. Our goal is to stop the least important and the least number of services. The paper presents a novel algorithm for home gateway memory management. The proposed algorithm takes into consideration the priority of the application and dependencies between different services, in addition to the amount of memory occupied by each service. We implement the proposed algorithm and performed many experiments to evaluate its performance and execution time. The proposed algorithm is implemented as a part of the OSGi framework (Open Service Gateway initiative). We used best fit and worst fit as yardstick to show the effectiveness of the proposed algorithm.

The multidriver: A reliable multicast service using the Xpress Transfer Protocol

NASA Technical Reports Server (NTRS)

Dempsey, Bert J.; Fenton, John C.; Weaver, Alfred C.

1990-01-01

A reliable multicast facility extends traditional point-to-point virtual circuit reliability to one-to-many communication. Such services can provide more efficient use of network resources, a powerful distributed name binding capability, and reduced latency in multidestination message delivery. These benefits will be especially valuable in real-time environments where reliable multicast can enable new applications and increase the availability and the reliability of data and services. We present a unique multicast service that exploits features in the next-generation, real-time transfer layer protocol, the Xpress Transfer Protocol (XTP). In its reliable mode, the service offers error, flow, and rate-controlled multidestination delivery of arbitrary-sized messages, with provision for the coordination of reliable reverse channels. Performance measurements on a single-segment Proteon ProNET-4 4 Mbps 802.5 token ring with heterogeneous nodes are discussed.

Patients’ mobility as an indicator for (in)efficiency:a panel data analysis on Italian health care authorities

PubMed Central

2013-01-01

Abstract This paper investigates the influence of internal managerial patterns of heath care authorities on the decision of patients to migrate towards different health care organizations to avail treatments. The efficiency and productivity issues are analyzed, considering the (passive) migration as a proxy for the (in)efficient service availed. We follow the “vote by feet” theorization by Tiebout , assuming that citizens can choose to avail a health treatment in a public service provider different from their resident one. The choice for a center that is far from home implies a negative judgment to the alternative health care supplier that is closer to the patient. Testing Fixed Effects Panel Model on a sample of Italian health care authorities, a strong correlation is found among variables in our model and some relevant dependence is tested between patients’ mobility behavior and their resident authorities’ efficiency in allocating resources on the proper operating cost. Spending in the proper way on health care could bring about an enhancement of performances. Instead, wasting resources is immediately perceived by the patient, who consequently seems to move to a different health care authority. JEL code M48 PMID:23422329

Turf Conversion Measurement and Verification Protocol

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

Kurnik, Charles W.; Stoughton, Kate M.; Figueroa, Jorge

This measurement and verification (M and V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings as a result of water conservation measures (WCMs) in energy performance contracts associated with converting turfgrass or other water-intensive plantings to water-wise and sustainable landscapes. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M and V plan, and details the procedures to use to determine water savings.

From production to performance: solving the positioning dilemma in dental practice.

PubMed

Armstrong, James; Pitt, Leyland; Berthon, Pierre

2006-09-01

Thriving dental practices are excellent at providing a warm personal experience or are efficient, fast and cost-effective. Those that that attempt to do both end up being mediocre at just about everything. Introducing ideas from dramaturgy and service simultaneity in the services marketing literature, the authors provide a model for the conceptualization and redesign of the dental practice. Successful dental practices will be those that concentrate on low customization of activities in the back office or high customization of activities in the front office.

Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit.

PubMed

Osman, Ibrahim H; Berbary, Lynn N; Sidani, Yusuf; Al-Ayoubi, Baydaa; Emrouznejad, Ali

2011-10-01

The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.

Energy efficiency business options for industrial end users in Latin American competitive energy markets: The case of Colombia

NASA Astrophysics Data System (ADS)

Botero, Sergio

2002-01-01

Energy markets today in Latin America and worldwide are being restructured from monopolies, either state-owned or privately-owned, to be more openly competitive and incorporate more participation from the private sector. Thus, the schemes that were formerly developed to foster end use energy efficiency are no longer applicable because they were based on mandatory regulations made with political decisions, without sufficiently considering economic feasibility. A consensus exists that the only way energy efficiency could survive in this new paradigm is by being market oriented, giving better services, and additional options to users. However; there is very little information on what end users prefer, and which options would most satisfy customers. Using Colombia as a case study, this research determines and categorizes the energy efficiency business options for large energy end users that can freely participate in the competitive energy market. The energy efficiency market is understood as a market of services aiming to increase efficiency in energy use. These services can be grouped into seven business options. A survey, following the descriptive method, was sent to energy end users in order to determine their preferences for specific energy efficiency business options, as well as the decision-making criteria taken into account for such options. This data was categorized in ten industry groups. As a conclusion, energy efficiency providers should adapt not only to the economic activity or processes of each customer, but also to the potential business options. It was also found that not all industries consider performance contracting as their most preferred option, as a matter of fact, some industries show much higher preference for conventional business options. Among end users, the divergence in option preferences contrasted with the convergence in decision-making criteria. The decision-making criteria "cost-benefit ratio" overwhelmed all other criterion. End users appear to chose a specific energy efficiency option based mostly on obtaining better economic returns, giving low consideration to other criterion that feature differences among the energy efficiency options.

Cost-effectiveness of aftercare services for people with severe mental disorders: an analysis parallel to a randomised controlled clinical trial in Iran.

PubMed

Moradi-Lakeh, Maziar; Yaghoubi, Mohsen; Hajebi, Ahmad; Malakouti, Seyed Kazem; Vasfi, Mohamad Ghadiri

2017-05-01

Aftercare services are not part of the usual care for people with severe mental disorders in Iran. This study was performed to assess the cost-effectiveness of aftercare services, including telephone follow-up or home visit, in addition to caregivers' education and training of social skills, for all subjects during the 20 months after hospital discharge. An economic evaluation was performed along with a registered randomised controlled trial (IRCT201009052557N2) on two groups of 60 persons recruited between 2010 and 2012. Intervention's effectiveness was measured by psychopathology and quality of life indicators. Cost-effectiveness and cost-utility were analysed from the societal and Ministry of Health (MoH) perspectives. All indicators of psychopathology, quality of life and satisfaction with services in the intervention group were significantly different from the control group. Mean intervention costs was US$674 (95% confidence interval [CI]: 572-776) per subject in the intervention group. Average total direct costs were US$1445 (95% CI: 1086-1804) and US$1640 (95% CI: 1087-2093) per subject in the intervention and control groups respectively. From the societal perspective, intervention had more effects with lower costs. The ratios for incremental cost-effectiveness was US$8399.1 (95% CI: 8178.2-8620.0) per quality-adjusted life year (QALY) gained from the MoH perspective for 20 months of follow-up. This study showed that aftercare services can create opportunities to use hospital beds more efficiently for unmet needs of people with psychiatric disorders. Indirect and intangible costs were not considered in this study, if taken into account, they are likely to further increase the efficiency of intervention. © 2017 John Wiley & Sons Ltd.

Full-subcarriers Polar-OFDM for optical spectrum-efficient transmission exploiting Polarization Multiplexing

NASA Astrophysics Data System (ADS)

Guo, Lei; Liu, Yejun; Zhou, Yufang; Wei, Xuetao; Liu, Yuying

2018-07-01

The exponential growth of the demand for broadband services has imposed great challenges on the design of spectrum-efficient optical transmission system in Passive Optical Network (PON). Recently, an innovative Orthogonal Frequency Division Multiplexing (OFDM) scheme, called Polar-OFDM (P-OFDM), has emerged as a promising solution to boost the spectral efficiency of optical transmission in PON. However, the traditional P-OFDM does not yet perform best in spectral efficiency as it only uses half of the total subcarriers. In this paper, we verify a promising complementation between Polarization Multiplexing (POLMUX) and P-OFDM aiming at higher spectral efficiency. We then propose the full-subcarriers P-OFDM by loading data on the even-indexed subcarriers of X polarization and the odd-indexed subcarriers of Y polarization, respectively. Thus, all of the subcarriers will be utilized for effective data transmission, which can double the spectral efficiency. More importantly, because the subcarriers are interlaced on different polarizations, the cross-polarization interference can be significantly mitigated, which enables the independent channel estimation and equalization at the receiver to recover the data carried on each polarization. Our evaluation results demonstrate that the proposed system realizes the double spectral efficiency of the traditional P-OFDM with reasonable Bit Error Rate (BER) performance loss.

Strategic groups, performance, and strategic response in the nursing home industry.

PubMed

Zinn, J S; Aaronson, W E; Rosko, M D

1994-06-01

This study examines the effect of strategic group membership on nursing home performance and strategic behavior. Data from the 1987 Medicare and Medicaid Automated Certification Survey were combined with data from the 1987 and 1989 Pennsylvania Long Term Care Facility Questionnaire. The sample consisted of 383 Pennsylvania nursing homes. Cluster analysis was used to place the 383 nursing homes into strategic groups on the basis of variables measuring scope and resource deployment. Performance was measured by indicators of the quality of nursing home care (rates of pressure ulcers, catheterization, and restraint usage) and efficiency in services provision. Changes in Medicare participation after passage of the 1988 Medicare Catastrophic Coverage Act (MCCA) measured strategic behavior. MANOVA and Turkey HSD post hoc means tests determined if significant differences were associated with strategic group membership. Cluster analysis produced an optimal seven-group solution. Differences in group means were significant for the clustering, performance, and conduct variables (p < .0001). Strategic groups characterized by facilities providing a continuum of care services had the best patient care outcomes. The most efficient groups were characterized by facilities with high Medicare census. While all strategic groups increased Medicare census following passage of the MCCA, those dominated by for-profits had the greatest increases. Our analysis demonstrates that strategic orientation influences nursing home response to regulatory initiatives, a factor that should be recognized in policy formation directed at nursing home reform.

GSKY: A scalable distributed geospatial data server on the cloud

NASA Astrophysics Data System (ADS)

Rozas Larraondo, Pablo; Pringle, Sean; Antony, Joseph; Evans, Ben

2017-04-01

Earth systems, environmental and geophysical datasets are an extremely valuable sources of information about the state and evolution of the Earth. Being able to combine information coming from different geospatial collections is in increasing demand by the scientific community, and requires managing and manipulating data with different formats and performing operations such as map reprojections, resampling and other transformations. Due to the large data volume inherent in these collections, storing multiple copies of them is unfeasible and so such data manipulation must be performed on-the-fly using efficient, high performance techniques. Ideally this should be performed using a trusted data service and common system libraries to ensure wide use and reproducibility. Recent developments in distributed computing based on dynamic access to significant cloud infrastructure opens the door for such new ways of processing geospatial data on demand. The National Computational Infrastructure (NCI), hosted at the Australian National University (ANU), has over 10 Petabytes of nationally significant research data collections. Some of these collections, which comprise a variety of observed and modelled geospatial data, are now made available via a highly distributed geospatial data server, called GSKY (pronounced [jee-skee]). GSKY supports on demand processing of large geospatial data products such as satellite earth observation data as well as numerical weather products, allowing interactive exploration and analysis of the data. It dynamically and efficiently distributes the required computations among cloud nodes providing a scalable analysis framework that can adapt to serve large number of concurrent users. Typical geospatial workflows handling different file formats and data types, or blending data in different coordinate projections and spatio-temporal resolutions, is handled transparently by GSKY. This is achieved by decoupling the data ingestion and indexing process as an independent service. An indexing service crawls data collections either locally or remotely by extracting, storing and indexing all spatio-temporal metadata associated with each individual record. GSKY provides the user with the ability of specifying how ingested data should be aggregated, transformed and presented. It presents an OGC standards-compliant interface, allowing ready accessibility for users of the data via Web Map Services (WMS), Web Processing Services (WPS) or raw data arrays using Web Coverage Services (WCS). The presentation will show some cases where we have used this new capability to provide a significant improvement over previous approaches.

Efficiency of Support Services within the Arizona Universities.

ERIC Educational Resources Information Center

Davis, George H.

One of the working papers in the final report of the Arizona Board of Regents' Task Force on Excellence, Efficiency and Competitiveness, this document discusses the efficiency of the Arizona state universities' support services. Faculty, staff, and students were asked to rate the quality, importance, and change in quality of the services provided…

Reliability theory for repair service organization simulation and increase of innovative attraction of industrial enterprises

NASA Astrophysics Data System (ADS)

Dolzhenkova, E. V.; Iurieva, L. V.

2018-05-01

The study presents the author's algorithm for the industrial enterprise repair service organization simulation based on the reliability theory, as well as the results of its application. The monitoring of the industrial enterprise repair service organization is proposed to perform on the basis of the enterprise's state indexes for the main resources (equipment, labour, finances, repair areas), which allows quantitative evaluation of the reliability level as a resulting summary rating of the said parameters and the ensuring of an appropriate level of the operation reliability of the serviced technical objects. Under the conditions of the tough competition, the following approach is advisable: the higher efficiency of production and a repair service itself, the higher the innovative attractiveness of an industrial enterprise. The results of the calculations show that in order to prevent inefficient losses of production and to reduce the repair costs, it is advisable to apply the reliability theory. The overall reliability rating calculated on the basis of the author's algorithm has low values. The processing of the statistical data forms the reliability characteristics for the different workshops and services of an industrial enterprise, which allows one to define the failure rates of the various units of equipment and to establish the reliability indexes necessary for the subsequent mathematical simulation. The proposed simulating algorithm contributes to an increase of the efficiency of the repair service organization and improvement of the innovative attraction of an industrial enterprise.

The first of a series of high efficiency, high bmep, turbocharged two-stroke cycle diesel engines; the general motors EMD 645FB engine

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

Kotlin, J.J.; Dunteman, N.R.; Scott, D.I.

1983-01-01

The current Electro-Motive Division 645 Series turbocharged engines are the Model FB and EC. The FB engine combines the highest thermal efficiency with the highest specific output of any EMD engine to date. The FB Series incorporates 16:1 compression ratio with a fire ring piston and an improved turbocharger design. Engine components included in the FB engine provide very high output levels with exceptional reliability. This paper also describes the performance of the lower rated Model EC engine series which feature high thermal efficiency and utilize many engine components well proven in service and basic to the Model FB Series.

IMPROVING TACONITE PROCESSING PLANT EFFICIENCY BY COMPUTER SIMULATION, Final Report

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

William M. Bond; Salih Ersayin

2007-03-30

This project involved industrial scale testing of a mineral processing simulator to improve the efficiency of a taconite processing plant, namely the Minorca mine. The Concentrator Modeling Center at the Coleraine Minerals Research Laboratory, University of Minnesota Duluth, enhanced the capabilities of available software, Usim Pac, by developing mathematical models needed for accurate simulation of taconite plants. This project provided funding for this technology to prove itself in the industrial environment. As the first step, data representing existing plant conditions were collected by sampling and sample analysis. Data were then balanced and provided a basis for assessing the efficiency ofmore » individual devices and the plant, and also for performing simulations aimed at improving plant efficiency. Performance evaluation served as a guide in developing alternative process strategies for more efficient production. A large number of computer simulations were then performed to quantify the benefits and effects of implementing these alternative schemes. Modification of makeup ball size was selected as the most feasible option for the target performance improvement. This was combined with replacement of existing hydrocyclones with more efficient ones. After plant implementation of these modifications, plant sampling surveys were carried out to validate findings of the simulation-based study. Plant data showed very good agreement with the simulated data, confirming results of simulation. After the implementation of modifications in the plant, several upstream bottlenecks became visible. Despite these bottlenecks limiting full capacity, concentrator energy improvement of 7% was obtained. Further improvements in energy efficiency are expected in the near future. The success of this project demonstrated the feasibility of a simulation-based approach. Currently, the Center provides simulation-based service to all the iron ore mining companies operating in northern Minnesota, and future proposals are pending with non-taconite mineral processing applications.« less

Hospital efficiency and transaction costs: a stochastic frontier approach.

PubMed

Ludwig, Martijn; Groot, Wim; Van Merode, Frits

2009-07-01

The make-or-buy decision of organizations is an important issue in the transaction cost theory, but is usually not analyzed from an efficiency perspective. Hospitals frequently have to decide whether to outsource or not. The main question we address is: Is the make-or-buy decision affected by the efficiency of hospitals? A one-stage stochastic cost frontier equation is estimated for Dutch hospitals. The make-or-buy decisions of ten different hospital services are used as explanatory variables to explain efficiency of hospitals. It is found that for most services the make-or-buy decision is not related to efficiency. Kitchen services are an important exception to this. Large hospitals tend to outsource less, which is supported by efficiency reasons. For most hospital services, outsourcing does not significantly affect the efficiency of hospitals. The focus on the make-or-buy decision may therefore be less important than often assumed.

Case Study for the ARRA-funded Ground Source Heat Pump (GSHP) Demonstration at Wilders Grove Solid Waste Service Center in Raleigh, NC

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

Liu, Xiaobing; Malhotra, Mini; Xiong, Zeyu

High initial costs and lack of public awareness of ground-source heat pump (GSHP) technology are the two major barriers preventing rapid deployment of this energy-saving technology in the United States. Under the American Recovery and Reinvestment Act (ARRA), 26 GSHP projects have been competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This paper highlights the findings of a case study of one of the ARRA-funded GSHP demonstration projects, a distributed GSHP system for providing all the space conditioning, outdoor air ventilation, and 100% domestic hot water tomore » the Wilders Grove Solid Waste Service Center of City of Raleigh, North Carolina. This case study is based on the analysis of measured performance data, construction costs, and simulations of the energy consumption of conventional central heating, ventilation, and air-conditioning (HVAC) systems providing the same level of space conditioning and outdoor air ventilation as the demonstrated GSHP system. The evaluated performance metrics include the energy efficiency of the heat pump equipment and the overall GSHP system, pumping performance, energy savings, carbon emission reductions, and cost-effectiveness of the GSHP system compared with conventional HVAC systems. This case study also identified opportunities for reducing uncertainties in the performance evaluation and improving the operational efficiency of the demonstrated GSHP system.« less

The ViennaRNA web services.

PubMed

Gruber, Andreas R; Bernhart, Stephan H; Lorenz, Ronny

2015-01-01

The ViennaRNA package is a widely used collection of programs for thermodynamic RNA secondary structure prediction. Over the years, many additional tools have been developed building on the core programs of the package to also address issues related to noncoding RNA detection, RNA folding kinetics, or efficient sequence design considering RNA-RNA hybridizations. The ViennaRNA web services provide easy and user-friendly web access to these tools. This chapter describes how to use this online platform to perform tasks such as prediction of minimum free energy structures, prediction of RNA-RNA hybrids, or noncoding RNA detection. The ViennaRNA web services can be used free of charge and can be accessed via http://rna.tbi.univie.ac.at.

Resource needs and gap analysis in achieving universal access to HIV/AIDS services: a data envelopment analysis of 45 countries.

PubMed

Zeng, Wu; Shepard, Donald S; Avila-Figueroa, Carlos; Ahn, Haksoon

2016-06-01

-To manage the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) epidemic, international donors have pledged unprecedented commitments for needed services. The Joint United Nations Programme on HIV/AIDS (UNAIDS) projected that low- and middle-income countries needed $25 billion to meet the 2010 HIV/AIDS goal of universal access to AIDS prevention and care, using the resource needs model (RNM). -Drawing from the results from its sister study, which used a data envelopment analysis (DEA) and a Tobit model to evaluate and adjust the technical efficiency of 61 countries in delivering HIV/AIDS services from 2002 to 2007, this study extended the DEA and developed an approach to estimate resource needs and decompose the performance gap into efficiency gap and resource gap. In the DEA, we considered national HIV/AIDS spending as the input and volume of voluntary counseling and testing (VCT), prevention of mother to child transmission (PMTCT) and antiretroviral treatment (ART) as the outputs. An input-oriented DEA model was constructed to project resource needs in achieving 2010 HIV/AIDS goal for 45 countries using the data in 2006, assuming that all study countries maximized efficiency. -The DEA approach demonstrated the potential to include efficiency of national HIV/AIDS programmes in resource needs estimation, using macro-level data. Under maximal efficiency, the annual projected resource needs for the 45 countries was $6.3 billion, ∼47% of their UNAIDS estimate of $13.5 billion. Given study countries' spending of $3.9 billion, improving efficiency could narrow the gap from $9.6 to $2.4 billion. The results suggest that along with continued financial commitment to HIV/AIDS, improving the efficiency of HIV/AIDS programmes would accelerate the pace to reach 2010 HIV/AIDS goals. The DEA approach provides a supplement to the AIDS RNM to inform policy making. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

The cost structure of routine infant immunization services: a systematic analysis of six countries

PubMed Central

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-01-01

Abstract Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77–93% of national routine infant immunization costs. Labour and vaccine costs comprised 14–69% and 13–69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48–78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. PMID:28575193

The cost structure of routine infant immunization services: a systematic analysis of six countries.

PubMed

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-10-01

Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77-93% of national routine infant immunization costs. Labour and vaccine costs comprised 14-69% and 13-69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48-78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Measuring the Efficiency of a Hospital based on the Econometric Stochastic Frontier Analysis (SFA) Method.

PubMed

Rezaei, Satar; Zandian, Hamed; Baniasadi, Akram; Moghadam, Telma Zahirian; Delavari, Somayeh; Delavari, Sajad

2016-02-01

Hospitals are the most expensive health services provider in the world. Therefore, the evaluation of their performance can be used to reduce costs. The aim of this study was to determine the efficiency of the hospitals at the Kurdistan University of Medical Sciences using stochastic frontier analysis (SFA). This was a cross-sectional and retrospective study that assessed the performance of Kurdistan teaching hospitals (n = 12) between 2007 and 2013. The Stochastic Frontier Analysis method was used to achieve this aim. The numbers of active beds, nurses, physicians, and other staff members were considered as input variables, while the inpatient admission was considered as the output. The data were analyzed using Frontier 4.1 software. The mean technical efficiency of the hospitals we studied was 0.67. The results of the Cobb-Douglas production function showed that the maximum elasticity was related to the active beds and the elasticity of nurses was negative. Also, the return to scale was increasing. The results of this study indicated that the performances of the hospitals were not appropriate in terms of technical efficiency. In addition, there was a capacity enhancement of the output of the hospitals, compared with the most efficient hospitals studied, of about33%. It is suggested that the effect of various factors, such as the quality of health care and the patients' satisfaction, be considered in the future studies to assess hospitals' performances.

Multiple Criteria and Multiple Periods Performance Analysis: The Comparison of North African Railways

NASA Astrophysics Data System (ADS)

Sabri, Karim; Colson, Gérard E.; Mbangala, Augustin M.

2008-10-01

Multi-period differences of technical and financial performances are analysed by comparing five North African railways over the period (1990-2004). A first approach is based on the Malmquist DEA TFP index for measuring the total factors productivity change, decomposed into technical efficiency change and technological changes. A multiple criteria analysis is also performed using the PROMETHEE II method and the software ARGOS. These methods provide complementary detailed information, especially by discriminating the technological and management progresses by Malmquist and the two dimensions of performance by Promethee: that are the service to the community and the enterprises performances, often in conflict.

Making Spatial Statistics Service Accessible On Cloud Platform

NASA Astrophysics Data System (ADS)

Mu, X.; Wu, J.; Li, T.; Zhong, Y.; Gao, X.

2014-04-01

Web service can bring together applications running on diverse platforms, users can access and share various data, information and models more effectively and conveniently from certain web service platform. Cloud computing emerges as a paradigm of Internet computing in which dynamical, scalable and often virtualized resources are provided as services. With the rampant growth of massive data and restriction of net, traditional web services platforms have some prominent problems existing in development such as calculation efficiency, maintenance cost and data security. In this paper, we offer a spatial statistics service based on Microsoft cloud. An experiment was carried out to evaluate the availability and efficiency of this service. The results show that this spatial statistics service is accessible for the public conveniently with high processing efficiency.

Quality measurement and benchmarking of HPV vaccination services: a new approach.

PubMed

Maurici, Massimo; Paulon, Luca; Campolongo, Alessandra; Meleleo, Cristina; Carlino, Cristiana; Giordani, Alessandro; Perrelli, Fabrizio; Sgricia, Stefano; Ferrante, Maurizio; Franco, Elisabetta

2014-01-01

A new measurement process based upon a well-defined mathematical model was applied to evaluate the quality of human papillomavirus (HPV) vaccination centers in 3 of 12 Local Health Units (ASLs) within the Lazio Region of Italy. The quality aspects considered for evaluation were communicational efficiency, organizational efficiency and comfort. The overall maximum achievable value was 86.10%, while the HPV vaccination quality scores for ASL1, ASL2 and ASL3 were 73.07%, 71.08%, and 67.21%, respectively. With this new approach it is possible to represent the probabilistic reasoning of a stakeholder who evaluates the quality of a healthcare provider. All ASLs had margins for improvements and optimal quality results can be assessed in terms of better performance conditions, confirming the relationship between the resulting quality scores and HPV vaccination coverage. The measurement process was structured into three steps and involved four stakeholder categories: doctors, nurses, parents and vaccinated women. In Step 1, questionnaires were administered to collect different stakeholders' points of view (i.e., subjective data) that were elaborated to obtain the best and worst performance conditions when delivering a healthcare service. Step 2 of the process involved the gathering of performance data during the service delivery (i.e., objective data collection). Step 3 of the process involved the elaboration of all data: subjective data from step 1 are used to define a "standard" to test objective data from step 2. This entire process led to the creation of a set of scorecards. Benchmarking is presented as a result of the probabilistic meaning of the evaluated scores.

Technical Assessment: Integrated Photonics

DTIC Science & Technology

2015-10-01

in global internet protocol traffic as a function of time by local access technology. Photonics continues to play a critical role in enabling this...communication networks. This has enabled services like the internet , high performance computing, and power-efficient large-scale data centers. The...signal processing, quantum information science, and optics for free space applications. However major obstacles challenge the implementation of

The Complete Toolkit for Building High-Performance Work Teams.

ERIC Educational Resources Information Center

Golden, Nancy; Gall, Joyce P.

This workbook is designed for leaders and members of work teams in educational and social-service systems. It presents in a systematic fashion a set of tested facilitation tools that will allow teams to work more efficiently and harmoniously, enabling them to achieve their goals, to deal directly with both personal and work-related issues that…

Energy efficiency in U.S. Forest Service facilities: a multiregion review

Treesearch

Rachelle S. Meyer; David L. Nicholls; Trista M. Patterson; Rachel E. White

2013-01-01

We reviewed energy efficiency measures in facilities across the U.S. Department of Agriculture Forest Service, examining opportunities and obstacles, and identifying factors of project success. The adoption of energy efficiency measures at Forest Service sites was seen to be most likely when decision control was local to the site and when budget timing and structures...

Dental care for the elderly through a Capped-fee funding model: Optimising outcomes for primary government dental services.

PubMed

Conquest, Jennifer H; Skinner, John; Kruger, Estie; Tennant, Marc

2017-12-01

The objectives of this study were to (i) compare a Capped Payment formula for adults, to the fee-for-service model and the New South Wales Government services payment model; (ii) identify the presenting oral health needs of a 65+ years of age cohort during the period January 2011 to March 2015. Australia faces an ageing population with the vast majority accessing free market dental care, whilst the poor access Government services. This cohort retains most of their dentition increasing demand on Government services. The analysis of New South Wales Government adult de-identified patients' record unit data was from 2011 to 2015, for the three payment models and undertaken in three stages; (i) development of the Capped Payment Model; (ii) evaluation of twenty (20) case studies of adults 65+ years of age; (iii) analyse the cost efficiency of the three payment models. This study found that the Government model was the most cost effective. The Capped-fee model performed less efficiently, particularly in the 75+ age group, with the fee-for-service model generally more costly. It was $2580 (85%) more costly for the 65-74 age cohort, and $4619 (66%) for the 75+ age cohort. Policy makers in partnership with Government and private service providers should seek to develop partnerships with Government, private services and universities, scope opportunities in applying a Capped-fee funding model, and one that helps address the oral needs of the elderly. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Modelling impacts of performance on the probability of reproducing, and thereby on productive lifespan, allow prediction of lifetime efficiency in dairy cows.

PubMed

Phuong, H N; Blavy, P; Martin, O; Schmidely, P; Friggens, N C

2016-01-01

Reproductive success is a key component of lifetime efficiency - which is the ratio of energy in milk (MJ) to energy intake (MJ) over the lifespan, of cows. At the animal level, breeding and feeding management can substantially impact milk yield, body condition and energy balance of cows, which are known as major contributors to reproductive failure in dairy cattle. This study extended an existing lifetime performance model to incorporate the impacts that performance changes due to changing breeding and feeding strategies have on the probability of reproducing and thereby on the productive lifespan, and thus allow the prediction of a cow's lifetime efficiency. The model is dynamic and stochastic, with an individual cow being the unit modelled and one day being the unit of time. To evaluate the model, data from a French study including Holstein and Normande cows fed high-concentrate diets and data from a Scottish study including Holstein cows selected for high and average genetic merit for fat plus protein that were fed high- v. low-concentrate diets were used. Generally, the model consistently simulated productive and reproductive performance of various genotypes of cows across feeding systems. In the French data, the model adequately simulated the reproductive performance of Holsteins but significantly under-predicted that of Normande cows. In the Scottish data, conception to first service was comparably simulated, whereas interval traits were slightly under-predicted. Selection for greater milk production impaired the reproductive performance and lifespan but not lifetime efficiency. The definition of lifetime efficiency used in this model did not include associated costs or herd-level effects. Further works should include such economic indicators to allow more accurate simulation of lifetime profitability in different production scenarios.

Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India.

PubMed

Prinja, Shankar; Manchanda, Neha; Aggarwal, Arun Kumar; Kaur, Manmeet; Jeet, Gursimer; Kumar, Rajesh

2013-12-01

Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation. The cost of referral transport per year varied from [symbol: see text] 5.2 million in Narnaul to [symbol: see text] 9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average [symbol: see text] 15.5 per km to [symbol: see text] 9.57 per km. Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances.

Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India

PubMed Central

Prinja, Shankar; Manchanda, Neha; Aggarwal, Arun Kumar; Kaur, Manmeet; Jeet, Gursimer; Kumar, Rajesh

2013-01-01

Background & objectives: Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. Methods: Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation. Results: The cost of referral transport per year varied from ₹5.2 million in Narnaul to ₹9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average ₹ 15.5 per km to ₹ 9.57 per km. Interpretation & conclusions: Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances. PMID:24521648

European Regional Climate Zone Modeling of a Commercial Absorption Heat Pump Hot Water Heater

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

Sharma, Vishaldeep; Shen, Bo; Keinath, Chris

2017-01-01

High efficiency gas-burning hot water heating takes advantage of a condensing heat exchanger to deliver improved combustion efficiency over a standard non-condensing configuration. The water heating is always lower than the gas heating value. In contrast, Gas Absorption Heat Pump (GAHP) hot water heating combines the efficiency of gas burning with the performance increase from a heat pump to offer significant gas energy savings. An ammonia-water system also has the advantage of zero Ozone Depletion Potential and low Global Warming Potential. In comparison with air source electric heat pumps, the absorption system can maintain higher coefficients of performance in coldermore » climates. In this work, a GAHP commercial water heating system was compared to a condensing gas storage system for a range of locations and climate zones across Europe. The thermodynamic performance map of a single effect ammonia-water absorption system was used in a building energy modeling software that could also incorporate the changing ambient air temperature and water mains temperature for a specific location, as well as a full-service restaurant water draw pattern.« less

Evaluation of the Effect of Decision Support on the Efficiency of Primary Care Providers in the Outpatient Practice

PubMed Central

Hankey, Ronald A.; Decker, Lindsay K.; Cha, Stephen S.; Greenes, Robert A.; Liu, Hongfang; Chaudhry, Rajeev

2015-01-01

Background: Clinical decision support (CDS) for primary care has been shown to improve delivery of preventive services. However, there is little evidence for efficiency of physicians due to CDS assistance. In this article, we report a pilot study for measuring the impact of CDS on the time spent by physicians for deciding on preventive services and chronic disease management. Methods: We randomly selected 30 patients from a primary care practice, and assigned them to 10 physicians. The physicians were requested to perform chart review to decide on preventive services and chronic disease management for the assigned patients. The patients assignment was done in a randomized crossover design, such that each patient received 2 sets of recommendations—one from a physician with CDS assistance and the other from a different physician without CDS assistance. We compared the physician recommendations made using CDS assistance, with the recommendations made without CDS assistance. Results: The physicians required an average of 1 minute 44 seconds, when they were they had access to the decision support system and 5 minutes when they were unassisted. Hence the CDS assistance resulted in an estimated saving of 3 minutes 16 seconds (65%) of the physicians’ time, which was statistically significant (P < .0001). There was no statistically significant difference in the number of recommendations. Conclusion: Our findings suggest that CDS assistance significantly reduced the time spent by physicians for deciding on preventive services and chronic disease management. The result needs to be confirmed by performing similar studies at other institutions. PMID:25155103

Cost effectiveness and efficiency in assistive technology service delivery.

PubMed

Warren, C G

1993-01-01

In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

The effectiveness of contracting-out primary health care services in developing countries: a review of the evidence.

PubMed

Liu, Xingzhu; Hotchkiss, David R; Bose, Sujata

2008-01-01

The purpose of this study is to review the research literature on the effectiveness of contracting-out of primary health care services and its impact on both programme and health systems performance in low- and middle-income countries. Due to the heightened interest in improving accountability relationships in the health sector and in rapidly scaling up priority interventions, there is an increasing amount of interest in and experimentation with contracting-out. Overall, while the review of the selected studies suggests that contracting-out has in many cases improved access to services, the effects on other performance dimensions such as equity, quality and efficiency are often unknown. Moreover, little is known about the system-wide effects of contracting-out, which could be either positive or negative. Although the study results leave open the question of how contracting-out can be used as a policy tool to improve overall health system performance, the results indicate that the context in which contracting-out is implemented and the design features of the interventions are likely to greatly influence the chances for success.

The impact of realignment on utilization and cost of community-based mental health services in California.

PubMed

Scheffler, R; Zhang, A; Snowden, L

2001-11-01

Decentralization of California's public mental health system under program realignment has changed the utilization and cost of community-based mental health services. This study examined a sample of 75,951 users, representing 1.5 million adults who visited California's public mental health services during a 6-year period (FY 1988-1990 and FY 1992-1994). Regression analysis was performed to examine cost and utilization reduction over time, across regions, and across psychiatric diagnoses. Overall utilization and cost of community-based mental health services dropped significantly after the implementation of realignment. They were significantly lower for (a) 24-hour services in the urban industrialized Southern Region and (b) outpatient services in the agricultural Central Region of the state. Users diagnosed with mood disorders took a greater portion, but were associated with significantly less treatment and cost than other users in the post-realignment period. When local communities bear the financial risks and rewards, they find more efficient methods of delivering community-based mental health services.

Using Simulation to Examine the Effect of Physician Heterogeneity on the Operational Efficiency of an Overcrowded Hospital Emergency Department

NASA Astrophysics Data System (ADS)

Kuo, Y.-H.; Leung, J. M. Y.; Graham, C. A.

2015-05-01

In this paper, we present a case study of modelling and analyzing the patient flow of a hospital emergency department in Hong Kong. The emergency department is facing the challenge of overcrowding and the patients there usually experience a long waiting time. Our project team was requested by a senior consultant of the emergency department to analyze the patient flow and provide a decision support tool to help improve their operations. We adopt a simulation approach to mimic their daily operations. With the simulation model, we conduct a computational study to examine the effect of physician heterogeneity on the emergency department performance. We found that physician heterogeneity has a great impact on the operational efficiency and thus should be considered when developing simulation models. Our computational results show that, with the same average of service rates among the physicians, variation in the rates can improve overcrowding situation. This suggests that emergency departments may consider having some efficient physicians to speed up the overall service rate in return for more time for patients who need extra medical care.

A Keystone Ant Species Provides Robust Biological Control of the Coffee Berry Borer Under Varying Pest Densities.

PubMed

Morris, Jonathan R; Vandermeer, John; Perfecto, Ivette

2015-01-01

Species' functional traits are an important part of the ecological complexity that determines the provisioning of ecosystem services. In biological pest control, predator response to pest density variation is a dynamic trait that impacts the provision of this service in agroecosystems. When pest populations fluctuate, farmers relying on biocontrol services need to know how natural enemies respond to these changes. Here we test the effect of variation in coffee berry borer (CBB) density on the biocontrol efficiency of a keystone ant species (Azteca sericeasur) in a coffee agroecosystem. We performed exclosure experiments to measure the infestation rate of CBB released on coffee branches in the presence and absence of ants at four different CBB density levels. We measured infestation rate as the number of CBB bored into fruits after 24 hours, quantified biocontrol efficiency (BCE) as the proportion of infesting CBB removed by ants, and estimated functional response from ant attack rates, measured as the difference in CBB infestation between branches. Infestation rates of CBB on branches with ants were significantly lower (71%-82%) than on those without ants across all density levels. Additionally, biocontrol efficiency was generally high and did not significantly vary across pest density treatments. Furthermore, ant attack rates increased linearly with increasing CBB density, suggesting a Type I functional response. These results demonstrate that ants can provide robust biological control of CBB, despite variation in pest density, and that the response of predators to pest density variation is an important factor in the provision of biocontrol services. Considering how natural enemies respond to changes in pest densities will allow for more accurate biocontrol predictions and better-informed management of this ecosystem service in agroecosystems.

A Keystone Ant Species Provides Robust Biological Control of the Coffee Berry Borer Under Varying Pest Densities

PubMed Central

Morris, Jonathan R.; Vandermeer, John; Perfecto, Ivette

2015-01-01

Species’ functional traits are an important part of the ecological complexity that determines the provisioning of ecosystem services. In biological pest control, predator response to pest density variation is a dynamic trait that impacts the provision of this service in agroecosystems. When pest populations fluctuate, farmers relying on biocontrol services need to know how natural enemies respond to these changes. Here we test the effect of variation in coffee berry borer (CBB) density on the biocontrol efficiency of a keystone ant species (Azteca sericeasur) in a coffee agroecosystem. We performed exclosure experiments to measure the infestation rate of CBB released on coffee branches in the presence and absence of ants at four different CBB density levels. We measured infestation rate as the number of CBB bored into fruits after 24 hours, quantified biocontrol efficiency (BCE) as the proportion of infesting CBB removed by ants, and estimated functional response from ant attack rates, measured as the difference in CBB infestation between branches. Infestation rates of CBB on branches with ants were significantly lower (71%-82%) than on those without ants across all density levels. Additionally, biocontrol efficiency was generally high and did not significantly vary across pest density treatments. Furthermore, ant attack rates increased linearly with increasing CBB density, suggesting a Type I functional response. These results demonstrate that ants can provide robust biological control of CBB, despite variation in pest density, and that the response of predators to pest density variation is an important factor in the provision of biocontrol services. Considering how natural enemies respond to changes in pest densities will allow for more accurate biocontrol predictions and better-informed management of this ecosystem service in agroecosystems. PMID:26562676

Assessing administrative costs of mental health and substance abuse services.

PubMed

Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

2004-05-01

Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care.

Towards a mLearning training solution to the adoption of a CPOE system.

PubMed

Pakonstantinou, Despoina; Poulymenopoulou, Mikaela; Malamateniou, Flora; Vassilacopoulos, George

2012-01-01

Computerized Physician Order Entry (CPOE) has been introduced as a solution that can fundamentally change the way healthcare is provided, affecting all types of healthcare stakeholders and improving healthcare decisions, patient outcomes, patient safety and efficiency. However, a relatively small proportion of healthcare organizations have implemented CPOE systems, due to its technological complexity and to its low acceptance rate by healthcare professionals who largely disregard the value of CPOE in efficient healthcare delivery. An online training facility embedded within a CPOE service may increase the likelihood of its adoption by healthcare professionals as it offers them guidelines on how to perform each task of the CPOE service. In contrast to CPOE, on the other hand, handheld devices and other mobile technologies have showed an increased adoption rate. This paper considers a CPOE service that can be accessed by authorized healthcare professionals through their mobile devices anytime anywhere, and allows embedded training content, which has been developed through a learning management system (LMS) to be presented to the user automatically upon request.

An efficient group multicast routing for multimedia communication

NASA Astrophysics Data System (ADS)

Wang, Yanlin; Sun, Yugen; Yan, Xinfang

2004-04-01

Group multicasting is a kind of communication mechanism whereby each member of a group sends messages to all the other members of the same group. Group multicast routing algorithms capable of satisfying quality of service (QoS) requirements of multimedia applications are essential for high-speed networks. We present a heuristic algorithm for group multicast routing with end to end delay constraint. Source-specific routing trees for each member are generated in our algorithm, which satisfy member"s bandwidth and end to end delay requirements. Simulations over random network were carried out to compare proposed algorithm performance with Low and Song"s. The experimental results show that our proposed algorithm performs better in terms of network cost and ability in constructing feasible multicast trees for group members. Moreover, our algorithm achieves good performance in balancing traffic, which can avoid link blocking and enhance the network behavior efficiently.

DoD High Performance Computing Modernization Program Users Group Conference (HPCMP UGC 2011) Held in Portland, Oregon on June 20-23, 2011

DTIC Science & Technology

2011-06-01

4. Conclusion The Web -based AGeS system described in this paper is a computationally-efficient and scalable system for high- throughput genome...method for protecting web services involves making them more resilient to attack using autonomic computing techniques. This paper presents our initial...20–23, 2011 2011 DoD High Performance Computing Modernzation Program Users Group Conference HPCMP UGC 2011 The papers in this book comprise the

Estimating technical efficiency in the hospital sector with panel data: a comparison of parametric and non-parametric techniques.

PubMed

Siciliani, Luigi

2006-01-01

Policy makers are increasingly interested in developing performance indicators that measure hospital efficiency. These indicators may give the purchasers of health services an additional regulatory tool to contain health expenditure. Using panel data, this study compares different parametric (econometric) and non-parametric (linear programming) techniques for the measurement of a hospital's technical efficiency. This comparison was made using a sample of 17 Italian hospitals in the years 1996-9. Highest correlations are found in the efficiency scores between the non-parametric data envelopment analysis under the constant returns to scale assumption (DEA-CRS) and several parametric models. Correlation reduces markedly when using more flexible non-parametric specifications such as data envelopment analysis under the variable returns to scale assumption (DEA-VRS) and the free disposal hull (FDH) model. Correlation also generally reduces when moving from one output to two-output specifications. This analysis suggests that there is scope for developing performance indicators at hospital level using panel data, but it is important that extensive sensitivity analysis is carried out if purchasers wish to make use of these indicators in practice.

Performance evaluation of data center service localization based on virtual resource migration in software defined elastic optical network.

PubMed

Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tan, Yuanlong; Lin, Yi; Han, Jianrui; Lee, Young

2015-09-07

Data center interconnection with elastic optical network is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented cross stratum optimization of optical network and application stratums resources that allows to accommodate data center services. In view of this, this study extends the data center resources to user side to enhance the end-to-end quality of service. We propose a novel data center service localization (DCSL) architecture based on virtual resource migration in software defined elastic data center optical network. A migration evaluation scheme (MES) is introduced for DCSL based on the proposed architecture. The DCSL can enhance the responsiveness to the dynamic end-to-end data center demands, and effectively reduce the blocking probability to globally optimize optical network and application resources. The overall feasibility and efficiency of the proposed architecture are experimentally verified on the control plane of our OpenFlow-based enhanced SDN testbed. The performance of MES scheme under heavy traffic load scenario is also quantitatively evaluated based on DCSL architecture in terms of path blocking probability, provisioning latency and resource utilization, compared with other provisioning scheme.

Performance evaluation of time-aware enhanced software defined networking (TeSDN) for elastic data center optical interconnection.

PubMed

Yang, Hui; Zhang, Jie; Zhao, Yongli; Ji, Yuefeng; Li, Hui; Lin, Yi; Li, Gang; Han, Jianrui; Lee, Young; Ma, Teng

2014-07-28

Data center interconnection with elastic optical networks is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. We previously implemented enhanced software defined networking over elastic optical network for data center application [Opt. Express 21, 26990 (2013)]. On the basis of it, this study extends to consider the time-aware data center service scheduling with elastic service time and service bandwidth according to the various time sensitivity requirements. A novel time-aware enhanced software defined networking (TeSDN) architecture for elastic data center optical interconnection has been proposed in this paper, by introducing a time-aware resources scheduling (TaRS) scheme. The TeSDN can accommodate the data center services with required QoS considering the time dimensionality, and enhance cross stratum optimization of application and elastic optical network stratums resources based on spectrum elasticity, application elasticity and time elasticity. The overall feasibility and efficiency of the proposed architecture is experimentally verified on our OpenFlow-based testbed. The performance of TaRS scheme under heavy traffic load scenario is also quantitatively evaluated based on TeSDN architecture in terms of blocking probability and resource occupation rate.

Semantic enrichment of medical forms - semi-automated coding of ODM-elements via web services.

PubMed

Breil, Bernhard; Watermann, Andreas; Haas, Peter; Dziuballe, Philipp; Dugas, Martin

2012-01-01

Semantic interoperability is an unsolved problem which occurs while working with medical forms from different information systems or institutions. Standards like ODM or CDA assure structural homogenization but in order to compare elements from different data models it is necessary to use semantic concepts and codes on an item level of those structures. We developed and implemented a web-based tool which enables a domain expert to perform semi-automated coding of ODM-files. For each item it is possible to inquire web services which result in unique concept codes without leaving the context of the document. Although it was not feasible to perform a totally automated coding we have implemented a dialog based method to perform an efficient coding of all data elements in the context of the whole document. The proportion of codable items was comparable to results from previous studies.

A Gateway for Phylogenetic Analysis Powered by Grid Computing Featuring GARLI 2.0

PubMed Central

Bazinet, Adam L.; Zwickl, Derrick J.; Cummings, Michael P.

2014-01-01

We introduce molecularevolution.org, a publicly available gateway for high-throughput, maximum-likelihood phylogenetic analysis powered by grid computing. The gateway features a garli 2.0 web service that enables a user to quickly and easily submit thousands of maximum likelihood tree searches or bootstrap searches that are executed in parallel on distributed computing resources. The garli web service allows one to easily specify partitioned substitution models using a graphical interface, and it performs sophisticated post-processing of phylogenetic results. Although the garli web service has been used by the research community for over three years, here we formally announce the availability of the service, describe its capabilities, highlight new features and recent improvements, and provide details about how the grid system efficiently delivers high-quality phylogenetic results. [garli, gateway, grid computing, maximum likelihood, molecular evolution portal, phylogenetics, web service.] PMID:24789072

Managing the NHS market.

PubMed Central

Ham, C.; Maynard, A.

1994-01-01

The purpose of the present NHS reforms is to introduce a managed market; developing some of the incentives for greater efficiency that are often found in markets while still being able to regulate proceedings to prevent market failures. If government intervenes too much there will be no incentive to improve efficiency and streamline operations: too little intervention may result in some areas having inadequate health service cover or monopoly powers abusing their position. Effective management of the NHS market requires eight core elements: openness of information, control of labour and capital markets, regulation of mergers and takeovers, arbitrating in disputes, protection of unprofitable functions such as research and development, overseeing national provision of health services, protection of basic principles of the NHS, and handling of closures and redundancy. Management of the market would best be performed by the NHS management executive and health authority purchasers acting within a framework set by politicians. Images p846-a p847-a PMID:8167496

[Nursing motivation leadership].

PubMed

Chen, Ia-Ling; Hung, Chich-Hsiu

2007-02-01

The concept of "patients treated as guests" is emphasized in today's medical service and patient-center nursing care. However, with rapid changes in health insurance and hospital accreditation systems as well as increasing consumer awareness, the nurse manager must both efficiently relieve the working pressure of nurses and motivate them. However, it would be an extreme challenge for nurse managers to build a team in which each member works in a self-fulfilling work environment and achieves a high quality of care. This article presents several theories and techniques that relate to motivation strategies. These strategies can serve as a guide and a reference for nurse managers to inspire teamwork and raise morale. It can be expected that increasing nurse satisfaction, performance, and care quality will decrease turnover and desertion rates. Hopefully, this article will assist nurse managers to become better leaders and to achieve success in providing efficient services and good of nursing care quality.

Investigations of complaints and quality of health care.

PubMed

Henderson, R F; North, N; Patterson, G

2005-02-01

Malpractice law is frequently justified by the claim that it improves health care services but this belief remains untested. Using a multiple case study in 16 remote rural areas in New Zealand, this study examined the effects of formal quasi-judicial investigations on the quality of health care services. The study found that the fragile local health systems were damaged by the quasi-judicial investigations of the medical disciplinary body and became less efficient and less user-friendly. A few doctors left rural practice and were difficult to replace. The remaining health workers responded to the investigations in a negative manner, losing confidence, enthusiasm and motivation for work; they performed in a less efficient manner, working more slowly, setting up barriers to access, ordering more tests and referring more to secondary care. Complainants also appeared to have been disadvantaged as a consequence of having complained.

An Efficient Conflict Detection Algorithm for Packet Filters

NASA Astrophysics Data System (ADS)

Lee, Chun-Liang; Lin, Guan-Yu; Chen, Yaw-Chung

Packet classification is essential for supporting advanced network services such as firewalls, quality-of-service (QoS), virtual private networks (VPN), and policy-based routing. The rules that routers use to classify packets are called packet filters. If two or more filters overlap, a conflict occurs and leads to ambiguity in packet classification. This study proposes an algorithm that can efficiently detect and resolve filter conflicts using tuple based search. The time complexity of the proposed algorithm is O(nW+s), and the space complexity is O(nW), where n is the number of filters, W is the number of bits in a header field, and s is the number of conflicts. This study uses the synthetic filter databases generated by ClassBench to evaluate the proposed algorithm. Simulation results show that the proposed algorithm can achieve better performance than existing conflict detection algorithms both in time and space, particularly for databases with large numbers of conflicts.

Performance and Challenges of Service-Oriented Architecture for Wireless Sensor Networks.

PubMed

Alshinina, Remah; Elleithy, Khaled

2017-03-08

Wireless Sensor Networks (WSNs) have become essential components for a variety of environmental, surveillance, military, traffic control, and healthcare applications. These applications face critical challenges such as communication, security, power consumption, data aggregation, heterogeneities of sensor hardware, and Quality of Service (QoS) issues. Service-Oriented Architecture (SOA) is a software architecture that can be integrated with WSN applications to address those challenges. The SOA middleware bridges the gap between the high-level requirements of different applications and the hardware constraints of WSNs. This survey explores state-of-the-art approaches based on SOA and Service-Oriented Middleware (SOM) architecture that provide solutions for WSN challenges. The categories of this paper are based on approaches of SOA with and without middleware for WSNs. Additionally, features of SOA and middleware architectures for WSNs are compared to achieve more robust and efficient network performance. Design issues of SOA middleware for WSNs and its characteristics are also highlighted. The paper concludes with future research directions in SOM architecture to meet all requirements of emerging application of WSNs.

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed Central

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-01-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific. PMID:21729919

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-07-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific.

Performance and Challenges of Service-Oriented Architecture for Wireless Sensor Networks

PubMed Central

Alshinina, Remah; Elleithy, Khaled

2017-01-01

Wireless Sensor Networks (WSNs) have become essential components for a variety of environmental, surveillance, military, traffic control, and healthcare applications. These applications face critical challenges such as communication, security, power consumption, data aggregation, heterogeneities of sensor hardware, and Quality of Service (QoS) issues. Service-Oriented Architecture (SOA) is a software architecture that can be integrated with WSN applications to address those challenges. The SOA middleware bridges the gap between the high-level requirements of different applications and the hardware constraints of WSNs. This survey explores state-of-the-art approaches based on SOA and Service-Oriented Middleware (SOM) architecture that provide solutions for WSN challenges. The categories of this paper are based on approaches of SOA with and without middleware for WSNs. Additionally, features of SOA and middleware architectures for WSNs are compared to achieve more robust and efficient network performance. Design issues of SOA middleware for WSNs and its characteristics are also highlighted. The paper concludes with future research directions in SOM architecture to meet all requirements of emerging application of WSNs. PMID:28282896

Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape.

PubMed

Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline

2015-01-01

With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers need to work closely with the compensation and rehabilitation sector as well as governments to establish robust evidence of the benefits and costs of payment models, from the perspectives of clients/consumers, funders, service providers and rehabilitation professionals.

Energy efficiency public service advertising campaign

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

Gibson-Grant, Amanda

The Advertising Council (“the Ad Council”) and The United States Department of Energy (DOE) created and launched a national public service advertising campaign designed to promote energy efficiency. The objective of the Energy Efficiency campaign was to redefine how consumers approach energy efficiency by showing that saving energy can save homeowners money.

Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis

PubMed Central

2011-01-01

Background Providing health care services in Africa is hampered by severe scarcity of personnel, medical supplies and financial funds. Consequently, managers of health care institutions are called to measure and improve the efficiency of their facilities in order to provide the best possible services with their resources. However, very little is known about the efficiency of health care facilities in Africa and instruments of performance measurement are hardly applied in this context. Objective This study determines the relative efficiency of primary care facilities in Nouna, a rural health district in Burkina Faso. Furthermore, it analyses the factors influencing the efficiency of these institutions. Methodology We apply a two-stage Data Envelopment Analysis (DEA) based on data from a comprehensive provider and household information system. In the first stage, the relative efficiency of each institution is calculated by a traditional DEA model. In the second stage, we identify the reasons for being inefficient by regression technique. Results The DEA projections suggest that inefficiency is mainly a result of poor utilization of health care facilities as they were either too big or the demand was too low. Regression results showed that distance is an important factor influencing the efficiency of a health care institution Conclusions Compared to the findings of existing one-stage DEA analyses of health facilities in Africa, the share of relatively efficient units is slightly higher. The difference might be explained by a rather homogenous structure of the primary care facilities in the Burkina Faso sample. The study also indicates that improving the accessibility of primary care facilities will have a major impact on the efficiency of these institutions. Thus, health decision-makers are called to overcome the demand-side barriers in accessing health care. PMID:22828358

The productivity and cost-efficiency of models for involving nurse practitioners in primary care: a perspective from queueing analysis.

PubMed

Liu, Nan; D'Aunno, Thomas

2012-04-01

To develop simple stylized models for evaluating the productivity and cost-efficiencies of different practice models to involve nurse practitioners (NPs) in primary care, and in particular to generate insights on what affects the performance of these models and how. The productivity of a practice model is defined as the maximum number of patients that can be accounted for by the model under a given timeliness-to-care requirement; cost-efficiency is measured by the corresponding annual cost per patient in that model. Appropriate queueing analysis is conducted to generate formulas and values for these two performance measures. Model parameters for the analysis are extracted from the previous literature and survey reports. Sensitivity analysis is conducted to investigate the model performance under different scenarios and to verify the robustness of findings. Employing an NP, whose salary is usually lower than a primary care physician, may not be cost-efficient, in particular when the NP's capacity is underutilized. Besides provider service rates, workload allocation among providers is one of the most important determinants for the cost-efficiency of a practice model involving NPs. Capacity pooling among providers could be a helpful strategy to improve efficiency in care delivery. The productivity and cost-efficiency of a practice model depend heavily on how providers organize their work and a variety of other factors related to the practice environment. Queueing theory provides useful tools to take into account these factors in making strategic decisions on staffing and panel size selection for a practice model. © Health Research and Educational Trust.

Managed care, vertical integration strategies and hospital performance.

PubMed

Wang, B B; Wan, T T; Clement, J; Begun, J

2001-09-01

The purpose of this study is to examine the association of managed care with hospital vertical integration strategies, as well as to observe the relationships of different types of vertical integration with hospital efficiency and financial performance. The sample consists of 363 California short-term acute care hospitals in 1994. Linear structure equation modeling is used to test six hypotheses derived from the strategic adaptation model. Several organizational and market factors are controlled statistically. Results suggest that managed care is a driving force for hospital vertical integration. In terms of performance, hospitals that are integrated with physician groups and provide outpatient services (backward integration) have better operating margins, returns on assets, and net cash flows (p < 0.01). These hospitals are not, however, likely to show greater productivity. Forward integration with a long-term-care facility, on the other hand, is positively and significantly related to hospital productivity (p < 0.001). Forward integration is negatively related to financial performance (p < 0.05), however, opposite to the direction hypothesized. Health executives should be responsive to the growth of managed care in their local market and should probably consider providing more backward integrated services rather than forward integrated services in order to improve the hospital's financial performance in today's competitive health care market.

Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency.

PubMed

Roberts, Harry W; Myerscough, James; Borsci, Simone; Ni, Melody; O'Brart, David P S

2017-11-24

To provide a quantitative assessment of cataract theatre lists focusing on productivity and staffing levels/tasks using time and motion studies. National Health Service (NHS) cataract theatre lists were prospectively observed in five different institutions (four NHS hospitals and one private hospital). Individual tasks and their timings of every member of staff were recorded. Multiple linear regression analyses were performed to investigate possible associations between individual timings and tasks. 140 operations were studied over 18 theatre sessions. The median number of scheduled cataract operations was 7 (range: 5-14). The average duration of an operation was 10.3 min±(SD 4.11 min). The average time to complete one case including patient turnaround was 19.97 min (SD 8.77 min). The proportion of the surgeons' time occupied on total duties or operating ranged from 65.2% to 76.1% and from 42.4% to 56.7%, respectively. The correlations of the surgical time to patient time in theatre was R 2 =0.95. A multiple linear regression model found a significant association (F(3,111)=32.86, P<0.001) with R 2 =0.47 between the duration of one operation and the number of allied healthcare professionals (AHPs), the number of AHP key tasks and the time taken to perform these key tasks by the AHPs. Significant variability in the number of cases performed and the efficiency of patient flow were found between different institutions. Time and motion studies identified requirements for high-volume models and factors relating to performance. Supporting the surgeon with sufficient AHPs and tasks performed by AHPs could improve surgical efficiency up to approximately double productivity over conventional theatre models. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Performance evaluation of multi-stratum resources integrated resilience for software defined inter-data center interconnect.

PubMed

Yang, Hui; Zhang, Jie; Zhao, Yongli; Ji, Yuefeng; Wu, Jialin; Lin, Yi; Han, Jianrui; Lee, Young

2015-05-18

Inter-data center interconnect with IP over elastic optical network (EON) is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented multi-stratum resources integration among IP networks, optical networks and application stratums resources that allows to accommodate data center services. In view of this, this study extends to consider the service resilience in case of edge optical node failure. We propose a novel multi-stratum resources integrated resilience (MSRIR) architecture for the services in software defined inter-data center interconnect based on IP over EON. A global resources integrated resilience (GRIR) algorithm is introduced based on the proposed architecture. The MSRIR can enable cross stratum optimization and provide resilience using the multiple stratums resources, and enhance the data center service resilience responsiveness to the dynamic end-to-end service demands. The overall feasibility and efficiency of the proposed architecture is experimentally verified on the control plane of our OpenFlow-based enhanced SDN (eSDN) testbed. The performance of GRIR algorithm under heavy traffic load scenario is also quantitatively evaluated based on MSRIR architecture in terms of path blocking probability, resilience latency and resource utilization, compared with other resilience algorithms.

Radiation Hardened, Modulator ASIC for High Data Rate Communications

NASA Technical Reports Server (NTRS)

McCallister, Ron; Putnam, Robert; Andro, Monty; Fujikawa, Gene

2000-01-01

Satellite-based telecommunication services are challenged by the need to generate down-link power levels adequate to support high quality (BER approx. equals 10(exp 12)) links required for modem broadband data services. Bandwidth-efficient Nyquist signaling, using low values of excess bandwidth (alpha), can exhibit large peak-to-average-power ratio (PAPR) values. High PAPR values necessitate high-power amplifier (HPA) backoff greater than the PAPR, resulting in unacceptably low HPA efficiency. Given the high cost of on-board prime power, this inefficiency represents both an economical burden, and a constraint on the rates and quality of data services supportable from satellite platforms. Constant-envelope signals offer improved power-efficiency, but only by imposing a severe bandwidth-efficiency penalty. This paper describes a radiation- hardened modulator which can improve satellite-based broadband data services by combining the bandwidth-efficiency of low-alpha Nyquist signals with high power-efficiency (negligible HPA backoff).

Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples.

PubMed

Bailie, Ross; Si, Damin; Shannon, Cindy; Semmens, James; Rowley, Kevin; Scrimgeour, David J; Nagel, Tricia; Anderson, Ian; Connors, Christine; Weeramanthri, Tarun; Thompson, Sandra; McDermott, Robyn; Burke, Hugh; Moore, Elizabeth; Leon, Dallas; Weston, Richard; Grogan, Haylene; Stanley, Andrew; Gardner, Karen

2010-05-19

Strengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE) project has facilitated the implementation of modern Continuous Quality Improvement (CQI) approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1) explore the factors associated with variation in clinical performance; 2) examine specific strategies that have been effective in improving primary care clinical performance; and 3) work with health service staff, management and policy makers to enhance the effective implementation of successful strategies. The study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria) over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management. By linking researchers directly to users of research (service providers, managers and policy makers), the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary health care and fostering effective and efficient exchange and use of data and information among service providers and policy makers to achieve evidence-based resource allocation, service planning, system development, and improvements of service delivery and Indigenous health outcomes.

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

PubMed

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

2010-11-01

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

The Use of Proxy Caches for File Access in a Multi-Tier Grid Environment

NASA Astrophysics Data System (ADS)

Brun, R.; Duellmann, D.; Ganis, G.; Hanushevsky, A.; Janyst, L.; Peters, A. J.; Rademakers, F.; Sindrilaru, E.

2011-12-01

The use of proxy caches has been extensively studied in the HEP environment for efficient access of database data and showed significant performance with only very moderate operational effort at higher grid tiers (T2, T3). In this contribution we propose to apply the same concept to the area of file access and analyse the possible performance gains, operational impact on site services and applicability to different HEP use cases. Base on a proof-of-concept studies with a modified XROOT proxy server we review the cache efficiency and overheads for access patterns of typical ROOT based analysis programs. We conclude with a discussion of the potential role of this new component at the different tiers of a distributed computing grid.

The Use of Proxy Caches for File Access in a Multi-Tier Grid Environment

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

Brun, R.; Dullmann, D.; Ganis, G.

2012-04-19

The use of proxy caches has been extensively studied in the HEP environment for efficient access of database data and showed significant performance with only very moderate operational effort at higher grid tiers (T2, T3). In this contribution we propose to apply the same concept to the area of file access and analyze the possible performance gains, operational impact on site services and applicability to different HEP use cases. Base on a proof-of-concept studies with a modified XROOT proxy server we review the cache efficiency and overheads for access patterns of typical ROOT based analysis programs. We conclude with amore » discussion of the potential role of this new component at the different tiers of a distributed computing grid.« less

A satellite mobile communication system based on Band-Limited Quasi-Synchronous Code Division Multiple Access (BLQS-CDMA)

NASA Technical Reports Server (NTRS)

Degaudenzi, R.; Elia, C.; Viola, R.

1990-01-01

Discussed here is a new approach to code division multiple access applied to a mobile system for voice (and data) services based on Band Limited Quasi Synchronous Code Division Multiple Access (BLQS-CDMA). The system requires users to be chip synchronized to reduce the contribution of self-interference and to make use of voice activation in order to increase the satellite power efficiency. In order to achieve spectral efficiency, Nyquist chip pulse shaping is used with no detection performance impairment. The synchronization problems are solved in the forward link by distributing a master code, whereas carrier forced activation and closed loop control techniques have been adopted in the return link. System performance sensitivity to nonlinear amplification and timing/frequency synchronization errors are analyzed.

Impact of technological innovation on a nursing home performance and on the medication-use process safety.

PubMed

Baril, Chantal; Gascon, Viviane; Brouillette, Christel

2014-03-01

Despite the fact that since 1985 the government of Québec increased by 5.75 % on average the amount of money spent on healthcare per year, little improvement was noted. It is obvious that an optimal use of resources is essential to reduce waiting times and provide safer and faster services to patients. The use of new technology can contribute to improve the healthcare system efficiency. Our study aims to assess the impact of a medication distribution technology on 1) the performance of a health and social services center's pharmacy, 2) the performance of one care unit in a nursing home and on 3) the medication-use process safety. To measure performance we were inspired by the Lean approach. The results show that medication distribution technology is considered as an effective way to significantly detect medication errors, to allow nurses to focus more on patients and pharmacy to react more rapidly to changes in patient medications.

Perm State University HPC-hardware and software services: capabilities for aircraft engine aeroacoustics problems solving

NASA Astrophysics Data System (ADS)

Demenev, A. G.

2018-02-01

The present work is devoted to analyze high-performance computing (HPC) infrastructure capabilities for aircraft engine aeroacoustics problems solving at Perm State University. We explore here the ability to develop new computational aeroacoustics methods/solvers for computer-aided engineering (CAE) systems to handle complicated industrial problems of engine noise prediction. Leading aircraft engine engineering company, including “UEC-Aviadvigatel” JSC (our industrial partners in Perm, Russia), require that methods/solvers to optimize geometry of aircraft engine for fan noise reduction. We analysed Perm State University HPC-hardware resources and software services to use efficiently. The performed results demonstrate that Perm State University HPC-infrastructure are mature enough to face out industrial-like problems of development CAE-system with HPC-method and CFD-solvers.

Pay-for-performance in orthopedics: how we got here and where we are going.

PubMed

Goldman, Ashton H; Kates, Stephen

2017-06-01

Recent health laws have shifted from the traditional fee-for-service model toward a pay-for-performance model. In this changing climate, it is imperative that a provider understands these changes and recognizes the importance of health services research on medicine. Increasing the value of care by improving quality and decreasing cost has been the focus of several projects. Preventing complications may be an effective way to increase value. Patient risk stratification is a modifiable variable that will allow for improved patient selection. This in turn may reduce adverse events, thereby lessening the economic burden of complications, increased length of stay, and hospital readmission. Providers must partner with their hospitals to align their goals and maximize quality and efficiency in order to decrease costs.

Strategies for the quality assessment of the health care service providers in the treatment of Gastric Cancer in Colombia.

PubMed

Villamil, María Del Pilar; Barrera, David; Velasco, Nubia; Bernal, Oscar; Fajardo, Esteban; Urango, Carlos; Buitrago, Sebastian

2017-09-15

While, at its inception in 1993, the health care system in Colombia was publicized as a paradigm to be copied across the developing world, numerous problems in its implementation have led to, what is now, an inefficient and crisis-ridden health system. Furthermore, as a result of inappropriate tools to measure the quality of the health service providers, several corruption scandals have arisen in the country. This study attempts to tackle this situation by proposing a strategy for the quality assessment of the health service providers (Entidades Promotoras de Salud, EPS) in the Colombian health system. In particular, as a case study, the quality of the treatment of stomach cancer is analyzed. The study uses two complementary techniques to address the problem. These techniques are applied based on data of the treatment of gastric cancer collected on a nation-wide scale by the Colombian Ministry of Health and Welfare. First, Data Envelopment Analysis (DEA) and the Malmquist Index (MI) are used to establish the most efficient EPS's within the system, according to indicators such as opportunity indicators. Second, sequential clustering algorithm, related to process mining a field of data mining, is used to determine the medical history of all patients and to construct typical care pathways of the patients belonging to efficient and inefficient EPS's. Lastly, efforts are made to identify traits and differences between efficient and inefficient EPS's. Efficient and inefficient EPS were identified for the years 2010 and 2011. Additionally, a Malmquist Index was used to calculate the relative changes in the efficiency of the health providers. Using these efficiency rates, the typical treatment path of patients with gastric cancer was found for two EPSs: one efficient and another inefficient. Finally, the typical traits of the care pathways were established. Combining DEA and process mining proved to be a powerful approach understanding the problem and gaining valuable insight into the inner workings of the Colombian Health System, especially in terms of the treatment process performed by health care providers in critical illnesses such as cancer. However, no sufficiently compelling results were found to establish the contribution of such a combination to evaluate the quality in the delivery of health services.

Simple-Minded Accountability Measures Create Failing Schools in Disadvantaged Contexts: A Case Study of a Swedish Junior High School

ERIC Educational Resources Information Center

Allodi, Mara Westling

2013-01-01

The principles of new public management -- market mechanisms, accountability and standards -- have been applied in the education system. These methods are supposed to increase efficiency, but there is also a risk of negative consequences from the services provided if the measures of performance target a reduced range of goals, ignore relevant…

Comparisons of Online Recruitment Strategies for Convenience Samples: Craigslist, Google AdWords, Facebook, and Amazon Mechanical Turk

ERIC Educational Resources Information Center

Antoun, Christopher; Zhang, Chan; Conrad, Frederick G.; Schober, Michael F.

2016-01-01

The rise of social media websites (e.g., Facebook) and online services such as Google AdWords and Amazon Mechanical Turk (MTurk) offers new opportunities for researchers to recruit study participants. Although researchers have started to use these emerging methods, little is known about how they perform in terms of cost efficiency and, more…

Supply-chain management: exceeding the customer's expectations.

PubMed

Ramsay, B

2000-10-01

Driven by increasing competition, manufacturers are desperate to cut costs and are looking for increased efficiency and customer service from their supply chains. E-commerce offers a new model of supply and demand, but many companies do not have the processes in place to support this new model. By implementing the techniques discussed here they can achieve substantial improvements in performance.

Good veterinary governance: definition, measurement and challenges.

PubMed

Msellati, L; Commault, J; Dehove, A

2012-08-01

Good veterinary governance assumes the provision of veterinary services that are sustainably financed, universally available, and provided efficiently without waste or duplication, in a manner that is transparent and free of fraud or corruption. Good veterinary governance is a necessary condition for sustainable economic development insomuch as it promotes the effective delivery of services and improves the overall performance of animal health systems. This article defines governance in Veterinary Services and proposes a framework for its measurement. It also discusses the role of Veterinary Services and analyses the governance dimensions of the performance-assessment tools developed by the World Organisation for Animal Health (OIE). These tools (OIE PVS Tool and PVS Gap Analysis) track the performance of Veterinary Services across countries (a harmonised tool) and over time (the PVS Pathway). The article shows the usefulness of the OIE PVS Tool for measuring governance, but also points to two shortcomings, namely (i) the lack of clear outcome indicators, which is an impediment to a comprehensive assessment of the performance of Veterinary Services, and (ii) the lack of specific measures for assessing the extent of corruption within Veterinary Services and the extent to which demand for better governance is being strengthened within the animal health system. A discussion follows on the drivers of corruption and instruments for perception-based assessments of country governance and corruption. Similarly, the article introduces the concept of social accountability, which is an approach to enhancing government transparency and accountability, and shows how supply-side and demand-side mechanisms complement each other in improving the governance of service delivery. It further elaborates on two instruments--citizen report card surveys and grievance redress mechanisms--because of their wider relevance and their possible applications in many settings, including Veterinary Services. Also, central to improving transparency and accountability is access to information and a discussion on the appropriate level of decentralisation of Veterinary Services. Bringing Veterinary Services into compliance with OIE international standards would contribute to improving governance and providing economic benefits through increased animal productivity, the expansion of trade and improved food security. It would also help to increase public health benefits, through greater food safety and better prevention and control of zoonoses.

Ethical issues in hospital clients' satisfaction: a Brazilian perspective.

PubMed

Rocha, Elyrose S B; Ventura, Carla A A; de Godoy, Simone; Mendes, Isabel A C; Trevizan, Maria A

2015-03-01

Health institutions can be considered as complex organizations because they need to be prepared to receive and satisfy patients. This clientele differs from other organizations because the use of hospital services is not a matter of choice. Another motive for this difference is that, most often, the patients do not determine what services and products they will use during their stay. Although they are the clients, usually, health professionals decide which service or product they will consume. Hence, nursing care delivery based on competence, efficiency and ethics represents a challenge. This critical reflection is meant to draw attention to the relevance of the ethical aspects of nurses' actions involving patients' satisfaction with nursing care. This paper highlights the responsibility of nurses to develop ethical actions in their commitment to manage and provide care with quality, commitment and efficiency. Possibilities of actions needed emerged from this discussion, such as the provision of reliable and updated information to clients, respect for standards, routines of care, exams and others, as well as clients' education, in order to further their involvement and participation in decisions concerning the care planned for them. The adoption of this paradigm entails a change in the performance of nurses' management and care roles, which may have to observe attitudes previously disregarded in most services provided. © The Author(s) 2014.

A multi-service data management platform for scientific oceanographic products

NASA Astrophysics Data System (ADS)

D'Anca, Alessandro; Conte, Laura; Nassisi, Paola; Palazzo, Cosimo; Lecci, Rita; Cretì, Sergio; Mancini, Marco; Nuzzo, Alessandra; Mirto, Maria; Mannarini, Gianandrea; Coppini, Giovanni; Fiore, Sandro; Aloisio, Giovanni

2017-02-01

An efficient, secure and interoperable data platform solution has been developed in the TESSA project to provide fast navigation and access to the data stored in the data archive, as well as a standard-based metadata management support. The platform mainly targets scientific users and the situational sea awareness high-level services such as the decision support systems (DSS). These datasets are accessible through the following three main components: the Data Access Service (DAS), the Metadata Service and the Complex Data Analysis Module (CDAM). The DAS allows access to data stored in the archive by providing interfaces for different protocols and services for downloading, variables selection, data subsetting or map generation. Metadata Service is the heart of the information system of the TESSA products and completes the overall infrastructure for data and metadata management. This component enables data search and discovery and addresses interoperability by exploiting widely adopted standards for geospatial data. Finally, the CDAM represents the back-end of the TESSA DSS by performing on-demand complex data analysis tasks.

De-optical-line-terminal hybrid access-aggregation optical network for time-sensitive services based on software-defined networking orchestration

NASA Astrophysics Data System (ADS)

Bai, Wei; Yang, Hui; Xiao, Hongyun; Yu, Ao; He, Linkuan; Zhang, Jie; Li, Zhen; Du, Yi

2017-11-01

With the increase in varieties of services in network, time-sensitive services (TSSs) appear and bring forward an impending need for delay performance. Ultralow-latency communication has become one of the important development goals for many scenarios in the coming 5G era (e.g., robotics and driverless cars). However, the conventional methods, which decrease delay by promoting the available resources and the network transmission speed, have limited effect; a new breakthrough for ultralow-latency communication is necessary. We propose a de-optical-line-terminal (De-OLT) hybrid access-aggregation optical network (DAON) for TSS based on software-defined networking (SDN) orchestration. In this network, low-latency all-optical communication based on optical burst switching can be achieved by removing OLT. For supporting this network and guaranteeing the quality of service for TSSs, we design SDN-driven control method and service provision method. Numerical results demonstrate the proposed DAON promotes network service efficiency and avoids traffic congestion.

Internal and external environmental factors affecting the performance of hospital-based home nursing care.

PubMed

Noh, J-W; Kwon, Y-D; Yoon, S-J; Hwang, J-I

2011-06-01

Numerous studies on HNC services have been carried out by signifying their needs, efficiency and effectiveness. However, no study has ever been performed to determine the critical factors associated with HNC's positive results despite the deluge of positive studies on the service. This study included all of the 89 training hospitals that were practising HNC service in Korea as of November 2006. The input factors affecting the performance were classified as either internal or external environmental factors. This analysis was conducted to understand the impact that the corresponding factors had on performance. Data were analysed by using multiple linear regressions. The internal and external environment variables affected the performance of HNC based on univariate analysis. The meaningful variables were internal environmental factors. Specifically, managerial resource (the number of operating beds and the outpatient/inpatient ratio) were meaningful when the multiple linear regression analysis was performed. Indeed, the importance of organizational culture (the passion of HNC nurses) was significant. This study, considering the limited market size of Korea, illustrates that the critical factor for the development of hospital-led HNC lies with internal environmental factors rather than external ones. Among the internal environmental factors, the hospitals' managerial resource-related factors (specifically, the passion of nurses) were the most important contributing element. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

SCM: A method to improve network service layout efficiency with network evolution.

PubMed

Zhao, Qi; Zhang, Chuanhao; Zhao, Zheng

2017-01-01

Network services are an important component of the Internet, which are used to expand network functions for third-party developers. Network function virtualization (NFV) can improve the speed and flexibility of network service deployment. However, with the evolution of the network, network service layout may become inefficient. Regarding this problem, this paper proposes a service chain migration (SCM) method with the framework of "software defined network + network function virtualization" (SDN+NFV), which migrates service chains to adapt to network evolution and improves the efficiency of the network service layout. SCM is modeled as an integer linear programming problem and resolved via particle swarm optimization. An SCM prototype system is designed based on an SDN controller. Experiments demonstrate that SCM could reduce the network traffic cost and energy consumption efficiently.

Advanced Concept Studies for Supersonic Commercial Transports Entering Service in the 2018 to 2020 Period

NASA Technical Reports Server (NTRS)

Morgenstern, John; Norstrud, Nicole; Sokhey, Jack; Martens, Steve; Alonso, Juan J.

2013-01-01

Lockheed Martin Aeronautics Company (LM), working in conjunction with General Electric Global Research (GE GR), Rolls-Royce Liberty Works (RRLW), and Stanford University, herein presents results from the "N+2 Supersonic Validations" contract s initial 22 month phase, addressing the NASA solicitation "Advanced Concept Studies for Supersonic Commercial Transports Entering Service in the 2018 to 2020 Period." This report version adds documentation of an additional three month low boom test task. The key technical objective of this effort was to validate integrated airframe and propulsion technologies and design methodologies. These capabilities aspired to produce a viable supersonic vehicle design with environmental and performance characteristics. Supersonic testing of both airframe and propulsion technologies (including LM3: 97-023 low boom testing and April-June nozzle acoustic testing) verified LM s supersonic low-boom design methodologies and both GE and RRLW's nozzle technologies for future implementation. The N+2 program is aligned with NASA s Supersonic Project and is focused on providing system-level solutions capable of overcoming the environmental and performance/efficiency barriers to practical supersonic flight. NASA proposed "Initial Environmental Targets and Performance Goals for Future Supersonic Civil Aircraft". The LM N+2 studies are built upon LM s prior N+3 100 passenger design studies. The LM N+2 program addresses low boom design and methodology validations with wind tunnel testing, performance and efficiency goals with system level analysis, and low noise validations with two nozzle (GE and RRLW) acoustic tests.

Strategic groups, performance, and strategic response in the nursing home industry.

PubMed Central

Zinn, J S; Aaronson, W E; Rosko, M D

1994-01-01

OBJECTIVE. This study examines the effect of strategic group membership on nursing home performance and strategic behavior. DATA SOURCES AND STUDY SETTING. Data from the 1987 Medicare and Medicaid Automated Certification Survey were combined with data from the 1987 and 1989 Pennsylvania Long Term Care Facility Questionnaire. The sample consisted of 383 Pennsylvania nursing homes. STUDY DESIGN. Cluster analysis was used to place the 383 nursing homes into strategic groups on the basis of variables measuring scope and resource deployment. Performance was measured by indicators of the quality of nursing home care (rates of pressure ulcers, catheterization, and restraint usage) and efficiency in services provision. Changes in Medicare participation after passage of the 1988 Medicare Catastrophic Coverage Act (MCCA) measured strategic behavior. MANOVA and Turkey HSD post hoc means tests determined if significant differences were associated with strategic group membership. FINDINGS. Cluster analysis produced an optimal seven-group solution. Differences in group means were significant for the clustering, performance, and conduct variables (p < .0001). Strategic groups characterized by facilities providing a continuum of care services had the best patient care outcomes. The most efficient groups were characterized by facilities with high Medicare census. While all strategic groups increased Medicare census following passage of the MCCA, those dominated by for-profits had the greatest increases. CONCLUSIONS. Our analysis demonstrates that strategic orientation influences nursing home response to regulatory initiatives, a factor that should be recognized in policy formation directed at nursing home reform. PMID:8005789

Product policy - the main component of the marketing mix in the Romanian health services.

PubMed

Coculescu, B I; Purcarea, V L; Coculescu, E C

2016-01-01

The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions.

Product policy - the main component of the marketing mix in the Romanian health services

PubMed Central

Coculescu, BI; Purcarea, VL; Coculescu, EC

2016-01-01

The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions. PMID:27974913

The role of non-financial performance measures in predicting hospital financial performance: the case of for-profit system hospitals.

PubMed

Vélez-González, Heltie; Pradhan, Rohit; Weech-Maldonado, Robert

2011-01-01

Non-financial measures have found increasing acceptance in the business world--however, their application in the health care industry remains limited. The purpose of this article is to understand the influence of non-financial measures (efficiency, productivity, and quality) on the financial performance of for-profit system hospitals. The sample consists of 499 for-profit system hospitals in the United States from 1999 to 2002. Data analyzed include the American Hospital Association's Annual Survey, Medicare Cost Reports, Joint Commission's quality scores, and the Centers for Medicare & Medicaid Services' Hospital Case Mix Index. Dependent variables consist of financial measures (operating and total margins), while independent variables include measures of efficiency, productivity, and quality. Our results suggest the influence of non-financial performance measures on financial performance; occupancy rate positively influences financial performance while greater labor intensity may have negative implications for financial performance. In addition, we show that quality positively influences financial performance thereby offering a potential business case for quality. This result has important managerial and policy implications as it may incentivize capital and human resource investments required to improve hospital quality of care.

A novel test method to determine the filter material service life of decentralized systems treating runoff from traffic areas.

PubMed

Huber, Maximilian; Welker, Antje; Dierschke, Martina; Drewes, Jörg E; Helmreich, Brigitte

2016-09-01

In recent years, there has been a significant increase in the development and application of technical decentralized filter systems for the treatment of runoff from traffic areas. However, there are still many uncertainties regarding the service life and the performance of filter materials that are employed in decentralized treatment systems. These filter media are designed to prevent the transport of pollutants into the environment. A novel pilot-scale test method was developed to determine - within a few days - the service lives and long-term removal efficiencies for dissolved heavy metals in stormwater treatment systems. The proposed method consists of several steps including preloading the filter media in a pilot-scale model with copper and zinc by a load of n-1 years of the estimated service life (n). Subsequently, three representative rain events are simulated to evaluate the long-term performance by dissolved copper and zinc during the last year of application. The presented results, which verified the applicability of this method, were obtained for three filter channel systems and six filter shaft systems. The performance of the evaluated systems varied largely for both tested heavy metals and during all three simulated rain events. A validation of the pilot-scale assessment method with field measurements was also performed for two systems. Findings of this study suggest that this novel method does provide a standardized and accurate estimation of service intervals of decentralized treatment systems employing various filter materials. The method also provides regulatory authorities, designers, and operators with an objective basis for performance assessment and supports stormwater managers to make decisions for the installation of such decentralized treatment systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Straw man trade between multi-junction, gallium arsenide, and silicon solar cells

NASA Technical Reports Server (NTRS)

Gaddy, Edward M.

1995-01-01

Multi-junction (MJ), gallium arsenide (GaAs), and silicon (Si) solar cells have respective test efficiencies of approximately 24%, 18.5% and 14.8%. Multi-junction and gallium arsenide solar cells weigh more than silicon solar cells and cost approximately five times as much per unit power at the cell level. A straw man trade is performed for the TRMM spacecraft to determine which of these cell types would have offered an overall performance and price advantage to the spacecraft. A straw man trade is also performed for the multi-junction cells under the assumption that they will cost over ten times that of silicon cells at the cell level. The trade shows that the TRMM project, less the cost of the instrument, ground systems and mission operations, would spend approximately $552 thousand dollars per kilogram to launch and service science in the case of the spacecraft equipped with silicon solar cells. If these cells are changed out for gallium arsenide solar cells, an additional 31 kilograms of science can be launched and serviced at a price of approximately $90 thousand per kilogram. The weight reduction is shown to derive from the smaller area of the array and hence reductions in the weight of the array substrate and supporting structure. If the silicon solar cells are changed out for multi-junction solar cells, an additional 45 kilograms of science above the silicon base line can be launched and serviced at a price of approximately $58 thousand per kilogram. The trade shows that even if the multi-junction arrays are priced over ten times that of silicon cells, a price that is much higher than projected, that the additional 45 kilograms of science are launched and serviced at $182 thousand per kilogram. This is still much less than original $552 thousand per kilogram to launch and service the science. Data and qualitative factors are presented to show that these figures are subject to a great deal of uncertainty. Nonetheless, the benefit of the higher efficiency solar cells for TRMM is far greater than the uncertainties in the analysis.

Rebound Effects in the Context of Developing Country Efficiency

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

de la Rue du Can, Stephane; McNeil, Michael A.; Leventis, Greg

Energy efficiency-related “rebound effects” usually refer to the tendency of most consumers to increase their use of energy services in response to efficiency measures that have reduced their energy costs. This phenomenon is one reason why energy efficiency policies often result in lower energy savings than engineering-based estimates predict. Rebound effects have been the subject of intense debate in the field of energy efficiency policy for many years.1 In the past, the focus of this debate has been on the perceived loss of the expected energy savings and related benefits resulting from the rebound effects. However, more recently, there hasmore » been a growing recognition that policymakers need to consider the health, economic and other non-energy benefits that often result from the increase in energy services represented by user “rebound effects”. This is especially true in developing countries where basic energy service demands—such as lighting, heating, cooling, and refrigeration of food—are often not being met. As economic conditions improve and household incomes increase, demand for increased energy services (such as space conditioning and appliances) tends to rise rapidly. Improving energy efficiency reduces the amount of energy needed to produce one unit of energy service output (for example an hour of cooling at 21°C delivered for X vs Y kWh). Greater efficiency therefore often enables more rapid increased in energy services (and sometimes access), expanding the amount of services that can be provided by a fixed amount (or cost) of energy.« less

Medical Care Provided Under California's Workers' Compensation Program: Effects of the Reforms and Additional Opportunities to Improve the Quality and Efficiency of Care.

PubMed

Wynn, Barbara O; Timbie, Justin W; Sorbero, Melony E

2011-01-01

Since 2004, significant changes have been made to the California workers' compensation (WC) system. The Commission on Health and Safety and Workers' Compensation (CHSWC) asked the RAND Corporation to examine the impact that these changes have on the medical care provided to injured workers. This study synthesizes findings from interviews and available information regarding the implementation of the changes affecting WC medical care and identifies areas in which additional changes might increase the quality and efficiency of care delivered under the WC system. To improve incentives for efficiently providing medically appropriate care, California should revise its fee schedule allowances for services provided by hospitals to inpatients, freestanding ambulatory surgery centers, and physicians, create nonmonetary incentives for providing medically appropriate care in the medical provider network (MPN) context through more-selective contracting with providers and reducing medical review requirements for high-performing physicians; reduce incentives for inappropriate prescribing practices by curtailing in-office physician dispensing; and implement pharmacy benefit network regulations. To increase accountability for performance, California should revise the MPN certification process to place accountability for meeting MPN standards on the entity contracting with the physician network; strengthen Division of Workers' Compensation (DWC) authorities to provide intermediate sanctions for failure to comply with MPN requirements; and modify the Labor Code to remove payers and MPNs from the definition of individually identifiable data so that performance on key measures can be publicly available. To facilitate monitoring and oversight, California should provide DWC with more flexibility to add needed data elements to medical data reporting and provide penalties for a claim administrator failing to comply with the data-reporting requirements; require that medical cost-containment expenses be reported by category of cost; compile information on the types of medical services that are subject to UR denials and expedited hearings; and expand ongoing monitoring of system performance. Finally, to increase administrative efficiency, California should use an external medical review organization to review medical-necessity determinations, and it should explore best practices of other WC programs and health programs in carrying out medical cost-containment activities.

Nursing home performance under case-mix reimbursement: responding to heavy-care incentives and market changes.

PubMed Central

Davis, M A; Freeman, J W; Kirby, E C

1998-01-01

OBJECTIVE: To examine the effect of case mix-adjusted reimbursement policy and market factors on nursing home performance. DATA SOURCES AND STUDY SETTING: Data from Medicaid certification inspection surveys, Medicaid cost reports, and the Kentucky State Center for Health Statistics for the years 1989 and 1991, to examine changes in nursing home performance stemming from the adoption of case mix-adjusted reimbursement in 1990. STUDY DESIGN: In addition to cross-sectional regressions, a first-difference approach to fixed-effects regression analyses was employed to control for facility differences that were essentially fixed during the survey years and to estimate the effects of time-varying predictors on changes in facility expenditures, efficiency, and profitability. PRINCIPAL FINDINGS: Facilities that increased the proportion of Medicaid residents and eliminated excess capacity experienced higher profitability gains during the beginning phase of case-mix reimbursement. Having a heavy-care resident population was positively related to expenditures prior to reimbursement reform, and it was negatively related to expenditures after the case-mix reimbursement policy was introduced. While facility-level changes in case mix had no reliable influence on costs or profits, nursing homes showing an increased prevalence of poor-quality nursing practices exhibited increases in efficiency and profitability. At the market level, reductions in excess or empty nursing home beds were accompanied by a significant growth in home health services. Moreover, nursing homes located in markets with expanding home health services exhibited higher increases in costs per case-mix unit. CONCLUSIONS: Characteristics of the reimbursement system appear to reward a cost minimization orientation with potentially detrimental effects on quality of care. These effects, exacerbated by a supply-constrained market, may be mitigated by policies that encourage the expansion of home health service availability. PMID:9776938

Nursing home performance under case-mix reimbursement: responding to heavy-care incentives and market changes.

PubMed

Davis, M A; Freeman, J W; Kirby, E C

1998-10-01

To examine the effect of case mix-adjusted reimbursement policy and market factors on nursing home performance. Data from Medicaid certification inspection surveys, Medicaid cost reports, and the Kentucky State Center for Health Statistics for the years 1989 and 1991, to examine changes in nursing home performance stemming from the adoption of case mix-adjusted reimbursement in 1990. In addition to cross-sectional regressions, a first-difference approach to fixed-effects regression analyses was employed to control for facility differences that were essentially fixed during the survey years and to estimate the effects of time-varying predictors on changes in facility expenditures, efficiency, and profitability. Facilities that increased the proportion of Medicaid residents and eliminated excess capacity experienced higher profitability gains during the beginning phase of case-mix reimbursement. Having a heavy-care resident population was positively related to expenditures prior to reimbursement reform, and it was negatively related to expenditures after the case-mix reimbursement policy was introduced. While facility-level changes in case mix had no reliable influence on costs or profits, nursing homes showing an increased prevalence of poor-quality nursing practices exhibited increases in efficiency and profitability. At the market level, reductions in excess or empty nursing home beds were accompanied by a significant growth in home health services. Moreover, nursing homes located in markets with expanding home health services exhibited higher increases in costs per case-mix unit. Characteristics of the reimbursement system appear to reward a cost minimization orientation with potentially detrimental effects on quality of care. These effects, exacerbated by a supply-constrained market, may be mitigated by policies that encourage the expansion of home health service availability.

A Framework for Adaptable Operating and Runtime Systems

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

Sterling, Thomas

The emergence of new classes of HPC systems where performance improvement is enabled by Moore’s Law for technology is manifest through multi-core-based architectures including specialized GPU structures. Operating systems were originally designed for control of uniprocessor systems. By the 1980s multiprogramming, virtual memory, and network interconnection were integral services incorporated as part of most modern computers. HPC operating systems were primarily derivatives of the Unix model with Linux dominating the Top-500 list. The use of Linux for commodity clusters was first pioneered by the NASA Beowulf Project. However, the rapid increase in number of cores to achieve performance gain throughmore » technology advances has exposed the limitations of POSIX general-purpose operating systems in scaling and efficiency. This project was undertaken through the leadership of Sandia National Laboratories and in partnership of the University of New Mexico to investigate the alternative of composable lightweight kernels on scalable HPC architectures to achieve superior performance for a wide range of applications. The use of composable operating systems is intended to provide a minimalist set of services specifically required by a given application to preclude overheads and operational uncertainties (“OS noise”) that have been demonstrated to degrade efficiency and operational consistency. This project was undertaken as an exploration to investigate possible strategies and methods for composable lightweight kernel operating systems towards support for extreme scale systems.« less

Opportunities and Efficiencies in Building a New Service Desk Model.

PubMed

Mayo, Alexa; Brown, Everly; Harris, Ryan

2017-01-01

In July 2015, the Health Sciences and Human Services Library (HS/HSL) at the University of Maryland, Baltimore (UMB), merged its reference and circulation services, creating the Information Services Department and Information Services Desk. Designing the Information Services Desk with a team approach allowed for the re-examination of the HS/HSL's service model from the ground up. With the creation of a single service point, the HS/HSL was able to create efficiencies, improve the user experience by eliminating handoffs, create a collaborative team environment, and engage information services staff in a variety of new projects.

Weighted bi-prediction for light field image coding

NASA Astrophysics Data System (ADS)

Conti, Caroline; Nunes, Paulo; Ducla Soares, Luís.

2017-09-01

Light field imaging based on a single-tier camera equipped with a microlens array - also known as integral, holoscopic, and plenoptic imaging - has currently risen up as a practical and prospective approach for future visual applications and services. However, successfully deploying actual light field imaging applications and services will require developing adequate coding solutions to efficiently handle the massive amount of data involved in these systems. In this context, self-similarity compensated prediction is a non-local spatial prediction scheme based on block matching that has been shown to achieve high efficiency for light field image coding based on the High Efficiency Video Coding (HEVC) standard. As previously shown by the authors, this is possible by simply averaging two predictor blocks that are jointly estimated from a causal search window in the current frame itself, referred to as self-similarity bi-prediction. However, theoretical analyses for motion compensated bi-prediction have suggested that it is still possible to achieve further rate-distortion performance improvements by adaptively estimating the weighting coefficients of the two predictor blocks. Therefore, this paper presents a comprehensive study of the rate-distortion performance for HEVC-based light field image coding when using different sets of weighting coefficients for self-similarity bi-prediction. Experimental results demonstrate that it is possible to extend the previous theoretical conclusions to light field image coding and show that the proposed adaptive weighting coefficient selection leads to up to 5 % of bit savings compared to the previous self-similarity bi-prediction scheme.

The number of service per conception of Indonesian Friesian Holstein with artificial insemination in Selo, Boyolali, Central Java, Indonesia

NASA Astrophysics Data System (ADS)

Wicaksono, A. M.; Pramono, A.; Susilowati, A.; Sutarno; Widyas, N.; Prastowo, S.

2018-03-01

Boyolali is an area in Central Java Indonesia, it has large number of Indonesian Friesian Holstein (IFH; dairy cattle). To improve its population as well as genetic quality of milk production, artificial insemination (AI) is widely applied as mating program. The success of AI can be evaluated from the number of service per conception (S/C), represent a number of service using AI to achieve one pregnancy. Its mirroring mating management and reproductive efficiency in dairy cattle, estimated in herd during specific time and location. For that, this study aims to estimate S/C in Selo, Boyolali during October 2016 to January 2017. Data were gathered with 95% confidence level. Sample size were 367 IFH, visited and selected purposively based on criteria one-time partus, 3 y.o and have complete AI record. Animal data were collected in reproduction and mating management. In addition, 124 dairy farmer who have minimum 5 years experiences in rearing IFH cow were interviewed as respondent in estrus detection, followed with 2 skilled inseminators for AI performing time data. Result shows that S/C is 1.71, this mean one pregnancy need 1.71 times AI services. In the estrus detection, most of dairy farmers were able to observe estrus sign in vulva color, size and the present of mucus by visual. Moreover, AI was performed in 9 to 12 hours after the sign of estrus observed. It is concluded that AI of IFH in Selo, Boyolali has been successfully applied, however there are still rooms to improve the reproduction efficiency through mating management in regard to lower S/C.

Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries.

PubMed

Sun, Daxin; Ahn, Haksoon; Lievens, Tomas; Zeng, Wu

2017-01-01

In an effort to improve health service delivery and achieve better health outcomes, the World Health Organization (WHO) has called for improved efficiency of health care systems to better use the available funding. This study aims to examine the efficiency of national health systems using longitudinal country-level data. Data on health spending per capita, infant mortality rate (IMR), under 5 mortality rate (U5MR), and life expectancy (LE) were collected from or imputed for 173 countries from 2004 through 2011. Data envelopment analyses were used to evaluate the efficiency and regression models were constructed to examine the determinants of efficiency. The average efficiency of the national health system, when examined yearly, was 78.9%, indicating a potential saving of 21.1% of health spending per capita to achieve the same level of health status for children and the entire population, if all countries performed as well as their peers. Additionally, the efficiency of the national health system varied widely among countries. On average, Africa had the lowest efficiency of 67%, while West Pacific countries had the highest efficiency of 86%. National economic status, HIV/AIDS prevalence, health financing mechanisms and governance were found to be statistically associated with the efficiency of national health systems. Taking health financing as an example, a 1% point increase of social security expenses as a percentage of total health expenditure correlated to a 1.9% increase in national health system efficiency. The study underscores the need to enhance efficiency of national health systems to meet population health needs, and highlights the importance of health financing and governance in improving the efficiency of health systems, to ultimately improve health outcomes.

Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation

PubMed Central

2012-01-01

Purpose A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a “real-lifeâ application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. Key messages (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. Conclusion (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care. PMID:22506504

Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation.

PubMed

Turner-Stokes, Lynne; Poppleton, Rob; Williams, Heather; Schoewenaars, Katie; Badwan, Derar

2012-01-01

A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a "real-life" application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care.

QoS support for end users of I/O-intensive applications using shared storage systems

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

Davis, Marion Kei; Zhang, Xuechen; Jiang, Song

2011-01-19

I/O-intensive applications are becoming increasingly common on today's high-performance computing systems. While performance of compute-bound applications can be effectively guaranteed with techniques such as space sharing or QoS-aware process scheduling, it remains a challenge to meet QoS requirements for end users of I/O-intensive applications using shared storage systems because it is difficult to differentiate I/O services for different applications with individual quality requirements. Furthermore, it is difficult for end users to accurately specify performance goals to the storage system using I/O-related metrics such as request latency or throughput. As access patterns, request rates, and the system workload change in time,more » a fixed I/O performance goal, such as bounds on throughput or latency, can be expensive to achieve and may not lead to a meaningful performance guarantees such as bounded program execution time. We propose a scheme supporting end-users QoS goals, specified in terms of program execution time, in shared storage environments. We automatically translate the users performance goals into instantaneous I/O throughput bounds using a machine learning technique, and use dynamically determined service time windows to efficiently meet the throughput bounds. We have implemented this scheme in the PVFS2 parallel file system and have conducted an extensive evaluation. Our results show that this scheme can satisfy realistic end-user QoS requirements by making highly efficient use of the I/O resources. The scheme seeks to balance programs attainment of QoS requirements, and saves as much of the remaining I/O capacity as possible for best-effort programs.« less

Efficiency in mental health practice and research.

PubMed

Lagomasino, Isabel T; Zatzick, Douglas F; Chambers, David A

2010-01-01

Limited financial resources, escalating mental health-related costs and opportunities for capitalizing on advances in health information technologies have brought the theme of efficiency to the forefront of mental health services research and clinical practice. In this introductory article to the journal series stemming from the 20th NIMH Mental Health Services Research Conference, we first delineate the need for a new focus on efficiency in both research and clinical practice. Second, we provide preliminary definitions of efficiency for the field and discuss issues related to measurement. Finally, we explore the interface between efficiency in mental health services research and practice and the NIMH strategic objectives of developing improved interventions for diverse populations and enhancing the public health impact of research. Case examples illustrate how perspectives from dissemination and implementation research may be used to maximize efficiencies in the development and implementation of new service delivery models. Allowing findings from the dissemination and implementation field to permeate and inform clinical practice and research may facilitate more efficient development of interventions and enhance the public health impact of research. Copyright © 2010 Elsevier Inc. All rights reserved.

[Evaluating the efficiency of basic public health service project in Beijing rural areas based on data envelopment analysis].

PubMed

Zhang, Gui-lin; Pan, Xi-long

2013-04-18

To measure the efficiency changes of basic public health service in Beijing rural areas and to provide some suggestions for the basic public health service project throughout China. In the study, stratified random samples from 32 township health centers (THCs) were measured by data envelopment analysis (DEA) model with the panel data from 2007 to 2009. (1) The average total efficiency score of samples was 0.972. The TE non-efficient THCs were with excess in all input indicators and insufficient outputs in technology management, health promotion and chronic disease management. (2) The total factor productivity (TFP) from 2007 to 2008 increased 8.8%, which was attributed to technology change. The TFP decreased by 6.6% from 2008 to 2009, but the technical efficiency increased by 3.3%. There is room for improvemrnt in the basic public health service project in Beijing rural areas. Scale efficiency should be improved and the common development of technical efficiency and technology progress promoted in order to increase the project outputs.

SCM: A method to improve network service layout efficiency with network evolution

PubMed Central

Zhao, Qi; Zhang, Chuanhao

2017-01-01

Network services are an important component of the Internet, which are used to expand network functions for third-party developers. Network function virtualization (NFV) can improve the speed and flexibility of network service deployment. However, with the evolution of the network, network service layout may become inefficient. Regarding this problem, this paper proposes a service chain migration (SCM) method with the framework of “software defined network + network function virtualization” (SDN+NFV), which migrates service chains to adapt to network evolution and improves the efficiency of the network service layout. SCM is modeled as an integer linear programming problem and resolved via particle swarm optimization. An SCM prototype system is designed based on an SDN controller. Experiments demonstrate that SCM could reduce the network traffic cost and energy consumption efficiently. PMID:29267299

The Productivity and Cost-Efficiency of Models for Involving Nurse Practitioners in Primary Care: A Perspective from Queueing Analysis

PubMed Central

Liu, Nan; D'Aunno, Thomas

2012-01-01

Objective To develop simple stylized models for evaluating the productivity and cost-efficiencies of different practice models to involve nurse practitioners (NPs) in primary care, and in particular to generate insights on what affects the performance of these models and how. Data Sources and Study Design The productivity of a practice model is defined as the maximum number of patients that can be accounted for by the model under a given timeliness-to-care requirement; cost-efficiency is measured by the corresponding annual cost per patient in that model. Appropriate queueing analysis is conducted to generate formulas and values for these two performance measures. Model parameters for the analysis are extracted from the previous literature and survey reports. Sensitivity analysis is conducted to investigate the model performance under different scenarios and to verify the robustness of findings. Principal Findings Employing an NP, whose salary is usually lower than a primary care physician, may not be cost-efficient, in particular when the NP's capacity is underutilized. Besides provider service rates, workload allocation among providers is one of the most important determinants for the cost-efficiency of a practice model involving NPs. Capacity pooling among providers could be a helpful strategy to improve efficiency in care delivery. Conclusions The productivity and cost-efficiency of a practice model depend heavily on how providers organize their work and a variety of other factors related to the practice environment. Queueing theory provides useful tools to take into account these factors in making strategic decisions on staffing and panel size selection for a practice model. PMID:22092009

Data envelopment analysis for estimating efficiency of intensive care units: a case study in Iran.

PubMed

Bahrami, Mohammad Amin; Rafiei, Sima; Abedi, Mahdieh; Askari, Roohollah

2018-05-14

Purpose As hospitals are the most costly service providers in every healthcare systems, special attention should be given to their performance in terms of resource allocation and consumption. The purpose of this paper is to evaluate technical, allocative and economic efficiency in intensive care units (ICUs) of hospitals affiliated by Yazd University of Medical Sciences (YUMS) in 2015. Design/methodology/approach This was a descriptive, analytical study conducted in ICUs of seven training hospitals affiliated by YUMS using data envelopment analysis (DEA) in 2015. The number of physicians, nurses, active beds and equipment were regarded as input variables and bed occupancy rate, the number of discharged patients, economic information such as bed price and physicians' fees were mentioned as output variables of the study. Available data from study variables were retrospectively gathered and analyzed through the Deap 2.1 software using the variable returns to scale methodology. Findings The study findings revealed the average scores of allocative, economic, technical, managerial and scale efficiency to be relatively 0.956, 0.866, 0.883, 0.89 and 0.913. Regarding to latter three types of efficiency, five hospitals had desirable performance. Practical implications Given that additional costs due to an extra number of manpower or unnecessary capital resources impose economic pressure on hospitals also the fact that reduction of surplus production plays a major role in reducing such expenditures in hospitals, it is suggested that departments with low efficiency reduce their input surpluses to achieve the optimal level of performance. Originality/value The authors applied a DEA approach to measure allocative, economic, technical, managerial and scale efficiency of under-study hospitals. This is a helpful linear programming method which acts as a powerful and understandable approach for comparative performance assessment in healthcare settings and a guidance for healthcare managers to improve their departments' performance.

Veterans Justice Outreach Program: VA Could Improve Management by Establishing Performance Measures and Fully Assessing Risks

DTIC Science & Technology

2016-04-01

Assessing Risks Report to Congressional Requesters April 2016 GAO-16-393 United States Government Accountability Office United States...Government Accountability Office Highlights of GAO-16-393, a report to congressional requesters April 2016 VETERANS JUSTICE OUTREACH PROGRAM...quality, timeliness, efficiency, cost of service, and outcome. GAO, Tax Administration: IRS Needs to Further Refine Its Tax Filing Season

An Analysis of Prime Vendor Support for the AH64 Apache.

DTIC Science & Technology

1998-06-05

efficiently manage repair parts. Circular h-16 The Congressional Budget Office has been studying public and private roles in maintaining military equipment...7. 5Ibid. Congressional Budget Office, Public and Private Roles in Maintaining Military Equipment at the Depot Level (Washington...performed exclusively by military personnel who are subject to deployment in a combat, combat support, or combat service support role are included in

48 CFR 970.2307 - Contracting for Environmentally Preferable and Energy-Efficient Products and Services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Safety and Drug-Free Work Place 970.2307 Contracting for Environmentally Preferable and Energy-Efficient... Environmentally Preferable and Energy-Efficient Products and Services. 970.2307 Section 970.2307 Federal Acquisition Regulations System DEPARTMENT OF ENERGY AGENCY SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND...

Linking functional and relational service quality to customer satisfaction and loyalty: differences between men and women.

PubMed

Sánchez-Hernández, Rosa M; Martínez-Tur, Vicente; Peiró, José M; Moliner, Carolina

2010-04-01

This study assessed differences between men and women in the association of perceptions of service quality with customer evaluations. Functional (efficiency with which the service is delivered) and relational (customers' emotional benefits, beyond the core performance, related to the social interaction of customers with employees) dimensions of service quality were measured as well as customer satisfaction and loyalty. The sample of 277 customers (191 men, 86 women), surveyed in 29 Mexican hotels, had a mean age of 38.1 yr. (SD=9.7) for men and 34.5 yr. (SD=11.0) for women. To be eligible for survey, customers had to have spent at least one night in the hotel in question. Analysis indicated that the women and men differed in the association of functional and relational dimensions of service quality with their satisfaction and loyalty. Functional service quality was higher for the men than the women, while relational service quality showed greater predictive power for women than for men, although these accounted for only 4% of the customers' satisfaction variance and 6% of the loyalty variance.

Highly efficient light management for perovskite solar cells

PubMed Central

Wang, Dong-Lin; Cui, Hui-Juan; Hou, Guo-Jiao; Zhu, Zhen-Gang; Yan, Qing-Bo; Su, Gang

2016-01-01

Organic-inorganic halide perovskite solar cells have enormous potential to impact the existing photovoltaic industry. As realizing a higher conversion efficiency of the solar cell is still the most crucial task, a great number of schemes were proposed to minimize the carrier loss by optimizing the electrical properties of the perovskite solar cells. Here, we focus on another significant aspect that is to minimize the light loss by optimizing the light management to gain a high efficiency for perovskite solar cells. In our scheme, the slotted and inverted prism structured SiO2 layers are adopted to trap more light into the solar cells, and a better transparent conducting oxide layer is employed to reduce the parasitic absorption. For such an implementation, the efficiency and the serviceable angle of the perovskite solar cell can be promoted impressively. This proposal would shed new light on developing the high-performance perovskite solar cells. PMID:26733112

Highly efficient light management for perovskite solar cells

NASA Astrophysics Data System (ADS)

Wang, Dong-Lin; Cui, Hui-Juan; Hou, Guo-Jiao; Zhu, Zhen-Gang; Yan, Qing-Bo; Su, Gang

2016-01-01

Organic-inorganic halide perovskite solar cells have enormous potential to impact the existing photovoltaic industry. As realizing a higher conversion efficiency of the solar cell is still the most crucial task, a great number of schemes were proposed to minimize the carrier loss by optimizing the electrical properties of the perovskite solar cells. Here, we focus on another significant aspect that is to minimize the light loss by optimizing the light management to gain a high efficiency for perovskite solar cells. In our scheme, the slotted and inverted prism structured SiO2 layers are adopted to trap more light into the solar cells, and a better transparent conducting oxide layer is employed to reduce the parasitic absorption. For such an implementation, the efficiency and the serviceable angle of the perovskite solar cell can be promoted impressively. This proposal would shed new light on developing the high-performance perovskite solar cells.

Highly efficient light management for perovskite solar cells.

PubMed

Wang, Dong-Lin; Cui, Hui-Juan; Hou, Guo-Jiao; Zhu, Zhen-Gang; Yan, Qing-Bo; Su, Gang

2016-01-06

Organic-inorganic halide perovskite solar cells have enormous potential to impact the existing photovoltaic industry. As realizing a higher conversion efficiency of the solar cell is still the most crucial task, a great number of schemes were proposed to minimize the carrier loss by optimizing the electrical properties of the perovskite solar cells. Here, we focus on another significant aspect that is to minimize the light loss by optimizing the light management to gain a high efficiency for perovskite solar cells. In our scheme, the slotted and inverted prism structured SiO2 layers are adopted to trap more light into the solar cells, and a better transparent conducting oxide layer is employed to reduce the parasitic absorption. For such an implementation, the efficiency and the serviceable angle of the perovskite solar cell can be promoted impressively. This proposal would shed new light on developing the high-performance perovskite solar cells.

Fingerstroke time estimates for touchscreen-based mobile gaming interaction.

PubMed

Lee, Ahreum; Song, Kiburm; Ryu, Hokyoung Blake; Kim, Jieun; Kwon, Gyuhyun

2015-12-01

The growing popularity of gaming applications and ever-faster mobile carrier networks have called attention to an intriguing issue that is closely related to command input performance. A challenging mirroring game service, which simultaneously provides game service to both PC and mobile phone users, allows them to play games against each other with very different control interfaces. Thus, for efficient mobile game design, it is essential to apply a new predictive model for measuring how potential touch input compares to the PC interfaces. The present study empirically tests the keystroke-level model (KLM) for predicting the time performance of basic interaction controls on the touch-sensitive smartphone interface (i.e., tapping, pointing, dragging, and flicking). A modified KLM, tentatively called the fingerstroke-level model (FLM), is proposed using time estimates on regression models. Copyright © 2015 Elsevier B.V. All rights reserved.

Robotic disaster recovery efforts with ad-hoc deployable cloud computing

NASA Astrophysics Data System (ADS)

Straub, Jeremy; Marsh, Ronald; Mohammad, Atif F.

2013-06-01

Autonomous operations of search and rescue (SaR) robots is an ill posed problem, which is complexified by the dynamic disaster recovery environment. In a typical SaR response scenario, responder robots will require different levels of processing capabilities during various parts of the response effort and will need to utilize multiple algorithms. Placing these capabilities onboard the robot is a mediocre solution that precludes algorithm specific performance optimization and results in mediocre performance. Architecture for an ad-hoc, deployable cloud environment suitable for use in a disaster response scenario is presented. Under this model, each service provider is optimized for the task and maintains a database of situation-relevant information. This service-oriented architecture (SOA 3.0) compliant framework also serves as an example of the efficient use of SOA 3.0 in an actual cloud application.

Healthcare seeking behaviour among Chinese elderly.

PubMed

Lu, Hui; Wang, Wei; Xu, Ling; Li, Zhenhong; Ding, Yan; Zhang, Jian; Yan, Fei

2017-04-18

Purpose The Chinese population is rapidly ageing before they are rich. The purpose of this paper is to describe healthcare seeking behaviour and the critical factors associated with healthcare seeking behaviour. Design/methodology/approach Using a purposive sampling method, the authors recruited 44 adults aged 60 years or older from three provinces, representing the developed (Shanghai), undeveloped (Ningxia) regions and the regions in between (Hubei). From July to September 2008, using a semi-structured guide, the authors interviewed participants in focus group discussions. Findings The healthcare needs for chronic and catastrophic diseases were high; however, the healthcare demands were low and healthcare utilizations were even lower owing to the limited accessibility to healthcare services, particularly, in underdeveloped rural areas. "Too expensive to see a doctor" was a prime complaint, explaining substantial discrepancies between healthcare needs, demands and use. Care seeking behaviour varied depending on insurance availability, perceived performance, particularly hospital services, and prescription medications. Participants consistently rated increasing healthcare accessibility as a high priority, including offering financial aid, and improving service convenience. Improving social security fairness was the first on the elderly's wish list. Originality/value Healthcare demand and use were lower than needs, and were influenced by multiple factors, primarily, service affordability and efficiency, perceived performance and hospital service quality.

Data federation strategies for ATLAS using XRootD

NASA Astrophysics Data System (ADS)

Gardner, Robert; Campana, Simone; Duckeck, Guenter; Elmsheuser, Johannes; Hanushevsky, Andrew; Hönig, Friedrich G.; Iven, Jan; Legger, Federica; Vukotic, Ilija; Yang, Wei; Atlas Collaboration

2014-06-01

In the past year the ATLAS Collaboration accelerated its program to federate data storage resources using an architecture based on XRootD with its attendant redirection and storage integration services. The main goal of the federation is an improvement in the data access experience for the end user while allowing more efficient and intelligent use of computing resources. Along with these advances come integration with existing ATLAS production services (PanDA and its pilot services) and data management services (DQ2, and in the next generation, Rucio). Functional testing of the federation has been integrated into the standard ATLAS and WLCG monitoring frameworks and a dedicated set of tools provides high granularity information on its current and historical usage. We use a federation topology designed to search from the site's local storage outward to its region and to globally distributed storage resources. We describe programmatic testing of various federation access modes including direct access over the wide area network and staging of remote data files to local disk. To support job-brokering decisions, a time-dependent cost-of-data-access matrix is made taking into account network performance and key site performance factors. The system's response to production-scale physics analysis workloads, either from individual end-users or ATLAS analysis services, is discussed.

Evaluation on the efficiencies of county-level Centers for Disease Control and Prevention in China: results from a national survey.

PubMed

Li, Chengyue; Sun, Mei; Shen, Jay J; Cochran, Christopher R; Li, Xiaojiao; Hao, Mo

2016-09-01

The Chinese government has greatly increased funding for disease control and prevention since the 2003 Severe Acute Respiration Syndrome crisis, but it is also concerned whether these increased resources have been used efficiently to improve public health services. We aimed to assess the efficiency of county-level Centers for Disease Control and Prevention (CDCs) of China and to identify strategies for optimising their performance. A total of 446 county-level CDCs were selected based on systematic sampling throughout China. The data envelopment analysis framework was used to calculate the efficiency score of sampled CDCs in 2010. The Charnes, Cooper and Rhodes (CCR) model was applied to calculate the overall and scale efficiency, and the Banker, Charnes and Cooper (BCC) model was used to assess technical efficiency. Models included three inputs and seven outputs. A projection analysis was conducted to identify the difference between projection value and actual value for inputs and outputs. The average overall efficiency score of CDCs was 0.317, and the average technical efficiency score was 0.442 and 88.3% with decreasing returns to scale. Projection analysis indicated that all seven categories of outputs were underproduced. CDCs in the eastern region tended to perform better than CDCs in the middle and the western region. Most county-level CDCs in China were operated inefficiently. Emphasis should be put on increasing staff and general operating expenses through current governmental funding, upgrading healthcare providers' competencies and enhancing the standardisation of operational management, so that CDCs could utilise their resources more efficiently. © 2016 John Wiley & Sons Ltd.

Hospital competition and inpatient services efficiency in Taiwan: a longitudinal study.

PubMed

Chu, Chiao-Lee; Chiang, Tung-Liang; Chang, Ray-E

2011-10-01

There is no consistent evidence of the relationship between market competition and hospital efficiency. Some studies indicated that more competition led to a faster patient turnover rate, higher hospital costs, and lower hospital efficiency. Since the 1980s some studies found market competition could increase the efficiency of inpatient services. However, there were few studies testing the market competition during a hospital's earlier stages on its efficiency during later stages, or the dynamic of efficiency. In this study, we examined the effect of early-stage market competition on later-stage hospital efficiency in Taiwan, and we determine the efficiency change using longitudinal study design. The data for the analysis came from the annual national hospital survey of 1996 and 2001 provided by the Department of Health. There were 102 teaching hospital be analysed. The results show that no evidence supports the proposition that higher market competition would improve the efficiency of hospitals in delivering inpatient services in Taiwan. Importantly, neither was the inefficiency score nor the Malmquist productivity index of inpatient services associated with the level of hospital market competition, regardless of the adjustment for hospital characteristics. However, the results may be related with the hospital increasing beds investment behavior. Copyright © 2010 John Wiley & Sons, Ltd.

Evaluation of the Demand Response Performance of Electric Water Heaters

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

Mayhorn, Ebony T.; Widder, Sarah H.; Parker, Steven A.

2015-03-17

The purpose of this project is to verify or refute many of the concerns raised by utilities regarding the ability of large tank HPWHs to perform DR by measuring the performance of HPWHs compared to ERWHs in providing DR services. perform DR by measuring the performance of HPWHs compared to ERWHs in providing DR services. This project was divided into three phases. Phase 1 consisted of week-long laboratory experiments designed to demonstrate technical feasibility of individual large-tank HPWHs in providing DR services compared to large-tank ERWHs. In Phase 2, the individual behaviors of the water heaters were then extrapolated tomore » a population by first calibrating readily available water heater models developed in GridLAB-D simulation software to experimental results obtained in Phase 1. These models were used to simulate a population of water heaters and generate annual load profiles to assess the impacts on system-level power and residential load curves. Such population modeling allows for the inherent and permanent load reduction accomplished by the more efficient HPWHs to be considered, in addition to the temporal DR services the water heater can provide by switching ON or OFF as needed by utilities. The economic and emissions impacts of using large-tank water heaters in DR programs are then analyzed from the utility and consumer perspective, based on National Impacts Analysis in Phase 3. Phase 1 is discussed in this report. Details on Phases 2 and 3 can be found in the companion report (Cooke et al. 2014).« less

Markets for hospital services in Zambia.

PubMed

Nakamba, Pamela; Hanson, Kara; McPake, Barbara

2002-01-01

Hospital reforms involving the introduction of measures to increase competition in hospital markets are being implemented in a range of low and middle-income countries. However, little is understood about the operation of hospital markets outside the USA and the UK. This paper assesses the degree of competition for hospital services in two hospital markets in Zambia (Copperbelt and Midlands), and the implications for prices, quality and efficiency. We found substantial differences among different hospital types in prices, costs and quality, suggesting that the hospital service market is a segmented market. The two markets differ significantly in their degree of competition, with the high cost inpatient services market in Copperbelt relatively more competitive than that in the Midlands market. The implications of these differences are discussed in terms of the potential for competition to improve hospital performance, the impact of market structure on equity of access, and how the government should address the problem of the mine hospitals.

Performance analysis of dynamic time-slot allocation system

NASA Astrophysics Data System (ADS)

Kong, Hongwei; Ruan, Fang; Feng, Chongxi

2001-10-01

Multi-service Access on the narrow-band DDN (Digital Data Network) leased lines to use the bandwidth more efficiently and reduce the cost has attracted much interest. In this paper, one novel multi-service multiplexing scheme based on DTSA (Dynamic Time-Slot Allocation) is given. This scheme can guarantee the QoS of the multiplexed services such as FAX, Voice and data and adapt to different link rates (64kb/s, 128kb/s, 256kb/s), A model is given in this paper to analyze the data behavior under this scheme. The simulation result and the model result have shown that the QoS guarantee to voice and FAX doesn't compromise the QoS of data service much in the meaning of delay and delay variance when the data load is not too high. The simulation result agrees with the model well when data load is not too high.

A gateway for phylogenetic analysis powered by grid computing featuring GARLI 2.0.

PubMed

Bazinet, Adam L; Zwickl, Derrick J; Cummings, Michael P

2014-09-01

We introduce molecularevolution.org, a publicly available gateway for high-throughput, maximum-likelihood phylogenetic analysis powered by grid computing. The gateway features a garli 2.0 web service that enables a user to quickly and easily submit thousands of maximum likelihood tree searches or bootstrap searches that are executed in parallel on distributed computing resources. The garli web service allows one to easily specify partitioned substitution models using a graphical interface, and it performs sophisticated post-processing of phylogenetic results. Although the garli web service has been used by the research community for over three years, here we formally announce the availability of the service, describe its capabilities, highlight new features and recent improvements, and provide details about how the grid system efficiently delivers high-quality phylogenetic results. © The Author(s) 2014. Published by Oxford University Press, on behalf of the Society of Systematic Biologists.

Interference graph-based dynamic frequency reuse in optical attocell networks

NASA Astrophysics Data System (ADS)

Liu, Huanlin; Xia, Peijie; Chen, Yong; Wu, Lan

2017-11-01

Indoor optical attocell network may achieve higher capacity than radio frequency (RF) or Infrared (IR)-based wireless systems. It is proposed as a special type of visible light communication (VLC) system using Light Emitting Diodes (LEDs). However, the system spectral efficiency may be severely degraded owing to the inter-cell interference (ICI), particularly for dense deployment scenarios. To address these issues, we construct the spectral interference graph for indoor optical attocell network, and propose the Dynamic Frequency Reuse (DFR) and Weighted Dynamic Frequency Reuse (W-DFR) algorithms to decrease ICI and improve the spectral efficiency performance. The interference graph makes LEDs can transmit data without interference and select the minimum sub-bands needed for frequency reuse. Then, DFR algorithm reuses the system frequency equally across service-providing cells to mitigate spectrum interference. While W-DFR algorithm can reuse the system frequency by using the bandwidth weight (BW), which is defined based on the number of service users. Numerical results show that both of the proposed schemes can effectively improve the average spectral efficiency (ASE) of the system. Additionally, improvement of the user data rate is also obtained by analyzing its cumulative distribution function (CDF).

How Does Electronic Health Information Exchange Affect Hospital Performance Efficiency? The Effects of Breadth and Depth of Information Sharing.

PubMed

Cho, Na-Eun; Ke, Weiling; Atems, Bebonchu; Chang, Jongwha

2018-01-01

This research was motivated by the large investment in health information technology (IT) by hospitals and the inconsistent findings related to the effects of health IT adoption on hospital performance. Building on resource orchestration theory and the information systems literature, the authors developed a research model to investigate how the configuration strategies for sharing information under health IT systems affect hospital efficiency. The hypotheses were tested using data from the 2010 annual and IT surveys of the American Hospital Association, Centers for Medicare & Medicaid Services case mix index, and U.S. Census Bureau's small-area income and poverty estimates. The study revealed that in health IT systems, the breadth (extent) and depth (level of detail) of digital information sharing among stakeholders each has a curvilinear relationship with hospital efficiency. In addition, breadth and depth reinforce each other's positive effects and attenuate each other's negative effects, and their balance has a positive effect on hospital efficiency. The results of this research have the potential to enrich the literature on the value of adopting health IT systems as well as in providing practitioner guidelines for meaningful use.

Army Reserve Comprehensive Water Efficiency Assessments

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

McMordie Stoughton, Kate; Kearney, Jaime

The Army Reserve has partnered with the Pacific Northwest National Laboratory (PNNL) to develop comprehensive water assessments for numerous Army Reserve Centers in all five regions including the Pacific islands and Puerto Rico, and at Fort Buchanan and Fort Hunter Liggett. The objective of these assessments is to quantify water use at the site, and identify innovative water efficiency projects that can be implemented to help reduce water demand and increase efficiency. Several of these assessments have focused on a strategic plan for achieving net zero water to help meet the Army’s Net Zero Directive . The Army Reserve hasmore » also leveraged this approach as part of the energy conservation investment program (ECIP), energy savings performance contracts (ESPCs), and utility energy service contracts (UESCs). This article documents the process involved.« less

VISIR: technological infrastructure of an operational service for safe and efficient navigation in the Mediterranean Sea

NASA Astrophysics Data System (ADS)

Mannarini, Gianandrea; Turrisi, Giuseppe; D'Anca, Alessandro; Scalas, Mario; Pinardi, Nadia; Coppini, Giovanni; Palermo, Francesco; Carluccio, Ivano; Scuro, Matteo; Cretì, Sergio; Lecci, Rita; Nassisi, Paola; Tedesco, Luca

2016-08-01

VISIR (discoVerIng Safe and effIcient Routes) is an operational decision support system (DSS) for optimal ship routing designed and implemented in the frame of the TESSA (TEchnology for Situational Sea Awareness) project. The system is aimed to increase safety and efficiency of navigation through the use of forecast environmental fields and route optimization. VISIR can be accessed through a web interface (www.visir-nav.com) and mobile applications for both iOS and Android devices. This paper focuses on the technological infrastructure developed for operating VISIR as a DSS. Its main components are described, the performance of the operational system is assessed through experimental measurements, and a few case studies are presented.

Network coding based joint signaling and dynamic bandwidth allocation scheme for inter optical network unit communication in passive optical networks

NASA Astrophysics Data System (ADS)

Wei, Pei; Gu, Rentao; Ji, Yuefeng

2014-06-01

As an innovative and promising technology, network coding has been introduced to passive optical networks (PON) in recent years to support inter optical network unit (ONU) communication, yet the signaling process and dynamic bandwidth allocation (DBA) in PON with network coding (NC-PON) still need further study. Thus, we propose a joint signaling and DBA scheme for efficiently supporting differentiated services of inter ONU communication in NC-PON. In the proposed joint scheme, the signaling process lays the foundation to fulfill network coding in PON, and it can not only avoid the potential threat to downstream security in previous schemes but also be suitable for the proposed hybrid dynamic bandwidth allocation (HDBA) scheme. In HDBA, a DBA cycle is divided into two sub-cycles for applying different coding, scheduling and bandwidth allocation strategies to differentiated classes of services. Besides, as network traffic load varies, the entire upstream transmission window for all REPORT messages slides accordingly, leaving the transmission time of one or two sub-cycles to overlap with the bandwidth allocation calculation time at the optical line terminal (the OLT), so that the upstream idle time can be efficiently eliminated. Performance evaluation results validate that compared with the existing two DBA algorithms deployed in NC-PON, HDBA demonstrates the best quality of service (QoS) support in terms of delay for all classes of services, especially guarantees the end-to-end delay bound of high class services. Specifically, HDBA can eliminate queuing delay and scheduling delay of high class services, reduce those of lower class services by at least 20%, and reduce the average end-to-end delay of all services over 50%. Moreover, HDBA also achieves the maximum delay fairness between coded and uncoded lower class services, and medium delay fairness for high class services.

Cross-layer restoration with software defined networking based on IP over optical transport networks

NASA Astrophysics Data System (ADS)

Yang, Hui; Cheng, Lei; Deng, Junni; Zhao, Yongli; Zhang, Jie; Lee, Young

2015-10-01

The IP over optical transport network is a very promising networking architecture applied to the interconnection of geographically distributed data centers due to the performance guarantee of low delay, huge bandwidth and high reliability at a low cost. It can enable efficient resource utilization and support heterogeneous bandwidth demands in highly-available, cost-effective and energy-effective manner. In case of cross-layer link failure, to ensure a high-level quality of service (QoS) for user request after the failure becomes a research focus. In this paper, we propose a novel cross-layer restoration scheme for data center services with software defined networking based on IP over optical network. The cross-layer restoration scheme can enable joint optimization of IP network and optical network resources, and enhance the data center service restoration responsiveness to the dynamic end-to-end service demands. We quantitatively evaluate the feasibility and performances through the simulation under heavy traffic load scenario in terms of path blocking probability and path restoration latency. Numeric results show that the cross-layer restoration scheme improves the recovery success rate and minimizes the overall recovery time.

The French Health Care System; What can We Learn?

PubMed

El Taguri, A; Nasef, A

2008-12-01

All public systems look for the best organizational structure to funnel part of their national income into healthcare services. Appropriate policies may differ widely across country settings. Most healthcare systems fall under one of two broad categories, either Bismark or Beveridge systems. There is no simple ideal model for the organization of health services, but most healthcare systems that follow the Beveridge healthcare model are poor performers. The Libyan Health system is a low responsive, inefficient and underperforming system that lacks goals and/or SMART. (Specific, Measurable, Achievable, Realistic, Time specific) objectives. A look at different organization models in the world would reinforce efforts to reorganize and improve the performance of the Libyan National Healthcare services. The French Health Care System (FHCS) ranked first according to the WHO and the European Health Consumer Powerhouse. The FHCS was described to have a technically efficient, generous healthcare system that provides the best overall health care. This makes the FHCS a practical model of organization having many of the essential aspects of a modern national health service. In this review, we describe the main features of the FHCS, current challenges and future trends with particular attention paid to aspects that could be of importance to the Libyan Healthcare System.

Cluster analysis of medical service resources at district hospitals in Taiwan, 2007-2011.

PubMed

Tseng, Shu-Fang; Lee, Tian-Shyug; Deng, Chung-Yeh

2015-12-01

A vast amount of the annual/national budget has been spent on the National Health Insurance program in Taiwan. However, the market for district hospitals has become increasingly competitive, and district hospitals are under pressure to optimize the use of health service resources. Therefore, we employed a clustering method to explore variations in input and output service volumes, and investigate resource allocation and health care service efficiency in district hospitals. Descriptive and cluster analyses were conducted to examine the district hospitals included in the Ministry of Health and Welfare database during 2007-2011. The results, according to the types of hospital ownership, suggested that the number of public hospitals has decreased and that of private hospitals increased; the largest increase in the number of district hospitals occurred when Taichung City was merged into Taichung County. The descriptive statistics from 2007 to 2011 indicated that 43% and 36.4% of the hospitals had 501-800 occupied beds and 101-200 physicians, respectively, and > 401 medical staff members. However, the number of outpatients and discharged patients exceeded 6001 and 90,001, respectively. In addition, the highest percentage of hospitals (43.9%) had 30,001-60,000 emergency department patients. In 2010, the number of patients varied widely, and the analysis of variance cluster results were nonsignificant (p > 0.05). District hospitals belonging to low-throughput and low-performance groups were encouraged to improve resource utilization for enhancing health care service efficiency. Copyright © 2015. Published by Elsevier Taiwan.

Impact of a mobile health aplication in the nursing care plan compliance of a home care service in Belo Horizonte, Minas Gerais, Brazil.

PubMed

de Britto, Felipe A; Martins, Tatiana B; Landsberg, Gustavo A P

2015-01-01

To assess impact of a mobile health solution in the nursing care plan compliance of a home care service. A retrospective cohort study was performed with 3,036 patients. Compliance rates before and after the implementation were compared. After the implementation of a mobile health aplication, compliance with the nursing care plan increased from 53% to 94%. The system reduced IT spending, increased the nursing team efficiency and prevented planned hiring. The use of a mobile health solution with geolocating feature by a nursing home care team increased compliance to the care plan.

An integrated data envelopment analysis-artificial neural network approach for benchmarking of bank branches

NASA Astrophysics Data System (ADS)

Shokrollahpour, Elsa; Hosseinzadeh Lotfi, Farhad; Zandieh, Mostafa

2016-06-01

Efficiency and quality of services are crucial to today's banking industries. The competition in this section has become increasingly intense, as a result of fast improvements in Technology. Therefore, performance analysis of the banking sectors attracts more attention these days. Even though data envelopment analysis (DEA) is a pioneer approach in the literature as of an efficiency measurement tool and finding benchmarks, it is on the other hand unable to demonstrate the possible future benchmarks. The drawback to it could be that the benchmarks it provides us with, may still be less efficient compared to the more advanced future benchmarks. To cover for this weakness, artificial neural network is integrated with DEA in this paper to calculate the relative efficiency and more reliable benchmarks of one of the Iranian commercial bank branches. Therefore, each branch could have a strategy to improve the efficiency and eliminate the cause of inefficiencies based on a 5-year time forecast.

Experimental Study on Ultrafine Particle Removal Performance of Portable Air Cleaners with Different Filters in an Office Room

PubMed Central

Ma, Huan; Shen, Henggen; Shui, Tiantian; Li, Qing; Zhou, Liuke

2016-01-01

Size- and time-dependent aerodynamic behaviors of indoor particles, including PM1.0, were evaluated in a school office in order to test the performance of air-cleaning devices using different filters. In-situ real-time measurements were taken using an optical particle counter. The filtration characteristics of filter media, including single-pass efficiency, volume and effectiveness, were evaluated and analyzed. The electret filter (EE) medium shows better initial removal efficiency than the high efficiency (HE) medium in the 0.3–3.5 μm particle size range, while under the same face velocity, the filtration resistance of the HE medium is several times higher than that of the EE medium. During service life testing, the efficiency of the EE medium decreased to 60% with a total purifying air flow of 25 × 104 m3/m2. The resistance curve rose slightly before the efficiency reached the bottom, and then increased almost exponentially. The single-pass efficiency of portable air cleaner (PAC) with the pre-filter (PR) or the active carbon granule filter (CF) was relatively poor. While PAC with the pre-filter and the high efficiency filter (PR&HE) showed maximum single-pass efficiency for PM1.0 (88.6%), PAC with the HE was the most effective at removing PM1.0. The enhancement of PR with HE and electret filters augmented the single-pass efficiency, but lessened the airflow rate and effectiveness. Combined with PR, the decay constant of large-sized particles could be greater than for PACs without PR. Without regard to the lifetime, the electret filters performed better with respect to resource saving and purification improvement. A most penetrating particle size range (MPPS: 0.4–0.65 μm) exists in both HE and electret filters; the MPPS tends to become larger after HE and electret filters are combined with PR. These results serve to provide a better understanding of the indoor particle removal performance of PACs when combined with different kinds of filters in school office buildings. PMID:26742055

Issues in evaluation: evaluating assessments of elderly people using a combination of methods.

PubMed

McEwan, R T

1989-02-01

In evaluating a health service, individuals will give differing accounts of its performance, according to their experiences of the service, and the evaluative perspective they adopt. The value of a service may also change through time, and according to the particular part of the service studied. Traditional health care evaluations have generally not accounted for this variability because of the approaches used. Studies evaluating screening or assessment programmes for the elderly have focused on programme effectiveness and efficiency, using relatively inflexible quantitative methods. Evaluative approaches must reflect the complexity of health service provision, and methods must vary to suit the particular research objective. Under these circumstances, this paper presents the case for the use of multiple triangulation in evaluative research, where differing methods and perspectives are combined in one study. Emphasis is placed on the applications and benefits of subjectivist approaches in evaluation. An example of combined methods is provided in the form of an evaluation of the Newcastle Care Plan for the Elderly.

Theory and Practice in the Design of Physician Payment Incentives

PubMed Central

Robinson, James C.

2001-01-01

Combining the economic literature on principal-agent relationships with examples of marketplace innovations allows analysis of the evolution of methods for paying physicians. Agency theory and the economic principles of performance-based compensation are applied in the context of imperfect information, risk aversion, multiple interrelated tasks, and team production efficiencies. Fee-for-service and capitation are flawed methods of motivating physicians to achieve specific goals. Payment innovations that blend elements of fee-for-service, capitation, and case rates can preserve the advantages and attenuate the disadvantages of each. These innovations include capitation with fee-for-service carve-outs, department budgets with individual fee-for-service or “contact” capitation, and case rates for defined episodes of illness. The context within which payment incentives are embedded, includes such nonprice mechanisms as screening and monitoring and such organizational relationships as employment and ownership. The analysis has implications for health services research and public policy with respect to physician payment incentives. PMID:11439463

Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach.

PubMed

Si, Sheng-Li; You, Xiao-Yue; Liu, Hu-Chen; Huang, Jia

2017-08-19

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that "accidents/adverse events", "nosocomial infection", ''incidents/errors", "number of operations/procedures" are significant influential indicators. Also, the indicators of "length of stay", "bed occupancy" and "financial measures" play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions.

International Space Station Increment Operations Services

NASA Astrophysics Data System (ADS)

Michaelis, Horst; Sielaff, Christian

2002-01-01

The Industrial Operator (IO) has defined End-to-End services to perform efficiently all required operations tasks for the Manned Space Program (MSP) as agreed during the Ministerial Council in Edinburgh in November 2001. Those services are the result of a detailed task analysis based on the operations processes as derived from the Space Station Program Implementation Plans (SPIP) and defined in the Operations Processes Documents (OPD). These services are related to ISS Increment Operations and ATV Mission Operations. Each of these End-to-End services is typically characterised by the following properties: It has a clearly defined starting point, where all requirements on the end-product are fixed and associated performance metrics of the customer are well defined. It has a clearly defined ending point, when the product or service is delivered to the customer and accepted by him, according to the performance metrics defined at the start point. The implementation of the process might be restricted by external boundary conditions and constraints mutually agreed with the customer. As far as those are respected the IO has the free choice to select methods and means of implementation. The ISS Increment Operations Service (IOS) activities required for the MSP Exploitation program cover the complete increment specific cycle starting with the support to strategic planning and ending with the post increment evaluation. These activities are divided into sub-services including the following tasks: - ISS Planning Support covering the support to strategic and tactical planning up to the generation - Development &Payload Integration Support - ISS Increment Preparation - ISS Increment Execution These processes are tight together by the Increment Integration Management, which provides the planning and scheduling of all activities as well as the technical management of the overall process . The paper describes the entire End-to-End ISS Increment Operations service and the implementation to support the Columbus Flight 1E related increment and subsequent ISS increments. Special attention is paid to the implications caused by long term operations on hardware, software and operations personnel.

Expanding Energy Performance Contracting in china: policy solutions and market mechanisms

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

Shen, Bo; Price, Lynn; Liu, Xu

Energy performance contracting is an important market mechanism that uses energy savings to pay over time for the upfront costs of energy efficiency retrofits in buildings, industries, and other types of facilities. Through energy performance contracts (EPCs), Energy Service Companies (ESCOs) play an important role in implementing energy efficiency retrofits. Both China and the United States have large markets for EPCs and significant opportunities for growth. The Chinese government has made great efforts in promoting the country’s ESCO business and expanding its EPC markets. This paper makes a series of recommendations for China to adopt more ambitious policy measures tomore » encourage deep energy savings projects via EPCs. These recommendations are built on initial insights from a white paper developed by researchers at the Pacific Northwest National Laboratory and the Lawrence Berkeley National Laboratory with the assistance from the ESCO Committee of China’s Energy Conservation Association (EMCA). Key recommendations are listed below.« less

Proportional-integral and proportional-integral-derivative-based cyclic sleep controllers with anti-windup technique for energy-efficient and delay-aware passive optical networks

NASA Astrophysics Data System (ADS)

Kikuchi, Takahiro; Kubo, Ryogo

2016-08-01

In energy-efficient passive optical network (PON) systems, the increase in the queuing delays caused by the power-saving mechanism of optical network units (ONUs) is an important issue. Some researchers have proposed quality-of-service (QoS)-aware ONU cyclic sleep controllers in PON systems. We have proposed proportional (P) and proportional-derivative (PD)-based controllers to maintain the average queuing delay at a constant level regardless of the amount of downstream traffic. However, sufficient performance has not been obtained because of the sleep period limitation. In this paper, proportional-integral (PI) and proportional-integral-derivative (PID)-based controllers considering the sleep period limitation, i.e., using an anti-windup (AW) technique, are proposed to improve both the QoS and power-saving performance. Simulations confirm that the proposed controllers provide better performance than conventional controllers in terms of the average downstream queuing delay and the time occupancy of ONU active periods.

Service Discovery Oriented Management System Construction Method

NASA Astrophysics Data System (ADS)

Li, Huawei; Ren, Ying

2017-10-01

In order to solve the problem that there is no uniform method for design service quality management system in large-scale complex service environment, this paper proposes a distributed service-oriented discovery management system construction method. Three measurement functions are proposed to compute nearest neighbor user similarity at different levels. At present in view of the low efficiency of service quality management systems, three solutions are proposed to improve the efficiency of the system. Finally, the key technologies of distributed service quality management system based on service discovery are summarized through the factor addition and subtraction of quantitative experiment.

HEPCloud, a New Paradigm for HEP Facilities: CMS Amazon Web Services Investigation

DOE PAGES

Holzman, Burt; Bauerdick, Lothar A. T.; Bockelman, Brian; ...

2017-09-29

Historically, high energy physics computing has been performed on large purpose-built computing systems. These began as single-site compute facilities, but have evolved into the distributed computing grids used today. Recently, there has been an exponential increase in the capacity and capability of commercial clouds. Cloud resources are highly virtualized and intended to be able to be flexibly deployed for a variety of computing tasks. There is a growing interest among the cloud providers to demonstrate the capability to perform large-scale scientific computing. In this paper, we discuss results from the CMS experiment using the Fermilab HEPCloud facility, which utilized bothmore » local Fermilab resources and virtual machines in the Amazon Web Services Elastic Compute Cloud. We discuss the planning, technical challenges, and lessons learned involved in performing physics workflows on a large-scale set of virtualized resources. Additionally, we will discuss the economics and operational efficiencies when executing workflows both in the cloud and on dedicated resources.« less

SSSFD manipulator engineering using statistical experiment design techniques

NASA Technical Reports Server (NTRS)

Barnes, John

1991-01-01

The Satellite Servicer System Flight Demonstration (SSSFD) program is a series of Shuttle flights designed to verify major on-orbit satellite servicing capabilities, such as rendezvous and docking of free flyers, Orbital Replacement Unit (ORU) exchange, and fluid transfer. A major part of this system is the manipulator system that will perform the ORU exchange. The manipulator must possess adequate toolplate dexterity to maneuver a variety of EVA-type tools into position to interface with ORU fasteners, connectors, latches, and handles on the satellite, and to move workpieces and ORUs through 6 degree of freedom (dof) space from the Target Vehicle (TV) to the Support Module (SM) and back. Two cost efficient tools were combined to perform a study of robot manipulator design parameters. These tools are graphical computer simulations and Taguchi Design of Experiment methods. Using a graphics platform, an off-the-shelf robot simulation software package, and an experiment designed with Taguchi's approach, the sensitivities of various manipulator kinematic design parameters to performance characteristics are determined with minimal cost.

The impact of contracting-out on health system performance: a conceptual framework.

PubMed

Liu, Xingzhu; Hotchkiss, David R; Bose, Sujata

2007-07-01

Despite the increased popularity of contracting-out of health services in developing countries, its effectiveness on overall health system performance is not yet conclusive. Except for substantial evidence of contracting-out's positive effect on access to health services and some evidence on improved equity in access, there is little evidence of contracting-out's impact on quality and efficiency. Most studies on the subject evaluate specific contracting-out projects against narrowly specified project objectives, not against more broadly defined health system goals. For this reason, conclusions of positive effects pertaining to project level may not hold at system level. This paper presents a conceptual framework that is expected to facilitate comprehensive, rigorous, and standardized evaluation of contracting-out at health system level. Specifically, this framework supports: full and standardized description of contracting-out interventions, study of the determinants of effectiveness, examination of provider and purchaser responses, assessment of the impact of contracting-out on all dimensions of health system performance, and cross-project analyses.

HEPCloud, a New Paradigm for HEP Facilities: CMS Amazon Web Services Investigation

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

Holzman, Burt; Bauerdick, Lothar A. T.; Bockelman, Brian

Historically, high energy physics computing has been performed on large purpose-built computing systems. These began as single-site compute facilities, but have evolved into the distributed computing grids used today. Recently, there has been an exponential increase in the capacity and capability of commercial clouds. Cloud resources are highly virtualized and intended to be able to be flexibly deployed for a variety of computing tasks. There is a growing interest among the cloud providers to demonstrate the capability to perform large-scale scientific computing. In this paper, we discuss results from the CMS experiment using the Fermilab HEPCloud facility, which utilized bothmore » local Fermilab resources and virtual machines in the Amazon Web Services Elastic Compute Cloud. We discuss the planning, technical challenges, and lessons learned involved in performing physics workflows on a large-scale set of virtualized resources. Additionally, we will discuss the economics and operational efficiencies when executing workflows both in the cloud and on dedicated resources.« less

Smart Buildings and Demand Response

NASA Astrophysics Data System (ADS)

Kiliccote, Sila; Piette, Mary Ann; Ghatikar, Girish

2011-11-01

Advances in communications and control technology, the strengthening of the Internet, and the growing appreciation of the urgency to reduce demand side energy use are motivating the development of improvements in both energy efficiency and demand response (DR) systems in buildings. This paper provides a framework linking continuous energy management and continuous communications for automated demand response (Auto-DR) in various times scales. We provide a set of concepts for monitoring and controls linked to standards and procedures such as Open Automation Demand Response Communication Standards (OpenADR). Basic building energy science and control issues in this approach begin with key building components, systems, end-uses and whole building energy performance metrics. The paper presents a framework about when energy is used, levels of services by energy using systems, granularity of control, and speed of telemetry. DR, when defined as a discrete event, requires a different set of building service levels than daily operations. We provide examples of lessons from DR case studies and links to energy efficiency.

Enhancing DSN Operations Efficiency with the Discrepancy Reporting Management System (DRMS)

NASA Technical Reports Server (NTRS)

Chatillon, Mark; Lin, James; Cooper, Tonja M.

2003-01-01

The DRMS is the Discrepancy Reporting Management System used by the Deep Space Network (DSN). It uses a web interface and is a management tool designed to track and manage: data outage incidents during spacecraft tracks against equipment and software known as DRs (discrepancy Reports), to record "out of pass" incident logs against equipment and software in a Station Log, to record instances where equipment has be restarted or reset as Reset records, and to electronically record equipment readiness status across the DSN. Tracking and managing these items increases DSN operational efficiency by providing: the ability to establish the operational history of equipment items, data on the quality of service provided to the DSN customers, the ability to measure service performance, early insight into processes, procedures and interfaces that may need updating or changing, and the capability to trace a data outage to a software or hardware change. The items listed above help the DSN to focus resources on areas of most need.

Designing train-speed trajectory with energy efficiency and service quality

NASA Astrophysics Data System (ADS)

Jia, Jiannan; Yang, Kai; Yang, Lixing; Gao, Yuan; Li, Shukai

2018-05-01

With the development of automatic train operations, optimal trajectory design is significant to the performance of train operations in railway transportation systems. Considering energy efficiency and service quality, this article formulates a bi-objective train-speed trajectory optimization model to minimize simultaneously the energy consumption and travel time in an inter-station section. This article is distinct from previous studies in that more sophisticated train driving strategies characterized by the acceleration/deceleration gear, the cruising speed, and the speed-shift site are specifically considered. For obtaining an optimal train-speed trajectory which has equal satisfactory degree on both objectives, a fuzzy linear programming approach is applied to reformulate the objectives. In addition, a genetic algorithm is developed to solve the proposed train-speed trajectory optimization problem. Finally, a series of numerical experiments based on a real-world instance of Beijing-Tianjin Intercity Railway are implemented to illustrate the practicability of the proposed model as well as the effectiveness of the solution methodology.

Increasing operating room productivity by duration categories and a newsvendor model.

PubMed

Lehtonen, Juha-Matti; Torkki, Paulus; Peltokorpi, Antti; Moilanen, Teemu

2013-01-01

Previous studies approach surgery scheduling mainly from the mathematical modeling perspective which is often hard to apply in a practical environment. The aim of this study is to develop a practical scheduling system that considers the advantages of both surgery categorization and newsvendor model to surgery scheduling. The research was carried out in a Finnish orthopaedic specialist centre that performs only joint replacement surgery. Four surgery categorization scenarios were defined and their productivity analyzed by simulation and newsvendor model. Detailed analyses of surgery durations and the use of more accurate case categories and their combinations in scheduling improved OR productivity 11.3 percent when compared to the base case. Planning to have one OR team to work longer led to remarkable decrease in scheduling inefficiency. In surgical services, productivity and cost-efficiency can be improved by utilizing historical data in case scheduling and by increasing flexibility in personnel management. The study increases the understanding of practical scheduling methods used to improve efficiency in surgical services.

Dynamic VMs placement for energy efficiency by PSO in cloud computing

NASA Astrophysics Data System (ADS)

Dashti, Seyed Ebrahim; Rahmani, Amir Masoud

2016-03-01

Recently, cloud computing is growing fast and helps to realise other high technologies. In this paper, we propose a hieratical architecture to satisfy both providers' and consumers' requirements in these technologies. We design a new service in the PaaS layer for scheduling consumer tasks. In the providers' perspective, incompatibility between specification of physical machine and user requests in cloud leads to problems such as energy-performance trade-off and large power consumption so that profits are decreased. To guarantee Quality of service of users' tasks, and reduce energy efficiency, we proposed to modify Particle Swarm Optimisation to reallocate migrated virtual machines in the overloaded host. We also dynamically consolidate the under-loaded host which provides power saving. Simulation results in CloudSim demonstrated that whatever simulation condition is near to the real environment, our method is able to save as much as 14% more energy and the number of migrations and simulation time significantly reduces compared with the previous works.

A new archival infrastructure for highly-structured astronomical data

NASA Astrophysics Data System (ADS)

Dovgan, Erik; Knapic, Cristina; Sponza, Massimo; Smareglia, Riccardo

2018-03-01

With the advent of the 2020 Radio Astronomy Telescopes era, the amount and format of the radioastronomical data is becoming a massive and performance-critical challenge. Such an evolution of data models and data formats require new data archiving techniques that allow massive and fast storage of data that are at the same time also efficiently processed. A useful expertise for efficient archiviation has been obtained through data archiving of Medicina and Noto Radio Telescopes. The presented archival infrastructure named the Radio Archive stores and handles various formats, such as FITS, MBFITS, and VLBI's XML, which includes description and ancillary files. The modeling and architecture of the archive fulfill all the requirements of both data persistence and easy data discovery and exploitation. The presented archive already complies with the Virtual Observatory directives, therefore future service implementations will also be VO compliant. This article presents the Radio Archive services and tools, from the data acquisition to the end-user data utilization.

Trends in Department of Defense hospital efficiency.

PubMed

Ozcan, Y A; Bannick, R R

1994-04-01

This study employs a simple cross sectional design using longitudinal data to explore the underlying factors associated with differences in hospital technical efficiency using data envelopment analysis (DEA) in the Department of Defense (DOD) sector across three service components, the Army, Air Force and Navy. The results suggest that the services do not differ significantly in hospital efficiency. Nor does hospital efficiency appear to differ over time. With respect to the efficient use of input resources, the services experienced a general decline in excessive usage of various inputs over the three years. Analysis of the returns to scale captures opportunities for planners of changing the relative mix of output to input slacks for increasing a hospital's efficiency. That is, policy makers would get more immediate "bang per buck" with emphasis on improving the efficiencies of hospitals with higher returns to scale than other hospitals. Findings also suggest a significant degree of comparability between the DEA measure and these measures often used to indicate efficiency.

Guiding Principles and Checklist for Population-Based Quality Metrics

PubMed Central

Brunelli, Steven M.; Maddux, Franklin W.; Parker, Thomas F.; Johnson, Douglas; Nissenson, Allen R.; Collins, Allan; Lacson, Eduardo

2014-01-01

The Centers for Medicare and Medicaid Services oversees the ESRD Quality Incentive Program to ensure that the highest quality of health care is provided by outpatient dialysis facilities that treat patients with ESRD. To that end, Centers for Medicare and Medicaid Services uses clinical performance measures to evaluate quality of care under a pay-for-performance or value-based purchasing model. Now more than ever, the ESRD therapeutic area serves as the vanguard of health care delivery. By translating medical evidence into clinical performance measures, the ESRD Prospective Payment System became the first disease-specific sector using the pay-for-performance model. A major challenge for the creation and implementation of clinical performance measures is the adjustments that are necessary to transition from taking care of individual patients to managing the care of patient populations. The National Quality Forum and others have developed effective and appropriate population-based clinical performance measures quality metrics that can be aggregated at the physician, hospital, dialysis facility, nursing home, or surgery center level. Clinical performance measures considered for endorsement by the National Quality Forum are evaluated using five key criteria: evidence, performance gap, and priority (impact); reliability; validity; feasibility; and usability and use. We have developed a checklist of special considerations for clinical performance measure development according to these National Quality Forum criteria. Although the checklist is focused on ESRD, it could also have broad application to chronic disease states, where health care delivery organizations seek to enhance quality, safety, and efficiency of their services. Clinical performance measures are likely to become the norm for tracking performance for health care insurers. Thus, it is critical that the methodologies used to develop such metrics serve the payer and the provider and most importantly, reflect what represents the best care to improve patient outcomes. PMID:24558050

Thermal barrier coatings (TBC's) for high heat flux thrust chambers

NASA Astrophysics Data System (ADS)

Bradley, Christopher M.

The last 30 years materials engineers have been under continual pressure to develop materials with a greater temperature potential or to produce configurations that can be effectively cooled or otherwise protected at elevated temperature conditions. Turbines and thrust chambers produce some of the harshest service conditions for materials which lead to the challenges engineers face in order to increase the efficiencies of current technologies due to the energy crisis that the world is facing. The key tasks for the future of gas turbines are to increase overall efficiencies to meet energy demands of a growing world population and reduce the harmful emissions to protect the environment. Airfoils or blades tend to be the limiting factor when it comes to the performance of the turbine because of their complex design making them difficult to cool as well as limitations of their thermal properties. Key tasks for space transportation it to lower costs while increasing operational efficiency and reliability of our space launchers. The important factor to take into consideration is the rocket nozzle design. The design of the rocket nozzle or thrust chamber has to take into account many constraints including external loads, heat transfer, transients, and the fluid dynamics of expanded hot gases. Turbine engines can have increased efficiencies if the inlet temperature for combustion is higher, increased compressor capacity and lighter weight materials. In order to push for higher temperatures, engineers need to come up with a way to compensate for increased temperatures because material systems that are being used are either at or near their useful properties limit. Before thermal barrier coatings were applied to hot-section components, material alloy systems were able to withstand the service conditions necessary. But, with the increased demand for performance, higher temperatures and pressures have become too much for those alloy systems. Controlled chemistry of hot-section components has become critical, but at the same time the service conditions have put our best alloy systems to their limits. As a result, implementation of cooling holes and thermal barrier coatings are new advances in hot-section technologies now looked at for modifications to reach higher temperature applications. Current thermal barrier coatings used in today's turbine applications is known as 8%yttria-stabilized zirconia (YSZ) and there are no coatings for current thrust chambers. Current research is looking at the applicability of 8%yttria-stabilized hafnia (YSH) for turbine applications and the implementation of 8%YSZ onto thrust chambers. This study intends to determine if the use of thermal barrier coatings are applicable for high heat flux thrust chambers using industrial YSZ will be advantageous for improvements in efficiency, thrust and longer service life by allowing the thrust chambers to be used more than once.

Three-year financial analysis of pharmacy services at an independent community pharmacy.

PubMed

Doucette, William R; McDonough, Randal P; Mormann, Megan M; Vaschevici, Renata; Urmie, Julie M; Patterson, Brandon J

2012-01-01

To assess the financial performance of pharmacy services including vaccinations, cholesterol screenings, medication therapy management (MTM), adherence management services, employee health fairs, and compounding services provided by an independent community pharmacy. Three years (2008-10) of pharmacy records were examined to determine the total revenue and costs of each service. Costs included products, materials, labor, marketing, overhead, equipment, reference materials, and fax/phone usage. Costs were allocated to each service using accepted principles (e.g., time for labor). Depending on the service, the total revenue was calculated by multiplying the frequency of the service by the revenue per patient or by adding the total revenue received. A sensitivity analysis was conducted for the adherence management services to account for average dispensing net profit. 7 of 11 pharmacy services showed a net profit each year. Those services include influenza and herpes zoster immunization services, MTM, two adherence management services, employee health fairs, and prescription compounding services. The services that realized a net loss included the pneumococcal immunization service, cholesterol screenings, and two adherence management services. The sensitivity analysis showed that all adherence services had a net gain when average dispensing net profit was included. Most of the pharmacist services had an annual positive net gain. It seems likely that these services can be sustained. Further cost management, such as reducing labor costs, could improve the viability of services with net losses. However, even with greater efficiency, external factors such as competition and reimbursement challenge the sustainability of these services.

South Carolina School Food Service Programs: A Study To Determine Fiscal Efficiency.

ERIC Educational Resources Information Center

Fulmer, Karl E.; Swann, John M.; Taylor, Susan L.

This report identifies those qualities and characteristics that are usually associated with efficiently and effectively operated school food-service programs. Data were extracted from district audit reports filed with the South Carolina State Department of Education; from the South Carolina Department of Education Office of School Food-services;…

Are larger dental practices more efficient? An analysis of dental services production.

PubMed Central

Lipscomb, J; Douglass, C W

1986-01-01

Whether cost-efficiency in dental services production increases with firm size is investigated through application of an activity analysis production function methodology to data from a national survey of dental practices. Under this approach, service delivery in a dental practice is modeled as a linear programming problem that acknowledges distinct input-output relationships for each service. These service-specific relationships are then combined to yield projections of overall dental practice productivity, subject to technical and organizational constraints. The activity analysis reported here represents arguably the most detailed evaluation yet of the relationship between dental practice size and cost-efficiency, controlling for such confounding factors as fee and service-mix differences across firms. We conclude that cost-efficiency does increase with practice size, over the range from solo to four-dentist practices. Largely because of data limitations, we were unable to test satisfactorily for scale economies in practices with five or more dentists. Within their limits, our findings are generally consistent with results from the neoclassical production function literature. From the standpoint of consumer welfare, the critical question raised (but not resolved) here is whether these apparent production efficiencies of group practice are ultimately translated by the market into lower fees, shorter queues, or other nonprice benefits. PMID:3102404

Rapid Building Assessment Project

DTIC Science & Technology

2014-05-01

ongoing management of commercial energy efficiency. No other company offers all of these proven services on a seamless, integrated Software -as-a- Service ...FirstFuel has added a suite of additional Software -as-a- Service analytics capabilities to support the entire energy efficiency lifecycle, including...the client side. In this document, we refer to the service side software as “BUILDER” and the client software as “BuilderRED,” following the Army

The feasibility of replacing or upgrading utility distribution transformers during routine maintenance

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

Barnes, P.R.; Van Dyke, J.W.; McConnell, B.W.

It is estimated that electric utilities use about 40 million distribution transformers in supplying electricity to customers in the United States. Although utility distribution transformers collectively have a high average efficiency, they account for approximately 61 billion kWh of the 229 billion kWh of energy lost annually in the delivery of electricity. Distribution transformers are being replaced over time by new, more efficient, lower-loss units during routine utility maintenance of power distribution systems. Maintenance is typically not performed on units in service. However, units removed from service with appreciable remaining life are often refurbished and returned to stock. Distribution transformersmore » may be removed from service for many reasons, including failure, over- or underloading, or line upgrades such as voltage changes or rerouting. When distribution transformers are removed from service, a decision must be made whether to dispose of the transformer and purchase a lower-loss replacement or to refurbish the transformer and return it to stock for future use. This report contains findings and recommendations on replacing utility distribution transformers during routine maintenance, which is required by section 124(c) of the Energy Policy Act of 1992. The objectives of the study are to evaluate the practicability, cost-effectiveness, and potential energy savings of replacing or upgrading existing transformers during routine utility maintenance and to develop recommendations on was to achieve the potential energy savings.« less

The New Guard: A Service-Equivalent Force

DTIC Science & Technology

2012-06-07

quartermas ter , medical , ordinance and inspector general. The bureaus were designed to be more efficient and deliver cost aving; but. onl y created...2. REPORT TYPE. State the type of report, such as final , technical, interim, memorandum, master’s thesis , progress, quarterly, research ...the report, performing the research , or credited with the content of the report. The form of entry is the last name, first name, middle initial, and

Nurse-led treatment for occipital neuralgia.

PubMed

Pike, Denise; Amphlett, Alexander; Weatherby, Stuart

Occipital neuralgia is a headache resulting from dysfunction of the occipital nerves. Medically resistant occipital neuralgia is treated by greater occipital nerve injection, which is traditionally performed by neurologists. A nurse-led clinic was developed to try to improve the service. Patient feedback showed that the clinic was positively perceived by patients, with most stating the nurse-led model was more efficient than the previous one, which had been led by consultants.

Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis.

PubMed

Medin, Emma; Anthun, Kjartan S; Häkkinen, Unto; Kittelsen, Sverre A C; Linna, Miika; Magnussen, Jon; Olsen, Kim; Rehnberg, Clas

2011-12-01

This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.

The Effect of Community on Distributed Bio-inspired Service Composition

NASA Astrophysics Data System (ADS)

Carroll, Raymond; Balasubramaniam, Sasitharan; Botvich, Dmitri; Donnelly, William

The Future Internet is expected to cater for both a larger number and variety of services, which in turn will make basic tasks such as service lifecycle management increasingly important and difficult. At the same time, the ability for users to efficiently discover and compose these services will become a key factor for service providers to differentiate themselves in a competitive market. In previous work, we examined the effect adding biological mechanisms to services had on service management and discovery. In this paper we examine the effects of community on services, specifically in terms of composing services in a distributed fashion. By introducing aspects of community we aim to demonstrate that services can further improve their sustainability and indeed their efficiency.

Climate Change and Ecosystem Services Output Efficiency in Southern Loblolly Pine Forests.

PubMed

Susaeta, Andres; Adams, Damian C; Carter, Douglas R; Dwivedi, Puneet

2016-09-01

Forests provide myriad ecosystem services that are vital to humanity. With climate change, we expect to see significant changes to forests that will alter the supply of these critical services and affect human well-being. To better understand the impacts of climate change on forest-based ecosystem services, we applied a data envelopment analysis method to assess plot-level efficiency in the provision of ecosystem services in Florida natural loblolly pine (Pinus taeda L.) forests. Using field data for n = 16 loblolly pine forest plots, including inputs such as site index, tree density, age, precipitation, and temperatures for each forest plot, we assessed the relative plot-level production of three ecosystem services: timber, carbon sequestered, and species richness. The results suggested that loblolly pine forests in Florida were largely inefficient in the provision of these ecosystem services under current climatic conditions. Climate change had a small negative impact on the loblolly pine forests efficiency in the provision of ecosystem services. In this context, we discussed the reduction of tree density that may not improve ecosystem services production.

Vouchers for family planning and sexual and reproductive health services: a review of voucher programs involving Marie Stopes International among 11 Asian and African countries.

PubMed

Eva, Gillian; Quinn, Andrew; Ngo, Thoai D

2015-08-01

To evaluate provision of vouchers for family planning and sexual and reproductive health (SRH) services. A review was conducted to assess the effects of 24 voucher programs in Marie Stopes International programs across 11 countries in Asia and Africa between 2005 and the present. The outcome measures were uptake of services; service use among specific subgroups; user satisfaction with service quality; and efficiency of service delivery. Twelve of the 24 programs covered family planning only, whereas the other 12 programs covered family planning and/or SRH. Service uptake increased following implementation, although voucher redemption rates varied by program (44.1%-92.4%). Most programs were successful in reaching subgroups, such as the poor and young (under 25years), although this outcome depended on the targeting approach. Most programs recorded high user satisfaction; however, the evidence regarding efficiency was mixed. Vouchers increased uptake of services and, in some cases, improved service quality and reach to specific groups. Nevertheless, robust evaluation designs are required to measure efficiency. Copyright © 2015. Published by Elsevier Ireland Ltd.

Climate Change and Ecosystem Services Output Efficiency in Southern Loblolly Pine Forests

NASA Astrophysics Data System (ADS)

Susaeta, Andres; Adams, Damian C.; Carter, Douglas R.; Dwivedi, Puneet

2016-09-01

Forests provide myriad ecosystem services that are vital to humanity. With climate change, we expect to see significant changes to forests that will alter the supply of these critical services and affect human well-being. To better understand the impacts of climate change on forest-based ecosystem services, we applied a data envelopment analysis method to assess plot-level efficiency in the provision of ecosystem services in Florida natural loblolly pine ( Pinus taeda L.) forests. Using field data for n = 16 loblolly pine forest plots, including inputs such as site index, tree density, age, precipitation, and temperatures for each forest plot, we assessed the relative plot-level production of three ecosystem services: timber, carbon sequestered, and species richness. The results suggested that loblolly pine forests in Florida were largely inefficient in the provision of these ecosystem services under current climatic conditions. Climate change had a small negative impact on the loblolly pine forests efficiency in the provision of ecosystem services. In this context, we discussed the reduction of tree density that may not improve ecosystem services production.

Space solar cell research: Problems and potential

NASA Technical Reports Server (NTRS)

Flood, D. J.

1986-01-01

The value of a passive, maintenance-free, renewable energy source was apparent in the early days of the space program, and the silicon solar cell was pressed into service. Efficiencies of those early space solar arrays were low, and lifetimes shorter than hoped for, but within a decade significant advances had been made in both areas. Better performance was achieved through improvements in silicon single crystal material, better device designs, and a better understanding of the factors that affect the performance of a solar cell in space. Chief among the latter, particularly for the mid-to-high altitude (HEO) and geosynchronous (GEO) orbits, are the effects of the naturally occurring particulate radiation environment. Although not as broadly important to the photovoltaic community at large as increased efficiency, the topic of radiation damage is critically important to use of solar cells in space, and is a major component of the NASA research program in space photovoltaics. A brief overview of some of the opportunities and challenges for space photovoltaic applications is given, and some of the current research directed at achieving high efficiency and controlling radiation damage in space solar cells is discussed.

Measuring routine nursing service efficiency: a comparison of cost per patient day and data envelopment analysis models.

PubMed Central

Nunamaker, T R

1983-01-01

This article provides an illustrative application of Data Envelopment Analysis (DEA) methodology to the measurement of routine nursing service efficiency at a group of Wisconsin hospitals. The DEA efficiency ratings and cost savings estimates are then compared to those resulting from application of Medicare's routine cost limitation to the sample data. DEA is also used to determine if any changes in the potential for efficient operations occurred during the 1978-1979 period. Empirical results were representative of the fundamental differences existing between the DEA and cost per patient day approaches. No evidence was found to support the notion that the overall potential for efficient delivery of routine services by the sample institutions was greater in one year than another. PMID:6874357

Adaptive proxy map server for efficient vector spatial data rendering

NASA Astrophysics Data System (ADS)

Sayar, Ahmet

2013-01-01

The rapid transmission of vector map data over the Internet is becoming a bottleneck of spatial data delivery and visualization in web-based environment because of increasing data amount and limited network bandwidth. In order to improve both the transmission and rendering performances of vector spatial data over the Internet, we propose a proxy map server enabling parallel vector data fetching as well as caching to improve the performance of web-based map servers in a dynamic environment. Proxy map server is placed seamlessly anywhere between the client and the final services, intercepting users' requests. It employs an efficient parallelization technique based on spatial proximity and data density in case distributed replica exists for the same spatial data. The effectiveness of the proposed technique is proved at the end of the article by the application of creating map images enriched with earthquake seismic data records.

A secure and efficient authentication and key agreement scheme based on ECC for telecare medicine information systems.

PubMed

Xu, Xin; Zhu, Ping; Wen, Qiaoyan; Jin, Zhengping; Zhang, Hua; He, Lian

2014-01-01

In the field of the Telecare Medicine Information System, recent researches have focused on consummating more convenient and secure healthcare delivery services for patients. In order to protect the sensitive information, various attempts such as access control have been proposed to safeguard patients' privacy in this system. However, these schemes suffered from some certain security defects and had costly consumption, which were not suitable for the telecare medicine information system. In this paper, based on the elliptic curve cryptography, we propose a secure and efficient two-factor mutual authentication and key agreement scheme to reduce the computational cost. Such a scheme enables to provide the patient anonymity by employing the dynamic identity. Compared with other related protocols, the security analysis and performance evaluation show that our scheme overcomes some well-known attacks and has a better performance in the telecare medicine information system.

Clinical comparison of masticatory performance and electromyographic activity of patients with complete dentures, overdentures, and natural teeth.

PubMed

Rissin, L; House, J E; Manly, R S; Kapur, K K

1978-05-01

In this study, which is the first of its kind, it has been shown that overdenture patients, when compared to complete denture patients, while chewing a test food for a constant number of strokes, expended an equivalent amount of muscle effort, chewed more slowly and efficiently, and evidenced significantly better masticatory performance by producing an increased volume of fine test food particles. These findings provide a sound justification for the extra effort required to retain some natural teeth to provide overdenture services to patients. The fact that patients can masticate food more efficiently with overdentures than with complete dentures justifies the increased cost and time involved in their construction. The longitudinal effects that overdentures have on the basic physiopathologic processed involved in the progression of ridge resorption and the advantages of maintaining periodontal proprioception also should be studied.

Is bigger better? An empirical analysis of waste management in New South Wales

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

Carvalho, Pedro, E-mail: pedrotcc@gmail.com; CESUR – Center for Urban and Regional Systems, Instituto Superior Técnico, University of Lisboa, Av. Rovisco Pais, 1049-001 Lisbon; Marques, Rui Cunha, E-mail: rui.marques@tecnico.ulisboa.pt

Highlights: • We search for the most efficient cost structure for NSW household waste services. • We found that larger services are no longer efficient. • We found an optimal size for the range 12,000–20,000 inhabitants. • We found significant economies of output density for household waste collection. • We found economies of scope in joint provision of unsorted and recycling services. - Abstract: Across the world, rising demand for municipal solid waste services has seen an ongoing increase in the costs of providing these services. Moreover, municipal waste services have typically been provided through natural or legal monopolies, wheremore » few incentives exist to reduce costs. It is thus vital to examine empirically the cost structure of these services in order to develop effective public policies which can make these services more cost efficient. Accordingly, this paper considers economies of size and economies of output density in the municipal waste collection sector in the New South Wales (NSW) local government system in an effort to identify the optimal size of utilities from the perspective of cost efficiency. Our results show that – as presently constituted – NSW municipal waste services are not efficient in terms of costs, thereby demonstrating that ‘bigger is not better.’ The optimal size of waste utilities is estimated to fall in the range 12,000–20,000 inhabitants. However, significant economies of output density for unsorted (residual) municipal waste collection and recycling waste collection were found, which means it is advantageous to increase the amount of waste collected, but maintaining constant the number of customers and the intervention area.« less

Efficient and Scalable Cross-Matching of (Very) Large Catalogs

NASA Astrophysics Data System (ADS)

Pineau, F.-X.; Boch, T.; Derriere, S.

2011-07-01

Whether it be for building multi-wavelength datasets from independent surveys, studying changes in objects luminosities, or detecting moving objects (stellar proper motions, asteroids), cross-catalog matching is a technique widely used in astronomy. The need for efficient, reliable and scalable cross-catalog matching is becoming even more pressing with forthcoming projects which will produce huge catalogs in which astronomers will dig for rare objects, perform statistical analysis and classification, or real-time transients detection. We have developed a formalism and the corresponding technical framework to address the challenge of fast cross-catalog matching. Our formalism supports more than simple nearest-neighbor search, and handles elliptical positional errors. Scalability is improved by partitioning the sky using the HEALPix scheme, and processing independently each sky cell. The use of multi-threaded two-dimensional kd-trees adapted to managing equatorial coordinates enables efficient neighbor search. The whole process can run on a single computer, but could also use clusters of machines to cross-match future very large surveys such as GAIA or LSST in reasonable times. We already achieve performances where the 2MASS (˜470M sources) and SDSS DR7 (˜350M sources) can be matched on a single machine in less than 10 minutes. We aim at providing astronomers with a catalog cross-matching service, available on-line and leveraging on the catalogs present in the VizieR database. This service will allow users both to access pre-computed cross-matches across some very large catalogs, and to run customized cross-matching operations. It will also support VO protocols for synchronous or asynchronous queries.

Experiences Building Globus Genomics: A Next-Generation Sequencing Analysis Service using Galaxy, Globus, and Amazon Web Services

PubMed Central

Madduri, Ravi K.; Sulakhe, Dinanath; Lacinski, Lukasz; Liu, Bo; Rodriguez, Alex; Chard, Kyle; Dave, Utpal J.; Foster, Ian T.

2014-01-01

We describe Globus Genomics, a system that we have developed for rapid analysis of large quantities of next-generation sequencing (NGS) genomic data. This system achieves a high degree of end-to-end automation that encompasses every stage of data analysis including initial data retrieval from remote sequencing centers or storage (via the Globus file transfer system); specification, configuration, and reuse of multi-step processing pipelines (via the Galaxy workflow system); creation of custom Amazon Machine Images and on-demand resource acquisition via a specialized elastic provisioner (on Amazon EC2); and efficient scheduling of these pipelines over many processors (via the HTCondor scheduler). The system allows biomedical researchers to perform rapid analysis of large NGS datasets in a fully automated manner, without software installation or a need for any local computing infrastructure. We report performance and cost results for some representative workloads. PMID:25342933

Experiences Building Globus Genomics: A Next-Generation Sequencing Analysis Service using Galaxy, Globus, and Amazon Web Services.

PubMed

Madduri, Ravi K; Sulakhe, Dinanath; Lacinski, Lukasz; Liu, Bo; Rodriguez, Alex; Chard, Kyle; Dave, Utpal J; Foster, Ian T

2014-09-10

We describe Globus Genomics, a system that we have developed for rapid analysis of large quantities of next-generation sequencing (NGS) genomic data. This system achieves a high degree of end-to-end automation that encompasses every stage of data analysis including initial data retrieval from remote sequencing centers or storage (via the Globus file transfer system); specification, configuration, and reuse of multi-step processing pipelines (via the Galaxy workflow system); creation of custom Amazon Machine Images and on-demand resource acquisition via a specialized elastic provisioner (on Amazon EC2); and efficient scheduling of these pipelines over many processors (via the HTCondor scheduler). The system allows biomedical researchers to perform rapid analysis of large NGS datasets in a fully automated manner, without software installation or a need for any local computing infrastructure. We report performance and cost results for some representative workloads.

Evaluation and Validation of Organic Materials for Advanced Stirling Convertors (ASCs): Overview

NASA Technical Reports Server (NTRS)

Shin, Euy-Sik Eugene

2015-01-01

Various organic materials are used as essential parts in Stirling Convertors for their unique properties and functionalities such as bonding, potting, sealing, thread locking, insulation, and lubrication. More efficient Advanced Stirling Convertors (ASC) are being developed for future space applications especially with a long mission cycle, sometimes up to 17 years, such as deep space exploration or lunar surface power or Mars rovers, and others. Thus, performance, durability, and reliability of those organics should be critically evaluated in every possible material-process-fabrication-service environment relations based on their mission specifications. In general, thermal stability, radiation hardness, outgassing, and material compatibility of the selected organics have been systematically evaluated while their process and fabrication conditions and procedures were being optimized. Service environment-simulated long term aging tests up to 4 years were performed as a function of temperature for durability assessment of the most critical organic material systems.

It's Just (Academic) Business: A Use Case in Improving Informatics Operations with Business Intelligence.

PubMed

McIntosh, Leslie D; Zabarovskaya, Connie; Uhlmansiek, Mary

2015-01-01

Academic biomedical informatics cores are beholden to funding agencies, institutional administration, collaborating researchers, and external agencies for ongoing funding and support. Services provided and translational research outcomes are increasingly important to monitor, report and analyze, to demonstrate value provided to the organization and the greater scientific community. Thus, informatics operations are also business operations. As such, adopting business intelligence practices offers an opportunity to improve the efficiency of evaluation efforts while fulfilling reporting requirements. Organizing informatics development documentation, service requests, and work performed with adaptable tools have greatly facilitated these and related business activities within our informatics center. Through the identification and measurement of key performance indicators, informatics objectives and results are now quickly and nimbly assessed using dashboards. Acceptance of the informatics operation as a business venture and the adoption of business intelligence strategies has allowed for data-driven decision making, faster corrective action, and greater transparency for interested stakeholders.

Acute pain management efficiency improves with point-of-care handheld electronic billing system.

PubMed

Fahy, Brenda G

2009-02-01

Technology advances continue to impact patient care and physician workflow. To enable more efficient performance of billing activities, a point-of-care (POC) handheld computer technology replaced a paper-based system on an acute pain management service. Using a handheld personal digital assistant (PDA) and software from MDeverywhere (MDe, MDeverywhere, Long Island, NY), we performed a 1-yr prospective observational study of an anesthesiology acute pain management service billings and collections. Seventeen anesthesiologists providing billable acute pain services were trained and entered their charges on a PDA. Twelve months of data, just before electronic implementation (pre-elec), were compared to a 12-m period after implementation (post-elec). The total charges were 4883 for 890 patients pre-elec and 5368 for 1128 patients post-elec. With adoption of handheld billing, the charge lag days decreased from 29.3 to 7.0 (P < 0.001). The days in accounts receivable trended downward from 59.9 to 51.1 (P = 0.031). The average number of charge lag days decreased significantly with month (P = 0.0002). The net collection rate increased from 37.4% pre-elec to 40.3% post-elec (P < 0.001). The return on investment was 1.18 fold (118%). Implementation of POC electronic billing using PDAs to replace a paper-based billing system improved the collection rate and decreased the number of charge lag days with a positive return on investment. The handheld PDA billing system provided POC support for physicians during their daily clinical (e.g., patient locations, rounding lists) and billing activities, improving workflow.

Effects of the performance management information system in improving performance: an empirical study in Shanghai Ninth People's Hospital.

PubMed

Cui, Yinghui; Wu, Zhengyi; Lu, Yao; Jin, Wenzhong; Dai, Xing; Bai, Jinxi

2016-01-01

Improving the performance of clinical departments is not only the significant content of the healthcare system reform in China, but also the essential approach to better satisfying the Chinese growing demand for medical services. Performance management is vital and meaningful to public hospitals in China. Several studies are conducted in hospital internal performance management, but almost none of them consider the effects of informational tools. Therefore, we carried out an empirical study on effects of using performance management information system in Shanghai Ninth People's Hospital. The main feature of the system is that it provides a real-time query platform for users to analyze and dynamically monitor the key performance indexes, timely detect problems and make adjustments. We collected pivotal medical data on 35 clinical departments of this hospital from January 2013 until December 2014, 1 year before and after applying the performance management information system. Comparative analysis was conducted by statistical methods. The results show that the system is beneficial to improve performance scores of clinical departments and lower the proportion of drug expenses, meanwhile, shorten the average hospitalized days and increase the bed turnover rate. That is to say, with the increasing medical services, the quality and efficiency is greatly improved. In a word, application of the performance management information system has a positive effect on improving performance of clinical departments.

Production of fortified food for a public supplementary nutrition program: performance and viability of a decentralised production model for the Integrated Child Development Services Program, India.

PubMed

Antier, Clémentine; Kumar, Salil; Bhagwat, Sadhana; Sankar, Rajan

2014-01-01

Integrated Child Development Services in India through its supplementary nutrition programme covers over 100 million children, pregnant and lactating women across the country. Providing a hot cooked meal each day to children aged between 3-6 years and a take-home ration to children aged between 6-36 months, pregnant and lactating women, the Integrated Child Development Services faces a monumental task to deliver this component of services of desired quality and regularity at scale. From intermediaries or contractors who acted as agents for procuring and distributing food to procurement directly from large food manufacturers to using women groups as food producers, different State Governments have adopted a variety of strategies to procure and distribute food, especially the take-home ration. India's Supreme Court, through its directive of 2004, encouraged the Government to engage women's groups for the production of the supplementary food. This study was conducted to determine the operational performance, economic sustainability and social impact of a decentralised production model for India's Supplementary Nutrition Program, in which women groups run smallscale industrialised units. Data were collected through observation, interviews and group discussions with key stakeholders. Operational performance was analysed through standard performance indicators that measured consistency in production, compliance with quality standards and distribution regularity. Assessment of the economic viability included cost structure analysis, five-year projections, and financial ratios. Social impact was assessed using a qualitative approach. The pilot unit has demonstrated its operational performance and cost-efficiency. More data is needed to evaluate the scalability and sustainability of this decentralised model.

Practical Approaches to Quality Improvement for Radiologists.

PubMed

Kelly, Aine Marie; Cronin, Paul

2015-10-01

Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. © RSNA, 2015.

A New Approach of Measuring Hospital Performance for Low- and Middle-income Countries

PubMed Central

Sapkota, Vishnu Prasad; Supakankunti, Siripen

2015-01-01

Efficiency of the hospitals affects the price of health services. Health care payments have equity implications. Evidence on hospital performance can support to design the policy; however, the recent literature on hospital efficiency produced conflicting results. Consequently, policy decisions are uncertain. Even the most of evidence were produced by using data from high income countries. Conflicting results were produced particularly due to differences in methods of measuring performance. Recently a management approach has been developed to measure the hospital performance. This approach to measure the hospital performance is very useful from policy perspective to improve health system from cost-effective way in low and middle income countries. Measuring hospital performance through management approach has some basic characteristics such as scoring management practices through double blind survey, measuring hospital outputs using various indicators, estimating the relationship between management practices and outputs of the hospitals. This approach has been successfully applied to developed countries; however, some revisions are required without violating the fundamental principle of this approach to replicate in low- and middle-income countries. The process has been clearly defined and applied to Nepal. As the results of this, the approach produced expected results. The paper contributes to improve the approach to measure hospital performance. PMID:26617448

International Space Station Bacteria Filter Element Post-Flight Testing and Service Life Prediction

NASA Technical Reports Server (NTRS)

Perry, J. L.; von Jouanne, R. G.; Turner, E. H.

2003-01-01

The International Space Station uses high efficiency particulate air (HEPA) filters to remove particulate matter from the cabin atmosphere. Known as Bacteria Filter Elements (BFEs), there are 13 elements deployed on board the ISS's U.S. Segment. The pre-flight service life prediction of 1 year for the BFEs is based upon performance engineering analysis of data collected during developmental testing that used a synthetic dust challenge. While this challenge is considered reasonable and conservative from a design perspective, an understanding of the actual filter loading is required to best manage the critical ISS Program resources. Thus testing was conducted on BFEs returned from the ISS to refine the service life prediction. Results from this testing and implications to ISS resource management are discussed. Recommendations for realizing significant savings to the ISS Program are presented.

Perspectives: parity--prelude to a fifth cycle of reform.

PubMed

Goldman, Howard H

2002-09-01

Based on 2000 Carl Taube Lecture at the NIMH Mental Health Economics Meeting. This perspective article examines the relationship between a policy of parity in financing mental health services and the future of reform in service delivery. Applying theories of static and dynamic efficiency to an understanding of parity and the evolution of mental health services, drawing upon Burton Weisbrod s concept of the health care quadrilemma . Each of four cycles of reform in mental health services have contended with issues of static and dynamic efficiency. Each cycle was associated with static efficiency in the management and financing of services, and each was associated with a set of new treatment technologies intended to improve dynamic efficiency. Each reform proved ultimately unsuccessful primarily because of the failure of the treatment technologies to prevent future patient chronicity or to achieve sustained recovery. Recent advances in treatment technology and management of care can permit an unprecedented level of efficiency consistent with a policy of improved access to mainstream health and social welfare resources, including insurance coverage. This policy of so-called financing parity can improve current mental health service delivery, but it may also portend a future fifth cycle of reform. If new technologies continue to advance as full technologies - simple to deliver and producing true recovery - and mainstream resources are made available, then the specialty mental health services may contract dramatically in favor of effective care and treatment of mental illness in primary care and other mainstream settings. Predicting the future of health care is speculative, but it may be easier using the Weisbrod formulation to understand the process of mental health reform. Over-reliance on administrative techniques for building static efficiency and false optimism about dynamic efficiency from new technology have stymied previous reforms. All the same, a fifth cycle of reform could succeed, if the right conditions are met and mainstream resources are available.

GAUSS Market Analysis for Integrated Satellite Communication and Navigation Location Based services

NASA Astrophysics Data System (ADS)

Di Fazio, Antonella; Dricot, Fabienne; Tata, Francesco

2003-07-01

The demand for mobile information services coupled with positioning technologies for delivering value- added services that depend on a user's location has rapidly increased during last years. In particular, services and applications related with improved mobility safety and transport efficiency look very attractive.Solutions for location services vary in respect of positioning accuracy and the technical infrastructure required, and the associated investment in terminals and networks. From the analysis of the state-of-the art, it comes that various technologies are currently available on the European market, while mobile industry is gearing up to launch a wide variety of location services like tracking, alarming and locating.Nevertheless, when addressing safety of life as well as security applications, severe hurdles have to be posed in the light of existing technologies. Existing navigation (e.g. GPS) and communication systems are not able to completely satisfy the needs and requirements of safety-of-life-critical applications. As a matter of fact, the GPS system's main weaknesses today is its lack of integrity, which means its inability to warn users of a malfunction in a reasonable time, while the other positioning techniques do not provide satisfactory accuracy as well, and terrestrial communication networks are not capable to cope with stringent requirement in terms of service reliability and coverage.In this context, GAUSS proposes an innovative satellite-based solution using novel technology and effective tools for addressing mobility challenges in a cost efficient manner, improving safety and effectiveness.GAUSS (Galileo And UMTS Synergetic System) is a Research and Technological Development project co- funded by European Commission, within the frame of the 5th IST Programme. The project lasted two years, and it was successfully completed in November 2002. GAUSS key concept is the integration of Satellite Navigation GNSS and UMTS communication technology, to provide high quality location based services (tracking, tracing, alarming, messaging, group broadcasting, fleet management information) oriented to mass and business markets transport & mobility management. The GAUSS rationales for the proposed solution rely on the consideration that the existing and available systems are not capable to completely fulfil stringent requirements for the navigation and communication capabilities, in terms of integrity/continuity positioning and guarantee of performances, as those coming from classes of users in the inter-modality and specific personal info-mobility sectors.For the navigation functions, the use of GALILEO will ensure a guaranteed quality of service and adequate performances, in terms of accuracy and integrity, as required for safety and working condition improvements (such as restricted waterways - ports, coasts, rivers - and hazardous goods transportation). Furthermore, it also will enable to cope with liability and certification requirements that are needed for responsibility issues, in case of damages or accidents.From the communication viewpoint, the challenges reside on the usage of the UMTS. This enables to fit GAUSS into an open market place: avoiding proliferation of standards and adoption of open interfaces to be defined by the business interest. Furthermore, the GAUSS solution fully exploits the advantages coming from the usage of the satellite of offering solutions for effectively complement terrestrial based systems (fast and large coverage, economically viable set-up cost, efficient provisioning of broadcasting and multicasting features, gap filler capability).A comprehensive market analysis was carried out in the frame of the project, aimed at investigating the techno-economical viability for a possible commercial introduction of the proposed solution.This paper presents the output of the performed studies, resulting in a realistic picture of the GAUSS market:§ Identification of potential actors/players (operators, manufacturers, professional and mass market users, service providers, authorities, etc.)§ Competitive analysis§ Market size and segmentation, and GAUSS position in the market§ Business models§ Business plan and cost/benefit ratio§ Identification of market opportunities for services and applications, in view of the future GALILEO and S-UMTS.

LED Provides Effective and Efficient Parking Area Lighting at the NAVFAC Engineering Service Center

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

None

2010-08-12

U.S. Department of Energy (DOE) Federal Energy Management Program (FEMP) emerging technology case study showcasing LED lighting to improve energy efficiency in parking areas at the NAVFAC Engineering Services Center.

An assessment of emergency medicine residents' ability to perform in a multitasking environment.

PubMed

Ledrick, David; Fisher, Susan; Thompson, Justin; Sniadanko, Mark

2009-09-01

Multitasking (MT) is a term often applied to emergency medicine (EM), but it is still poorly understood. In an effort to facilitate MT research in EM, the authors conducted this pilot study to describe EM residents' scores on a Multi-Tasking Assessment Tool (MTAT) and compare these scores with the residents' work efficiency in the emergency department. The authors administered a previously developed test of MT ability to EM residents. They performed a multiple regression analysis to determine the effect of MT ability on resident work efficiency, defining efficiency as the number of relative value units billed per hour. They controlled the analysis for year of training and medical knowledge using as a standard the in-service exam administered by the American Board of Emergency Medicine. Complete data for 35 residents were available for analysis. Work efficiency was multivariately correlated with MTAT scores and year of training (P < .05). Whereas year of training explained the majority of the variance, a resident's MT ability accounted for a smaller but still significant portion. This pilot study further validates the MTAT and lays the groundwork for further research in MT in EM. Resident year of training and MTAT scores explain the variability in resident work efficiency significantly more than medical knowledge. Understanding MT ability may ultimately help in resident selection, education, and remediation as well as career counseling and improvement of practice systems in EM.

[Integrated health care organizations: guideline for analysis].

PubMed

Vázquez Navarrete, M Luisa; Vargas Lorenzo, Ingrid; Farré Calpe, Joan; Terraza Núñez, Rebeca

2005-01-01

There has been a tendency recently to abandon competition and to introduce policies that promote collaboration between health providers as a means of improving the efficiency of the system and the continuity of care. A number of countries, most notably the United States, have experienced the integration of health care providers to cover the continuum of care of a defined population. Catalonia has witnessed the steady emergence of increasing numbers of integrated health organisations (IHO) but, unlike the United States, studies on health providers' integration are scarce. As part of a research project currently underway, a guide was developed to study Catalan IHOs, based on a classical literature review and the development of a theoretical framework. The guide proposes analysing the IHO's performance in relation to their final objectives of improving the efficiency and continuity of health care by an analysis of the integration type (based on key characteristics); external elements (existence of other suppliers, type of services' payment mechanisms); and internal elements (model of government, organization and management) that influence integration. Evaluation of the IHO's performance focuses on global strategies and results on coordination of care and efficiency. Two types of coordination are evaluated: information coordination and coordination of care management. Evaluation of the efficiency of the IHO refers to technical and allocative efficiency. This guide may have to be modified for use in the Catalan context.

Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review

PubMed Central

Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

2012-01-01

Introduction Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Methods and Findings Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of “private sector” included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. “Competitive dynamics” for funding appeared between the two sectors, such that public funds and personnel were redirected to private sector development, followed by reductions in public sector service budgets and staff. Conclusions Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients. Please see later in the article for the Editors' Summary PMID:22723748

Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review.

PubMed

Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

2012-01-01

Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of "private sector" included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. "Competitive dynamics" for funding appeared between the two sectors, such that public funds and personnel were redirected to private sector development, followed by reductions in public sector service budgets and staff. Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients.

Personalization of Rule-based Web Services.

PubMed

Choi, Okkyung; Han, Sang Yong

2008-04-04

Nowadays Web users have clearly expressed their wishes to receive personalized services directly. Personalization is the way to tailor services directly to the immediate requirements of the user. However, the current Web Services System does not provide any features supporting this such as consideration of personalization of services and intelligent matchmaking. In this research a flexible, personalized Rule-based Web Services System to address these problems and to enable efficient search, discovery and construction across general Web documents and Semantic Web documents in a Web Services System is proposed. This system utilizes matchmaking among service requesters', service providers' and users' preferences using a Rule-based Search Method, and subsequently ranks search results. A prototype of efficient Web Services search and construction for the suggested system is developed based on the current work.

Emergency surgery pre-operative delays - realities and economic impacts.

PubMed

O'Leary, D P; Beecher, S; McLaughlin, R

2014-12-01

A key principle of acute surgical service provision is the establishment of a distinct patient flow process and an emergency theatre. Time-to-theatre (TTT) is a key performance indicator of theatre efficiency. The combined impacts of an aging population, increasing demands and complexity associated with centralisation of emergency and oncology services has placed pressure on emergency theatre access. We examined our institution's experience with running a designated emergency theatre for acute surgical patients. A retrospective review of an electronic prospectively maintained database was performed between 1/1/12 and 31/12/13. A cost analysis was conducted to assess the economic impact of delayed TTT, with every 24hr delay incurring the cost of an additional overnight bed. Delays and the economic effects were assessed only after the first 24 h as an in-patient had elapsed. In total, 7041 procedures were performed. Overall mean TTT was 26 h, 2 min. There were significant differences between different age groups, with those aged under 16 year and over 65 having mean TTT at 6 h, 34 min (95% C.I. 0.51-2.15, p < 0.001) and 23 h, 41 min (95% C.I. 19.6-23.9, p < 0.001) respectively. 2421 (34%) waited greater than 24 h for emergency procedures. The >65 years age group had a mean TTT of 23 h, 41 min which was significantly longer than the overall mean TTT Vascular and urological emergencies are significantly disadvantaged in competition with other services for a shared emergency theatre. The economic impact of delayed TTT was calculated at €7,116,000, or €9880/day of additional costs generated from delayed TTT over a 24 month period. One third of patients waited longer than 24 h for emergency surgery, with the elderly disproportionately represented in this group. Aside from the clinical risks of delayed and out of hours surgery, such practices incur significant additional costs. New strategies must be devised to ensure efficient access to emergency theatres, investment in such services is likely to be financially and clinically beneficial. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Cheques and challenges: business performance in New Zealand general practice.

PubMed

Greatbanks, Richard; Doolan-Noble, Fiona; McKenna, Alex

2017-09-01

INTRODUCTION New Zealand general practice mainly functions as small businesses, usually owned by a single or small group of doctors. Consequently, owners often have to balance the provision of patient care with varying funding priorities, changing patient needs and the pressures of running a sustainable business. Such balancing inevitably leads to tensions developing between these factors. AIM To explore and understand these tensions and responses to them, by examining the business performance measurements used by general practice. METHODS For this study, the unit of analysis and focus were individual practices, but qualitative semi-structured interviews with general practitioners (GPs) and practice managers were used to gather the data. RESULTS All participating practices had some form of governance or board review, where high-level aggregated business performance data were presented. More sophisticated business performance measures were evident in the larger, more developed practices and in practices functioning as community trusts. Examples of such measures included doctor utilisation and efficiency, appraisal of risk, patient satisfaction with services and responses to changes in patient demand. DISCUSSION As the number of general practices based on the traditional model decrease, a corresponding increase is likely in the establishment and development of 'super practices' based on a corporatized, multi-service, single-location model. Consequently, service delivery will become increasingly complex and will drive a need for increased sophistication in how general practice measures its business performance, thus ensuring a balance between high-quality, safe patient care and the maintenance of a sustainable business.

Online access to journal abstracts and articles.

PubMed

Giedd, J N; Smith, K G

1997-01-01

Advances in information technology now offer several options for child and adolescent psychopharmacologists to navigate the increasingly complex terrain of scientific literature and keep abreast of the rapidly changing advances in our field. MEDLINE, the world's largest database of medical literature, can be accessed and searched by a variety of free or fee-based services. In addition to efficient retrieval of citations and abstracts based on subject, author, or title, many of these services now provide, for a fee, the entire text and graphics of articles (displayed on computer screen, faxed, or mailed). There are also current awareness services to alert the user when new requested literature become available as well as services to send via e-mail the tables of contents of requested journals (sometimes prior to paper publication). For online citation and abstract retrieval, we found that free services, such as PubMed, performed as good or better than fee-based services. Physicians' Online, sponsored by the pharmaceutical industry, offered the lowest price for full-text manuscript delivery. In this article, we review literature search, delivery, and update services and offer some tips on how to most effectively use these resources.

Organisational benefits of a strong research culture in a health service: a systematic review.

PubMed

Harding, Katherine; Lynch, Lauren; Porter, Judi; Taylor, Nicholas F

2017-03-01

Objective The aim of the present study was to determine whether there is an association between having research culture in a health service and better organisational performance. Methods Using systematic review methods, databases were searched, inclusion criteria applied and study quality appraised. Data were extracted from selected studies and the results were synthesised descriptively. Results Eight studies were selected for review. Five studies compared health services with high versus low levels of research activity among the workforce. Three studies evaluated the effect of specific interventions focused on the health workforce. All studies reported a positive association between research activity and organisational performance. Improved organisational performance included lower patient mortality rates (two of two studies), higher levels of patient satisfaction (one of one study), reduced staff turnover (two of two studies), improved staff satisfaction (one of two studies) and improved organisational efficiency (four of five studies). Conclusions A stronger research culture appears to be associated with benefits to patients, staff and the organisation. What is known about this topic? Research investment in the health workforce can increase research productivity of the health workforce. In addition, investment in clinical research can lead to positive health outcomes. However, it is not known whether a positive research culture among the health workforce is associated with improved organisational performance. What does this paper add? The present systematic review of the literature provides evidence that a positive research culture and interventions directed at the health workforce are associated with patient, staff and organisational benefits. What are the implications for practitioners? For health service managers and policy makers, one interpretation of the results could be to provide support for initiatives directed at the health workforce to increase a research culture in health services. However, because association does not imply causation, managers need to interpret the results with caution and evaluate the effect of any initiatives to increase the research culture of the health workforce on the performance of their organisation.

SPP: A data base processor data communications protocol

NASA Technical Reports Server (NTRS)

Fishwick, P. A.

1983-01-01

The design and implementation of a data communications protocol for the Intel Data Base Processor (DBP) is defined. The protocol is termed SPP (Service Port Protocol) since it enables data transfer between the host computer and the DBP service port. The protocol implementation is extensible in that it is explicitly layered and the protocol functionality is hierarchically organized. Extensive trace and performance capabilities have been supplied with the protocol software to permit optional efficient monitoring of the data transfer between the host and the Intel data base processor. Machine independence was considered to be an important attribute during the design and implementation of SPP. The protocol source is fully commented and is included in Appendix A of this report.

Three-factor anonymous authentication and key agreement scheme for Telecare Medicine Information Systems.

PubMed

Arshad, Hamed; Nikooghadam, Morteza

2014-12-01

Nowadays, with comprehensive employment of the internet, healthcare delivery services is provided remotely by telecare medicine information systems (TMISs). A secure mechanism for authentication and key agreement is one of the most important security requirements for TMISs. Recently, Tan proposed a user anonymity preserving three-factor authentication scheme for TMIS. The present paper shows that Tan's scheme is vulnerable to replay attacks and Denial-of-Service attacks. In order to overcome these security flaws, a new and efficient three-factor anonymous authentication and key agreement scheme for TMIS is proposed. Security and performance analysis shows superiority of the proposed scheme in comparison with previously proposed schemes that are related to security of TMISs.

Evaluating alternative service contracts for medical equipment.

PubMed

De Vivo, L; Derrico, P; Tomaiuolo, D; Capussotto, C; Reali, A

2004-01-01

Managing medical equipments is a formidable task that has to be pursued maximizing the benefits within a highly regulated and cost-constrained environment. Clinical engineers are uniquely equipped to determine which policies are the most efficacious and cost effective for a health care institution to ensure that medical devices meet appropriate standards of safety, quality and performance. Part of this support is a strategy for preventive and corrective maintenance. This paper describes an alternative scheme of OEM (Original Equipment Manufacturer) service contract for medical equipment that combines manufacturers' technical support and in-house maintenance. An efficient and efficacious organization can reduce the high cost of medical equipment maintenance while raising reliability and quality. Methodology and results are discussed.

Scaling up the energy service company business: market status and company feedback in the Russian Federation

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

Roshchanka, Volha; Evans, Meredydd

Many energy efficiency professionals have proposed using Energy Performance Contracts (EPCs) as a mechanism to improve public sector energy efficiency in countries with restrictive government budgets. However, in practice, most middle-income countries have used this mechanism only in a limited way. Russia offers an interesting case study because of its huge energy savings opportunities, increasing energy prices, robust political backing for public sector energy efficiency, and evolving legislation that supports EPCs. In 2009, the Russian Federation launched a program to reduce the energy intensity of the country’s large public sector, which accounts for 9 percent of Russia’s total energy consumption.more » To achieve energy efficiency goals, Russia experimented with its public procurement rules, adjusting them to encourage EPCs. We conducted structured interviews with Energy Service Companies (ESCOs) in Russia and supplemented them with online research. Our review shows that, to date, nearly 50 ESCOs signed about 150 contracts in public facilities. Most ESCO contracts in Russia are for 5 years, and they generally are small (under $100,000). ESCOs in Russia face a challenging environment, which leads to smaller projects. ESCOs also are concerned about costly and risky tender procedures, uncertainty regarding repayment from public facilities, the inability to expand projects, and financing. We discuss these challenges and propose potential solutions at policy and company levels. The ESCOs feedback regarding Russia’s experimental model can inform the country’s program for public sector energy efficiency and offer lessons for other countries attempting to develop the EPC mechanism.« less

Efficiency and quality of care in nursing homes: an Italian case study.

PubMed

Garavaglia, Giulia; Lettieri, Emanuele; Agasisti, Tommaso; Lopez, Silvano

2011-03-01

This study investigates efficiency and quality of care in nursing homes. By means of Data Envelopment Analysis (DEA), the efficiency of 40 nursing homes that deliver their services in the north-western area of the Lombardy Region was assessed over a 3-year period (2005-2007). Lombardy is a very peculiar setting, since it is the only Region in Italy where the healthcare industry is organised as a quasi-market, in which the public authority buys health and nursing services from independent providers-establishing a reimbursement system for this purpose. The analysis is conducted by generating bootstrapped DEA efficiency scores for each nursing home (stage one), then regressing those scores on explanatory variables (stage two). Our DEA model employed two input (i.e. costs for health and nursing services and costs for residential services) and three output variables (case mix, extra nursing hours and residential charges). In the second-stage analysis, Tobit regressions and the Kruskall-Wallis tests of hypothesis to the efficiency scores were applied to define what are the factors that affect efficiency: (a) the ownership (private nursing houses outperform their public counterparts); and (b) the capability to implement strategies for labour cost and nursing costs containment, since the efficiency heavily depends upon the alignment of the costs to the public reimbursement system. Lastly, even though the public institutions are less efficient than the private ones, the results suggest that public nursing homes are moving towards their private counterparts, and thus competition is benefiting efficiency.

Efficiency of the Technology Acceptance Model to Explain Pre-Service Teachers' Intention to Use Technology: A Turkish Study

ERIC Educational Resources Information Center

Teo, Timothy; Ursavas, Omer Faruk; Bahcekapili, Ekrem

2011-01-01

Purpose: The purpose of this study is to assess the efficiency of the technology acceptance model (TAM) to explain pre-service teachers' intention to use technology in Turkey. Design/methodology/approach: A total of 197 pre-service teachers from a Turkish university completed a survey questionnaire measuring their responses to four constructs…

Developing an Energy Performance Modeling Startup Kit

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

Wood, A.

2012-10-01

In 2011, the NAHB Research Center began the first part of the multi-year effort by assessing the needs and motivations of residential remodelers regarding energy performance remodeling. The scope is multifaceted - all perspectives will be sought related to remodeling firms ranging in size from small-scale, sole proprietor to national. This will allow the Research Center to gain a deeper understanding of the remodeling and energy retrofit business and the needs of contractors when offering energy upgrade services. To determine the gaps and the motivation for energy performance remodeling, the NAHB Research Center conducted (1) an initial series of focusmore » groups with remodelers at the 2011 International Builders' Show, (2) a second series of focus groups with remodelers at the NAHB Research Center in conjunction with the NAHB Spring Board meeting in DC, and (3) quantitative market research with remodelers based on the findings from the focus groups. The goal was threefold, to: Understand the current remodeling industry and the role of energy efficiency; Identify the gaps and barriers to adding energy efficiency into remodeling; and Quantify and prioritize the support needs of professional remodelers to increase sales and projects involving improving home energy efficiency. This report outlines all three of these tasks with remodelers.« less

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China

PubMed Central

Zhang, Xinyu; Zhao, Lin; Cui, Zhuang; Wang, Yaogang

2015-01-01

Background This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China. Methods We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI) and Gini coefficient. Data envelopment analysis (DEA) was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA) was used to determine input/output indicators. Results The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742%) were observed to be technically efficient constituting the “best practice frontier”. The other 8 (25.8%) provinces were technically inefficient. Conclusions Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces. PMID:26679187

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China.

PubMed

Zhang, Xinyu; Zhao, Lin; Cui, Zhuang; Wang, Yaogang

2015-01-01

This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China. We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI) and Gini coefficient. Data envelopment analysis (DEA) was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA) was used to determine input/output indicators. The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742%) were observed to be technically efficient constituting the "best practice frontier". The other 8 (25.8%) provinces were technically inefficient. Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces.

MEDLINE SDI services: how do they compare?*

PubMed Central

Shultz, Mary; De Groote, Sandra L.

2003-01-01

Introduction: Selective dissemination of information (SDI) services regularly alert users to new information on their chosen topics. This type of service can increase a user's ability to keep current and may have a positive impact on efficiency and productivity. Currently, there are many venues available where users can establish, store, and automatically run MEDLINE searches. Purpose: To describe, evaluate, and compare SDI services for MEDLINE. Resources: The following SDI services were selected for this study: PubMed Cubby, BioMail, JADE, PubCrawler, OVID, and ScienceDirect. Methodology: Identical searches were established in four of the six selected SDI services and were run on a weekly basis over a period of two months. Eight search strategies were used in each system to test performance under various search conditions. The PubMed Cubby system was used as the baseline against which the other systems were compared. Other aspects were evaluated in all six services and include ease of use, frequency of results, ability to use MeSH, ability to access and edit existing search strategies, and ability to download to a bibliographic management program. Results: Not all MEDLINE SDI services retrieve identical results, even when identical search strategies are used. This study also showed that the services vary in terms of features and functions offered. PMID:14566377

Dynamic Resource Allocation to Improve Service Performance in Order Fulfillment Systems

DTIC Science & Technology

2009-01-01

efficient system uses economies of scale at two points: orders are batched before processing, which reduces processing costs, and processed or- ders ...the ef- fects of batching on order picking processes is well-researched and well-understood ( van den Berg and Gademann, 1999). Because orders are...a final so- journ time distribution. Our work builds on existing research in matrix-geometric methods by Neuts (1981), Asmussen and M0ller (2001

A Solar Dynamic Power Option for Space Solar Power

NASA Technical Reports Server (NTRS)

Mason, Lee S.

1999-01-01

A study was performed to determine the potential performance and related technology requirements of Solar Dynamic power systems for a Space Solar Power satellite. Space Solar Power is a concept where solar energy is collected in orbit and beamed to Earth receiving stations to supplement terrestrial electric power service. Solar Dynamic systems offer the benefits of high solar-to-electric efficiency, long life with minimal performance degradation, and high power scalability. System analyses indicate that with moderate component development, SD systems can exhibit excellent mass and deployed area characteristics. Using the analyses as a guide, a technology roadmap was -enerated which identifies the component advances necessary to make SD power generation a competitive option for the SSP mission.

Efficient Wideband Spectrum Sensing with Maximal Spectral Efficiency for LEO Mobile Satellite Systems

PubMed Central

Li, Feilong; Li, Zhiqiang; Li, Guangxia; Dong, Feihong; Zhang, Wei

2017-01-01

The usable satellite spectrum is becoming scarce due to static spectrum allocation policies. Cognitive radio approaches have already demonstrated their potential towards spectral efficiency for providing more spectrum access opportunities to secondary user (SU) with sufficient protection to licensed primary user (PU). Hence, recent scientific literature has been focused on the tradeoff between spectrum reuse and PU protection within narrowband spectrum sensing (SS) in terrestrial wireless sensing networks. However, those narrowband SS techniques investigated in the context of terrestrial CR may not be applicable for detecting wideband satellite signals. In this paper, we mainly investigate the problem of joint designing sensing time and hard fusion scheme to maximize SU spectral efficiency in the scenario of low earth orbit (LEO) mobile satellite services based on wideband spectrum sensing. Compressed detection model is established to prove that there indeed exists one optimal sensing time achieving maximal spectral efficiency. Moreover, we propose novel wideband cooperative spectrum sensing (CSS) framework where each SU reporting duration can be utilized for its following SU sensing. The sensing performance benefits from the novel CSS framework because the equivalent sensing time is extended by making full use of reporting slot. Furthermore, in respect of time-varying channel, the spatiotemporal CSS (ST-CSS) is presented to attain space and time diversity gain simultaneously under hard decision fusion rule. Computer simulations show that the optimal sensing settings algorithm of joint optimization of sensing time, hard fusion rule and scheduling strategy achieves significant improvement in spectral efficiency. Additionally, the novel ST-CSS scheme performs much higher spectral efficiency than that of general CSS framework. PMID:28117712

[Imaging center - optimization of the imaging process].

PubMed

Busch, H-P

2013-04-01

Hospitals around the world are under increasing pressure to optimize the economic efficiency of treatment processes. Imaging is responsible for a great part of the success but also of the costs of treatment. In routine work an excessive supply of imaging methods leads to an "as well as" strategy up to the limit of the capacity without critical reflection. Exams that have no predictable influence on the clinical outcome are an unjustified burden for the patient. They are useless and threaten the financial situation and existence of the hospital. In recent years the focus of process optimization was exclusively on the quality and efficiency of performed single examinations. In the future critical discussion of the effectiveness of single exams in relation to the clinical outcome will be more important. Unnecessary exams can be avoided, only if in addition to the optimization of single exams (efficiency) there is an optimization strategy for the total imaging process (efficiency and effectiveness). This requires a new definition of processes (Imaging Pathway), new structures for organization (Imaging Center) and a new kind of thinking on the part of the medical staff. Motivation has to be changed from gratification of performed exams to gratification of process quality (medical quality, service quality, economics), including the avoidance of additional (unnecessary) exams. © Georg Thieme Verlag KG Stuttgart · New York.

Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach

PubMed Central

Si, Sheng-Li; You, Xiao-Yue; Huang, Jia

2017-01-01

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that “accidents/adverse events”, “nosocomial infection”, ‘‘incidents/errors”, “number of operations/procedures” are significant influential indicators. Also, the indicators of “length of stay”, “bed occupancy” and “financial measures” play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions. PMID:28825613

BPcontrol

PubMed Central

Carrera, Adrián; Pifarré, Marc; Vilaplana, Jordi; Cuadrado, Josep; Solsona, Sara; Mateo, Jordi

2016-01-01

Summary Background Hypertension or high blood pressure is on the rise. Not only does it affect the elderly but is also increasingly spreading to younger sectors of the population. Treating this condition involves exhaustive monitoring of patients. The current mobile health services can be improved to perform this task more effectively. Objective To develop a useful, user-friendly, robust and efficient app, to monitor hypertensive patients and adapted to the particular requirements of hypertension. Methods This work presents BPcontrol, an Android and iOS app that allows hypertensive patients to communicate with their health-care centers, thus facilitating monitoring and diagnosis. Usability, robustness and efficiency factors for BPcontrol were evaluated for different devices and operating systems (Android, iOS and system-aware). Furthermore, its features were compared with other similar apps in the literature. Results BPcontrol is robust and user-friendly. The respective start-up efficiency of the Android and iOS versions of BPcontrol were 2.4 and 8.8 times faster than a system-aware app. Similar values were obtained for the communication efficiency (7.25 and 11.75 times faster for the Android and iOS respectively). When comparing plotting performance, BPcontrol was on average 2.25 times faster in the Android case. Most of the apps in the literature have no communication with a server, thus making it impossible to compare their performance with BPcontrol. Conclusions Its optimal design and the good behavior of its facilities make BPcontrol a very promising mobile app for monitoring hypertensive patients. PMID:27924346

BPcontrol. A Mobile App to Monitor Hypertensive Patients.

PubMed

Carrera, Adrian; Pifarré, Marc; Vilaplana, Jordi; Cuadrado, Josep; Solsona, Sara; Mateo, Jordi; Solsona, Francesc

2016-12-07

Hypertension or high blood pressure is on the rise. Not only does it affect the elderly but is also increasingly spreading to younger sectors of the population. Treating this condition involves exhaustive monitoring of patients. The current mobile health services can be improved to perform this task more effectively. To develop a useful, user-friendly, robust and efficient app, to monitor hypertensive patients and adapted to the particular requirements of hypertension. This work presents BPcontrol, an Android and iOS app that allows hypertensive patients to communicate with their health-care centers, thus facilitating monitoring and diagnosis. Usability, robustness and efficiency factors for BPcontrol were evaluated for different devices and operating systems (Android, iOS and system-aware). Furthermore, its features were compared with other similar apps in the literature. BPcontrol is robust and user-friendly. The respective start-up efficiency of the Android and iOS versions of BPcontrol were 2.4 and 8.8 times faster than a system-aware app. Similar values were obtained for the communication efficiency (7.25 and 11.75 times faster for the Android and iOS respectively). When comparing plotting performance, BPcontrol was on average 2.25 times faster in the Android case. Most of the apps in the literature have no communication with a server, thus making it impossible to compare their performance with BPcontrol. Its optimal design and the good behavior of its facilities make BPcontrol a very promising mobile app for monitoring hypertensive patients.

Reducing readmissions to detoxification: an interorganizational network perspective.

PubMed

Spear, Suzanne E

2014-04-01

The high cost of detoxification (detox) services and health risks associated with continued substance abuse make readmission to detox an important indicator of poor performance for substance use disorder treatment systems. This study examined the extent to which the structure of local networks available to detox programs affects patients' odds of readmission to detox within 1 year. Administrative data from 32 counties in California in 2008-2009 were used to map network ties between programs based on patient transfers. Social network analysis was employed to measure structural features of detox program networks. Contextual predictors included efficiency (proportion of ties within a network that are non-redundant) and out-degree (number of outgoing ties to other programs). A binary mixed model was used to predict the odds of readmission among detox patients in residential (non-hospital) facilities (N=18,278). After adjusting for patient-level covariates and continuity of service from detox to outpatient or residential treatment, network efficiency was associated with lower odds of readmission. The impact of network structure on detox readmissions suggests that the interorganizational context in which detox programs operate may be important for improving continuity of service within substance use disorder treatment systems. Implications for future research are discussed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Reducing Readmissions to Detoxification: An Interorganizational Network Perspective

PubMed Central

Spear, Suzanne E.

2014-01-01

Background The high cost of detoxification (detox) services and health risks associated with continued substance abuse make readmission to detox an important indicator of poor performance for substance use disorder treatment systems. This study examined the extent to which the structure of local networks available to detox programs affects patients’ odds of readmission to detox within 1 year. Methods Administrative data from 32 counties in California in 2008–2009 were used to map network ties between programs based on patient transfers. Social network analysis was employed to measure structural features of detox program networks. Contextual predictors included efficiency (proportion of ties within a network that are non-redundant) and out-degree (number of outgoing ties to other programs). A binary mixed model was used to predict the odds of readmission among detox patients in residential (non-hospital) facilities (N =18,278). Results After adjusting for patient-level covariates and continuity of service from detox to outpatient or residential treatment, network efficiency was associated with lower odds of readmission. Conclusion The impact of network structure on detox readmissions suggests that the interorganizational context in which detox programs operate may be important for improving continuity of service within substance use disorder treatment systems. Implications for future research are discussed. PMID:24529966

The role of private non-profit healthcare organizations in NHS systems: Implications for the Portuguese hospital devolution program.

PubMed

Almeida, Álvaro S

2017-06-01

The national health services (NHS) of England, Portugal, Finland and other single-payer universalist systems financed by general taxation, are based on the theoretical principle of an integrated public sector payer-provider. However, in practice one can find different forms of participation of non-public healthcare providers in those NHS, including private for profit providers, but also third sector non-profit organizations (NPO). This paper reviews the role of non-public non-profit healthcare organizations in NHS systems. By crossing a literature review on privatization of national health services with a literature review on the comparative performance of non-profit and for-profit healthcare organizations, this paper assesses the impact of contracting private non-profit healthcare organizations on the efficiency, quality and responsiveness of services, in public universal health care systems. The results of the review were then compared to the existing evidence on the Portuguese hospital devolution to NPO program. The evidence in this paper suggests that NHS health system reforms that transfer some public-sector hospitals to NPO should deliver improvements to the health system with minimal downside risks. The very limited existing evidence on the Portuguese hospital devolution program suggests it improved efficiency and access, without sacrificing quality. Copyright © 2017 Elsevier B.V. All rights reserved.

Fast decision algorithms in low-power embedded processors for quality-of-service based connectivity of mobile sensors in heterogeneous wireless sensor networks.

PubMed

Jaraíz-Simón, María D; Gómez-Pulido, Juan A; Vega-Rodríguez, Miguel A; Sánchez-Pérez, Juan M

2012-01-01

When a mobile wireless sensor is moving along heterogeneous wireless sensor networks, it can be under the coverage of more than one network many times. In these situations, the Vertical Handoff process can happen, where the mobile sensor decides to change its connection from a network to the best network among the available ones according to their quality of service characteristics. A fitness function is used for the handoff decision, being desirable to minimize it. This is an optimization problem which consists of the adjustment of a set of weights for the quality of service. Solving this problem efficiently is relevant to heterogeneous wireless sensor networks in many advanced applications. Numerous works can be found in the literature dealing with the vertical handoff decision, although they all suffer from the same shortfall: a non-comparable efficiency. Therefore, the aim of this work is twofold: first, to develop a fast decision algorithm that explores the entire space of possible combinations of weights, searching that one that minimizes the fitness function; and second, to design and implement a system on chip architecture based on reconfigurable hardware and embedded processors to achieve several goals necessary for competitive mobile terminals: good performance, low power consumption, low economic cost, and small area integration.

Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network

NASA Astrophysics Data System (ADS)

Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

2016-07-01

Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes.

Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network.

PubMed

Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

2016-07-28

Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes.

The impact of e-Procurement practice in Indonesia government: A Preliminary Study (The case of Electronic Procurement Service at Bekasi District)

NASA Astrophysics Data System (ADS)

Candra, S.; E Gunawan, F.

2017-01-01

In digital economy, government of Indonesia uses the internet to deliver services and to communicate with citizens and organizations. One of applications are e-Procurement and LPSE is a unit to hold the service system of e-Procurement. Procurement of goods and services electronically in addition will increase transparency and accountability, improve market access and healthy competition, as well as improving the efficiency of the procurement process. Based on the background and specific objectives to be achieved, then the research will be viewed from e-Marketplace participation, Trust and its impact on the performance of existing procurement within the institution. Methods of data analysis used in this research is by using analysis of Structural Equation Modelling (SEM) by using the program Partial Least Square (PLS) to examine the relationship between variables. The population used in this study is an enterprise as well as other clients using the system LPSE Bekasi District. There are three part in this study population, namely the provision of a company, customer, and supplier of LPSE users amounted to 60 users. From data analysis, there are one hypothesis that rejected. The implication of this study are implementation of e-procurement and e-marketplace participation giving impact to procurement performance.

Benchmarks for health expenditures, services and outcomes in Africa during the 1990s.

PubMed Central

Peters, D. H.; Elmendorf, A. E.; Kandola, K.; Chellaraj, G.

2000-01-01

There is limited information on national health expenditures, services, and outcomes in African countries during the 1990s. We intend to make statistical information available for national level comparisons. National level data were collected from numerous international databases, and supplemented by national household surveys and World Bank expenditure reviews. The results were tabulated and analysed in an exploratory fashion to provide benchmarks for groupings of African countries and individual country comparison. There is wide variation in scale and outcome of health care spending between African countries, with poorer countries tending to do worse than wealthier ones. From 1990-96, the median annual per capita government expenditure on health was nearly US$ 6, but averaged US$ 3 in the lowest-income countries, compared to US$ 72 in middle-income countries. Similar trends were found for health services and outcomes. Results from individual countries (particularly Ethiopia, Ghana, Côte d'Ivoire and Gabon) are used to indicate how the data can be used to identify areas of improvement in health system performance. Serious gaps in data, particularly concerning private sector delivery and financing, health service utilization, equity and efficiency measures, hinder more effective health management. Nonetheless, the data are useful for providing benchmarks for performance and for crudely identifying problem areas in health systems for individual countries. PMID:10916913

Performance evaluation of multi-stratum resources integration based on network function virtualization in software defined elastic data center optical interconnect.

PubMed

Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tian, Rui; Han, Jianrui; Lee, Young

2015-11-30

Data center interconnect with elastic optical network is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented multi-stratum resilience between IP and elastic optical networks that allows to accommodate data center services. In view of this, this study extends to consider the resource integration by breaking the limit of network device, which can enhance the resource utilization. We propose a novel multi-stratum resources integration (MSRI) architecture based on network function virtualization in software defined elastic data center optical interconnect. A resource integrated mapping (RIM) scheme for MSRI is introduced in the proposed architecture. The MSRI can accommodate the data center services with resources integration when the single function or resource is relatively scarce to provision the services, and enhance globally integrated optimization of optical network and application resources. The overall feasibility and efficiency of the proposed architecture are experimentally verified on the control plane of OpenFlow-based enhanced software defined networking (eSDN) testbed. The performance of RIM scheme under heavy traffic load scenario is also quantitatively evaluated based on MSRI architecture in terms of path blocking probability, provisioning latency and resource utilization, compared with other provisioning schemes.

Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network

PubMed Central

Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

2016-01-01

Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes. PMID:27465296

Improvement of hospital performance through innovation: toward the value of hospital care.

PubMed

Dias, Casimiro; Escoval, Ana

2013-01-01

The perspective of innovation as the strategic lever of organizational performance has been widespread in the hospital sector. While public value of innovation can be significant, it is not evident that innovation always ends up in higher levels of performance. Within this context, the purpose of the article was to critically analyze the relationship between innovation and performance, taking into account the specificities of the hospital sector. This article pulls together primary data on organizational flexibility, innovation, and performance from 95 hospitals in Portugal, collected through a survey, data from interviews to hospital administration boards, and a panel of 15 experts. The diversity of data sources allowed for triangulation. The article uses mixed methods to explore the relationship between innovation and performance in the hospital sector in Portugal. The relationship between innovation and performance is analyzed through cluster analysis, supplemented with content analysis of interviews and the technical nominal group. The main findings reveal that the cluster of efficient innovators has twice the level of performance than other clusters. Organizational flexibility and external cooperation are the 2 major factors explaining these differences. The article identifies various organizational strategies to use innovation in order to enhance hospital performance. Overall, it proposes the alignment of perspectives of different stakeholders on the value proposition of hospital services, the embeddedness of information loops, and continuous adjustments toward high-value services.

Improvement of hospital performance through innovation: toward the value of hospital care.

PubMed

Dias, Casimiro; Escoval, Ana

2013-01-01

The perspective of innovation as the strategic lever of organizational performance has been widespread in the hospital sector. While public value of innovation can be significant, it is not evident that innovation always ends up in higher levels of performance. Within this context, the purpose of the article was to critically analyze the relationship between innovation and performance,taking into account the specificities of the hospital sector. This article pulls together primary data on organizational flexibility, innovation, and performance from 95 hospitals in Portugal,collected through a survey, data from interviews to hospital administration boards, and a panel of 15 experts. The diversity of data sources allowed for triangulation. The article uses mixed methods to explore the relationship between innovation and performance in the hospital sector in Portugal. The relationship between innovation and performance is analyzed through cluster analysis, supplemented with content analysis of interviews and the technical nominal group. The main findings reveal that the cluster of efficient innovators has twice the level of performance than other clusters. Organizational flexibility and external cooperation are the 2 major factors explaining these differences. The article identifies various organizational strategies to use innovation in order to enhance hospital performance. Overall, it proposes the alignment of perspectives of different stakeholders on the value proposition of hospital services, the embeddedness of information loops, and continuous adjustments toward high-value services.

Performance-based management and quality of work: an empirical assessment.

PubMed

Falzon, Pierre; Nascimento, Adelaide; Gaudart, Corinne; Piney, Cécile; Dujarier, Marie-Anne; Germe, Jean-François

2012-01-01

In France, in the private sector as in the public sector, performance-based management tends to become a norm. Performance-based management is supposed to improve service quality, productivity and efficiency, transparency of allotted means and achieved results, and to better focus the activity of employees and of the whole organization. This text reports a study conducted for the French Ministry of Budget by a team of researchers in ergonomics, sociology and management science, in order to assess the impact of performance-based management on employees, on teams and on work organization. About 100 interviews were conducted with employees of all categories and 6 working groups were set up in order to discuss and validate or amend our first analyses. Results concern several aspects: workload and work intensification, indicators and performance management and the transformation of jobs induced by performance management.

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

Yu, Sha; Evans, Meredydd; Shi, Qing

China will account for about half of the new construction globally in the coming decade. Its floorspace doubled from 1996 to 2011, and Chinese rural buildings alone have as much floorspace as all of U.S. residential buildings. Building energy consumption has also grown, increasing by over 40% since 1990. To curb building energy demand, the Chinese government has launched a series of policies and programs. Combined, this growth in buildings and renovations, along with the policies to promote green buildings, are creating a large market for energy efficiency products and services. This report assesses the impact of China’s policies onmore » building energy efficiency and on the market for energy efficiency in the future. The first chapter of this report introduces the trends in China, drawing on both historical analysis, and detailed modeling of the drivers behind changes in floorspace and building energy demand such as economic and population growth, urbanization, policy. The analysis describes the trends by region, building type and energy service. The second chapter discusses China’s policies to promote green buildings. China began developing building energy codes in the 1980s. Over time, the central government has increased the stringency of the code requirements and the extent of enforcement. The codes are mandatory in all new buildings and major renovations in China’s cities, and they have been a driving force behind the expansion of China’s markets for insulation, efficient windows, and other green building materials. China also has several other important policies to encourage efficient buildings, including the Three-Star Rating System (somewhat akin to LEED), financial incentives tied to efficiency, appliance standards, a phasing out of incandescent bulbs and promotion of efficient lighting, and several policies to encourage retrofits in existing buildings. In the third chapter, we take “deep dives” into the trends affecting key building components. This chapter examines insulation in walls and roofs; efficient windows and doors; heating, air conditioning and controls; and lighting. These markets have seen significant growth because of the strength of the construction sector but also the specific policies that require and promote efficient building components. At the same time, as requirements have become more stringent, there has been fierce competition, and quality has at time suffered, which in turn has created additional challenges. Next we examine existing buildings in chapter four. China has many Soviet-style, inefficient buildings built before stringent requirements for efficiency were more widely enforced. As a result, there are several specific market opportunities related to retrofits. These fall into two or three categories. First, China now has a code for retrofitting residential buildings in the north. Local governments have targets of the number of buildings they must retrofit each year, and they help finance the changes. The requirements focus on insulation, windows, and heat distribution. Second, the Chinese government recently decided to increase the scale of its retrofits of government and state-owned buildings. It hopes to achieve large scale changes through energy service contracts, which creates an opportunity for energy service companies. Third, there is also a small but growing trend to apply energy service contracts to large commercial and residential buildings. This report assesses the impacts of China’s policies on building energy efficiency. By examining the existing literature and interviewing stakeholders from the public, academic, and private sectors, the report seeks to offer an in-depth insights of the opportunities and barriers for major market segments related to building energy efficiency. The report also discusses trends in building energy use, policies promoting building energy efficiency, and energy performance contracting for public building retrofits.« less

Design and implementation of priority and time-window based traffic scheduling and routing-spectrum allocation mechanism in elastic optical networks

NASA Astrophysics Data System (ADS)

Wang, Honghuan; Xing, Fangyuan; Yin, Hongxi; Zhao, Nan; Lian, Bizhan

2016-02-01

With the explosive growth of network services, the reasonable traffic scheduling and efficient configuration of network resources have an important significance to increase the efficiency of the network. In this paper, an adaptive traffic scheduling policy based on the priority and time window is proposed and the performance of this algorithm is evaluated in terms of scheduling ratio. The routing and spectrum allocation are achieved by using the Floyd shortest path algorithm and establishing a node spectrum resource allocation model based on greedy algorithm, which is proposed by us. The fairness index is introduced to improve the capability of spectrum configuration. The results show that the designed traffic scheduling strategy can be applied to networks with multicast and broadcast functionalities, and makes them get real-time and efficient response. The scheme of node spectrum configuration improves the frequency resource utilization and gives play to the efficiency of the network.

An efficient chaotic maps-based authentication and key agreement scheme using smartcards for telecare medicine information systems.

PubMed

Lee, Tian-Fu

2013-12-01

A smartcard-based authentication and key agreement scheme for telecare medicine information systems enables patients, doctors, nurses and health visitors to use smartcards for secure login to medical information systems. Authorized users can then efficiently access remote services provided by the medicine information systems through public networks. Guo and Chang recently improved the efficiency of a smartcard authentication and key agreement scheme by using chaotic maps. Later, Hao et al. reported that the scheme developed by Guo and Chang had two weaknesses: inability to provide anonymity and inefficient double secrets. Therefore, Hao et al. proposed an authentication scheme for telecare medicine information systems that solved these weaknesses and improved performance. However, a limitation in both schemes is their violation of the contributory property of key agreements. This investigation discusses these weaknesses and proposes a new smartcard-based authentication and key agreement scheme that uses chaotic maps for telecare medicine information systems. Compared to conventional schemes, the proposed scheme provides fewer weaknesses, better security, and more efficiency.

In-service education and training as experienced by registered nurses.

PubMed

Norushe, T F; Van Rooyen, D; Strumpher, J

2004-11-01

Nursing is a dynamic profession that is subject to rapid changes in health care provision, hence the need for in-service training programmes for nurses. Newly employed registered nurses require in-service training in order to update them regarding the latest developments in nursing practice. The researcher noted that some newly appointed registered nurses were not competent in all aspects relating to their tasks. This could have been due to a knowledge deficit relating to either new developments or of the procedure relating to a specific task. In some institutions newly-appointed registered nurses on probation reported not receiving in-service training for six months or longer, yet they were still expected to perform their tasks efficiently. The objectives of the study were to, firstly, explore and describe the experiences of registered nurses regarding in-service training programmes in their institutions and, secondly, to make recommendations to Nursing Service Managers relating to the development of effective in-service training programmes in their institutions. A qualitative, exploratory, descriptive design was implemented. Data was analysed using Tesch's descriptive approach (in Creswell, 1994:155). Two main themes emerged, namely that registered nurses experienced in-service training programmes as inadequate and reacted negatively towards them. This article focuses on the experiences of registered nurses relating to in-service training programmes, as well as the formulation of guidelines to assist nursing service managers in the development of effective in-service training programmes.

The privatization of environmental health services: a national survey of practices and perspectives in local health departments.

PubMed

Keane, Christopher; Marx, John; Ricci, Edmund

2002-01-01

This article presents nationally representative data on environmental health (EH) services privatized by local public health departments, enforcement and assurance mechanisms for privatized services, and administrators' views about EH services that should not be privatized. A national sample of 380 local public health departments, stratified by jurisdiction size, was drawn from a universe of 2,488 departments. Telephone interviews were conducted with 347 administrators of departments. Results were weighted to be nationally representative. Approximately one-quarter of departments had privatized at least one EH service, almost always to for-profit organizations. The two most common reasons given for privatizing EH services were cost savings or increased efficiency and lack of capacity or expertise to carry out the service. The most rigorous, although infrequent, technique of enforcement and assurance of EH standards when services were privatized was double-testing of samples. Departments more commonly relied on state licensing and certification of contractors. When asked what services should not be privatized, 27% of respondents cited EH services. Many respondents argued against privatizing environmental services that have inherent regulatory functions. They expressed concern that privatization would fragment the public health infrastructure by impairing communication, diminishing control over performance, or weakening health departments' capacity to respond to environmental and other health crises. These findings raise serious concerns about the privatization of EH.

7 CFR 4280.109 - Qualification for simplified applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

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