A Comprehensive Approach in Dissemination of Evidence-Based Care for PTSD

DTIC Science & Technology

2012-09-01

been published, to provide evidence-based resources to facilitate practice evaluation and identification of potential gaps in care. In order to...practice’s capacity to provide evidence-based care and identify potential gaps in care as targets for improvement. Finally, strategies to implement...existing patients, the PIP tools can inform improvement efforts at the clinician-, practice-or systems-level, facilitate detection of potential gaps in

An Improved Transformation and Optimized Sampling Scheme for the Numerical Evaluation of Singular and Near-Singular Potentials

NASA Technical Reports Server (NTRS)

Khayat, Michael A.; Wilton, Donald R.; Fink, Patrick W.

2007-01-01

Simple and efficient numerical procedures using singularity cancellation methods are presented for evaluating singular and near-singular potential integrals. Four different transformations are compared and the advantages of the Radial-angular transform are demonstrated. A method is then described for optimizing this integration scheme.

A Comprehensive Approach in Dissemination of Evidence Based Care for PTSD

DTIC Science & Technology

2010-09-01

evaluate their practices’ capacity to provide evidence-based care and identify potential gaps in the assessment and treatment of PTSD and depression...Project participants will use the PIP tools to evaluate their practices’ capacity to provide evidence-based care and identify potential gaps in the...PIP tools can inform improvement efforts at the clinician-, practice- or systems-level, facilitate detection of potential gaps in evidence-based care

Analyses on hydrophobicity and attractiveness of all-atom distance-dependent potentials

PubMed Central

Shirota, Matsuyuki; Ishida, Takashi; Kinoshita, Kengo

2009-01-01

Accurate model evaluation is a crucial step in protein structure prediction. For this purpose, statistical potentials, which evaluate a model structure based on the observed atomic distance frequencies in comparison with those in reference states, have been widely used. The reference state is a virtual state where all of the atomic interactions are turned off, and it provides a standard to measure the observed frequencies. In this study, we examined seven all-atom distance-dependent potentials with different reference states. As results, we observed that the variations of atom pair composition and those of distance distributions in the reference states produced systematic changes in the hydrophobic and attractive characteristics of the potentials. The performance evaluations with the CASP7 structures indicated that the preference of hydrophobic interactions improved the correlation between the energy and the GDT-TS score, but decreased the Z-score of the native structure. The attractiveness of potential improved both the correlation and Z-score for template-based modeling targets, but the benefit was smaller in free modeling targets. These results indicated that the performances of the potentials were more strongly influenced by their characteristics than by the accuracy of the definitions of the reference states. PMID:19588493

Interim Evaluation of the National Literacy Program. Final Report

ERIC Educational Resources Information Center

Human Resources and Social Development Canada, 2007

2007-01-01

The evaluation examined issues related to: (1) Rationale and Relevance; (2) Implementation; and (3) Success. In addition, the interim evaluation was intended to: (1) Determine whether sufficient data was being collected to inform the summative evaluation and identify opportunities for improvement to fill any potential gaps; (2) Assess whether the…

77 FR 12318 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

... potential new cancer diagnostics. The outcome of the evaluation will provide information for consideration... available contract resources for development of the potential diagnostics to improve the treatment of cancer... development resources for potential new diagnostics for cancer. Place: National Cancer Institute, NIH, 6001...

78 FR 36201 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... potential new cancer diagnostics. The outcome of the evaluation will be information for consideration by an... contract resources for development of the potential diagnostics to improve the treatment of cancer. The... development resources for potential new diagnostics for cancer. Place: National Cancer Institute, 9609 Medical...

Effect of ergonomics training on agreement between expert and nonexpert ratings of the potential for musculoskeletal harm in manufacturing tasks.

PubMed

Fethke, Nathan B; Merlino, Linda; Gerr, Fred

2013-12-01

To evaluate the effect of ergonomics training on non-ergonomists' ability to recognize and characterize the potential for musculoskeletal harm in manufacturing tasks. Ergonomics training was delivered to members of a participatory ergonomics team in a manufacturing facility. Before and after training, participatory ergonomics team members and the research team rated the potential for musculoskeletal harm for each of 30 tasks. Measures of agreement included Pearson, concordance, and intraclass correlation coefficients. Measures of agreement generally improved after training. The greatest agreement was observed for ratings of the potential for musculoskeletal harm to the low back. The greatest improvement in agreement was observed for ratings of the potential for musculoskeletal harm to the neck/shoulder. The training seemed to improve non-experts' ability to identify the potential for musculoskeletal harm.

Practical Guide to Designing Comprehensive Principal Evaluation Systems: A Tool to Assist in the Development of Principal Evaluation Systems. Revised Edition

ERIC Educational Resources Information Center

Clifford, Matthew; Hansen, Ulcca Joshni; Wraight, Sara

2014-01-01

Across the country, states and districts are designing principal evaluation systems as a means of improving leadership, learning, and school performance. Principal evaluation systems hold potential for supporting leaders' learning and sense of accountability for instructional excellence and student performance. Principal evaluation also is an…

A Practical Guide to Designing Comprehensive Principal Evaluation Systems: A Tool to Assist in the Development of Principal Evaluation Systems

ERIC Educational Resources Information Center

Clifford, Matthew; Hansen, Ulcca Joshni; Wraight, Sara

2012-01-01

Across the country, states and districts are designing principal evaluation systems as a means of improving leadership, learning, and school performance. Principal evaluation systems hold potential for supporting leaders' learning and sense of accountability for instructional excellence and student performance. Principal evaluation is also an…

A framework for learning about improvement: embedded implementation and evaluation design to optimize learning

PubMed Central

Barry, Danika; Kimble, Leighann E; Nambiar, Bejoy; Parry, Gareth; Jha, Ashish; Chattu, Vijay Kumar; Massoud, M Rashad; Goldmann, Don

2018-01-01

Abstract Improving health care involves many actors, often working in complex adaptive systems. Interventions tend to be multi-factorial, implementation activities diverse, and contexts dynamic and complicated. This makes improvement initiatives challenging to describe and evaluate as matching evaluation and program designs can be difficult, requiring collaboration, trust and transparency. Collaboration is required to address important epidemiological principles of bias and confounding. If this does not take place, results may lack credibility because the association between interventions implemented and outcomes achieved is obscure and attribution uncertain. Moreover, lack of clarity about what was implemented, how it was implemented, and the context in which it was implemented often lead to disappointment or outright failure of spread and scale-up efforts. The input of skilled evaluators into the design and conduct of improvement initiatives can be helpful in mitigating these potential problems. While evaluation must be rigorous, if it is too rigid necessary adaptation and learning may be compromised. This article provides a framework and guidance on how improvers and evaluators can work together to design, implement and learn about improvement interventions more effectively. PMID:29873794

25 CFR 162.514 - May permanent improvements be made under a WEEL?

Code of Federal Regulations, 2014 CFR

2014-04-01

... PERMITS Wind and Solar Resource Leases Weels § 162.514 May permanent improvements be made under a WEEL? (a... magnitude necessary for evaluation of wind resource capacity and potential effects of development. These...

25 CFR 162.514 - May permanent improvements be made under a WEEL?

Code of Federal Regulations, 2013 CFR

2013-04-01

... PERMITS Wind and Solar Resource Leases Weels § 162.514 May permanent improvements be made under a WEEL? (a... magnitude necessary for evaluation of wind resource capacity and potential effects of development. These...

I-87/US 9 integrated corridor management plan.

DOT National Transportation Integrated Search

2015-11-01

This study evaluates the potentiality of developing an integrated freeway / arterial corridor : plan to improve overall operations of I-87 and US 9 (parallel arterial) by improving the methodology of : addressing recurring and non-recurring delays (i...

Using Geographic Information Systems to Evaluate Energy Initiatives in Austere Environments

DTIC Science & Technology

2013-03-01

conducting economic analysis of energy reduction initiatives. This research examined the energy savings potential of improving the thermal properties...shelter improvements in any climate and location in the world. Specifically, solar flies developed through Solar Integrated Power Shelter System...94 Improvements to the Existing Model

Evaluation of the Buckeye Crossbuck at public, passive railroad/highway grade crossings in Ohio.

DOT National Transportation Integrated Search

2000-12-01

Two new crossbuck designs for use at passive Railroad/Highway Grade Crossings (RRX) were evaluated. The Standard Improved and the Buckeye crossbuck were evaluated on a state-wide basis in Ohio with respect to their potential to alter driver risk taki...

Analytical investigation of thermal barrier coatings for advanced power generation combustion turbines

NASA Technical Reports Server (NTRS)

Amos, D. J.

1977-01-01

An analytical evaluation was conducted to determine quantitatively the improvement potential in cycle efficiency and cost of electricity made possible by the introduction of thermal barrier coatings to power generation combustion turbine systems. The thermal barrier system, a metallic bond coat and yttria stabilized zirconia outer layer applied by plasma spray techniques, acts as a heat insulator to provide substantial metal temperature reductions below that of the exposed thermal barrier surface. The study results show the thermal barrier to be a potentially attractive means for improving performance and reducing cost of electricity for the simple, recuperated, and combined cycles evaluated.

Alkaline fuel cell performance investigation

NASA Technical Reports Server (NTRS)

Martin, R. E.; Manzo, M. A.

1988-01-01

An exploratory experimental fuel cell test program was conducted to investigate the performance characteristics of alkaline laboratory research electrodes. The objective of this work was to establish the effect of temperature, pressure, and concentration upon performance and evaluate candidate cathode configurations having the potential for improved performance. The performance characterization tests provided data to empirically establish the effect of temperature, pressure, and concentration upon performance for cell temperatures up to 300 F and reactant pressures up to 200 psia. Evaluation of five gold alloy cathode catalysts revealed that three doped gold alloys had more that two times the surface areas of reference cathodes and therefore offered the best potential for improved performance.

Alkaline fuel cell performance investigation

NASA Technical Reports Server (NTRS)

Martin, R. E.; Manzo, M. A.

1988-01-01

An exploratory experimental fuel cell test program was conducted to investigate the performance characteristics of alkaline laboratory research electrodes. The objective of this work was to establish the effect of temperature, pressure, and concentration upon performance and evaluate candidate cathode configurations having the potential for improved performance. The performance characterization tests provided data to empirically establish the effect of temperature, pressure, and concentration upon performance for cell temperatures up to 300 F and reactant pressures up to 200 psia. Evaluation of five gold alloy cathode catalysts revealed that three doped gold alloys had more than two times the surface areas of reference cathodes and therefore offered the best potential for improved performance.

38 CFR 21.8140 - Evaluation and improvement of vocational potential.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... A CP or VRC may use the services that paragraph (d) of this section describes to: (1) Evaluate... CP or VRC may authorize the services described in paragraph (d) of this section, except those in...

Clinical peer review program self-evaluation for US hospitals.

PubMed

Edwards, Marc T

2010-01-01

Prior research has shown wide variation in clinical peer review program structure, process, governance, and perceived effectiveness. This study sought to validate the utility of a Peer Review Program Self-Evaluation Tool as a potential guide to physician and hospital leaders seeking greater program value. Data from 330 hospitals show that the total score from the self-evaluation tool is strongly associated with perceived quality impact. Organizational culture also plays a significant role. When controlling for these factors, there was no evidence of benefit from a multispecialty review process. Physicians do not generally use reliable methods to measure clinical performance. A high rate of change since 2007 has not produced much improvement. The Peer Review Program Self-Evaluation Tool reliably differentiates hospitals along a continuum of perceived program performance. The full potential of peer review as a process to improve the quality and safety of care has yet to be realized.

42 CFR 422.503 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... activities, the furnishing of services, the quality improvement program, and the administrative and... program, including but not limited to reporting potential issues, investigating issues, conducting self... raised, investigating potential compliance problems as identified in the course of self-evaluations and...

Evaluation of the Buckeye Crossbuck at public, passive railroad/highway grade crossings in Ohio : executive summary.

DOT National Transportation Integrated Search

2000-12-01

Two new crossbuck designs for use at passive Railroad/Highway Grade Crossings (RRX) were evaluated. : The Standard Improved and the Buckeye crossbuck were evaluated on a state-wide basis in Ohio with : respect to their potential to alter driver risk ...

Audit Culture: Unintended Consequences of Accountability Practices in Evidence-Based Programs

ERIC Educational Resources Information Center

Owczarzak, Jill; Broaddus, Michelle; Pinkerton, Steven

2016-01-01

Evaluation has become expected within the nonprofit sector, including HIV prevention service delivery through community-based organizations (CBOs). While staff and directors at CBOs may acknowledge the potential contribution of evaluation data to the improvement of agency services, the results of evaluation are often used to demonstrate fiscal…

Natural gas applications for hybrid vehicles. Final report, October 1992-July 1993

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

Bentley, J.M.

1993-08-01

Hybrid vehicle technology holds the potential for improved efficiency and emissions compared with internal combustion (IC) engines and improved range and refueling convenience over electric vehicles. This study evaluated the potential for using natural gas as a hybrid vehicle fuel. Potential regulatory and market drivers were evaluated for hybrids generally and natural gas hybrids in specific. Heat engine options and other configuration issues were investigated to determine efficiency, emissions or other benefits of light- and heavy-duty hybrids. Several hybrid vehicle configurations were evaluated to determine the specific packaging attributes of natural gas in a hybrid configuration. Generally, conventional IC enginesmore » appear adequate for most emissions-sensitive hybrid applications with no great advantage being gained from using turbines or other more advanced heat engines. The largest technology barrier to a near-term hybrid is the weight of available or near-term batteries. Smaller, light-duty hybrid vehicles will be more sensitive to this weight handicap than larger vehicles such as the urban transit bus.« less

Potential improvements in turbofan engine fuel economy

NASA Technical Reports Server (NTRS)

Hines, R. W.; Gaffin, W. O.

1976-01-01

The method developed for initial evaluation of possible performance improvements in the NASA Aircraft Energy Efficiency Program, directed toward improving the fuel economy of turbofan engines, is outlined, and results of the evaluation of 100 candidate engine modifications are presented. The study indicates that fuel consumption improvements of as much as 5% may be possible in current JT3D, JT8D, and JT9D turbofan engines. Aerodynamic, thermodynamic, material, and structural advances are expected to yield fuel consumption improvements on the order of 10 to 15% in advanced turbofan engines, with the greatest improvement stemming from significantly higher cycle pressure ratios. Higher turbine temperature and fan bypass ratios are also expected to contribute to fuel conservation.

Codifying Practice into Theory: Commentary on Wandersman et al.

ERIC Educational Resources Information Center

Leviton, Laura C.

2016-01-01

In this commentary I discuss how Getting to Outcomes and other empowerment strategies have potential to contribute to a theory of evaluation practice, address the epistemology of quality improvement, and inform the external validity of outcome evaluations.

A systematic review of studies evaluating Australian indigenous community development projects: the extent of community participation, their methodological quality and their outcomes.

PubMed

Snijder, Mieke; Shakeshaft, Anthony; Wagemakers, Annemarie; Stephens, Anne; Calabria, Bianca

2015-11-21

Community development is a health promotion approach identified as having great potential to improve Indigenous health, because of its potential for extensive community participation. There has been no systematic examination of the extent of community participation in community development projects and little analysis of their effectiveness. This systematic review aims to identify the extent of community participation in community development projects implemented in Australian Indigenous communities, critically appraise the qualitative and quantitative methods used in their evaluation, and summarise their outcomes. Ten electronic peer-reviewed databases and two electronic grey literature databases were searched for relevant studies published between 1990 and 2015. The level of community participation and the methodological quality of the qualitative and quantitative components of the studies were assessed against standardised criteria. Thirty one evaluation studies of community development projects were identified. Community participation varied between different phases of project development, generally high during project implementation, but low during the evaluation phase. For the majority of studies, methodological quality was low and the methods were poorly described. Although positive qualitative or quantitative outcomes were reported in all studies, only two studies reported statistically significant outcomes. Partnerships between researchers, community members and service providers have great potential to improve methodological quality and community participation when research skills and community knowledge are integrated to design, implement and evaluate community development projects. The methodological quality of studies evaluating Australian Indigenous community development projects is currently too weak to confidently determine the cost-effectiveness of community development projects in improving the health and wellbeing of Indigenous Australians. Higher quality studies evaluating community development projects would strengthen the evidence base.

Field evaluation of roller integrated intelligent compaction monitoring : tech summary.

DOT National Transportation Integrated Search

2016-04-01

The objectives of the research were to: : 1. Demonstrate the value of RICM to accelerate construction, reduce re-work, and improve uniformity : of pavement layers. : 2. Evaluate the reliability and potential use of RICM data for acceptance and measur...

Using expert opinion to quantify accuracy and reliability of nondestructive evaluation on bridges : [project brief].

DOT National Transportation Integrated Search

2015-08-01

Research is currently being conducted to improve bridge inspection practices. One potential : improvement is the use of nondestructive testing equipment to supplement visual inspection. To : consider the costs and benefits of this equipment, data abo...

Making Observation Count: Key Design Elements for Meaningful Teacher Observation. Policy Brief 13-5

ERIC Educational Resources Information Center

Goldstein, Jennifer

2013-01-01

Teacher evaluation has emerged as a potentially powerful policy lever in state and federal debates about how to improve public education. The role of student test scores and "value-added" measures in teacher evaluation has generated intense public controversy, but other approaches to evaluation including especially classroom observations…

Formic acid electrooxidation on thallium-decorated shape-controlled platinum nanoparticles: an improvement in electrocatalytic activity.

PubMed

Busó-Rogero, Carlos; Perales-Rondón, Juan V; Farias, Manuel J S; Vidal-Iglesias, Francisco J; Solla-Gullon, Jose; Herrero, Enrique; Feliu, Juan M

2014-07-21

Thallium modified shape-controlled Pt nanoparticles were prepared and their electrocatalytic activity towards formic acid electrooxidation was evaluated in 0.5 M sulfuric acid. The electrochemical and in situ FTIR spectroscopic results show a remarkable improvement in the electrocatalytic activity, especially in the low potential region (around 0.1-0.2 V vs. RHE). Cubic Pt nanoparticles modified with Tl were found to be more active than the octahedral Pt ones in the entire range of Tl coverages and potential windows. In situ FTIR spectra indicate that the promotional effect produced by Tl results in the inhibition of the poisoning step leading to COads, thus improving the onset potential for the complete formic acid oxidation to CO2. Chronoamperometric experiments were also performed at 0.2 V to evaluate the stability of the electrocatalysts at constant potential. Finally, experiments with different concentrations of formic acid (0.05-1 M) were also carried out. In all cases, Tl-modified cubic Pt nanoparticles result to be the most active. All these facts reinforce the importance of controlling the surface structure of the electrocatalysts to optimize their electrocatalytic properties.

Quality improvement collaborative: A novel approach to improve infection prevention and control. Perceptions of lead infection prevention nurses who participated.

PubMed

Adams, Debra; Hine, Victoria; Bucior, Helen; Foster, Wendy; Mukombe, Nyarayi; Ryan, Jane; Smirthwaite, Sandra; Winfield, Jodie

2018-03-01

In response to the ongoing infection prevention (IP) challenges in England, a 90-day quality improvement (QI) collaborative programme was developed. The paper discusses the approach, benefits, challenges and evaluation of the programme. The objective of the collaborative was to develop new approaches to enable sustainable and effective IP. Six trusts in the region participated in the collaborative. Each defined their bespoke IP focus. There was no expectation that statistically significant measurable improvements would be identified during the short time frame. The experiences of the participants were sought both during the programme to facilitate its constant review and at the end of the programme to evaluate its effectiveness. The feedback focused on achievements, barriers to change and benefits of participating in a QI collaborative. To measure the potential success of the projects, participants completed the Model for Understanding Success in Quality framework. (MUSIQ; Kaplan et al., 2012). Since each trusts IP focus was bespoke commonalities of success were not evaluated. Participants identified a positive outcome from their QI interventions. The MUSIQ score identified the projects had the potential for success. The feedback from the participants demonstrated that it is worthy of further development.

Sound management may sequester methane in grazed rangeland ecosystems

PubMed Central

Wang, Chengjie; Han, Guodong; Wang, Shiping; Zhai, Xiajie; Brown, Joel; Havstad, Kris M.; Ma, Xiuzhi; Wilkes, Andreas; Zhao, Mengli; Tang, Shiming; Zhou, Pei; Jiang, Yuanyuan; Lu, Tingting; Wang, Zhongwu; Li, Zhiguo

2014-01-01

Considering their contribution to global warming, the sources and sinks of methane (CH4) should be accounted when undertaking a greenhouse gas inventory for grazed rangeland ecosystems. The aim of this study was to evaluate the mitigation potential of current ecological management programs implemented in the main rangeland regions of China. The influences of rangeland improvement, utilization and livestock production on CH4 flux/emission were assessed to estimate CH4 reduction potential. Results indicate that the grazed rangeland ecosystem is currently a net source of atmospheric CH4. However, there is potential to convert the ecosystem to a net sink by improving management practices. Previous assessments of capacity for CH4 uptake in grazed rangeland ecosystems have not considered improved livestock management practices and thus underestimated potential for CH4 uptake. Optimal fertilization, rest and light grazing, and intensification of livestock management contribute mitigation potential significantly. PMID:24658176

Sound management may sequester methane in grazed rangeland ecosystems.

PubMed

Wang, Chengjie; Han, Guodong; Wang, Shiping; Zhai, Xiajie; Brown, Joel; Havstad, Kris M; Ma, Xiuzhi; Wilkes, Andreas; Zhao, Mengli; Tang, Shiming; Zhou, Pei; Jiang, Yuanyuan; Lu, Tingting; Wang, Zhongwu; Li, Zhiguo

2014-03-24

Considering their contribution to global warming, the sources and sinks of methane (CH4) should be accounted when undertaking a greenhouse gas inventory for grazed rangeland ecosystems. The aim of this study was to evaluate the mitigation potential of current ecological management programs implemented in the main rangeland regions of China. The influences of rangeland improvement, utilization and livestock production on CH4 flux/emission were assessed to estimate CH4 reduction potential. Results indicate that the grazed rangeland ecosystem is currently a net source of atmospheric CH4. However, there is potential to convert the ecosystem to a net sink by improving management practices. Previous assessments of capacity for CH4 uptake in grazed rangeland ecosystems have not considered improved livestock management practices and thus underestimated potential for CH4 uptake. Optimal fertilization, rest and light grazing, and intensification of livestock management contribute mitigation potential significantly.

Stakeholder Engagement to Identify Priorities for Improving the Quality and Value of Critical Care.

PubMed

Stelfox, Henry T; Niven, Daniel J; Clement, Fiona M; Bagshaw, Sean M; Cook, Deborah J; McKenzie, Emily; Potestio, Melissa L; Doig, Christopher J; O'Neill, Barbara; Zygun, David

2015-01-01

Large amounts of scientific evidence are generated, but not implemented into patient care (the 'knowledge-to-care' gap). We identified and prioritized knowledge-to-care gaps in critical care as opportunities to improve the quality and value of healthcare. We used a multi-method community-based participatory research approach to engage a Network of all adult (n = 14) and pediatric (n = 2) medical-surgical intensive care units (ICUs) in a fully integrated geographically defined healthcare system serving 4 million residents. Participants included Network oversight committee members (n = 38) and frontline providers (n = 1,790). Network committee members used a modified RAND/University of California Appropriateness Methodology, to serially propose, rate (validated 9 point scale) and revise potential knowledge-to-care gaps as priorities for improvement. The priorities were sent to frontline providers for evaluation. Results were relayed back to all frontline providers for feedback. Initially, 68 knowledge-to-care gaps were proposed, rated and revised by the committee (n = 32 participants) over 3 rounds of review and resulted in 13 proposed priorities for improvement. Then, 1,103 providers (62% response rate) evaluated the priorities, and rated 9 as 'necessary' (median score 7-9). Several factors were associated with rating priorities as necessary in multivariable logistic regression, related to the provider (experience, teaching status of ICU) and topic (strength of supporting evidence, potential to benefit the patient, potential to improve patient/family experience, potential to decrease costs). A community-based participatory research approach engaged a diverse group of stakeholders to identify 9 priorities for improving the quality and value of critical care. The approach was time and cost efficient and could serve as a model to prioritize areas for research quality improvement across other settings.

Evaluating potential trade-offs among fuel treatment strategies in mixed-conifer forests of the Sierra Nevada

Treesearch

Jens T. Stevens; Brandon M. Collins; Jonathan W. Long; Malcolm P. North; Susan J. Prichard; Leland W. Tarnay; Angela M. White

2016-01-01

Fuel treatments in fire-suppressed mixed-conifer forests are designed to moderate potential wildfire behavior and effects. However, the objectives for modifying potential fire effects can vary widely, from improving fire suppression efforts and protecting infrastructure, to reintroducing low-severity fire, to restoring and maintaining variable forest structure and...

Evaluating Process Improvement Courses of Action Through Modeling and Simulation

DTIC Science & Technology

2017-09-16

changes to a process is time consuming and has potential to overlook stochastic effects. By modeling a process as a Numerical Design Structure Matrix...13 Methods to Evaluate Process Performance ................................................................15 The Design Structure...Matrix ......................................................................................16 Numerical Design Structure Matrix

A Cost Comparison Framework for Use in Optimizing Ground Water Pump and Treat Systems

EPA Pesticide Factsheets

This fact sheet has been prepared to provide a framework for conducting cost comparisons to evaluate whether or not to pursue potential opportunities from an optimization evaluation for improving, replacing, or supplementing the P&T system.

models of congenital heart disease.

PubMed

Biglino, Giovanni; Capelli, Claudio; Leaver, Lindsay-Kay; Schievano, Silvia; Taylor, Andrew M; Wray, Jo

2015-01-01

To develop a participatory approach in the evaluation of 3D printed patient-specific models of congenital heart disease (CHD) with different stakeholders who would potentially benefit from the technology (patients, parents, clinicians and nurses). Workshops, focus groups and teaching sessions were organised, targeting different stakeholders. Sessions involved displaying and discussing different 3D models of CHD. Model evaluation involved response counts from questionnaires and thematic analysis of audio-recorded discussions and written feedback. Stakeholders’ responses indicated the scope and potential for clinical translation of 3D models. As tangible, three-dimensional artefacts, these can have a role in communicative processes. Their patient-specific quality is also important in relation to individual characteristics of CHD. Patients indicated that 3D models can help them visualise ‘what’s going on inside’. Parents agreed that models can spark curiosity in young people. Clinicians indicated that teaching might be the most relevant application. Nurses agreed that 3D models improved their learning experience during a CHD course. Engagement of different stakeholders to evaluate 3D printing technology for CHD identified the potential of the models for improving patient– doctor communication, patient empowerment and training. A participatory approach could benefit the clinical evaluation and translation of 3D printing technology.

Investigating Improvements to Pedestrian Crossings with an Emphasis on the Rectangular Rapid-Flashing Beacon

DOT National Transportation Integrated Search

2015-06-01

The goal of this research effort was to improve pedestrian safety at urban and suburban crossing locations by identifying and evaluating low- to medium-cost pedestrian treatments. The treatments were to have the potential to reduce pedestrian crashes...

Optimizing the performance and structure of the D0 Collie confidence limit evaluator

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

Fishchler, Mark; /Fermilab

2010-07-01

D0 Collie is a program used to perform limit calculations based on ensembles of pseudo-experiments ('PEs'). Since the application of this program to the crucial Higgs mass limit is quite CPU intensive, it has been deemed important to carefully review this program, with an eye toward identifying and implementing potential performance improvements. At the same time, we identify any coding errors or opportunities for potential structural (or algorithm) improvement discovered in the course of gaining sufficient understanding of the workings of Collie to sensibly explore for optimizations. Based on a careful analysis of the program, a series of code changesmore » with potential for improving performance has been identified. The implementation and evaluation of the most important parts of this series has been done, with gratifying speedup results. The bottom line: We have identified and implemented changes leading to a factor of 2.19 speedup in the example program provided, and expected to translate to a factor of roughly 4 speedup in typical realistic usage.« less

Test and evaluation of vehicle platooning proof-of-concept based on cooperative adaptive cruise control

DOT National Transportation Integrated Search

2017-04-01

This report presents a high-level test and evaluation framework for cooperative driving automation systems that have the potential to significantly improve mobility and enhance traffic flow stability with better safety. It focuses on the test and eva...

A Brief History of the Evaluation of VET in Australia. Review of Research.

ERIC Educational Resources Information Center

McDonald, Rod; Hayton, Geoff

The history and current state of evaluation of vocational education and training (VET) in Australia was examined. The study's main conclusion was that, despite its important potential, evaluation has thus far been little used for the improvement of VET in Australia. Other conclusions of the study were as follows: (1) little development of…

The Impact of a Hepatobiliary Multidisciplinary Team Assessment in Patients with Colorectal Cancer Liver Metastases: A Population-Based Study.

PubMed

Engstrand, Jennie; Kartalis, Nikolaos; Strömberg, Cecilia; Broberg, Mats; Stillström, Anna; Lekberg, Tobias; Jonas, Eduard; Freedman, Jacob; Nilsson, Henrik

2017-09-01

Assessing patients with colorectal cancer liver metastases (CRCLM) by a liver multidisciplinary team (MDT) results in higher resection rates and improved survival. The aim of this study was to evaluate the potentially improved resection rate in a defined cohort if all patients with CRCLM were evaluated by a liver MDT. A retrospective analysis of patients diagnosed with colorectal cancer during 2008 in the greater Stockholm region was conducted. All patients with liver metastases (LM), detected during 5-year follow-up, were re-evaluated at a fictive liver MDT in which previous imaging studies, tumor characteristics, medical history, and patients' own treatment preferences were presented. Treatment decisions for each patient were compared to the original management. Odds ratios (ORs) and 95% confidence intervals were estimated for factors associated with referral to the liver MDT. Of 272 patients diagnosed with LM, 102 patients were discussed at an original liver MDT and 69 patients were eventually resected. At the fictive liver MDT, a further 22 patients were considered as resectable/potentially resectable, none previously assessed by a hepatobiliary surgeon. Factors influencing referral to liver MDT were age (OR 3.12, 1.72-5.65), American Society of Anaesthesiologists (ASA) score (OR 0.34, 0.18-0.63; ASA 2 vs. ASA 3), and number of LM (OR 0.10, 0.04-0.22; 1-5 LM vs. >10 LM), while gender ( p  = .194) and treatment at a teaching hospital ( p  = .838) were not. A meaningful number of patients with liver metastases are not managed according to best available evidence and the potential for higher resection rates is substantial. Patients with liver metastatic colorectal cancer who are assessed at a hepatobiliary multidisciplinary meeting achieve higher resection rates and improved survival. Unfortunately, patients who may benefit from resection are not always properly referred. In this study, the potential improved resection rate was assessed by re-evaluating all patients with liver metastases from a population-based cohort, including patients with extrahepatic metastases and accounting for comorbidity and patients' own preferences towards treatment. An additional 12.9% of the patients were found to be potentially resectable. The results highlight the importance of all patients being evaluated in the setting of a hepatobiliary multidisciplinary meeting. © AlphaMed Press 2017.

78 FR 9933 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... potential new cancer diagnostics. The outcome of the evaluation will be information for consideration by an... contract resources for development of the potential diagnostics to improve the treatment of cancer. The...

77 FR 61614 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

... potential new cancer diagnostics. The outcome of the evaluation will be information for consideration by an... contract resources for development of the potential diagnostics to improve the treatment of cancer. The... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

Identification of Management and Personnel Responsibility to Provide and Accept Opportunities for Improvement Thru Vocational and Educational Programs. Evaluation of PROJECT IMPROVE.

ERIC Educational Resources Information Center

Coast Guard, Washington, DC. Office of Personnel.

Project Improve, the new title for the Coast Guard Aircraft Repair and Supply Center (AR&SC) Testing and Counseling Program in Elizabeth City, N.C., expresses the idea of this study: to assist all employees in gaining better understanding of their full potential and their training needs. The results of Project Improve are listed in tables…

Synthesis and biological evaluation of arctigenin ester and ether derivatives as activators of AMPK.

PubMed

Shen, Sida; Zhuang, Jingjing; Chen, Yijia; Lei, Min; Chen, Jing; Shen, Xu; Hu, Lihong

2013-07-01

A series of new arctigenin and 9-deoxy-arctigenin derivatives bearing different ester and ether side chains at the phenolic hydroxyl positions are designed, synthesized, and evaluated for activating AMPK potency in L6 myoblasts. Initial biological evaluation indicates that some alkyl ester and phenethyl ether arctigenin derivatives display potential activities in AMPK phosphorylation improvement. Further structure-activity relationship analysis shows that arctigenin ester derivatives 3a, 3h and 9-deoxy-arctigenin phenethyl ether derivatives 6a, 6c, 6d activate AMPK more potently than arctigenin. Moreover, the 2-(3,4-dimethoxyphenyl)ethyl ether moiety of 6c has been demonstrated as a potential functional group to improve the effect of AMPK phosphorylation. The structural optimization of arctigenin leads to the identification of 6c as a promising lead compound that exhibits excellent activity in AMPK activation. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Economic analysis of the health impacts of housing improvement studies: a systematic review.

PubMed

Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

2013-10-01

Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid 'balance sheet' approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy.

Single-scale renormalisation group improvement of multi-scale effective potentials

NASA Astrophysics Data System (ADS)

Chataignier, Leonardo; Prokopec, Tomislav; Schmidt, Michael G.; Świeżewska, Bogumiła

2018-03-01

We present a new method for renormalisation group improvement of the effective potential of a quantum field theory with an arbitrary number of scalar fields. The method amounts to solving the renormalisation group equation for the effective potential with the boundary conditions chosen on the hypersurface where quantum corrections vanish. This hypersurface is defined through a suitable choice of a field-dependent value for the renormalisation scale. The method can be applied to any order in perturbation theory and it is a generalisation of the standard procedure valid for the one-field case. In our method, however, the choice of the renormalisation scale does not eliminate individual logarithmic terms but rather the entire loop corrections to the effective potential. It allows us to evaluate the improved effective potential for arbitrary values of the scalar fields using the tree-level potential with running coupling constants as long as they remain perturbative. This opens the possibility of studying various applications which require an analysis of multi-field effective potentials across different energy scales. In particular, the issue of stability of the scalar potential can be easily studied beyond tree level.

7 CFR 3430.401 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., breeding, and processing methods; (2) Evaluating the potential economic benefits to producers and... produced agricultural products; and (8) Developing new and improved seed varieties that are particularly...

7 CFR 3430.401 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., breeding, and processing methods; (2) Evaluating the potential economic benefits to producers and... produced agricultural products; and (8) Developing new and improved seed varieties that are particularly...

7 CFR 3430.401 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., breeding, and processing methods; (2) Evaluating the potential economic benefits to producers and... produced agricultural products; and (8) Developing new and improved seed varieties that are particularly...

7 CFR 3430.401 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., breeding, and processing methods; (2) Evaluating the potential economic benefits to producers and... produced agricultural products; and (8) Developing new and improved seed varieties that are particularly...

Aspirin-Exacerbated Respiratory Disease: Evaluation and Management

DTIC Science & Technology

2011-01-01

will be to discuss the specific issues related to aspirin desensitization , the clinical benefits, patient selection, aspirin dosing, potential ...to the potential of “silent desensitization ” (under the blocking influence of montelukast), we recommend that all patients with history consistent...that this procedure could potentially improve existing protocols for aspi- rin challenges and desensitization . In our study, we found that patients

Improving a web-based employability intervention for work-disabled employees: results of a pilot economic evaluation.

PubMed

Noben, Cindy; Evers, Silvia; Genabeek, Joost van; Nijhuis, Frans; de Rijk, Angelique

2017-04-01

Purpose The purpose of this study is to improve web-based employability interventions for employees with work-related health problems for both intervention content and study design by means of a pilot economic evaluation. Methods Uptake rate analysis for the intervention elements, cost effectiveness, cost utility and subgroup analyses were conducted to identify potential content-related intervention improvements. Differences in work ability and quality-adjusted life years and overall contribution of resource items to the total costs were assessed. These were used to guide study design improvements. Results Sixty-three participants were a-select allocated to either the intervention (n = 29) or the control (n = 34) group. Uptake regarding the intervention elements ranged between 3% and 70%. Cost-effectiveness and cost-utility analyses resulted in negative effects although higher total costs. Incremental effects were marginal (work ability -0.51; QALY -0.01). Conclusions The web-based tool to enhance employability among work disabled employees requires improvements regarding targeting and intensity; outcome measures selected and collection of cost data. With respect to the studies of disability and rehabilitation, the findings and methods presented in this pilot economic evaluation could guide the assessment of future assistive "e-health" technologies. IMPLICATIONS FOR REHABILITATION The methods presented in this pilot economic evaluation have large potentials to guide the assessment of future assistive e-health technologies addressing work-disabilities. The findings show that the web-based tool requires content related improvements with respect to targeting and intensity to enhance employability among work disabled employees. The findings show that the web-based tool would benefit from improvements related to the study design by more adequately selecting and collecting both outcome measures and cost data. The burden attributable to large-scale studies and implementation issues were prevented as the outcomes of the pilot economic evaluation did not support the implementation of the web-based tool.

Automotive Fuel Economy - Potential Improvement Through Selected Engine and Differential Gear Lubricants

DOT National Transportation Integrated Search

1981-07-01

This report evaluates the effects of four engine lubricants and three differential gear lubricants on the fuel economy of two 1978 automobiles operated at 20F, 70F, and 100F ambient temperatures. The engine lubricants were evaluated using the 1978 Fe...

Incorporation of genomic information into genetic evaluation: U. S. beef industry as a model

USDA-ARS?s Scientific Manuscript database

In his presentation, Dr. Kuehn described approaches for using information garnered through developments in genomics to improve the accuracy of genetic evaluation. He considered the history of these molecular-based techniques, including their strengths and potential weaknesses, and his experiences wi...

Evaluation of FGD-gypsum to improve forage production and reduce phosphorus lossed from Piedmont soils

USDA-ARS?s Scientific Manuscript database

Flue gas desulfurization gypsum (FGD-gypsum), a byproduct from coal fired electricity generators, has the potential for beneficial use in agricultural systems as a soil amendment. Similar to mined gypsum it can improve soil chemical and physical properties and increase crop productivity. FGD-gypsum ...

Optimum outlier model for potential improvement of environmental cleaning and disinfection.

PubMed

Rupp, Mark E; Huerta, Tomas; Cavalieri, R J; Lyden, Elizabeth; Van Schooneveld, Trevor; Carling, Philip; Smith, Philip W

2014-06-01

The effectiveness and efficiency of 17 housekeepers in terminal cleaning 292 hospital rooms was evaluated through adenosine triphosphate detection. A subgroup of housekeepers was identified who were significantly more effective and efficient than their coworkers. These optimum outliers may be used in performance improvement to optimize environmental cleaning.

Evaluation of rare Helianthus eggertii achenes for oil concentration and fatty acid composition

USDA-ARS?s Scientific Manuscript database

Sunflower (Helianthus annuus L.) oil has the potential to be improved for nutritional and industrial purposes through selection and breeding. The narrow genetic base of cultivated sunflower has been broadened by the infusion of genes from wild species, resulting in a continuous improvement in agrono...

Long-term bed degradation in Maryland streams (phase 2) : Blue Ridge and Western Piedmont provinces.

DOT National Transportation Integrated Search

2012-03-01

Estimation of potential long-term down-cutting of the stream bed is necessary for evaluation and design of bridges for scour and culverts for fish passage. The purpose of this study has been to improve predictions of this potential long-term bed degr...

Safer Chemicals Research

EPA Pesticide Factsheets

EPA's Chemical Safety research protects human health and the environment by evaluating chemicals for potential risk and providing tools and guidance for improved chemical production that supports a sustainable environment.

Novel Flow Cytometry Analyses of Boar Sperm Viability: Can the Addition of Whole Sperm-Rich Fraction Seminal Plasma to Frozen-Thawed Boar Sperm Affect It?

PubMed

Torres, Mariana Andrade; Díaz, Rommy; Boguen, Rodrigo; Martins, Simone Maria Massami Kitamura; Ravagnani, Gisele Mouro; Leal, Diego Feitosa; Oliveira, Melissa de Lima; Muro, Bruno Bracco Donatelli; Parra, Beatriz Martins; Meirelles, Flávio Vieira; Papa, Frederico Ozanan; Dell'Aqua, José Antônio; Alvarenga, Marco Antônio; Moretti, Aníbal de Sant'Anna; Sepúlveda, Néstor; de Andrade, André Furugen Cesar

2016-01-01

Boar semen cryopreservation remains a challenge due to the extension of cold shock damage. Thus, many alternatives have emerged to improve the quality of frozen-thawed boar sperm. Although the use of seminal plasma arising from boar sperm-rich fraction (SP-SRF) has shown good efficacy; however, the majority of actual sperm evaluation techniques include a single or dual sperm parameter analysis, which overrates the real sperm viability. Within this context, this work was performed to introduce a sperm flow cytometry fourfold stain technique for simultaneous evaluation of plasma and acrosomal membrane integrity and mitochondrial membrane potential. We then used the sperm flow cytometry fourfold stain technique to study the effect of SP-SRF on frozen-thawed boar sperm and further evaluated the effect of this treatment on sperm movement, tyrosine phosphorylation and fertility rate (FR). The sperm fourfold stain technique is accurate (R2 = 0.9356, p > 0.01) for simultaneous evaluation of plasma and acrosomal membrane integrity and mitochondrial membrane potential (IPIAH cells). Centrifugation pre-cryopreservation was not deleterious (p > 0.05) for any analyzed variables. Addition of SP-SRF after cryopreservation was able to improve total and progressive motility (p < 0.05) when boar semen was cryopreserved without SP-SRF; however, it was not able to decrease tyrosine phosphorylation (p > 0.05) or improve IPIAH cells (p > 0.05). FR was not (p > 0.05) statistically increased by the addition of seminal plasma, though females inseminated with frozen-thawed boar semen plus SP-SRF did perform better than those inseminated with sperm lacking seminal plasma. Thus, we conclude that sperm fourfold stain can be used to simultaneously evaluate plasma and acrosomal membrane integrity and mitochondrial membrane potential, and the addition of SP-SRF at thawed boar semen cryopreserved in absence of SP-SRF improve its total and progressive motility.

Novel Flow Cytometry Analyses of Boar Sperm Viability: Can the Addition of Whole Sperm-Rich Fraction Seminal Plasma to Frozen-Thawed Boar Sperm Affect It?

PubMed Central

Díaz, Rommy; Boguen, Rodrigo; Martins, Simone Maria Massami Kitamura; Ravagnani, Gisele Mouro; Leal, Diego Feitosa; Oliveira, Melissa de Lima; Muro, Bruno Bracco Donatelli; Parra, Beatriz Martins; Meirelles, Flávio Vieira; Papa, Frederico Ozanan; Dell’Aqua, José Antônio; Alvarenga, Marco Antônio; Moretti, Aníbal de Sant’Anna; Sepúlveda, Néstor

2016-01-01

Boar semen cryopreservation remains a challenge due to the extension of cold shock damage. Thus, many alternatives have emerged to improve the quality of frozen-thawed boar sperm. Although the use of seminal plasma arising from boar sperm-rich fraction (SP-SRF) has shown good efficacy; however, the majority of actual sperm evaluation techniques include a single or dual sperm parameter analysis, which overrates the real sperm viability. Within this context, this work was performed to introduce a sperm flow cytometry fourfold stain technique for simultaneous evaluation of plasma and acrosomal membrane integrity and mitochondrial membrane potential. We then used the sperm flow cytometry fourfold stain technique to study the effect of SP-SRF on frozen-thawed boar sperm and further evaluated the effect of this treatment on sperm movement, tyrosine phosphorylation and fertility rate (FR). The sperm fourfold stain technique is accurate (R2 = 0.9356, p > 0.01) for simultaneous evaluation of plasma and acrosomal membrane integrity and mitochondrial membrane potential (IPIAH cells). Centrifugation pre-cryopreservation was not deleterious (p > 0.05) for any analyzed variables. Addition of SP-SRF after cryopreservation was able to improve total and progressive motility (p < 0.05) when boar semen was cryopreserved without SP-SRF; however, it was not able to decrease tyrosine phosphorylation (p > 0.05) or improve IPIAH cells (p > 0.05). FR was not (p > 0.05) statistically increased by the addition of seminal plasma, though females inseminated with frozen-thawed boar semen plus SP-SRF did perform better than those inseminated with sperm lacking seminal plasma. Thus, we conclude that sperm fourfold stain can be used to simultaneously evaluate plasma and acrosomal membrane integrity and mitochondrial membrane potential, and the addition of SP-SRF at thawed boar semen cryopreserved in absence of SP-SRF improve its total and progressive motility. PMID:27529819

The TALKS study to improve communication, logistical, and financial barriers to live donor kidney transplantation in African Americans: protocol of a randomized clinical trial.

PubMed

Strigo, Tara S; Ephraim, Patti L; Pounds, Iris; Hill-Briggs, Felicia; Darrell, Linda; Ellis, Matthew; Sudan, Debra; Rabb, Hamid; Segev, Dorry; Wang, Nae-Yuh; Kaiser, Mary; Falkovic, Margaret; Lebov, Jill F; Boulware, L Ebony

2015-10-09

Live donor kidney transplantation (LDKT), an optimal therapy for many patients with end-stage kidney disease, is underutilized, particularly by African Americans. Potential recipient difficulties initiating and sustaining conversations about LDKT, identifying willing and medically eligible donors, and potential donors' logistical and financial hurdles have been cited as potential contributors to race disparities in LDKT. Few interventions specifically targeting these factors have been tested. We report the protocol of the Talking about Living Kidney Donation Support (TALKS) study, a study designed to evaluate the effectiveness of behavioral, educational and financial assistance interventions to improve access to LDKT among African Americans on the deceased donor kidney transplant recipient waiting list. We adapted a previously tested educational and social worker intervention shown to improve consideration and pursuit of LDKT among patients and their family members for its use among patients on the kidney transplant waiting list. We also developed a financial assistance intervention to help potential donors overcome logistical and financial challenges they might face during the pursuit of live kidney donation. We will evaluate the effectiveness of these interventions by conducting a randomized controlled trial in which patients on the deceased donor waiting list receive 1) usual care while on the transplant waiting list, 2) the educational and social worker intervention, or 3) the educational and social worker intervention plus the option of participating in the financial assistance program. The primary outcome of the randomized controlled trial will measure potential recipients' live kidney donor activation (a composite rate of live donor inquiries, completed new live donor evaluations, or live kidney donation) at 1 year. The TALKS study will rigorously assess the effectiveness of promising interventions to reduce race disparities in LDKT. NCT02369354.

Planning, Management and Evaluation: Realizing PIC Potential. Private Industry Council Guide. Working Draft.

ERIC Educational Resources Information Center

National Alliance of Business, Inc., Washington, DC.

This Planning, Management, and Evaluation (PME) guide was developed by the National Alliance of Business as part of its program of management assistance for Private Industry Councils (PICs). The guide is a tool which PICs can use to improve their capability to plan, manage, and evaluate the programs which they administer, and to establish locally…

Unlocking the Potential of the "What Works" Approach to Policymaking and Practice: Improving Impact Evaluations

ERIC Educational Resources Information Center

Granger, Robert C.; Maynard, Rebecca

2015-01-01

Despite bipartisan support in Washington, DC, which dates back to the mid-1990s, the "what works" approach has yet to gain broad support among policymakers and practitioners. One way to build such support is to increase the usefulness of program impact evaluations for these groups. We describe three ways to make impact evaluations more…

Impact of Standardized New Medication Education Program on Postdischarge Patients' Knowledge and Satisfaction.

PubMed

Jones, Tammie R; Coke, Lola

2016-10-01

This study, implemented on 2 medical-surgical units, evaluated the impact of a standardized, evidence-based new medication education program. Outcomes evaluated included patient postdischarge knowledge of new medication purpose and side effects, patient satisfaction with new medication, and Medicare reimbursement earn-back potential. As a result, knowledge scores for new medication purpose and side effects were high post intervention. Patient satisfaction with new medication education increased. Value-based purchasing reimbursement earn-back potential improved.

42 CFR 59a.4 - How are grant applications evaluated?

Code of Federal Regulations, 2010 CFR

2010-10-01

... LIBRARY OF MEDICINE GRANTS Grants for Establishing, Expanding, and Improving Basic Resources § 59a.4 How... Secretary's evaluation shall consider the scope of library or related services for the population and... coordination with other libraries and related facilities, and (d) Potential for testing or demonstration of new...

Evaluation of Attention Training and Metacognitive Facilitation to Improve Reading Comprehension in Aphasia

ERIC Educational Resources Information Center

Lee, Jaime B.; Sohlberg, McKay Moore

2013-01-01

Purpose: This pilot study investigated the impact of direct attention training combined with metacognitive facilitation on reading comprehension in individuals with aphasia. Method: A single-subject, multiple baseline design was employed across 4 participants to evaluate potential changes in reading comprehension resulting from an 8-week…

Evaluating hybrid bermudagrass using spectral reflectance under different mowing heights and trinexapac-ethyl applications

USDA-ARS?s Scientific Manuscript database

Quantitative spectral reflectance data has the potential to improve the evaluation of turfgrass variety trials when management practices are factors in the testing of turf aesthetics and functionality. However, the practical application of this methodology has not been well-developed. The objectives...

Acknowledging patient heterogeneity in economic evaluation : a systematic literature review.

PubMed

Grutters, Janneke P C; Sculpher, Mark; Briggs, Andrew H; Severens, Johan L; Candel, Math J; Stahl, James E; De Ruysscher, Dirk; Boer, Albert; Ramaekers, Bram L T; Joore, Manuela A

2013-02-01

Patient heterogeneity is the part of variability that can be explained by certain patient characteristics (e.g. age, disease stage). Population reimbursement decisions that acknowledge patient heterogeneity could potentially save money and increase population health. To date, however, economic evaluations pay only limited attention to patient heterogeneity. The objective of the present paper is to provide a comprehensive overview of the current knowledge regarding patient heterogeneity within economic evaluation of healthcare programmes. A systematic literature review was performed to identify methodological papers on the topic of patient heterogeneity in economic evaluation. Data were obtained using a keyword search of the PubMed database and manual searches. Handbooks were also included. Relevant data were extracted regarding potential sources of patient heterogeneity, in which of the input parameters of an economic evaluation these occur, methods to acknowledge patient heterogeneity and specific concerns associated with this acknowledgement. A total of 20 articles and five handbooks were included. The relevant sources of patient heterogeneity (demographics, preferences and clinical characteristics) and the input parameters where they occurred (baseline risk, treatment effect, health state utility and resource utilization) were combined in a framework. Methods were derived for the design, analysis and presentation phases of an economic evaluation. Concerns related mainly to the danger of false-positive results and equity issues. By systematically reviewing current knowledge regarding patient heterogeneity within economic evaluations of healthcare programmes, we provide guidance for future economic evaluations. Guidance is provided on which sources of patient heterogeneity to consider, how to acknowledge them in economic evaluation and potential concerns. The improved acknowledgement of patient heterogeneity in future economic evaluations may well improve the efficiency of healthcare.

Improving rapeseed production practices in the southeastern United States

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

Thomas, D.L.; Breve, M.A.; Raymer, P.L.

1990-04-01

Oilseed rape or rapeseed is a crop which offers a potential for double-cropping in the southeastern United States. This final project report describes the results from a three year study aimed at evaluating the effect of different planting and harvesting practices on establishment and yield of three rape cultivars, and the double cropping potential of rapeseed in the southeastern United States. The project was conducted on two yield sites in Tifton, Georgia during 1986--87, 1987--88 and 1988--89. The general objective of this research is to improve the seed and biomass yield of winter rapeseed in the southeastern United States bymore » developing appropriate agronomic practices for the region. The primary constraint is to grow rapeseed within the allowable period for double cropping with an economically desirable crop, such as peanut or soybean. Planting and harvesting are the most critical steps in this process. Therefore, the specific objectives of this research were: evaluate and improve the emergence of rapeseed by developing planting techniques that enhance the soil, water and seed regimes for winter rapeseed in the southeast, and evaluate and improve the yields of harvested rapeseed by developing techniques for determining the optimum timing of harvest and efficient methods for harvesting winter rapeseed in the southeast. 6 refs., 12 figs., 9 tabs.« less

Trials of Intervention Principles: Evaluation Methods for Evolving Behavioral Intervention Technologies

PubMed Central

Schueller, Stephen M; Riley, William T; Brown, C Hendricks; Cuijpers, Pim; Duan, Naihua; Kwasny, Mary J; Stiles-Shields, Colleen; Cheung, Ken

2015-01-01

In recent years, there has been increasing discussion of the limitations of traditional randomized controlled trial (RCT) methodologies for the evaluation of eHealth and mHealth interventions, and in particular, the requirement that these interventions be locked down during evaluation. Locking down these interventions locks in defects and eliminates the opportunities for quality improvement and adaptation to the changing technological environment, often leading to validation of tools that are outdated by the time that trial results are published. Furthermore, because behavioral intervention technologies change frequently during real-world deployment, even if a tested intervention were deployed in the real world, its shelf life would be limited. We argue that RCTs will have greater scientific and public health value if they focus on the evaluation of intervention principles (rather than a specific locked-down version of the intervention), allowing for ongoing quality improvement modifications to the behavioral intervention technology based on the core intervention principles, while continuously improving the functionality and maintaining technological currency. This paper is an initial proposal of a framework and methodology for the conduct of trials of intervention principles (TIPs) aimed at minimizing the risks of in-trial changes to intervention technologies and maximizing the potential for knowledge acquisition. The focus on evaluation of intervention principles using clinical and usage outcomes has the potential to provide more generalizable and durable information than trials focused on a single intervention technology. PMID:26155878

Trials of Intervention Principles: Evaluation Methods for Evolving Behavioral Intervention Technologies.

PubMed

Mohr, David C; Schueller, Stephen M; Riley, William T; Brown, C Hendricks; Cuijpers, Pim; Duan, Naihua; Kwasny, Mary J; Stiles-Shields, Colleen; Cheung, Ken

2015-07-08

In recent years, there has been increasing discussion of the limitations of traditional randomized controlled trial (RCT) methodologies for the evaluation of eHealth and mHealth interventions, and in particular, the requirement that these interventions be locked down during evaluation. Locking down these interventions locks in defects and eliminates the opportunities for quality improvement and adaptation to the changing technological environment, often leading to validation of tools that are outdated by the time that trial results are published. Furthermore, because behavioral intervention technologies change frequently during real-world deployment, even if a tested intervention were deployed in the real world, its shelf life would be limited. We argue that RCTs will have greater scientific and public health value if they focus on the evaluation of intervention principles (rather than a specific locked-down version of the intervention), allowing for ongoing quality improvement modifications to the behavioral intervention technology based on the core intervention principles, while continuously improving the functionality and maintaining technological currency. This paper is an initial proposal of a framework and methodology for the conduct of trials of intervention principles (TIPs) aimed at minimizing the risks of in-trial changes to intervention technologies and maximizing the potential for knowledge acquisition. The focus on evaluation of intervention principles using clinical and usage outcomes has the potential to provide more generalizable and durable information than trials focused on a single intervention technology.

Prioritizing investments in innovations to protect women from the leading causes of maternal death

PubMed Central

2014-01-01

PATH, an international nonprofit organization, assessed nearly 40 technologies for their potential to reduce maternal mortality from postpartum hemorrhage and preeclampsia and eclampsia in low-resource settings. The evaluation used a new Excel-based prioritization tool covering 22 criteria developed by PATH, the Maternal and Neonatal Directed Assessment of Technology (MANDATE) model, and consultations with experts. It identified five innovations with especially high potential: technologies to improve use of oxytocin, a uterine balloon tamponade, simplified dosing of magnesium sulfate, an improved proteinuria test, and better blood pressure measurement devices. Investments are needed to realize the potential of these technologies to reduce mortality. PMID:24405972

Prioritizing investments in innovations to protect women from the leading causes of maternal death.

PubMed

Herrick, Tara M; Harner-Jay, Claudia M; Levisay, Alice M; Coffey, Patricia S; Free, Michael J; LaBarre, Paul D

2014-01-09

PATH, an international nonprofit organization, assessed nearly 40 technologies for their potential to reduce maternal mortality from postpartum hemorrhage and preeclampsia and eclampsia in low-resource settings. The evaluation used a new Excel-based prioritization tool covering 22 criteria developed by PATH, the Maternal and Neonatal Directed Assessment of Technology (MANDATE) model, and consultations with experts. It identified five innovations with especially high potential: technologies to improve use of oxytocin, a uterine balloon tamponade, simplified dosing of magnesium sulfate, an improved proteinuria test, and better blood pressure measurement devices. Investments are needed to realize the potential of these technologies to reduce mortality.

The Impact of Current and Future Polar Orbiting Satellite Data on Numerical Weather Prediction at NASA/GSFC

NASA Technical Reports Server (NTRS)

Atlas, Robert

2004-01-01

The lack of adequate observational data continues to be recognized as a major factor limiting both atmospheric research and numerical prediction on a variety of temporal and spatial scales. Since the advent of meteorological satellites in the 1960's, a considerable research effort has been directed toward the design of space-borne meteorological sensors, the development of optimal methods for the utilization of these data, (and an assessment of the influence of existing satellite data and the potential influence of future satellite observations on numerical weather prediction. This has included both Observing System Experiments (OSEs) and Observing System Simulation Experiments (OSSEs). OSEs are conducted to evaluate the impact of specific observations or classes of observations on analyses and forecasts. While OSEs are performed with existing data, OSSEs are conducted to evaluate the potential for future observing systems to improve-NWP, as well as to evaluate trade-offs in observing system design, and to develop and test improved methods for data assimilation. At the conference, results from OSEs to evaluate satellite data sets that have recently become available to the global observing system, such as AIRS and Seawinds, and results from OSSEs to determine the potential impact of space-based lidar winds will be presented.

National trends in safety performance of electronic health record systems in children's hospitals.

PubMed

Chaparro, Juan D; Classen, David C; Danforth, Melissa; Stockwell, David C; Longhurst, Christopher A

2017-03-01

To evaluate the safety of computerized physician order entry (CPOE) and associated clinical decision support (CDS) systems in electronic health record (EHR) systems at pediatric inpatient facilities in the US using the Leapfrog Group's pediatric CPOE evaluation tool. The Leapfrog pediatric CPOE evaluation tool, a previously validated tool to assess the ability of a CPOE system to identify orders that could potentially lead to patient harm, was used to evaluate 41 pediatric hospitals over a 2-year period. Evaluation of the last available test for each institution was performed, assessing performance overall as well as by decision support category (eg, drug-drug, dosing limits). Longitudinal analysis of test performance was also carried out to assess the impact of testing and the overall trend of CPOE performance in pediatric hospitals. Pediatric CPOE systems were able to identify 62% of potential medication errors in the test scenarios, but ranged widely from 23-91% in the institutions tested. The highest scoring categories included drug-allergy interactions, dosing limits (both daily and cumulative), and inappropriate routes of administration. We found that hospitals with longer periods since their CPOE implementation did not have better scores upon initial testing, but after initial testing there was a consistent improvement in testing scores of 4 percentage points per year. Pediatric computerized physician order entry (CPOE) systems on average are able to intercept a majority of potential medication errors, but vary widely among implementations. Prospective and repeated testing using the Leapfrog Group's evaluation tool is associated with improved ability to intercept potential medication errors. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Online Education Improves Dementia Knowledge: Evidence From an International Intervention.

PubMed

Annear, Michael J

2018-03-01

Dementia education disseminated through massive open online courses (MOOCs) has the potential to improve knowledge and care provision among health professionals and lay people. The potential learning effects of a dementia MOOC were assessed using a reliable and valid measure with international volunteers ( N = 3,649) who completed the measure before and after online education. Evaluation of learning effects suggests that the MOOC significantly increased dementia knowledge by at least 17% across six cohorts. Knowledge was improved by the MOOC in three ways: it significantly improved overall understanding of dementia for diverse cohorts; it reduced knowledge disparity within occupational and lay cohorts; and it reduced knowledge disparity across occupational and lay cohorts. The capacity of a dementia MOOC to significantly improve knowledge and reach a wide audience may lead to population-level improvements in understanding about dementia. This may foster improvements in treatment and quality of care for people with dementia.

The Impact of Providing Performance Feedback to Teachers and Principals. NCEE 2018-4001

ERIC Educational Resources Information Center

Garet, Michael S.; Wayne, Andrew J.; Brown, Seth; Rickles, Jordan; Song, Mengli; Manzeske, David

2017-01-01

Educator performance evaluation systems are a potential tool for improving student achievement by increasing the effectiveness of the educator workforce. For example, recent research suggests that giving more frequent, specific feedback on classroom practice may lead to improvements in teacher performance and student achievement. This report is…

The Impact of Providing Performance Feedback to Teachers and Principals. Executive Summary. NCEE 2018-4000

ERIC Educational Resources Information Center

Garet, Michael S.; Wayne, Andrew J.; Brown, Seth; Rickles, Jordan; Song, Mengli; Manzeske, David

2017-01-01

Educator performance evaluation systems are a potential tool for improving student achievement by increasing the effectiveness of the educator workforce. For example, recent research suggests that giving more frequent, specific feedback on classroom practice may lead to improvements in teacher performance and student achievement. This report is…

Youth Can! Results of a Pilot Trial to Improve the School Food Environment

ERIC Educational Resources Information Center

Jones, Sonya; Spence, Marsha; Hardin, Sonia; Clemente, Nicolle; Schoch, Ashlee

2011-01-01

Objective: This study evaluated the potential of youth partnerships to improve the school environment and child nutrition. Methods: A quasi-experimental trial was conducted with 2 intervention and 3 control schools. Intervention schools selected student leaders to participate in youth-led interventions in their schools. Students (n = 104) were…

38 CFR 21.140 - Evaluation and improvement of rehabilitation potential.

Code of Federal Regulations, 2010 CFR

2010-07-01

... reasonably feasible for a vocational goal or an independent living goal. (2) Provide a basis for planning: (i... improvement services are furnished on a full-time basis as a preliminary part of the period of rehabilitation... training, speech and voice correction, training in ambulation, and one-hand typewriting; (6) Orientation...

Assessment of Mycobacterium tuberculosis OmpATb as a Novel Antigen for the Diagnosis of Bovine Tuberculosis

USDA-ARS?s Scientific Manuscript database

In search for improved tools to control bovine tuberculosis, the development of diagnostic tests with improved specificity and sensitivity has a high priority. Such tests require the identification of enhanced immunodiagnostic reagents. In this study, we evaluated the potential of Rv0899 (Outer memb...

Surgical innovation and quality assurance: Can we have both?

PubMed

Georgeson, Keith

2015-06-01

Innovation is the major force for progress in pediatric surgery. Most of the progress in surgery has evolved secondary to novel approaches developed by surgeons confronted with difficult pathologic conditions. Up to the present time, most surgical innovation has been practiced with few rules for guidance. Innovation to make surgical procedures more effective and less morbid is highly desirable. However, the absence of oversight has the potential to lead to unbridled human experimentation. The quality improvement movement in medicine is attempting to improve outcomes using evidence-based clinical pathways. Quality improvement aims to decrease the variation in therapeutic approaches by scientifically defining best practices. There is a significant potential for autonomous surgical innovators to clash with well-meaning proponents of quality improvement. A suggested remedy to encourage surgical innovators while protecting patients from unintended harm is for institutions to develop Surgical Innovation Committees to evaluate and give oversight to the early application of new techniques and devices. Scientific evaluation under the auspices of an IRB should follow when feasible. Copyright © 2015 Elsevier Inc. All rights reserved.

Long-term bed degradation in Maryland streams (phase 3, part I) : urban streams in the Piedmont Plateau province.

DOT National Transportation Integrated Search

2014-05-01

Estimation of potential long-term down-cutting of the stream bed is necessary for evaluation and design of bridges for scour and culverts for fish passage. The purpose of this study has been to improve predictions of this potential long-term bed degr...

The economic potential of CT scanners for hardwood sawmills

Treesearch

Donald G. Hodges; Walter C. Anderson; Charles W. McMillin

1990-01-01

Research has demonstrated that a knowledge of internal log defects prior to sawing could improve lumber value yields significantly. This study evaluated the potential economic returns from investments in computerized tomographic (CT) scanners to detect internal defects in hardwood logs at southern sawmills. The results indicate that such investments would be profitable...

Economic analysis of the health impacts of housing improvement studies: a systematic review

PubMed Central

Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

2013-01-01

Background Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Methods Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. Results 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid ‘balance sheet’ approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Conclusions Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy. PMID:23929616

Prioritizing environmental justice and equality: diesel emissions in southern California.

PubMed

Marshall, Julian D; Swor, Kathryn R; Nguyen, Nam P

2014-04-01

Existing environmental policies aim to reduce emissions but lack standards for addressing environmental justice. Environmental justice research documents disparities in exposure to air pollution; however, little guidance currently exists on how to make improvements or on how specific emission-reduction scenarios would improve or deteriorate environmental justice conditions. Here, we quantify how emission reductions from specific sources would change various measures of environmental equality and justice. We evaluate potential emission reductions for fine diesel particulate matter (DPM) in Southern California for five sources: on-road mobile, off-road mobile, ships, trains, and stationary. Our approach employs state-of-the-science dispersion and exposure models. We compare four environmental goals: impact, efficiency, equality, and justice. Results indicate potential trade-offs among those goals. For example, reductions in train emissions produce the greatest improvements in terms of efficiency, equality, and justice, whereas off-road mobile source reductions can have the greatest total impact. Reductions in on-road emissions produce improvements in impact, equality, and justice, whereas emission reductions from ships would widen existing population inequalities. Results are similar for complex versus simplified exposure analyses. The approach employed here could usefully be applied elsewhere to evaluate opportunities for improving environmental equality and justice in other locations.

A scoping review about conference objectives and evaluative practices: how do we get more out of them?

PubMed

Neves, Justin; Lavis, John N; Ranson, M Kent

2012-08-02

Large multi-day conferences have often been criticized as ineffective ways to improve social outcomes and to influence policy or practice. Unfortunately, many conference evaluations have also been inadequate in determining the impact of a conference on its associated social sector, with little evidence gathered or analyzed to substantiate or refute these criticisms. The aim of this scoping review is to investigate and report stakeholders' objectives for planning or participating in large multi-day conferences and how these objectives are being evaluated. We conducted a scoping review supplemented by a small number of key informant interviews. Eight bibliographic databases were systematically searched to identify papers describing conference objectives and/or evaluations. We developed a conference evaluation framework based on theoretical models and empirical findings, which structured the descriptive synthesis of the data. We identified 3,073 potential papers for review, of which 44 were included in this study. Our evaluation framework connects five key elements in planning a conference and its evaluation (number in brackets refers to number of themes identified): conference objectives (8), purpose of evaluation (7), evaluation methods (5), indicators of success (9) and theories/models (8). Further analysis of indicators of success identified three categories of indicators with differing scopes (i.e. immediate, prospective or follow-up) as well as empirical links between the purpose of evaluations and these indicators. Conference objectives and evaluations were largely correlated with the type of conference (i.e. academic, political/governmental or business) but diverse overall. While much can be done to improve the quality and usefulness of conference evaluations, there are innovative assessments that are currently being utilized by some conferences and warrant further investigation. This review provides conference evaluators and organizers a simple resource to improve their own assessments by highlighting and categorizing potential objectives and evaluation strategies.

A scoping review about conference objectives and evaluative practices: how do we get more out of them?

PubMed Central

2012-01-01

Large multi-day conferences have often been criticized as ineffective ways to improve social outcomes and to influence policy or practice. Unfortunately, many conference evaluations have also been inadequate in determining the impact of a conference on its associated social sector, with little evidence gathered or analyzed to substantiate or refute these criticisms. The aim of this scoping review is to investigate and report stakeholders’ objectives for planning or participating in large multi-day conferences and how these objectives are being evaluated. We conducted a scoping review supplemented by a small number of key informant interviews. Eight bibliographic databases were systematically searched to identify papers describing conference objectives and/or evaluations. We developed a conference evaluation framework based on theoretical models and empirical findings, which structured the descriptive synthesis of the data. We identified 3,073 potential papers for review, of which 44 were included in this study. Our evaluation framework connects five key elements in planning a conference and its evaluation (number in brackets refers to number of themes identified): conference objectives (8), purpose of evaluation (7), evaluation methods (5), indicators of success (9) and theories/models (8). Further analysis of indicators of success identified three categories of indicators with differing scopes (i.e. immediate, prospective or follow-up) as well as empirical links between the purpose of evaluations and these indicators. Conference objectives and evaluations were largely correlated with the type of conference (i.e. academic, political/governmental or business) but diverse overall. While much can be done to improve the quality and usefulness of conference evaluations, there are innovative assessments that are currently being utilized by some conferences and warrant further investigation. This review provides conference evaluators and organizers a simple resource to improve their own assessments by highlighting and categorizing potential objectives and evaluation strategies. PMID:22857399

Plasma rich in growth factors (PRGF-Endoret) stimulates tendon and synovial fibroblasts migration and improves the biological properties of hyaluronic acid.

PubMed

Anitua, E; Sanchez, M; De la Fuente, M; Zalduendo, M M; Orive, G

2012-09-01

Cell migration plays an essential role in development, wound healing, and tissue regeneration. Plasma rich in growth factors (PRGF-Endoret) technology offers a potential source of growth factors involved in tissue regeneration. Here, we evaluate the potential of PRGF-Endoret over tendon cells and synovial fibroblasts migration and study whether the combination of this autologous technology with hyaluronic acid (HA) improves the effect and potential of the biomaterials over the motility of both types of fibroblasts. Migration of primary tendon cells and synovial fibroblasts after culturing with either PRGF or PPGF (plasma poor in growth factors) at different doses was evaluated. Furthermore, the migratory capacity induced by the combination of PPGF and PRGF with HA was tested. PPGF stimulated migration of both types of cells but this effect was significantly higher when PRGF was used. Tendon cells showed an increase of 212% in migratory ability when HA was combined with PPGF and of 335% in the case of HA + PRGF treatment compared with HA alone. PRGF-Endoret stimulates migration of tendon cells and synovial fibroblasts and improves the biological properties of HA.

Applied genetic evaluations for production and functional traits in dairy cattle.

PubMed

Mark, T

2004-08-01

The objective of this study was to review the current status of genetic evaluation systems for production and functional traits as practiced in different Interbull member countries and to discuss that status in relation to research results and potential improvements. Thirty-one countries provided information. Substantial variation was evident for number of traits considered per country, trait definition, genetic evaluation procedure within trait, effects included, and how these were treated in genetic evaluation models. All countries lacked genetic evaluations for one or more economically important traits. Improvement in the genetic evaluation models, especially for many functional traits, could be achieved by closing the gaps between research and practice. More detailed and up to date information about national genetic evaluation systems for traits in different countries is available at www.interbull.org. Female fertility and workability traits were considered in many countries and could be next in line for international genetic evaluations.

Silymarin improves the behavioural, biochemical and histoarchitecture alterations in focal ischemic rats: a comparative evaluation with piracetam and protocatachuic acid.

PubMed

Muley, Milind M; Thakare, Vishnu N; Patil, Rajesh R; Kshirsagar, Ajay D; Naik, Suresh R

2012-08-01

Comparative neuroprotective potential of silymarin, piracetam and protocatechuic acid ethyl ester (PCA) was evaluated in focal ischemic rats. Various pharmacological, biochemical (lipid peroxidation, reduced glutathione, catalase, nitrite content, brain water content) and behavioural (memory impairment, motor control, neurological score) including infarct size and histopathological alterations were evaluated. Silymarin (200mg/kg) and PCA treatment significantly improved behavioural, biochemical and histopathological changes, and reduced water content and infarct size. However, piracetam only improved behavioural and histopathological changes, reduced water content and infarct size. The findings indicate that silymarin exhibits neuroprotective activity better than PCA and piracetam in focal ischemia/reperfusion reflected by its better restoration of behavioural and antioxidant profile. Copyright © 2012 Elsevier Inc. All rights reserved.

Validity of using photographs to simulate visible qualities of forest recreation environments

Treesearch

Robin E. Hoffman; James F. Palmer

1995-01-01

Forest recreation managers and researchers interested in conserving and improving the visual quality and recreation opportunities available in forest environments must often resort to simulations as a means of illustrating alternatives for potential users to evaluate. This paper reviews the results of prior research evaluating the validity of using photographic...

Evaluation of Smoking Prevention Television Messages Based on the Elaboration Likelihood Model

ERIC Educational Resources Information Center

Flynn, Brian S.; Worden, John K.; Bunn, Janice Yanushka; Connolly, Scott W.; Dorwaldt, Anne L.

2011-01-01

Progress in reducing youth smoking may depend on developing improved methods to communicate with higher risk youth. This study explored the potential of smoking prevention messages based on the Elaboration Likelihood Model (ELM) to address these needs. Structured evaluations of 12 smoking prevention messages based on three strategies derived from…

Teacher Evaluation in Practice: Year 3 Teacher and Administrator Perceptions of REACH. Research Brief

ERIC Educational Resources Information Center

Sporte, Susan E.; Jiang, Jennie Y.

2016-01-01

Three years after the launch of Chicago's redesigned teacher evaluation system, Recognizing Educators Advancing Chicago Students (REACH) Students, most teachers and administrators continue to report they believe REACH has the potential to improve instruction and student learning, and they remain negative about the use of student growth in…

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

Mamedov, Bahtiyar A.; Somuncu, Elif; Askerov, Iskender M.

In this work, a new theoretical approach is proposed for calculating fourth virial coefficient with Lennard-Jones potential. The established algorithm can be used to evaluate the thermodynamics properties and the intermolecular interaction potentials of liquids and gases with an improved accuracy. Note that the evaluation of the high-order virial coefficients is very valuable for accurate calculation of thermodynamic parameters. By using the suggested method, the fourth virial coefficient of CH{sub 4}, Ar, C{sub 2}H{sub 6} and SF{sub 6} molecules are evaluated. The calculation results are useful for accurate interpretation of the experimental data and of the determination of related physicalmore » properties.« less

Some Results Bearing on the Value of Improvements of Membranes for Reverse Osmosis

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

Lamont, A

2006-03-08

This analysis evaluates the potential economic benefits that could result from the improvements in the permeability of membranes for reverse osmosis. The discussion provides a simple model of the operation of a reverse osmosis plant. It examines the change in the operation that might result from improvements in the membrane and computes the cost of water as a function of the membrane permeability.

Magnetic resonance metabolomics of intact tissue: a biotechnological tool in cancer diagnostics and treatment evaluation.

PubMed

Bathen, Tone F; Sitter, Beathe; Sjøbakk, Torill E; Tessem, May-Britt; Gribbestad, Ingrid S

2010-09-01

Personalized medicine is increasingly important in cancer treatment for its role in staging and its potential to improve stratification of patients. Different types of molecules, genes, proteins, and metabolites are being extensively explored as potential biomarkers. This review discusses the major findings and potential of tissue metabolites determined by high-resolution magic angle spinning magnetic resonance spectroscopy for cancer detection, characterization, and treatment monitoring.

Economic evaluation of the anti-stigma social marketing campaign in England 2009-2011.

PubMed

Evans-Lacko, Sara; Henderson, Claire; Thornicroft, Graham; McCrone, Paul

2013-04-01

Evidence on the economic impact of social marketing anti-stigma campaigns in relation to people with mental illness is limited. To describe the economic impact of the Time to Change (TTC) anti-stigma social marketing campaign, including the potential effects on the wider economy. Data collected for the evaluation of TTC were combined with the social marketing campaign expenditure data to investigate differences in knowledge, attitudes and behaviour in relation to campaign awareness. To evaluate the return on investment, we applied a decision model that estimated the impact on employment for people with depression. Based on average national social marketing campaign costs, the economic benefits outweighed costs even if the campaign resulted in only 1% more people with depression accessing services and gaining employment if they experienced a health improvement. The cost per person with improved intended behaviour was at most £ 4 if we assume the campaign was responsible for 50% of the change. Costs associated with improved knowledge and attitudes, however, were more variable. The findings suggest that the TTC anti-stigma social marketing campaign is a potentially cost-effective and low-cost intervention for reducing the impact of stigma on people with mental health problems.

Hepcare Europe - bridging the gap in the treatment of hepatitis C: study protocol.

PubMed

Swan, Davina; Cullen, Walter; Macias, Juan; Oprea, Cristiana; Story, Alistair; Surey, Julian; Vickerman, Peter; Lambert, John S

2018-03-01

Hepatitis C (HCV) infection is highly prevalent among people who inject drugs (PWID). Many PWID are unaware of their infection and few have received HCV treatment. Recent developments in treatment offer cure rates >90%. However, the potential of these treatments will only be realised if HCV identification among PWID with linkage to treatment is optimised. This paper describes the Hepcare Europe project, a collaboration between five institutions across four member states (Ireland, UK, Spain, Romania), to develop, implement and evaluate interventions to improve the identification, evaluation and treatment of HCV among PWID. A service innovation project and a mixed-methods, pre-post intervention study, Hepcare will design and deliver interventions in Dublin, London, Seville and Bucharest to enhance PWID engagement and retention in the cascade of HCV care. The feasibility, acceptability, potential efficacy and cost-effectiveness of these interventions to improve care processes and outcomes among PWID will be evaluated. Hepcare has the potential to make an important impact on patient care for marginalised populations who might otherwise go undiagnosed and untreated. Lessons learned from the study can be incorporated into national and European guidelines and strategies for HCV.

Hybrid Power Management Program Evaluated Fuel Cell/Ultracapacitor Combinations and Developed Other New Applications

NASA Technical Reports Server (NTRS)

Eichenberg, Dennis J.

2004-01-01

In fiscal year 2003, the continuation of the Hybrid Power Management (HPM) Program through NASA Glenn Research Center's Commercial Technology Office resulted in several new successful applications of this pioneering technology. HPM is the innovative integration of diverse, state-of-the-art power devices in an optimal configuration for space and terrestrial applications. The appropriate application and control of the various power devices significantly improves overall system performance and efficiency. The advanced power devices include ultracapacitors, fuel cells, and photovoltaics. HPM has extremely wide potential, with applications from nanowatts to megawatts--including power generation, transportation systems, biotechnology systems, and space power systems. HPM has the potential to significantly alleviate global energy concerns, improve the environment, and stimulate the economy. Fuel cells provide excellent efficiency and energy density, but do not have good power density. In contrast, ultracapacitors have excellent power density and virtually unlimited cycle life. To improve the power density of the fuel cell, the combination of fuel cells and ultracapacitors was evaluated.

Laboratory studies of sweets re-formulated to improve their dental properties.

PubMed

Grenby, T H; Mistry, M

1996-03-01

To evaluate the potential dental effects of ten new types of sugar-free sweets formulated with Lycasin or isomalt as bulk sweeteners instead of sugars. Examination of the sweets for their acidity, fermentability by oral microorganisms, influence on the demineralisation of dental enamel, and their influence on human interdental plaque pH, compared with conventional sugar-containing sweets. The importance of reducing the levels of flavouring acids in the sweets was demonstrated. It was not straightforward to evaluate chocolate products in this system, but the potential benefits of re-formulating fruit gums, lollipops, chew-bars, toffee and fudge with Lycasin or isomalt in place of sugars were shown by determining their reduced acidogenicity and fermentability compared with conventional confectionery. The extent of demineralisation of dental enamel was related to both the acidity and the fermentability of the sweets. Re-formulating sweets with reduced acidity levels and bulk sweeteners not fermentable by dental plaque microorganisms can provide a basis for improving their potential dental effects.

Embedding technology into inter-professional best practices in home safety evaluation.

PubMed

Burns, Suzanne Perea; Pickens, Noralyn Davel

2017-08-01

To explore inter-professional home evaluators' perspectives and needs for building useful and acceptable decision-support tools for the field of home modifications. Twenty semi-structured interviews were conducted with a range of home modification professionals from different regions of the United States. The interview transcripts were analyzed with a qualitative, descriptive, perspective approach. Technology supports current best practice and has potential to inform decision making through features that could enhance home evaluation processes, quality, efficiency and inter-professional communication. Technological advances with app design have created numerous opportunities for the field of home modifications. Integrating technology and inter-professional best practices will improve home safety evaluation and intervention development to meet client-centred and societal needs. Implications for rehabilitation Understanding home evaluators technology needs for home safety evaluations contributes to the development of app-based assessments. Integrating inter-professional perspectives of best practice and technological needs in an app for home assessments improves processes. Novice and expert home evaluators would benefit from decision support systems embedded in app-based assessments. Adoption of app-based assessment would improve efficiency while remaining client-centred.

NorthStar, a support tool for the design and evaluation of quality improvement interventions in healthcare.

PubMed

Akl, Elie A; Treweek, Shaun; Foy, Robbie; Francis, Jill; Oxman, Andrew D

2007-06-26

The Research-Based Education and Quality Improvement (ReBEQI) European partnership aims to establish a framework and provide practical tools for the selection, implementation, and evaluation of quality improvement (QI) interventions. We describe the development and preliminary evaluation of the software tool NorthStar, a major product of the ReBEQI project. We focused the content of NorthStar on the design and evaluation of QI interventions. A lead individual from the ReBEQI group drafted each section, and at least two other group members reviewed it. The content is based on published literature, as well as material developed by the ReBEQI group. We developed the software in both a Microsoft Windows HTML help system version and a web-based version. In a preliminary evaluation, we surveyed 33 potential users about the acceptability and perceived utility of NorthStar. NorthStar consists of 18 sections covering the design and evaluation of QI interventions. The major focus of the intervention design sections is on how to identify determinants of practice (factors affecting practice patterns), while the major focus of the intervention evaluation sections is on how to design a cluster randomised trial. The two versions of the software can be transferred by email or CD, and are available for download from the internet. The software offers easy navigation and various functions to access the content. Potential users (55% response rate) reported above-moderate levels of confidence in carrying out QI research related tasks if using NorthStar, particularly when developing a protocol for a cluster randomised trial NorthStar is an integrated, accessible, practical, and acceptable tool to assist developers and evaluators of QI interventions.

NorthStar, a support tool for the design and evaluation of quality improvement interventions in healthcare

PubMed Central

Akl, Elie A; Treweek, Shaun; Foy, Robbie; Francis, Jill; Oxman, Andrew D

2007-01-01

Background The Research-Based Education and Quality Improvement (ReBEQI) European partnership aims to establish a framework and provide practical tools for the selection, implementation, and evaluation of quality improvement (QI) interventions. We describe the development and preliminary evaluation of the software tool NorthStar, a major product of the ReBEQI project. Methods We focused the content of NorthStar on the design and evaluation of QI interventions. A lead individual from the ReBEQI group drafted each section, and at least two other group members reviewed it. The content is based on published literature, as well as material developed by the ReBEQI group. We developed the software in both a Microsoft Windows HTML help system version and a web-based version. In a preliminary evaluation, we surveyed 33 potential users about the acceptability and perceived utility of NorthStar. Results NorthStar consists of 18 sections covering the design and evaluation of QI interventions. The major focus of the intervention design sections is on how to identify determinants of practice (factors affecting practice patterns), while the major focus of the intervention evaluation sections is on how to design a cluster randomised trial. The two versions of the software can be transferred by email or CD, and are available for download from the internet. The software offers easy navigation and various functions to access the content. Potential users (55% response rate) reported above-moderate levels of confidence in carrying out QI research related tasks if using NorthStar, particularly when developing a protocol for a cluster randomised trial Conclusion NorthStar is an integrated, accessible, practical, and acceptable tool to assist developers and evaluators of QI interventions. PMID:17594495

Cardiac PET/CT for the Evaluation of Known or Suspected Coronary Artery Disease

PubMed Central

Murthy, Venkatesh L.

2011-01-01

Positron emission tomography (PET) is increasingly being applied in the evaluation of myocardial perfusion. Cardiac PET can be performed with an increasing variety of cyclotron- and generator-produced radiotracers. Compared with single photon emission computed tomography, PET offers lower radiation exposure, fewer artifacts, improved spatial resolution, and, most important, improved diagnostic performance. With its capacity to quantify rest–peak stress left ventricular systolic function as well as coronary flow reserve, PET is superior to other methods for the detection of multivessel coronary artery disease and, potentially, for risk stratification. Coronary artery calcium scoring may be included for further risk stratification in patients with normal perfusion imaging findings. Furthermore, PET allows quantification of absolute myocardial perfusion, which also carries substantial prognostic value. Hybrid PET–computed tomography scanners allow functional evaluation of myocardial perfusion combined with anatomic characterization of the epicardial coronary arteries, thereby offering great potential for both diagnosis and management. Additional studies to further validate the prognostic value and cost effectiveness of PET are warranted. © RSNA, 2011 PMID:21918042

KAP study on mothers of children with Down syndrome.

PubMed

Lakshminarayana, P; Ibrahim, S; Venkataraman, P; Jagatheesan, T; Kamala, K G

1991-09-01

We evaluated 50 mothers of children with Down syndrome attending Genetic Clinic of the Institute of Child Health and Hospital for Children, Madras, with special reference to their knowledge, belief and attitudes in the care of these children. After evaluation, they were educated individually and in groups with demonstration, picture cards and pamphlets, on the causation, expected health problems, developmental potential of Down syndrome and the ways and means to help the child to attain the maximum developmental potential. They were taught on preventive aspects of Down syndrome as well. Re-evaluation was done after three months, and considerable improvement was noted in the mother's knowledge, and attitude towards bringing up such a child. The mothers also showed an improvement in the skills in providing developmental enrichment to these children. Thus this study has formulated a programme in the management of such children, which can be practised on any population, anywhere, especially, in rural areas, and by less affluent folk, with poor educational background.

Gold-standard evaluation of a folksonomy-based ontology learning model

NASA Astrophysics Data System (ADS)

Djuana, E.

2018-03-01

Folksonomy, as one result of collaborative tagging process, has been acknowledged for its potential in improving categorization and searching of web resources. However, folksonomy contains ambiguities such as synonymy and polysemy as well as different abstractions or generality problem. To maximize its potential, some methods for associating tags of folksonomy with semantics and structural relationships have been proposed such as using ontology learning method. This paper evaluates our previous work in ontology learning according to gold-standard evaluation approach in comparison to a notable state-of-the-art work and several baselines. The results show that our method is comparable to the state-of the art work which further validate our approach as has been previously validated using task-based evaluation approach.

Improving Process Evaluations of Health Behavior Interventions: Learning From the Social Sciences.

PubMed

Morgan-Trimmer, Sarah

2015-09-01

This article reflects on the current state of process evaluations of health behavior interventions and argues that evaluation practice in this area could be improved by drawing on the social science literature to a greater degree. While process evaluations of health behavior interventions have increasingly engaged with the social world and sociological aspects of interventions, there has been a lag in applying relevant and potentially useful approaches from the social sciences. This has limited the scope for health behavior process evaluations to address pertinent contextual issues and methodological challenges. Three aspects of process evaluations are discussed: the incorporation of contexts of interventions; engagement with the concept of "process" in process evaluation; and working with theory to understand interventions. Following on from this, the article also comments on the need for new methodologies and on the implications for addressing health inequalities. © The Author(s) 2013.

Evaluation of Military Field-Water Quality. Volume 7. Performance Evaluation of the 600-GPH Reverse Osmosis Water Purification Unit (ROWPU): reverse Osmosis (RO) Components

DTIC Science & Technology

1986-02-01

Data-for ASsessingHealthRISKS In Potential Theaters ~ of Operation forU,5. Mil-itary._orces. Jf-jr cLAss t:cAToN 9; r-.$ ’AGg UNCLASSIFIED Volume 7...Bypass, Potable-Water Disinfection,_ and Water-Quality Analysis Techniques; and Vol. 9, Data for Assessing Health Risks in Potential Theaters of Operation ...cleaning the RO elements, with objectives of improving solute rejection and reducing operating pressure. The most common method is to flush citric acid

A quality improvement management model for renal care.

PubMed

Vlchek, D L; Day, L M

1991-04-01

The purpose of this article is to explore the potential for applying the theory and tools of quality improvement (total quality management) in the renal care setting. We believe that the coupling of the statistical techniques used in the Deming method of quality improvement, with modern approaches to outcome and process analysis, will provide the renal care community with powerful tools, not only for improved quality (i.e., reduced morbidity and mortality), but also for technology evaluation and resource allocation.

Evaluating the Mentor-Mentee Relationship in the 4-H Tech Wizards Program

ERIC Educational Resources Information Center

Toelle, Andy; Terry, Bryan D.; Broaddus, Brent; Kent, Heather; Barnett, Lauren

2015-01-01

Youth rely on mentors to provide camaraderie, encouragement, and guidance. The authors asserted that the measurement of youth-mentor relationship would vastly improve the reaching effects of mentorship and expose areas of potential improvement. A questionnaire was given to youth at the beginning and end of a small group mentoring program. The…

Alternative Loglinear Smoothing Models and Their Effect on Equating Function Accuracy. Research Report. ETS RR-09-48

ERIC Educational Resources Information Center

Moses, Tim; Holland, Paul

2009-01-01

This simulation study evaluated the potential of alternative loglinear smoothing strategies for improving equipercentile equating function accuracy. These alternative strategies use cues from the sample data to make automatable and efficient improvements to model fit, either through the use of indicator functions for fitting large residuals or by…

Robust Evaluation Matrix: Towards a More Principled Offline Exploration of Instructional Policies

ERIC Educational Resources Information Center

Doroudi, Shayan; Aleven, Vincent; Brunskill, Emma

2017-01-01

The gold standard for identifying more effective pedagogical approaches is to perform an experiment. Unfortunately, frequently a hypothesized alternate way of teaching does not yield an improved effect. Given the expense and logistics of each experiment, and the enormous space of potential ways to improve teaching, it would be highly preferable if…

Long-term bed degradation in Maryland streams (Phase III Part 2) : urban streams in the Piedmont Plateau Province : research report : final report.

DOT National Transportation Integrated Search

2017-02-01

Estimation of potential long-term down-cutting of the stream bed is necessary for evaluation and design of bridges for scour and culverts for fish passage. The purpose of this study has been to improve predictions of this potential long-term bed degr...

The Development of B2C E-Commerce in Greece: Current Situation and Future Potential.

ERIC Educational Resources Information Center

Kardaras, Dimitris; Papathanassiou, Eleutherios

2000-01-01

Reports on the results of a survey of 120 companies in Greece that evaluated the potential of business to customer (B2C) Internet applications and investigated how the Internet and e-commerce can offer new opportunities for businesses to improve their customers' satisfaction. Discusses electronic commerce problems and future technology. (Contains…

Changing Less-Preferred Duties to More-Preferred: A Potential Strategy for Improving Supervisor Work Enjoyment

ERIC Educational Resources Information Center

Green, Carolyn W.; Reid, Dennis H.; Passante, Susan; Canipe, Vicki

2008-01-01

We evaluated a strategy for making highly nonpreferred work duties more preferred as a potential means of enhancing work enjoyment among supervisors in a human service setting. Repeated preference ratings and rankings were completed by 4 supervisors during baseline to identify their most disliked work tasks. These tasks were then altered by…

Thinking beyond the Bioreactor Box: Incorporating Stream Ecology into Edge-of-Field Nitrate Management.

PubMed

Goeller, Brandon C; Febria, Catherine M; Harding, Jon S; McIntosh, Angus R

2016-05-01

Around the world, artificially drained agricultural lands are significant sources of reactive nitrogen to stream ecosystems, creating substantial stream health problems. One management strategy is the deployment of denitrification enhancement tools. Here, we evaluate the factors affecting the potential of denitrifying bioreactors to improve stream health and ecosystem services. The performance of bioreactors and the structure and functioning of stream biotic communities are linked by environmental parameters like dissolved oxygen and nitrate-nitrogen concentrations, dissolved organic carbon availability, flow and temperature regimes, and fine sediment accumulations. However, evidence of bioreactors' ability to improve waterway health and ecosystem services is lacking. To improve the potential of bioreactors to enhance desirable stream ecosystem functioning, future assessments of field-scale bioreactors should evaluate the influences of bioreactor performance on ecological indicators such as primary production, organic matter processing, stream metabolism, and invertebrate and fish assemblage structure and function. These stream health impact assessments should be conducted at ecologically relevant spatial and temporal scales. Bioreactors have great potential to make significant contributions to improving water quality, stream health, and ecosystem services if they are tailored to site-specific conditions and implemented strategically with land-based and stream-based mitigation tools within watersheds. This will involve combining economic, logistical, and ecological information in their implementation. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Applying Behavioral Economics to Public Health Policy

PubMed Central

Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

2016-01-01

Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

Reservoir characterization of the Smackover Formation in southwest Alabama. Final report

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

Kopaska-Merkel, D.C.; Hall, D.R.; Mann, S.D.

1993-02-01

The Upper Jurassic Smackover Formation is found in an arcuate belt in the subsurface from south Texas to panhandle Florida. The Smackover is the most prolific hydrocarbon-producing formation in Alabama and is an important hydrocarbon reservoir from Florida to Texas. In this report Smackover hydrocarbon reservoirs in southwest Alabama are described. Also, the nine enhanced- and improved-recovery projects that have been undertaken in the Smackover of Alabama are evaluated. The report concludes with recommendations about potential future enhanced- and improved-recovery projects in Smackover reservoirs in Alabama and an estimate of the potential volume of liquid hydrocarbons recoverable by enhanced- andmore » improved-recovery methods from the Smackover of Alabama.« less

Reservoir characterization of the Smackover Formation in southwest Alabama

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

Kopaska-Merkel, D.C.; Hall, D.R.; Mann, S.D.

1993-02-01

The Upper Jurassic Smackover Formation is found in an arcuate belt in the subsurface from south Texas to panhandle Florida. The Smackover is the most prolific hydrocarbon-producing formation in Alabama and is an important hydrocarbon reservoir from Florida to Texas. In this report Smackover hydrocarbon reservoirs in southwest Alabama are described. Also, the nine enhanced- and improved-recovery projects that have been undertaken in the Smackover of Alabama are evaluated. The report concludes with recommendations about potential future enhanced- and improved-recovery projects in Smackover reservoirs in Alabama and an estimate of the potential volume of liquid hydrocarbons recoverable by enhanced- andmore » improved-recovery methods from the Smackover of Alabama.« less

Global scale analysis and evaluation of an improved mechanistic representation of plant nitrogen and carbon dynamics in the Community Land Model (CLM)

NASA Astrophysics Data System (ADS)

Ghimire, B.; Riley, W. J.; Koven, C. D.; Randerson, J. T.; Mu, M.; Kattge, J.; Rogers, A.; Reich, P. B.

2014-12-01

In many ecosystems, nitrogen is the most limiting nutrient for plant growth and productivity. However mechanistic representation of nitrogen uptake linked to root traits, and functional nitrogen allocation among different leaf enzymes involved in respiration and photosynthesis is currently lacking in Earth System models. The linkage between nitrogen availability and plant productivity is simplistically represented by potential photosynthesis rates, and is subsequently downregulated depending on nitrogen supply and other nitrogen consumers in the model (e.g., nitrification). This type of potential photosynthesis rate calculation is problematic for several reasons. Firstly, plants do not photosynthesize at potential rates and then downregulate. Secondly, there is considerable subjectivity on the meaning of potential photosynthesis rates. Thirdly, there exists lack of understanding on modeling these potential photosynthesis rates in a changing climate. In addition to model structural issues in representing photosynthesis rates, the role of plant roots in nutrient acquisition have been largely ignored in Earth System models. For example, in CLM4.5, nitrogen uptake is linked to leaf level processes (e.g., primarily productivity) rather than root scale process involved in nitrogen uptake. We present a new plant model for CLM with an improved mechanistic presentation of plant nitrogen uptake based on root scale Michaelis Menten kinetics, and stronger linkages between leaf nitrogen and plant productivity by inferring relationships observed in global databases of plant traits (including the TRY database and several individual studies). We also incorporate improved representation of plant nitrogen leaf allocation, especially in tropical regions where significant over-prediction of plant growth and productivity in CLM4.5 simulations exist. We evaluate our improved global model simulations using the International Land Model Benchmarking (ILAMB) framework. We conclude that mechanistic representation of leaf-level nitrogen allocation and a theoretically consistent treatment of competition with belowground consumers leads to overall improvements in CLM4.5's global carbon cycling predictions.

Safety performance functions for intersections : final report, December 2009.

DOT National Transportation Integrated Search

2009-12-01

Road safety management activities include screening the network for sites with a potential for safety improvement (Network : Screening), diagnosing safety problems at specific sites, and evaluating the safety effectiveness of implemented : countermea...

EDUCTOR VAPOR RECOVERY UNIT

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

Improving driver safety with behavioral countermeasures.

DOT National Transportation Integrated Search

2011-09-30

"The purpose of this project was to provide MDOT with insight regarding the effectiveness of potential implementations of behavioral countermeasures for increasing driver safety in Michigan. The Center for Driver Evaluation, Education, and Research a...

Nanoparticle-mediated drug delivery to treat infections in the female reproductive tract: evaluation of experimental systems and the potential for mathematical modeling.

PubMed

Sims, Lee B; Frieboes, Hermann B; Steinbach-Rankins, Jill M

2018-01-01

A variety of drug-delivery platforms have been employed to deliver therapeutic agents across cervicovaginal mucus (CVM) and the vaginal mucosa, offering the capability to increase the longevity and retention of active agents to treat infections of the female reproductive tract (FRT). Nanoparticles (NPs) have been shown to improve retention, diffusion, and cell-specific targeting via specific surface modifications, relative to other delivery platforms. In particular, polymeric NPs represent a promising option that has shown improved distribution through the CVM. These NPs are typically fabricated from nontoxic, non-inflammatory, US Food and Drug Administration-approved polymers that improve biocompatibility. This review summarizes recent experimental studies that have evaluated NP transport in the FRT, and highlights research areas that more thoroughly and efficiently inform polymeric NP design, including mathematical modeling. An overview of the in vitro, ex vivo, and in vivo NP studies conducted to date - whereby transport parameters are determined, extrapolated, and validated - is presented first. The impact of different NP design features on transport through the FRT is summarized, and gaps that exist due to the limitations of iterative experimentation alone are identified. The potential of mathematical modeling to complement the characterization and evaluation of diffusion and transport of delivery vehicles and active agents through the CVM and mucosa is discussed. Lastly, potential advancements combining experimental and mathematical knowledge are suggested to inform next-generation NP designs, such that infections in the FRT may be more effectively treated.

Software Reuse Methods to Improve Technological Infrastructure for e-Science

NASA Technical Reports Server (NTRS)

Marshall, James J.; Downs, Robert R.; Mattmann, Chris A.

2011-01-01

Social computing has the potential to contribute to scientific research. Ongoing developments in information and communications technology improve capabilities for enabling scientific research, including research fostered by social computing capabilities. The recent emergence of e-Science practices has demonstrated the benefits from improvements in the technological infrastructure, or cyber-infrastructure, that has been developed to support science. Cloud computing is one example of this e-Science trend. Our own work in the area of software reuse offers methods that can be used to improve new technological development, including cloud computing capabilities, to support scientific research practices. In this paper, we focus on software reuse and its potential to contribute to the development and evaluation of information systems and related services designed to support new capabilities for conducting scientific research.

Evaluation of carcinogenic hazard of diesel engine exhaust needs to consider revolutionary changes in diesel technology.

PubMed

McClellan, Roger O; Hesterberg, Thomas W; Wall, John C

2012-07-01

Diesel engines, a special type of internal combustion engine, use heat of compression, rather than electric spark, to ignite hydrocarbon fuels injected into the combustion chamber. Diesel engines have high thermal efficiency and thus, high fuel efficiency. They are widely used in commerce prompting continuous improvement in diesel engines and fuels. Concern for health effects from exposure to diesel exhaust arose in the mid-1900s and stimulated development of emissions regulations and research to improve the technology and characterize potential health hazards. This included epidemiological, controlled human exposure, laboratory animal and mechanistic studies to evaluate potential hazards of whole diesel exhaust. The International Agency for Research on Cancer (1989) classified whole diesel exhaust as - "probably carcinogenic to humans". This classification stimulated even more stringent regulations for particulate matter that required further technological developments. These included improved engine control, improved fuel injection system, enhanced exhaust cooling, use of ultra low sulfur fuel, wall-flow high-efficiency exhaust particulate filters, exhaust catalysts, and crankcase ventilation filtration. The composition of New Technology Diesel Exhaust (NTDE) is qualitatively different and the concentrations of particulate constituents are more than 90% lower than for Traditional Diesel Exhaust (TDE). We recommend that future reviews of carcinogenic hazards of diesel exhaust evaluate NTDE separately from TDE. Copyright © 2012 Elsevier Inc. All rights reserved.

Detection of cracks beneath rivet heads via pulsed eddy current technique

NASA Astrophysics Data System (ADS)

Giguère, J. S. R.; Lepine, B. A.; Dubois, J. M. S.

2002-05-01

Improving the detectability of fatigue cracks under installed fasteners is one of the many goals of the aging aircraft nondestructive evaluation (NDE) community. The pulsed eddy current offers new capabilities to address this requirement. The aim of the paper is to evaluate the potential of this technique for detecting and quantifying notches under installed fasteners.

Evaluation of the TBET model for potential improvement of southern P indices

USDA-ARS?s Scientific Manuscript database

Due to a shortage of available phosphorus (P) loss data sets, simulated data from a quantitative P transport model could be used to evaluate a P-index. However, the model would need to accurately predict the P loss data sets that are available. The objective of this study was to compare predictions ...

Evaluation of a hybrid pixel detector for electron microscopy.

PubMed

Faruqi, A R; Cattermole, D M; Henderson, R; Mikulec, B; Raeburn, C

2003-04-01

We describe the application of a silicon hybrid pixel detector, containing 64 by 64 pixels, each 170 microm(2), in electron microscopy. The device offers improved resolution compared to CCDs along with faster and noiseless readout. Evaluation of the detector, carried out on a 120 kV electron microscope, demonstrates the potential of the device.

Intraoperative acceleration measurements to quantify improvement in tremor during deep brain stimulation surgery.

PubMed

Shah, Ashesh; Coste, Jérôme; Lemaire, Jean-Jacques; Taub, Ethan; Schüpbach, W M Michael; Pollo, Claudio; Schkommodau, Erik; Guzman, Raphael; Hemm-Ode, Simone

2017-05-01

Deep brain stimulation (DBS) surgery is extensively used in the treatment of movement disorders. Nevertheless, methods to evaluate the clinical response during intraoperative stimulation tests to identify the optimal position for the implantation of the chronic DBS lead remain subjective. In this paper, we describe a new, versatile method for quantitative intraoperative evaluation of improvement in tremor with an acceleration sensor that is mounted on the patient's wrist during surgery. At each anatomical test position, the improvement in tremor compared to the initial tremor is estimated on the basis of extracted outcome measures. This method was tested on 15 tremor patients undergoing DBS surgery in two centers. Data from 359 stimulation tests were acquired. Our results suggest that accelerometric evaluation detects tremor changes more sensitively than subjective visual ratings. The effective stimulation current amplitudes identified from the quantitative data (1.1 ± 0.8 mA) are lower than those identified by visual evaluation (1.7 ± 0.8 mA) for similar improvement in tremor. Additionally, if these data had been used to choose the chronic implant position of the DBS lead, 15 of the 26 choices would have been different. These results show that our method of accelerometric evaluation can potentially improve DBS targeting.

Applying usability heuristics to radiotherapy systems.

PubMed

Chan, Alvita J; Islam, Mohammad K; Rosewall, Tara; Jaffray, David A; Easty, Anthony C; Cafazzo, Joseph A

2012-01-01

Heuristic evaluations have been used to evaluate safety of medical devices by identifying and assessing usability issues. Since radiotherapy treatment delivery systems often consist of multiple complex user-interfaces, a heuristic evaluation was conducted to assess the potential safety issues of such a system. A heuristic evaluation was conducted to evaluate the treatment delivery system at Princess Margaret Hospital (Toronto, Canada). Two independent evaluators identified usability issues with the user-interfaces and rated the severity of each issue. The evaluators identified 75 usability issues in total. Eighteen of them were rated as high severity, indicating the potential to have a major impact on patient safety. A majority of issues were found on the record and verify system, and many were associated with the patient setup process. While the hospital has processes in place to ensure patient safety, recommendations were developed to further mitigate the risks of potential consequences. Heuristic evaluation is an efficient and inexpensive method that can be successfully applied to radiotherapy delivery systems to identify usability issues and improve patient safety. Although this study was conducted only at one site, the findings may have broad implications for the design of these systems. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A Meta-Analysis of Typhoid Diagnostic Accuracy Studies: A Recommendation to Adopt a Standardized Composite Reference

PubMed Central

Storey, Helen L.; Huang, Ying; Crudder, Chris; Golden, Allison; de los Santos, Tala; Hawkins, Kenneth

2015-01-01

Novel typhoid diagnostics currently under development have the potential to improve clinical care, surveillance, and the disease burden estimates that support vaccine introduction. Blood culture is most often used as the reference method to evaluate the accuracy of new typhoid tests; however, it is recognized to be an imperfect gold standard. If no single gold standard test exists, use of a composite reference standard (CRS) can improve estimation of diagnostic accuracy. Numerous studies have used a CRS to evaluate new typhoid diagnostics; however, there is no consensus on an appropriate CRS. In order to evaluate existing tests for use as a reference test or inclusion in a CRS, we performed a systematic review of the typhoid literature to include all index/reference test combinations observed. We described the landscape of comparisons performed, showed results of a meta-analysis on the accuracy of the more common combinations, and evaluated sources of variability based on study quality. This wide-ranging meta-analysis suggests that no single test has sufficiently good performance but some existing diagnostics may be useful as part of a CRS. Additionally, based on findings from the meta-analysis and a constructed numerical example demonstrating the use of CRS, we proposed necessary criteria and potential components of a typhoid CRS to guide future recommendations. Agreement and adoption by all investigators of a standardized CRS is requisite, and would improve comparison of new diagnostics across independent studies, leading to the identification of a better reference test and improved confidence in prevalence estimates. PMID:26566275

Pilot study on the effects of a computer-based medical image system.

PubMed Central

Wu, S. C.; Smith, J. W.; Swan, J. E.

1996-01-01

Current medical imaging systems are developed for the purpose of data management. Evaluations of these systems are usually done by assessing users' subjective appreciation rather than objectively gauging performance influence. The present report discusses the evaluation of a medical image presentation system prototype utilizing a cognitive approach. Experimental results showed hypothesized performance improvement attributed to advanced presentation techniques. However, this improvement was almost inadvertently masked by users' previous strategies and interactions with new technology. Overall these data demonstrate the potential benefit of implementing such a system in actual practice as well as provide an example of applying the cognitive approach in evaluating the usability of medical systems. Images Figure 1 PMID:8947750

Putting evaluation capacity building in context: Reflections on the Ontario Brain Institute's Evaluation Support Program.

PubMed

King, Jean A

2017-05-13

This article, in three parts, reflects on the content of the six articles included in the forum. It begins with a description of the Evaluation Support Program, emphasizing its key attributes. Next, it raises two points regarding ECB theory: (1) the need to become clearer about the concepts and terms used to describe and study this phenomenon, and (2) the potential value of social science theory to understand ECB and improve its practice. The article concludes with practical ideas for improving ECB: (1) framing it as an educative act, which assigns the evaluator the critical role of evaluation teacher/coach; and (2) the importance of never assuming that an ECB effort begins in unchartered territory, but rather that it builds on people's knowledge, skills, attitudes, and previous experiences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of a New Grading System for Clinical Skills in Dental Student Clinics.

PubMed

Bodenmann, Aurel D; Bühler, Julia M; Amato, Mauro; Weiger, Ronald; Zitzmann, Nicola U

2017-05-01

Several evaluation systems for clinical exams have been suggested over the years, but no systematic analysis of checklists or criteria-based exam forms has yet been undertaken. The aims of this study were to analyze criteria-based evaluation forms and to identify areas in the teaching process potentially requiring improvements. All evaluation forms introduced in 2012 at the Clinic for Periodontology, Endodontology, and Cariology at the University Center of Dental Medicine in Basel, Switzerland, and applied over a three-year period (n=1,093 in 2015) were analyzed using predefined criteria. The authors investigated how well clinical tasks were examined with the given criteria and which criteria were preferably evaluated with a grading system (0-2) or a yes/no choice. The average final grades ranged from 0.89 (n=92) for gold inlay preparation to 1.76 (n=46) for periodontal treatment. Comments were made in 38.5% (n=356) of all exams, mainly highlighting specific aspects of existing criteria. Overall, 13 criteria out of 66 should be checked instead of graded. This methodological analysis of exam forms assessing tasks in operative dentistry yielded valuable information on areas with potential for improvement in the dental curriculum and the evaluation process. Aspects that require more theoretical background and/or hands-on recommendations from experienced clinicians were identified, and ways of further refining and redesigning the evaluation forms were proposed.

Thermal Manikin Evaluation of Passive and Active Cooling Garments to Improve Comfort of Military Body Armor

DTIC Science & Technology

2007-08-01

increased TM evaporative cooling potential approximately 18%. Military use of these garments could allow for increases in sweat evaporation and overall thermal comfort during operational heat exposure.

IMMUNOASSAY TEST KITS FOR ATRAZINE

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

Economic Evaluation of Advanced Winter Highway Maintenance Strategies

DOT National Transportation Integrated Search

1998-01-01

Highway agencies face demands to maintain or improve the existing winter roadway level of service. This paper examines the potential benefits of applying advanced winter highway maintenance strategies. The Vermont Agency of Transportation conducted "...

Attention Process Training-3 to improve reading comprehension in mild aphasia: A single-case experimental design study.

PubMed

Lee, Jaime B; Sohlberg, McKay Moore; Harn, Beth; Horner, Robert; Cherney, Leora R

2018-06-04

People with aphasia frequently present with nonlinguistic deficits, in addition to their compromised language abilities, which may contribute to their problems with reading comprehension. Treatment of attention, working memory and executive control may improve reading comprehension in individuals with aphasia, particularly those with mild reading problems. This single-case experimental design study evaluated the efficacy of Attention Process Training-3, an intervention combining direct attention training and metacognitive facilitation, for improving reading comprehension in individuals with mild aphasia. A multiple baseline design across six participants was used to evaluate treatment effects. The primary outcome measure was a maze reading task. Cognitive measures were administered pre- and post-treatment. Visual inspection of graphed maze reading performance data indicated a basic effect between APT-3 and improved maze reading for three of the six participants. Quantitative analyses, using Tau-U, corroborated findings identified through visual analysis. The overall effect size was significant (Tau = .48, p = .01). Results suggest that APT-3 has the potential to improve reading in individuals with aphasia, but that it may be more efficacious under certain conditions. Treatment and participant variables, including intensity of treatment and metacognitive strategy usage, are discussed as potential influences on participants' responsiveness to APT-3.

Improving Student Reading through Parents' Implementation of a Structured Reading Program

ERIC Educational Resources Information Center

Mitchell, Courtney; Begeny, John C.

2014-01-01

Parent tutoring offers potential as a means for assisting the large percentage of students who need to improve their reading skills. The primary purpose of this study was to examine the impact of a reading fluency intervention program when used by parents in the home during the summer months. Specifically, this study evaluated the effects of the…

Building Parental Capacity to Improve Child Development: Impact Evaluation of an Early Childhood Stimulation Program in Bangladesh

ERIC Educational Resources Information Center

Chinen, Marjorie; Bos, Hans; Murray, Matthew; Hamadani, Jena; Hossain, Najmul; Mahmud, Minhaj

2015-01-01

Globally, at least 200 million children younger than five years old are falling short of their potential for development and growth. There is some evidence that improvements to children's health, nutrition, and development outcomes can be made through programs that provide direct learning experiences to children and families; are targeted toward…

Empowering Oncology Nurses to Lead Change Through a Shared Governance Project.

PubMed

Gordon, Jeanine N

2016-11-01

Nurses at the bed- or chairside are knowledgeable about clinical and operational concerns that need improvement and, consequently, are in the best position to generate and evaluate practical options and potential solutions to improve efficacy and care processes. Implementation of a shared governance model is effective in engaging staff nurses to make meaningful and sustainable change in patient care processes.

Evaluating projects for improving fish and wildlife habitat on National Forests.

Treesearch

Fred H. Everest; Daniel R. Talhelm

1982-01-01

Recent legislation (PL. 93-452; P.L. 94-588) has emphasized improvement of fish and wildlife habitat on lands of the National Forest System. A sequential procedure has been developed for screening potential projects to identify those producing the greatest fishery benefits. The procedure—which includes program planning, project planning, and intensive benefit/cost...

Development and Evaluation of an Internet-Based Program to Improve the Mental Health and Wellbeing of Young Men

ERIC Educational Resources Information Center

Ellis, Louise A.; McCabe, Kathryn; Davenport, Tracey; Burns, Jane M.; Rahilly, Kitty; Nicholas, Mariesa; Hickie, Ian B

2015-01-01

Purpose: This paper aims to describe the development of WorkOut, an Internet-based program designed to help young men overcome the barriers towards help-seeking and to build the skills they need to understand and manage their own mental health. Information and communication technologies (ICT) hold great potential to significantly improve mental…

Ring Shake in Eastern Hemlock: Frequency and Relationship to Tree Attributes

Treesearch

John E. Baumgras; Paul E. Sendak; David L. Sonderman; David L. Sonderman

2000-01-01

Ring shake is a barrier to improved utilization of eastern hemlock, an important component of the total softwood timber resource in the Eastern United States and Canada. Ring shake is the lengthwise separation of wood that occurs between and parallel to growth rings, diminishing lumber yields and values. Evaluating the potential for ring shake is essential to improving...

Ring shake in eastern hemlock: frequency and relationship to tree attributes

Treesearch

John E. Baumgras; Paul E. Sendak; David L. Sonderman

2000-01-01

Ring shake is a barrier to improved utilization of eastern hemlock, an important component of the total softwood timber resource in the Eastern United States and Canada. Ring shake is the lengthwise separation of wood that occurs between and parallel to growth rings, diminishing lumber yields and values. Evaluating the potential for ring shake is essential to improving...

Assessment of Students’ Critical-Thinking and Problem-Solving Abilities Across a 6-Year Doctor of Pharmacy Program

PubMed Central

Gaebelein, Claude J.; Grice, Gloria R.; Crannage, Andrew J.; Weck, Margaret A.; Hurd, Peter; Walter, Brenda; Duncan, Wendy

2013-01-01

Objective. To determine the feasibility of using a validated set of assessment rubrics to assess students’ critical-thinking and problem-solving abilities across a doctor of pharmacy (PharmD) curriculum. Methods. Trained faculty assessors used validated rubrics to assess student work samples for critical-thinking and problem-solving abilities. Assessment scores were collected and analyzed to determine student achievement of these 2 ability outcomes across the curriculum. Feasibility of the process was evaluated in terms of time and resources used. Results. One hundred sixty-one samples were assessed for critical thinking, and 159 samples were assessed for problem-solving. Rubric scoring allowed assessors to evaluate four 5- to 7-page work samples per hour. The analysis indicated that overall critical-thinking scores improved over the curriculum. Although low yield for problem-solving samples precluded meaningful data analysis, it was informative for identifying potentially needed curricular improvements. Conclusions. Use of assessment rubrics for program ability outcomes was deemed authentic and feasible. Problem-solving was identified as a curricular area that may need improving. This assessment method has great potential to inform continuous quality improvement of a PharmD program. PMID:24159207

Assessment of students' critical-thinking and problem-solving abilities across a 6-year doctor of pharmacy program.

PubMed

Gleason, Brenda L; Gaebelein, Claude J; Grice, Gloria R; Crannage, Andrew J; Weck, Margaret A; Hurd, Peter; Walter, Brenda; Duncan, Wendy

2013-10-14

To determine the feasibility of using a validated set of assessment rubrics to assess students' critical-thinking and problem-solving abilities across a doctor of pharmacy (PharmD) curriculum. Trained faculty assessors used validated rubrics to assess student work samples for critical-thinking and problem-solving abilities. Assessment scores were collected and analyzed to determine student achievement of these 2 ability outcomes across the curriculum. Feasibility of the process was evaluated in terms of time and resources used. One hundred sixty-one samples were assessed for critical thinking, and 159 samples were assessed for problem-solving. Rubric scoring allowed assessors to evaluate four 5- to 7-page work samples per hour. The analysis indicated that overall critical-thinking scores improved over the curriculum. Although low yield for problem-solving samples precluded meaningful data analysis, it was informative for identifying potentially needed curricular improvements. Use of assessment rubrics for program ability outcomes was deemed authentic and feasible. Problem-solving was identified as a curricular area that may need improving. This assessment method has great potential to inform continuous quality improvement of a PharmD program.

Nurturing Quality of Higher Education through National Ranking: A Potential Empowerment Model for Developing Countries

ERIC Educational Resources Information Center

Kusumastuti, Dyah; Idrus, Nirwan

2017-01-01

This paper reviews the recently introduced National Higher Education ranking system in Indonesia in order to evaluate its potential as a sustainable model to improve the quality of higher education in the country. It is a scaffold towards an established world-universities ranking system that may prove formidable for a developing country. This…

Planning Strategies for Transportation Fuel Consumption Reduction: An Evaluation of the Hawaii Clean Energy Initiative’s Transportation Plan

DTIC Science & Technology

2014-04-01

technologies to improve fleet efficiency goals, and evaluate switching to biodiesel for trucks and vehicles without other alternatives (HCEI 2011...standards and biodiesel usage levels 2020 Goal 50 MGY of renewable fuels 28 working with industry to increase EV market penetration, and...Strategy Reduction Potential Purchase more efficient vehicles 10-20% Promote hybrid technologies 10-20% Evaluate biodiesel switching (freight) TBD

Development of Improved Composite Pressure Vessels for Hydrogen Storage

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

Newhouse, Norman L.

2016-04-29

Hexagon Lincoln started this DOE project as part of the Hydrogen Storage Engineering Center of Excellence (HSECoE) contract on 1 February 2009. The purpose of the HSECoE was the research and development of viable material based hydrogen storage systems for on-board vehicular applications to meet DOE performance and cost targets. A baseline design was established in Phase 1. Studies were then conducted to evaluate potential improvements, such as alternate fiber, resin, and boss materials. The most promising concepts were selected such that potential improvements, compared with the baseline Hexagon Lincoln tank, resulted in a projected weight reduction of 11 percent,more » volume increase of 4 percent, and cost reduction of 10 percent. The baseline design was updated in Phase 2 to reflect design improvements and changes in operating conditions specified by HSECoE Partners. Evaluation of potential improvements continued during Phase 2. Subscale prototype cylinders were designed and fabricated for HSECoE Partners’ use in demonstrating their components and systems. Risk mitigation studies were conducted in Phase 3 that focused on damage tolerance of the composite reinforcement. Updated subscale prototype cylinders were designed and manufactured to better address the HSECoE Partners’ requirements for system demonstration. Subscale Type 1, Type 3, and Type 4 tanks were designed, fabricated and tested. Laboratory tests were conducted to evaluate vacuum insulated systems for cooling the tanks during fill, and maintaining low temperatures during service. Full scale designs were prepared based on results from the studies of this program. The operating conditions that developed during the program addressed adsorbent systems operating at cold temperatures. A Type 4 tank would provide the lowest cost and lightest weight, particularly at higher pressures, as long as issues with liner compatibility and damage tolerance could be resolved. A Type 1 tank might be the choice if the liner and damage tolerance issues were not resolved, particularly if the operating pressure was reduced.« less

Vestibular Response to Electrical Stimulation of the Otolith Organs. Implications in the Development of A Vestibular Implant for the Improvement of the Sensation of Gravitoinertial Accelerations.

PubMed

Ramos de Miguel, Angel; Falcon Gonzalez, Juan Carlos; Ramos Macias, Angel

2017-08-01

Electrical stimulation of the utricular and saccular portions of the vestibular nerve improves stability in patients suffering from vestibular dysfunction. The main objective of this study was to evaluate a new technique, vestibular response telemetry (VRT), for measuring the electrically evoked vestibular compound action potential (saccular and utricular) after stimulating the otolith organ (saccular and utricular) in adults. This study used evidence that the otolith organ can be electrically stimulated in order to develop a new vestibular implant design to improve the sensation of gravitoinertial acceleration. Four adult patients were evaluated by using a variety of measurement procedures with novel VRT software. VRT values were obtained by stimulating with three full-band Nucleus CI24RE (ST) electrodes. Specific stimuli were used. Simultaneously, electrical ocular vestibular evoked myogenic potentials (eoVEMPs) were recorded in the contralateral side. Electrically evoked compound action potentials were obtained in 10 of the 12 electrodes tested, and eoVEMPs were recorded when VRT was present. In addition to the validation of this technique, a set of default clinical test parameters was established. The VRT response morphology consisted of a biphasic waveform with an initial negative peak (N1) followed by a positive peak (P1), and latencies were typically 400 μs for N1 and 800 μs for P1. The consequences for the development of a vestibular implant for the improvement of gravitoinertial acceleration sensation are also presented. The VRT measurement technique has been shown to be a useful tool to record neural response on the otolith organ, and thus it is a convenient tool to evaluate whether the implanted electrodes provide a neural response or not. This can be used for the early development of vestibular implants to improve gravitoinertial acceleration sensation.

A review of micro-powder injection moulding as a microfabrication technique

NASA Astrophysics Data System (ADS)

Attia, Usama M.; Alcock, Jeffrey R.

2011-04-01

Micro-powder injection moulding (µPIM) is a fast-developing micro-manufacturing technique for the production of metal and ceramic components. Shape complexity, dimensional accuracy, replication fidelity, material variety combined with high-volume capabilities are some of the key advantages of the technology. This review assesses the capabilities and limitations of µPIM as a micro-manufacturing technique by reviewing the latest developments in the area and by considering potential improvements. The basic elements of the process chain, variant processes and simulation attempts are discussed and evaluated. Challenges and research gaps are highlighted, and potential areas for improvement are presented.

Evaluation of Healthcare Interventions and Big Data: Review of Associated Data Issues.

PubMed

Asche, Carl V; Seal, Brian; Kahler, Kristijan H; Oehrlein, Elisabeth M; Baumgartner, Meredith Greer

2017-08-01

Although the analysis of 'big data' holds tremendous potential to improve patient care, there remain significant challenges before it can be realized. Accuracy and completeness of data, linkage of disparate data sources, and access to data are areas that require particular focus. This article discusses these areas and shares strategies to promote progress. Improvement in clinical coding, innovative matching methodologies, and investment in data standardization are potential solutions to data validation and linkage problems. Challenges to data access still require significant attention with data ownership, security needs, and costs representing significant barriers to access.

Standard test evaluation of graphite fiber/resin matrix composite materials for improved toughness

NASA Technical Reports Server (NTRS)

Chapman, Andrew J.

1984-01-01

Programs sponsored by NASA with the commercial transport manufacturers to develop a technology data base are required to design and build composite wing and fuselage structures. To realize the full potential of composite structures in these strength critical designs, material systems having improved ductility and interlaminar toughness are being sought. To promote systematic evaluation of new materials, NASA and the commercial transport manufacturers have selected and standardized a set of five common tests. These tests evaluate open hole tension and compression performance, compression performance after impact at an energy level of 20 ft-lb, and resistance to delamination. Ten toughened resin matrix/graphite fiber composites were evaluated using this series of tests, and their performance is compared with a widely used composite system.

The identification of criteria to evaluate prehospital trauma care using the Delphi technique.

PubMed

Rosengart, Matthew R; Nathens, Avery B; Schiff, Melissa A

2007-03-01

Current trauma system performance improvement emphasizes hospital- and patient-based outcome measures such as mortality and morbidity, with little focus upon the processes of prehospital trauma care. Little data exist to suggest which prehospital criteria should serve as potential filters. This study identifies the most important filters for auditing prehospital trauma care using a Delphi technique to achieve consensus of expert opinion. Experts in trauma care from the United States (n = 81) were asked to generate filters of potential utility in monitoring the prehospital aspect of the trauma system, and were then required to rank these questions in order of importance to identify those of greatest importance. Twenty-eight filters ranking in the highest tertile are proposed. The majority (54%) pertains to aspects of emergency medical services, which comprise 7 of the top 10 (70%) filters. Triage filters follow in priority ranking, comprising 29% of the final list. Filters concerning interfacility transfers and transportation ranked lowest. This study identifies audit filters representing the most important aspects of prehospital trauma care that merit continued evaluation and monitoring. A subsequent trial addressing the utility of these filters could potentially enhance the sensitivity of identifying deviations in prehospital care, standardize the performance improvement process, and translate into an improvement in patient care and outcome.

Randomized Prospective Double-Blind Studies to Evaluate the Cognitive Effects of Inositol-Stabilized Arginine Silicate in Healthy Physically Active Adults

PubMed Central

Kalman, Douglas; Harvey, Philip D.; Perez Ojalvo, Sara; Komorowski, James

2016-01-01

Inositol-stabilized arginine silicate (ASI; Nitrosigine®) has been validated to increase levels of arginine, silicon and nitric oxide production. To evaluate potential enhancement of mental focus and clarity, ASI (1500 mg/day) was tested in two double-blind placebo-controlled crossover (DBPC-X) studies using the Trail Making Test (TMT, Parts A and B). In the two studies, healthy males took ASI for 14 and 3 days, respectively. In the first study, after 14 days of dosing, TMT B time decreased significantly from baseline (28% improvement, p = 0.045). In the second study evaluating shorter-term effects, TMT B time decreased significantly compared to placebo (33% improvement, p = 0.024) in a 10-min period. After 3 days of dosing, TMT B time significantly decreased from baseline scores (35% improvement, p < 0.001). These findings show that ASI significantly improved the ability to perform complex cognitive tests requiring mental flexibility, processing speed and executive functioning. PMID:27869715

Improvement of bioavailability and anti-inflammatory potential of curcumin in combination with emu oil.

PubMed

Jeengar, Manish Kumar; Shrivastava, Shweta; Nair, Kala; Singareddy, Sreenivasa Reddy; Putcha, Uday Kumar; Talluri, M V N Kumar; Naidu, V G M; Sistla, Ramakrishna

2014-12-01

The purpose of the present study is to evaluate the effect of emu oil on bioavailability of curcumin when co-administered and to evaluate the property that enhances the anti-inflammatory potential of curcumin. Oral bioavailability of curcumin in combination with emu oil was determined by measuring the plasma concentration of curcumin by HPLC. The anti-inflammatory potential was evaluated in carrageenan-induced paw edema model (acute model) and in Freund's complete adjuvant (FCA)-induced arthritis model (chronic model) in male SD rats. The anti-inflammatory potential of curcumin in combination with emu oil has been significantly increased in both acute and chronic inflammatory models as evident from inhibition of increase in paw volume, arthritic score, and expression of pro-inflammatory cytokines. The increased anti-inflammatory activity in combination therapy is due to enhanced bioavailability (5.2-fold compared to aqueous suspension) of curcumin by emu oil. Finally, it is concluded that the combination of emu oil with curcumin will be a promising approach for the treatment of arthritis.

[Ethical perspectives on E‑health and health apps : Is all that is achievable desirable?

PubMed

Groß, Dominik; Schmidt, Mathias

2018-03-01

The aim of technical innovation-and the standpoint from which to assess technology-must be to expand human spaces of action and improve social coexistence. Although many current developments have the potential for furthering this aim, they also imply the danger of being misused. The potential for misuse can be recognized and dealt with at an early stage if ethics is an integral part of technology development. Relevant evaluation criteria include benefit and damage potential, possible repercussions on the physician-patient relationship, self-efficacy, and self-determination (autonomy) of the actors based on full knowledge, appropriate attribution of responsibility, and the access and distribution of rights.This report meditates on the ethical evaluation of E‑health and the role of ethics in developing new medical technologies. It first discusses the effects of the digitalization of the healthcare market on patients and health workers and then reconsiders the potential, framework, and instruments of ethical evaluation from a theoretical and application-oriented point of view.

Recalibrating Baseline Evidence in Burundi, Malawi, Senegal and Uganda: Exploring the Potential of Multi-Site, National-Level Stakeholder Engagement in Participatory Evaluation

ERIC Educational Resources Information Center

Edge, Karen; Marphatia, Akanksha A.

2015-01-01

This paper details our collaborative work on the Improving Learning Outcomes in Primary Schools (ILOPS) project in Burundi, Malawi, Uganda and Senegal. ILOPS set out to establish an innovative template for multi-stakeholder, multinational participatory evaluation (PE) and examine the fundamental roles, relationships and evidence that underpin the…

Testing a full‐range soil‐water retention function in modeling water potential and temperature

USGS Publications Warehouse

Andraski, Brian J.; Jacobson, Elizabeth A.

2000-01-01

Recent work has emphasized development of full‐range water‐retention functions that are applicable under both wet and dry soil conditions, but evaluation of such functions in numerical modeling has been limited. Here we show that simulations using the Rossi‐Nimmo (RN) full‐range function compared favorably with those using the common Brooks‐Corey function and that the RN function can improve prediction of water potentials in near‐surface soil, particularly under dry conditions. Simulations using the RN function also improved prediction of temperatures throughout the soil profile. Such improvements could be important for calculations of liquid and vapor flow in near‐surface soils and in deep unsaturated zones of arid and semiarid regions.

Modelling the impacts of pests and diseases on agricultural systems.

PubMed

Donatelli, M; Magarey, R D; Bregaglio, S; Willocquet, L; Whish, J P M; Savary, S

2017-07-01

The improvement and application of pest and disease models to analyse and predict yield losses including those due to climate change is still a challenge for the scientific community. Applied modelling of crop diseases and pests has mostly targeted the development of support capabilities to schedule scouting or pesticide applications. There is a need for research to both broaden the scope and evaluate the capabilities of pest and disease models. Key research questions not only involve the assessment of the potential effects of climate change on known pathosystems, but also on new pathogens which could alter the (still incompletely documented) impacts of pests and diseases on agricultural systems. Yield loss data collected in various current environments may no longer represent a adequate reference to develop tactical, decision-oriented, models for plant diseases and pests and their impacts, because of the ongoing changes in climate patterns. Process-based agricultural simulation modelling, on the other hand, appears to represent a viable methodology to estimate the impacts of these potential effects. A new generation of tools based on state-of-the-art knowledge and technologies is needed to allow systems analysis including key processes and their dynamics over appropriate suitable range of environmental variables. This paper offers a brief overview of the current state of development in coupling pest and disease models to crop models, and discusses technical and scientific challenges. We propose a five-stage roadmap to improve the simulation of the impacts caused by plant diseases and pests; i) improve the quality and availability of data for model inputs; ii) improve the quality and availability of data for model evaluation; iii) improve the integration with crop models; iv) improve the processes for model evaluation; and v) develop a community of plant pest and disease modelers.

Evaluating the accuracy of SHAPE-directed RNA secondary structure predictions

PubMed Central

Sükösd, Zsuzsanna; Swenson, M. Shel; Kjems, Jørgen; Heitsch, Christine E.

2013-01-01

Recent advances in RNA structure determination include using data from high-throughput probing experiments to improve thermodynamic prediction accuracy. We evaluate the extent and nature of improvements in data-directed predictions for a diverse set of 16S/18S ribosomal sequences using a stochastic model of experimental SHAPE data. The average accuracy for 1000 data-directed predictions always improves over the original minimum free energy (MFE) structure. However, the amount of improvement varies with the sequence, exhibiting a correlation with MFE accuracy. Further analysis of this correlation shows that accurate MFE base pairs are typically preserved in a data-directed prediction, whereas inaccurate ones are not. Thus, the positive predictive value of common base pairs is consistently higher than the directed prediction accuracy. Finally, we confirm sequence dependencies in the directability of thermodynamic predictions and investigate the potential for greater accuracy improvements in the worst performing test sequence. PMID:23325843

Safety and feasibility of countering neurological impairment by intravenous administration of autologous cord blood in cerebral palsy

PubMed Central

2012-01-01

Backgrounds We conducted a pilot study of the infusion of intravenous autologous cord blood (CB) in children with cerebral palsy (CP) to assess the safety and feasibility of the procedure as well as its potential efficacy in countering neurological impairment. Methods Patients diagnosed with CP were enrolled in this study if their parents had elected to bank their CB at birth. Cryopreserved CB units were thawed and infused intravenously over 10~20 minutes. We assessed potential efficacy over 6 months by brain magnetic resonance imaging (MRI)-diffusion tensor imaging (DTI), brain perfusion single-photon emission computed tomography (SPECT), and various evaluation tools for motor and cognitive functions. Results Twenty patients received autologous CB infusion and were evaluated. The types of CP were as follows: 11 quadriplegics, 6 hemiplegics, and 3 diplegics. Infusion was generally well-tolerated, although 5 patients experienced temporary nausea, hemoglobinuria, or urticaria during intravenous infusion. Diverse neurological domains improved in 5 patients (25%) as assessed with developmental evaluation tools as well as by fractional anisotropy values in brain MRI-DTI. The neurologic improvement occurred significantly in patients with diplegia or hemiplegia rather than quadriplegia. Conclusions Autologous CB infusion is safe and feasible, and has yielded potential benefits in children with CP. PMID:22443810

Impact of a Pharmacy-Cardiology Collaborative Practice on Dofetilide Safety Monitoring.

PubMed

Quffa, Lieth H; Panna, Mark; Kaufmann, Michael R; McKillop, Matthew; Dietrich, Nicole Maltese; Franck, Andrew J

2017-01-01

Limited studies have been published examining dofetilide's postmarketing use and its recommended monitoring. To evaluate the impact of a collaborative pharmacy-cardiology antiarrhythmic drug (AAD) monitoring program on dofetilide monitoring. This retrospective cohort study was performed to assess if a novel monitoring program improved compliance with dofetilide-specific monitoring parameters based on the Food and Drug Administration's Risk Evaluation and Mitigation Strategy. A total of 30 patients were included in the analysis. The monitoring parameters evaluated included electrocardiogram, serum potassium, serum magnesium, and kidney function. The primary outcome evaluated was the composite of these dofetilide monitoring parameters obtained in each cohort. In the standard cohort, 245 of 352 (69.6%) monitoring parameters were completed versus 134 of 136 (98.5%) in the intervention group ( P < 0.05). A collaborative pharmacy-cardiology AAD monitoring program was associated with a significant improvement in dofetilide monitoring. This improvement could potentially translate into enhanced patient safety outcomes, such as prevention of adverse drug reactions and decreased hospitalizations.

Cultural competence in mental health care: a review of model evaluations

PubMed Central

Bhui, Kamaldeep; Warfa, Nasir; Edonya, Patricia; McKenzie, Kwame; Bhugra, Dinesh

2007-01-01

Background Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. Methods A systematic review that included evaluated models of professional education or service delivery. Results Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. Conclusion There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes. PMID:17266765

R-IDEAL: A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology.

PubMed

Verkooijen, Helena M; Kerkmeijer, Linda G W; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

2017-01-01

The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I-IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting. Like surgery, clinical evaluation of innovations in radiation oncology is complicated by continuous technical development, team and operator dependence, and differences in quality control. Contrary to surgery, radiotherapy innovations may be used in various ways, e.g., at different tumor sites and with different aims, such as radiation volume reduction and dose escalation. Also, the effect of radiation treatment can be modeled, allowing better prediction of potential benefits and improved patient selection. Key distinctive features of R-IDEAL include the important role of predicate and modeling studies (Stage 0), randomization at an early stage in the development of the technology, and long-term follow-up for late toxicity. We implemented R-IDEAL for clinical evaluation of a recent innovation in radiation oncology, the MRI-guided linear accelerator (MR-Linac). MR-Linac combines a radiotherapy linear accelerator with a 1.5-T MRI, aiming for improved targeting, dose escalation, and margin reduction, and is expected to increase the use of hypofractionation, improve tumor control, leading to higher cure rates and less toxicity. An international consortium, with participants from seven large cancer institutes from Europe and North America, has adopted the R-IDEAL framework to work toward coordinated, evidence-based introduction of the MR-Linac. R-IDEAL holds the promise for timely, evidence-based introduction of radiotherapy innovations with proven superior effectiveness, while preventing unnecessary exposure of patients to potentially harmful interventions.

SMARTE: IMPROVING REVITALIZATION DECISIONS - PRESENTATION IN NRMRL SEMINAR SERIES

EPA Science Inventory

SMARTe (Sustainable Management Approaches and Revitalization Tools-electribuc) is an open-source, web-based, decision-support system for developing and evaluating alternative reuse scenarios for potentially contaminated sites (e.g., brownfields). It is being developed collaborati...

SMARTE: IMPROVING REVITALIZATION DECISIONS - PRESENTATION FOR ETV INTERNATIONAL FORUM

EPA Science Inventory

SMARTe (Sustainable Management Approaches and Revitalization Tools - electronic) is an open-source, web-based, decision-support system for developing and evaluating alternative reuse scenarios for potentially contaminated sites (e.g., brownfields). It is being developed collabora...

Economic Evaluation of Advanced Winter Highway Maintenance Strategies

DOT National Transportation Integrated Search

1988-01-01

Highway agencies face demands to maintain or improve the existing winter roadway level of service. The benefits of advanced winter highway maintenance strategies now become more attractive. This paper examines the potential benefits of applying advan...

Evaluation philosophy for shuttle launched payloads

NASA Technical Reports Server (NTRS)

Heuser, R. E.

1975-01-01

Potential benefits of factory-to-pad testing constitute major cost savings and increase test effectiveness. Overall flight performance will be improved. The factory-to-pad approach is compatible with space shuttle processing and the large space telescope program.

ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: GREEN BUILDING TECHNOLOGIES

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) Program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techno...

ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: FUEL CELLS

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) Program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techno...

ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: STORMWATER TECHNOLOGIES

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM; BAGHOUSE FILTRATION PRODUCTS

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) Program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techno...

Economic evaluation of advanced winter highway maintenance strategies

DOT National Transportation Integrated Search

1998-08-19

Highway agencies face demands to maintain or improve the existing winter roadway level of service. The benefits of advanced winter highway maintenance strategies now become more attractive. This paper examines the potential benefits of applying advan...

PORTABLE TECHNOLOGIES FOR MEASURING LEADING IN DUST

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

Improvement of Expansive Soils Using Chemical Stabilizers

NASA Astrophysics Data System (ADS)

Ikizler, S. B.; Senol, A.; Khosrowshahi, S. K.; Hatipoğlu, M.

2014-12-01

The aim of this study is to investigate the effect of two chemical stabilizers on the swelling potential of expansive soil. A high plasticity sodium bentonite was used as the expansive soil. The additive materials including fly ash (FA) and lime (L) were evaluated as potential stabilizers to decrease the swelling pressure of bentonite. Depending on the type of additive materials, they were blended with bentonite in different percentages to assess the optimum state and approch the maximum swell pressure reduction. According to the results of swell pressure test, both fly ash and lime reduce the swelling potential of bentonite but the maximum improvement occurs using bentonite-lime mixture while the swelling pressure reduction approaches to 49%. The results reveal a significant reduction of swelling potential of expansive soil using chemical stabilizers. Keywords: Expansive soil; swell pressure; chemical stabilization; fly ash; lime

Clinic Workflow Simulations using Secondary EHR Data

PubMed Central

Hribar, Michelle R.; Biermann, David; Read-Brown, Sarah; Reznick, Leah; Lombardi, Lorinna; Parikh, Mansi; Chamberlain, Winston; Yackel, Thomas R.; Chiang, Michael F.

2016-01-01

Clinicians today face increased patient loads, decreased reimbursements and potential negative productivity impacts of using electronic health records (EHR), but have little guidance on how to improve clinic efficiency. Discrete event simulation models are powerful tools for evaluating clinical workflow and improving efficiency, particularly when they are built from secondary EHR timing data. The purpose of this study is to demonstrate that these simulation models can be used for resource allocation decision making as well as for evaluating novel scheduling strategies in outpatient ophthalmology clinics. Key findings from this study are that: 1) secondary use of EHR timestamp data in simulation models represents clinic workflow, 2) simulations provide insight into the best allocation of resources in a clinic, 3) simulations provide critical information for schedule creation and decision making by clinic managers, and 4) simulation models built from EHR data are potentially generalizable. PMID:28269861

Summary

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

Powell, Danny H; Elwood Jr, Robert H

2011-01-01

An effective risk assessment system is needed to address the threat posed by an active or passive insider who, acting alone or in collusion, could attempt diversion or theft of nuclear material. The material control and accountability (MC&A) system effectiveness tool (MSET) is a self-assessment or inspection tool utilizing probabilistic risk assessment (PRA) methodology to calculate the system effectiveness of a nuclear facility's material protection, control, and accountability (MPC&A) system. The MSET process is divided into four distinct and separate parts: (1) Completion of the questionnaire that assembles information about the operations of every aspect of the MPC&A system; (2)more » Conversion of questionnaire data into numeric values associated with risk; (3) Analysis of the numeric data utilizing the MPC&A fault tree and the SAPHIRE computer software; and (4) Self-assessment using the MSET reports to perform the effectiveness evaluation of the facility's MPC&A system. The process should lead to confirmation that mitigating features of the system effectively minimize the threat, or it could lead to the conclusion that system improvements or upgrades are necessary to achieve acceptable protection against the threat. If the need for system improvements or upgrades is indicated when the system is analyzed, MSET provides the capability to evaluate potential or actual system improvements or upgrades. A facility's MC&A system can be evaluated at a point in time. The system can be reevaluated after upgrades are implemented or after other system changes occur. The total system or specific subareas within the system can be evaluated. Areas of potential system improvement can be assessed to determine where the most beneficial and cost-effective improvements should be made. Analyses of risk importance factors show that sustainability is essential for optimal performance and reveals where performance degradation has the greatest impact on total system risk. The risk importance factors show the amount of risk reduction achievable with potential upgrades and the amount of risk reduction achieved after upgrades are completed. Applying the risk assessment tool gives support to budget prioritization by showing where budget support levels must be sustained for MC&A functions most important to risk. Results of the risk assessment are also useful in supporting funding justifications for system improvements that significantly reduce system risk. The functional model, the system risk assessment tool, and the facility evaluation questionnaire are valuable educational tools for MPC&A personnel. These educational tools provide a framework for ongoing dialogue between organizations regarding the design, development, implementation, operation, assessment, and sustainability of MPC&A systems. An organization considering the use of MSET as an analytical tool for evaluating the effectiveness of its MPC&A system will benefit from conducting a complete MSET exercise at an existing nuclear facility.« less

Quality improvement in the use of medications through a drug use evaluation service.

PubMed

Stevenson, J G; Bakst, C M; Zaran, F K; Rybak, M J; Smolarek, R T; Alexander, M R

1992-10-01

Continuous quality improvement methods have the potential to improve processes that cross several disciplines. The medication system is one in which coordination of activities between physicians, pharmacists, and nurses is essential for optimal therapy to occur. DUE services can play an important role in helping to ensure that patients receive high-quality pharmaceutical care. It is necessary for pharmacy managers to review the structure, goals, and outcomes of their DUE programs to ensure that they are consistent with a philosophy of continuous improvement in the quality of drug therapy.

Evaluating online continuing medical education seminars: evidence for improving clinical practices.

PubMed

Weston, Christine M; Sciamanna, Christopher N; Nash, David B

2008-01-01

The purpose of this study was to evaluate the potential for online continuing medical education (CME) seminars to improve quality of care. Primary care physicians (113) participated in a randomized controlled trial to evaluate an online CME series. Physicians were randomized to view either a seminar about type 2 diabetes or a seminar about systolic heart failure. Following the seminar, physicians were presented with 4 clinical vignettes and asked to describe what tests, treatments, counseling, or referrals they would recommend. Physicians who viewed the seminars were significantly more likely to recommend guideline-consistent care to patients in the vignettes. For example, physicians who viewed the diabetes seminar were significantly more likely to order an eye exam for diabetes patients (63%) compared with physicians in the control group (27%). For some guidelines there were no group differences. These results provide early evidence of the effectiveness of online CME programs to improve physician clinical practice.

Evaluation of the ergogenic potential of noni juice.

PubMed

Ma, De-lu; West, Brett J; Su, Chen X; Gao, Jian-hua; Liu, Tin-zhong; Liu, Yu-Wen

2007-11-01

Morinda citrifolia (noni) fruit juice is an increasingly popular health food with many reported benefits, such as antioxidant and immunomodulatory properties. Traditionally, noni fruit was used by Polynesians to combat fatigue. Also, clinical studies have revealed that noni juice consumption improves quality of life scores related to physical functioning and energy levels. To further evaluate the ergogenic (antifatigue and endurance promoting) potential of noni juice, aged mice were pretreated orally with increasing doses (10, 20 and 40 mL/kg body weight) of Tahitian Noni Juice (TNJ) and then compared with young and aged controls in the forced swim test and rotarod test. The average times of all TNJ dose groups were significantly longer than the aged controls in both the swim test (36% to 45%) and the rotarod test (59% to 128%), and were similar to those of the young controls. This demonstrates not only an improvement in endurance but also in balance and flexibility. These results confirm the reported use of noni juice to combat fatigue, improve endurance and increase overall physical performance. Copyright (c) 2007 John Wiley & Sons, Ltd.

A Natural Language Processing System That Links Medical Terms in Electronic Health Record Notes to Lay Definitions: System Development Using Physician Reviews

PubMed Central

Druhl, Emily; Polepalli Ramesh, Balaji; Houston, Thomas K; Brandt, Cynthia A; Zulman, Donna M; Vimalananda, Varsha G; Malkani, Samir; Yu, Hong

2018-01-01

Background Many health care systems now allow patients to access their electronic health record (EHR) notes online through patient portals. Medical jargon in EHR notes can confuse patients, which may interfere with potential benefits of patient access to EHR notes. Objective The aim of this study was to develop and evaluate the usability and content quality of NoteAid, a Web-based natural language processing system that links medical terms in EHR notes to lay definitions, that is, definitions easily understood by lay people. Methods NoteAid incorporates two core components: CoDeMed, a lexical resource of lay definitions for medical terms, and MedLink, a computational unit that links medical terms to lay definitions. We developed innovative computational methods, including an adapted distant supervision algorithm to prioritize medical terms important for EHR comprehension to facilitate the effort of building CoDeMed. Ten physician domain experts evaluated the user interface and content quality of NoteAid. The evaluation protocol included a cognitive walkthrough session and a postsession questionnaire. Physician feedback sessions were audio-recorded. We used standard content analysis methods to analyze qualitative data from these sessions. Results Physician feedback was mixed. Positive feedback on NoteAid included (1) Easy to use, (2) Good visual display, (3) Satisfactory system speed, and (4) Adequate lay definitions. Opportunities for improvement arising from evaluation sessions and feedback included (1) improving the display of definitions for partially matched terms, (2) including more medical terms in CoDeMed, (3) improving the handling of terms whose definitions vary depending on different contexts, and (4) standardizing the scope of definitions for medicines. On the basis of these results, we have improved NoteAid’s user interface and a number of definitions, and added 4502 more definitions in CoDeMed. Conclusions Physician evaluation yielded useful feedback for content validation and refinement of this innovative tool that has the potential to improve patient EHR comprehension and experience using patient portals. Future ongoing work will develop algorithms to handle ambiguous medical terms and test and evaluate NoteAid with patients. PMID:29358159

Identifying the potential of changes to blood sample logistics using simulation.

PubMed

Jørgensen, Pelle; Jacobsen, Peter; Poulsen, Jørgen Hjelm

2013-01-01

Using simulation as an approach to display and improve internal logistics at hospitals has great potential. This study shows how a simulation model displaying the morning blood-taking round at a Danish public hospital can be developed and utilized with the aim of improving the logistics. The focus of the simulation was to evaluate changes made to the transportation of blood samples between wards and the laboratory. The average- (AWT) and maximum waiting time (MWT) from a blood sample was drawn at the ward until it was received at the laboratory, and the distribution of arrivals of blood samples in the laboratory were used as the evaluation criteria. Four different scenarios were tested and compared with the current approach: (1) Using AGVs (mobile robots), (2) using a pneumatic tube system, (3) using porters that are called upon, or (4) using porters that come to the wards every 45 minutes. Furthermore, each of the scenarios was tested in terms of what amount of resources would give the optimal result. The simulations showed a big improvement potential in implementing a new technology/mean for transporting the blood samples. The pneumatic tube system showed the biggest potential lowering the AWT and MWT with approx. 36% and 18%, respectively. Additionally, all of the scenarios had a more even distribution of arrivals except for porters coming to the wards every 45 min. As a consequence of the results obtained in the study, the hospital decided to implement a pneumatic tube system.

A treatment program for individuals with deficient evaluative processing and consequent impaired social and risk judgement.

PubMed

Park, Norman W; Conrod, Brian; Hussain, Zahra; Murphy, Kelly J; Rewilak, Dmytro; Black, Sandra E

2003-01-01

The current study evaluated the effectiveness of a rehabilitation program developed to assist individuals such as AM who have impaired social and risk judgement. AM's difficulties developed after a severe traumatic brain injury that resulted in bilateral frontal and temporal lobe damage including damage to the amygdala. Previous work (Park et al., 2001) established that AM had impaired automatic processing of negative, but not positive evaluative information, and relatively spared processing of both types of evaluative information when using controlled or strategic processing. In the Strategic Evaluation of Alternatives (SEA) treatment program, AM was trained to compensate for his impairments by explicitly retrieving positive and negative attributes associated with potential actions prior to performing them. The SEA treatment focused specifically on improving AM's ability to obtain financial compensation for his work-related activities. Results showed improved performance on work-related activities and evidence of generalization. Analyses suggested that the process underlying improved performance was compensatory rather than restorative in nature. We discuss the implications of these results for the development of rehabilitation treatment for patients with impaired social and risk judgement.

Using Eye Trackers for Usability Evaluation of Health Information Technology: A Systematic Literature Review

PubMed Central

Yang, Yushi

2015-01-01

Background Eye-tracking technology has been used to measure human cognitive processes and has the potential to improve the usability of health information technology (HIT). However, it is still unclear how the eye-tracking method can be integrated with other traditional usability methodologies to achieve its full potential. Objective The objective of this study was to report on HIT evaluation studies that have used eye-tracker technology, and to envision the potential use of eye-tracking technology in future research. Methods We used four reference databases to initially identify 5248 related papers, which resulted in only 9 articles that met our inclusion criteria. Results Eye-tracking technology was useful in finding usability problems in many ways, but is still in its infancy for HIT usability evaluation. Limited types of HITs have been evaluated by eye trackers, and there has been a lack of evaluation research in natural settings. Conclusions More research should be done in natural settings to discover the real contextual-based usability problems of clinical and mobile HITs using eye-tracking technology with more standardized methodologies and guidance. PMID:27026079

Vehicle testing of Cummins turbocompound diesel engine

NASA Technical Reports Server (NTRS)

Brands, M. C.; Werner, J. R.; Hoehne, J. L.

1980-01-01

Two turbocompound diesel engines were installed in Class VIII heavy-duty vehicles to determine the fuel consumption potential and performance characteristics. One turbocompound powered vehicle was evaluated at the Cummins Pilot Center where driveability, fuel consumption, torsional vibration, and noise were evaluated. Fuel consumption testing showed a 14.8% benefit for the turbocompound engine in comparison to a production NTC-400 used as a baseline. The turbocompound engine also achieved lower noise levels, improved driveability, improved gradeability, and marginally superior engine retardation. The second turbocompound engine was placed in commercial service and accumulated 50,000 miles on a cross-country route without malfunction. Tank mileage revealed a 15.92% improvement over a production NTCC-400 which was operating on the same route.

Yield Improvement and Energy Savings Uing Phosphonates as Additives in Kraft pulping

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

Ulrike W. Tschirner; Timothy Smith

2007-03-31

Project Objective: Develop a commercially viable modification to the Kraft process resulting in energy savings, increased yield and improved bleachability. Evaluate the feasibility of this technology across a spectrum of wood species used in North America. Develop detailed fundamental understanding of the mechanism by which phosphonates improve KAPPA number and yield. Evaluate the North American market potential for the use of phosphonates in the Kraft pulping process. Examine determinants of customer perceived value and explore organizational and operational factors influencing attitudes and behaviors. Provide an economic feasibility assessment for the supply chain, both suppliers (chemical supply companies) and buyers (Kraftmore » mills). Provide background to most effectively transfer this new technology to commercial mills.« less

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

MAEZAWA,Y.; AOKI, S.; EJIRI, S.

The authors report the current status of the systematic studies of the QCD thermodynamics by lattice QCD simulations with two flavors of improved Wilson quarks. They evaluate the critical temperature of two flavor QCD in the chiral limit at zero chemical potential and show the preliminary result. Also they discuss fluctuations at none-zero temperature and density by calculating the quark number and isospin susceptibilities and their derivatives with respect to chemical potential.

An Evaluation Tool for Agricultural Health and Safety Mobile Applications.

PubMed

Reyes, Iris; Ellis, Tammy; Yoder, Aaron; Keifer, Matthew C

2016-01-01

As the use of mobile devices and their software applications, or apps, becomes ubiquitous, use amongst agricultural working populations is expanding as well. The smart device paired with a well-designed app has potential for improving workplace health and safety in the hands of those who can act upon the information provided. Many apps designed to assess workplace hazards and implementation of worker protections already exist. However, the abundance and diversity of such applications also presents challenges regarding evaluation practices and assignation of value. This is particularly true in the agricultural workspace, as there is currently little information on the value of these apps for agricultural safety and health. This project proposes a framework for developing and evaluating apps that have potential usefulness in agricultural health and safety. The evaluation framework is easily transferable, with little modification for evaluation of apps in several agriculture-specific areas.

Benefit/cost framework for evaluating modular energy storage : a study for the DOE energy storage systems program.

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

Eyer, James M.; Schoenung, Susan M.

2008-02-01

The work documented in this report represents another step in the ongoing investigation of innovative and potentially attractive value propositions for electricity storage by the United States Department of Energy (DOE) and Sandia National Laboratories (SNL) Energy Storage Systems (ESS) Program. This study uses updated cost and performance information for modular energy storage (MES) developed for this study to evaluate four prospective value propositions for MES. The four potentially attractive value propositions are defined by a combination of well-known benefits that are associated with electricity generation, delivery, and use. The value propositions evaluated are: (1) transportable MES for electric utilitymore » transmission and distribution (T&D) equipment upgrade deferral and for improving local power quality, each in alternating years, (2) improving local power quality only, in all years, (3) electric utility T&D deferral in year 1, followed by electricity price arbitrage in following years; plus a generation capacity credit in all years, and (4) electric utility end-user cost management during times when peak and critical peak pricing prevail.« less

Application of Observing System Simulation Experiments (OSSEs) to determining science and user requirements for space-based missions

NASA Astrophysics Data System (ADS)

Atlas, R. M.

2016-12-01

Observing System Simulation Experiments (OSSEs) provide an effective method for evaluating the potential impact of proposed new observing systems, as well as for evaluating trade-offs in observing system design, and in developing and assessing improved methodology for assimilating new observations. As such, OSSEs can be an important tool for determining science and user requirements, and for incorporating these requirements into the planning for future missions. Detailed OSSEs have been conducted at NASA/ GSFC and NOAA/AOML in collaboration with Simpson Weather Associates and operational data assimilation centers over the last three decades. These OSSEs determined correctly the quantitative potential for several proposed satellite observing systems to improve weather analysis and prediction prior to their launch, evaluated trade-offs in orbits, coverage and accuracy for space-based wind lidars, and were used in the development of the methodology that led to the first beneficial impacts of satellite surface winds on numerical weather prediction. In this talk, the speaker will summarize the development of OSSE methodology, early and current applications of OSSEs and how OSSEs will evolve in order to enhance mission planning.

Taiji for individuals with Parkinson disease and their support partners: a program evaluation.

PubMed

Klein, Penelope J; Rivers, Lynn

2006-03-01

Exercise is advocated in the management of Parkinson disease (PD), however, little is known regarding the potential benefits of complementary mind/body exercise for this clinical population. The purpose of this pilot program evaluation was to gain insight into participant and instructor perceptions of the perceived benefits and potential utility of a taiji exercise program. Program participants (N=15) included 8 individuals with PD and 7 support partners with no history of PD. Group taiji instruction was offered in 45-minute weekly sessions, for 12 weeks at a community facility. Post-program evaluation included administration of a survey questionnaire, thematic analysis of a focus group discussion, instructor reflections, and review of attendance records. Benefits were perceived by participants in physical, psychological, and social domains. Thirteen of the survey respondents, including 6 of the 8 respondents with PD reported perceiving a physical benefit attributed to taiji practice. Improved balance was reported most frequently. Instructor observations and participant testimony suggest movement capability for individuals with Parkinsons may also be improved by performing taiji. This preliminary research provides support for further Taiji Buddy program examination and application.

Enzyme-assisted extraction of phenolics from winemaking by-products: Antioxidant potential and inhibition of alpha-glucosidase and lipase activities.

PubMed

de Camargo, Adriano Costa; Regitano-d'Arce, Marisa Aparecida Bismara; Biasoto, Aline Camarão Telles; Shahidi, Fereidoon

2016-12-01

Phenolics in food and agricultural processing by-products exist in the soluble and insoluble-bound forms. The ability of selected enzymes in improving the extraction of insoluble-bound phenolics from the starting material (experiment I) or the residues containing insoluble-bound phenolics (experiment II) were evaluated. Pronase and Viscozyme improved the extraction of insoluble-bound phenolics as evaluated by total phenolic content, antioxidant potential as determined by ABTS and DPPH assays, and hydroxyl radical scavenging capacity, reducing power as well as evaluation of inhibition of alpha-glucosidase and lipase activities. Viscozyme released higher amounts of gallic acid, catechin, and prodelphinidin dimer A compared to Pronase treatment. Furthermore, p-coumaric and caffeic acids, as well as procyanidin dimer B, were extracted with Viscozyme but not with Pronase treatment. Solubility plays an important role in the bioavailability of phenolic compounds, hence this study may assist in better exploitation of phenolics from winemaking by-products as functional food ingredients and/or supplements. Copyright © 2016. Published by Elsevier Ltd.

Recommendations for extending asphalt pavement surface life within Washington State.

DOT National Transportation Integrated Search

2016-10-01

This study identifies and evaluates hot mix asphalt (HMA) mix design and construction techniques with potential for improving WSDOT pavement surface life. WSDOT pavement failure mechanisms are found to be predominantly cracking. Rutting may reach a f...

Evaluating the need for surface treatments to reduce crash frequency on horizontal curves.

DOT National Transportation Integrated Search

2013-10-01

The application of high-friction surface treatments at appropriate horizontal curve locations throughout the : state has the potential to improve driver performance and reduce the number of crashes experienced at : horizontal curves. These treatments...

Safety Evaluation Of Intelligent Transportation Systems, Workshop Proceedings

DOT National Transportation Integrated Search

1995-05-01

IMPROVED SAFETY IS PRESENTED AS AN IMPORTANT POTENTIAL BENEFIT OF INTELLIGENT TRANSPORTATION SYSTEMS (ITS). SYSTEMS ARE EMERGING AND ARE UNDER DEVELOPMENT THAT ARE DESIGNED TO REDUCE THE NUMBER OF ACCIDENTS AND THE SEVERITY OF THOSE ACCIDENTS THAT CA...

NANOFILTRATION FOR REMOVAL OF DRINKING WATER DISINFECTION BY-PRODUCT PRCURSORS

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techno...

ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM CASE STUDIES: DEMONSTRATING PROGRAM OUTCOMES

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) Program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This bookle...

ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: ETV AND ANIMAL FEEDING OPERATIONS

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

Considerations of Environmentally Relevant Test Conditions for Improved Evaluation of Ecological Hazards of Engineered Nanomaterials

EPA Science Inventory

Engineered nanomaterials (ENMs) are increasingly entering the environment with uncertain consequences including potential ecological effects. Various research communities view differently whether ecotoxicological testing of ENMs should be conducted using environmentally relevant ...

Transit Feasibility Analysis and Recommendations : Arapaho-Roosevelt National Forest Transportation System Alternatives Study

DOT National Transportation Integrated Search

2015-06-01

The purpose of the ArapahoRoosevelt National Forest Transportation System Alternatives Study is to identify and evaluate the feasibility of potential alternative transportation solutions to improve recreation and resource management at three of th...

IMPROVING THE TMDL PROCESS USING WATERSHED RISK ASSESSMENT PRINCIPLES

EPA Science Inventory

Watershed ecological risk assessment (WERA) evaluates potential causal relationships between multiple sources and stressors and impacts on valued ecosystem components. This has many similarities tothe placed-based analuses that are undertaken to develop total maximum daily loads...

Use of automated enforcement for red light violations

DOT National Transportation Integrated Search

1997-08-01

The use of automated enforcement systems offers the potential to decrease the number of red light violations and improve the safety of intersections. Included in this report are an evaluation of the operating conditions where automated enforcement wa...

Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

PubMed

Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

2018-04-20

Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

Evaluation of 'SAEFVIC', A Pharmacovigilance Surveillance Scheme for the Spontaneous Reporting of Adverse Events Following Immunisation in Victoria, Australia.

PubMed

Clothier, Hazel J; Crawford, Nigel W; Russell, Melissa; Kelly, Heath; Buttery, Jim P

2017-06-01

Australia is traditionally an early adopter of vaccines, therefore comprehensive and effective post-licensure vaccine pharmacovigilance is critical to maintain confidence in immunisation, both nationally and internationally. With adverse event following immunisation (AEFI) surveillance the responsibility of Australian jurisdictions, Victoria operates an enhanced passive AEFI surveillance system integrated with clinical services, called 'SAEFVIC' (Surveillance of Adverse Events Following Vaccination In the Community). The aim of this study was to evaluate Victoria's current AEFI surveillance system 'SAEFVIC' and inform ongoing quality improvement of vaccine pharmacovigilance in Victoria and Australia. We conducted a retrospective structured desktop evaluation of AEFI reporting received by SAEFVIC from 2007 to 2014, to evaluate the system according to its stated objectives, i.e. to improve AEFI reporting; provide AEFI signal detection; and to maintain consumer confidence in vaccination. AEFI reporting has tripled since SAEFVIC commenced (incidence risk ratio [IRR] 3.04, 95% confidence interval [CI] 2.35-3.93), raising Victoria to be the lead jurisdiction by AEFI reporting volume and to rank third by population reporting rate nationally. The largest increase was observed in children. Data were utilised to investigate potential signal events and inform vaccine policy. Signal detection required clinical suspicion by surveillance nurses, or prior vaccine-specific concerns. Subsequent vaccination post-AEFI was documented for 56.2% (95% CI 54.1-58.4) of reports, and the proportion of children due or overdue for vaccination was 2.3% higher for those reporting AEFI compared with the general population. SAEFVIC has improved AEFI surveillance, facilitates signal investigation and validation, and supports consumer confidence in immunisation. Expansion of the system nationally has the potential to improve capacity and capability of vaccine pharmacovigilance, particularly through data consistency and jurisdictional comparability in Australia.

Parts on Demand: Evaluation of Approaches to Achieve Flexible Manufacturing Systems for Navy Parts on Demand. Volume 2. Appendices

DTIC Science & Technology

1984-02-01

of Cost Analysis Worksheets * POD Program-Economic Analysis & Methodology - Economic Evaluation Procedures for POD Investment Program - System...Approval Considerations - POD Investment Program - Potential Improvement Areas for POD - Example Cost Categories and Determinants Appendix E Long Range R&D...Funding Profiles * Investment Strategy for Integrated Circuits Diminishing Sources of Supply - Problem Scope - Approach - Alternatives - Proposed

First Destination Transportation Study

DTIC Science & Technology

1978-03-03

avoidance potentials on a daily procurement basis. A "total" sys- tematic cost evaluation program, including specific de - cision rules needed on an...implementation priority :x needed. The rec- ommended priority is as follows: [ (1) Develop improved system management concepts that will "form the framework ...priority as it provides the overall framework for better system management. Cost evaluation and CCSS Enhancement Programs deserve next consideration, as

Development of multi-functional streetscape green infrastructure using a performance index approach.

PubMed

Tiwary, A; Williams, I D; Heidrich, O; Namdeo, A; Bandaru, V; Calfapietra, C

2016-01-01

This paper presents a performance evaluation framework for streetscape vegetation. A performance index (PI) is conceived using the following seven traits, specific to the street environments - Pollution Flux Potential (PFP), Carbon Sequestration Potential (CSP), Thermal Comfort Potential (TCP), Noise Attenuation Potential (NAP), Biomass Energy Potential (BEP), Environmental Stress Tolerance (EST) and Crown Projection Factor (CPF). Its application is demonstrated through a case study using fifteen street vegetation species from the UK, utilising a combination of direct field measurements and inventoried literature data. Our results indicate greater preference to small-to-medium size trees and evergreen shrubs over larger trees for streetscaping. The proposed PI approach can be potentially applied two-fold: one, for evaluation of the performance of the existing street vegetation, facilitating the prospects for further improving them through management strategies and better species selection; two, for planning new streetscapes and multi-functional biomass as part of extending the green urban infrastructure. Copyright © 2015 Elsevier Ltd. All rights reserved.

Characteristics of School Districts That Participate in Rigorous National Educational Evaluations

PubMed Central

Stuart, Elizabeth A.; Bell, Stephen H.; Ebnesajjad, Cyrus; Olsen, Robert B.; Orr, Larry L.

2017-01-01

Given increasing interest in evidence-based policy, there is growing attention to how well the results from rigorous program evaluations may inform policy decisions. However, little attention has been paid to documenting the characteristics of schools or districts that participate in rigorous educational evaluations, and how they compare to potential target populations for the interventions that were evaluated. Utilizing a list of the actual districts that participated in 11 large-scale rigorous educational evaluations, we compare those districts to several different target populations of districts that could potentially be affected by policy decisions regarding the interventions under study. We find that school districts that participated in the 11 rigorous educational evaluations differ from the interventions’ target populations in several ways, including size, student performance on state assessments, and location (urban/rural). These findings raise questions about whether, as currently implemented, the results from rigorous impact studies in education are likely to generalize to the larger set of school districts—and thus schools and students—of potential interest to policymakers, and how we can improve our study designs to retain strong internal validity while also enhancing external validity. PMID:29276552

[Guidance of FDA risk evaluation and mitigation strategy and enlightenment to drug risk management of post-marketing Chinese medicine].

PubMed

Li, Yuanyuan; Xie, Yanming

2011-10-01

The FDA risk evaluation and mitigation strategy (REMS) aims to drugs or biological products known or potential serious risk management. Analysis with the example of the content of the Onsolis REMS named FOCOS. Our country can be reference for the analysis of relevant experience and establish a scientific evaluation mechanism, strengthen the drug risk consciousness, promote the rational drug use, organic combined with the before-marketing and post-marketing evaluation of traditional Chinese medicine, and promote the evaluation of risk management of the drug development and improvement.

In-hospital experiences of families of potential organ donors: A systematic review and qualitative synthesis

PubMed Central

Dicks, Sean Glenton; Ranse, Kristen; van Haren, Frank MP; Boer, Douglas P

2017-01-01

Information and compassion assist families of potential organ donors to make informed decisions. However, psychological implications of the in-hospital process are not well described with past research focusing on decision-making. To enhance understanding and improve service delivery, a systematic review was conducted. Inductive analysis and synthesis utilised Grounded Theory Methodology within a systems theory framework and contributed to a model proposing that family and staff form a System of Systems with shared responsibility for process outcomes. This model can guide evaluation and improvement of care and will be tested by means of a longitudinal study of family experiences. PMID:28680696

Commentary: Learning from Variations in Fidelity of Implementation.

PubMed

Balu, Rekha; Doolittle, Fred

2016-12-01

The articles in this special issue discuss efforts to improve academic reading outcomes for students and ways to achieve high implementation fidelity of promising strategies. At times the authors discuss if-and how-strong fidelity is associated with strong outcomes and potentially even impacts (the difference between program and control group outcomes). We want to explore this theme in two ways: (a) learning from the variation in fidelity to think about potential points of entry and levers for improvement in implementation, and (b) broadening the evaluation focus to include "service contrast" as a factor driving impacts on student outcomes. We conclude with suggestions for future research. © 2016 Wiley Periodicals, Inc.

It helps me live, sends my children to school, and feeds me: a qualitative study of how food and cash incentives may improve adherence to treatment and care among adults living with HIV in Tanzania.

PubMed

Czaicki, Nancy L; Mnyippembe, Agatha; Blodgett, Madeline; Njau, Prosper; McCoy, Sandra I

2017-07-01

Financial and in-kind incentives have been shown to improve outcomes along the HIV care cascade, however the potential mechanismsthrough which they work remain unclear. To identify the pathways through which incentives improve retention in care and adherence to antiretroviral therapy (ART), we conducted a qualitative study with participants in a trial evaluating conditional food and cash incentives for HIV-positive food insecure adults in Shinyanga, Tanzania. We found that the incentives acted through three pathways to potentially increase retention in care and adherence to ART: (1) addressing competing needs and offsetting opportunity costs associated with clinic attendance, (2) alleviating stress associated with attending clinic and meeting basic needs, and (3) by potentially increasing motivation. Participants did not report any harmful events associated with the incentives, but reported myriad beneficial effects on household welfare. Understanding how incentives are used and how they impact outcomes can improve the design of future interventions.

Advanced single crystal for SSME turbopumps

NASA Technical Reports Server (NTRS)

Fritzemeier, L. G.

1989-01-01

The objective of this program was to evaluate the influence of high thermal gradient casting, hot isostatic pressing (HIP) and alternate heat treatments on the microstructure and mechanical properties of a single crystal nickel base superalloy. The alloy chosen for the study was PWA 1480, a well characterized, commercial alloy which had previously been chosen as a candidate for the Space Shuttle Main Engine high pressure turbopump turbine blades. Microstructural characterization evaluated the influence of casting thermal gradient on dendrite arm spacing, casting porosity distribution and alloy homogeneity. Hot isostatic pressing was evaluated as a means of eliminating porosity as a preferred fatigue crack initiation site. The alternate heat treatment was chosen to improve hydrogen environment embrittlement resistance and for potential fatigue life improvement. Mechanical property evaluation was aimed primarily at determining improvements in low cycle and high cycle fatigue life due to the advanced processing methods. Statistically significant numbers of tests were conducted to quantitatively demonstrate life differences. High thermal gradient casting improves as-cast homogeneity, which facilitates solution heat treatment of PWA 1480 and provides a decrease in internal pore size, leading to increases in low cycle and high cycle fatigue lives.

Characteristics of future air cargo demand and impact on aircraft development - A report on the Cargo/Logistic Airlift Systems Study /CLASS/ project

NASA Technical Reports Server (NTRS)

Whitehead, A. H., Jr.

1978-01-01

The considered study has been conducted to evaluate the future potential for an advanced air cargo transport. A current operations analysis is discussed, taking into account the traffic structure, modal cost comparisons, terminal operations, containerization, and institutional factors. Attention is also given to case studies, a demand forecast, and an advanced air cargo systems analysis. The effects of potential improvements on reducing costs are shown. Improvement to the current infrastructure can occur from 1978 to 1985 with off-the-shelf technology, which when combined with higher load factors for aircraft and containers, can provide up to a 16 percent reduction in total operating costs and a 15 percent rate reduction. The results of the analysis indicate that the proposed changes in the infrastructure and improved cargo loading efficiencies are as important to improving the airlines' financial posture as is the anticipated large dedicated cargo aircraft.

Quantifying the Global Fresh Water Budget: Capabilities from Current and Future Satellite Sensors

NASA Technical Reports Server (NTRS)

Hildebrand, Peter; Zaitchik, Benjamin

2007-01-01

The global water cycle is complex and its components are difficult to measure, particularly at the global scales and with the precision needed for assessing climate impacts. Recent advances in satellite observational capabilities, however, are greatly improving our knowledge of the key terms in the fresh water flux budget. Many components of the of the global water budget, e.g. precipitation, atmospheric moisture profiles, soil moisture, snow cover, sea ice are now routinely measured globally using instruments on satellites such as TRMM, AQUA, TERRA, GRACE, and ICESat, as well as on operational satellites. New techniques, many using data assimilation approaches, are providing pathways toward measuring snow water equivalent, evapotranspiration, ground water, ice mass, as well as improving the measurement quality for other components of the global water budget. This paper evaluates these current and developing satellite capabilities to observe the global fresh water budget, then looks forward to evaluate the potential for improvements that may result from future space missions as detailed by the US Decadal Survey, and operational plans. Based on these analyses, and on the goal of improved knowledge of the global fresh water budget under the effects of climate change, we suggest some priorities for the future, based on new approaches that may provide the improved measurements and the analyses needed to understand and observe the potential speed-up of the global water cycle under the effects of climate change.

ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM CASE STUDIES: DEMONSTRATING PROGRAM OUTCOMES, VOLUME II

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) Program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This bookle...

ULTRAVIOLET (UV) DISINFECTION SYSTEMS FOR SECONDARY WASTEWATER EFFLUENT AND WATER REUSE

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

Environmental Technology Verification Program - ETV - Case Studies: Demonstrating Program Outcomes

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) Program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This cd con...

ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: MICROTURBINES AND COMBINED HEAT AND POWER TECHNOLOGIES

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification(ETV) Program evaluates the performance of innovatiave air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techno...

Robotics and Automation for Flight Deck Aircraft Servicing

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

Chesser, J.B.; Draper, J.V.; Pin, F.G.

1999-03-01

One of the missions of the Future Aircraft Carriers Program is to investigate methods that would improve aircraft turnaround servicing activities on carrier decks. The major objectives and criteria for evaluating alternative aircraft servicing methods are to reduce workload requirements, turnaround times (TAT), and life-cycle costs (LCC). Technologies in the field of Robotics and Automation (R and A) have the potential to significantly contribute to these objectives. The objective of this study was to investigate aircraft servicing functions on carrier decks which would offer the potentially most significant payoff if improved by various R and A technologies. Improvement in thismore » case means reducing workload, time and LCC. This objective was accomplished using a ''bottom-up'' formalized approach as described in the following.« less

Applying Behavioral Economics to Public Health Policy: Illustrative Examples and Promising Directions.

PubMed

Matjasko, Jennifer L; Cawley, John H; Baker-Goering, Madeleine M; Yokum, David V

2016-05-01

Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

State-of-the-art molecular imaging in esophageal cancer management: implications for diagnosis, prognosis, and treatment

PubMed Central

Lin, Jolinta; Kligerman, Seth; Goel, Rakhi; Sajedi, Payam; Suntharalingam, Mohan

2015-01-01

Molecular imaging techniques are increasingly being used in addition to standard imaging methods such as endoscopic ultrasound (EUS) and computed tomography (CT) for many cancers including those of the esophagus. In this review, we will discuss the utility of the most widely used molecular imaging technique, 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET). 18F-FDG PET has a variety of potential applications ranging from improving staging accuracy at the time of initial diagnosis to assisting in radiation target volume delineation. Furthermore, 18F-FDG PET can be used to evaluate treatment response after completion of neoadjuvant therapy or potentially during neoadjuvant therapy. Finally, we will also discuss other novel molecular imaging techniques that have potential to further improve cancer care. PMID:25642333

Using Student Data to Improve Teaching and Learning: Findings from an Evaluation of the Formative Assessments of Students Thinking in Reading (FAST-R) Program in Boston Elementary Schools

ERIC Educational Resources Information Center

Quint, Janet C.; Sepanik, Susan; Smith, Janell K.

2008-01-01

Formative assessments--assessments that measure what students do and do not know, so that teachers can modify their instruction accordingly--have been widely hailed as a potential vehicle for improving student achievement. Yet little solid research evidence exists about their effectiveness, especially in reform-rich school districts. This study…

Improved black-blood imaging using DANTE-SPACE for simultaneous carotid and intracranial vessel wall evaluation

PubMed Central

Xie, Yibin; Yang, Qi; Xie, Guoxi; Pang, Jianing; Fan, Zhaoyang; Li, Debiao

2015-01-01

Purpose The purpose of this work is to develop a 3D black-blood imaging method for simultaneously evaluating carotid and intracranial arterial vessel wall with high spatial resolution and excellent blood suppression with and without contrast enhancement. Methods DANTE preparation module was incorporated into SPACE sequence to improve blood signal suppression. Simulations and phantom studies were performed to quantify image contrast variations induced by DANTE. DANTE-SPACE, SPACE and 2D TSE were compared for apparent SNR, CNR and morphometric measurements in fourteen healthy subjects. Preliminary clinical validation was performed in six symptomatic patients. Results Apparent residual luminal blood was observed in 5 (pre-CE) and 9 (post-CE) subjects with SPACE, and only 2 (post-CE) subjects with DANTE-SPACE. DANTE-SPACE showed 31% (pre-CE) and 100% (post-CE) improvement in wall-to-blood CNR over SPACE. Vessel wall area measured from SPACE was significantly larger than that from DANTE-SPACE due to possible residual blood signal contamination. In patients DANTE-SPACE showed the potential to detect vessel wall dissection and identify plaque components. Conclusion DANTE-SPACE significantly improved arterial and venous blood suppression compared with SPACE. Simultaneous high-resolution carotid and intracranial vessel wall imaging to potentially identify plaque components was feasible with scan time under 6 minutes. PMID:26152900

Force-field functor theory: classical force-fields which reproduce equilibrium quantum distributions

PubMed Central

Babbush, Ryan; Parkhill, John; Aspuru-Guzik, Alán

2013-01-01

Feynman and Hibbs were the first to variationally determine an effective potential whose associated classical canonical ensemble approximates the exact quantum partition function. We examine the existence of a map between the local potential and an effective classical potential which matches the exact quantum equilibrium density and partition function. The usefulness of such a mapping rests in its ability to readily improve Born-Oppenheimer potentials for use with classical sampling. We show that such a map is unique and must exist. To explore the feasibility of using this result to improve classical molecular mechanics, we numerically produce a map from a library of randomly generated one-dimensional potential/effective potential pairs then evaluate its performance on independent test problems. We also apply the map to simulate liquid para-hydrogen, finding that the resulting radial pair distribution functions agree well with path integral Monte Carlo simulations. The surprising accessibility and transferability of the technique suggest a quantitative route to adapting Born-Oppenheimer potentials, with a motivation similar in spirit to the powerful ideas and approximations of density functional theory. PMID:24790954

Indicators for tracking programmes to strengthen health research capacity in lower- and middle-income countries: a qualitative synthesis

PubMed Central

2014-01-01

Background The monitoring and evaluation of health research capacity strengthening (health RCS) commonly involves documenting activities and outputs using indicators or metrics. We sought to catalogue the types of indicators being used to evaluate health RCS and to assess potential gaps in quality and coverage. Methods We purposively selected twelve evaluations to maximize diversity in health RCS, funders, countries, and approaches to evaluation. We explored the quality of the indicators and extracted them into a matrix across individual, institutional, and national/regional/network levels, based on a matrix in the ESSENCE Planning, Monitoring and Evaluation framework. We synthesized across potential impact pathways (activities to outputs to outcomes) and iteratively checked our findings with key health RCS evaluation stakeholders. Results Evaluations varied remarkably in the strengths of their evaluation designs. The validity of indicators and potential biases were documented in a minority of reports. Indicators were primarily of activities, outputs, or outcomes, with little on their inter-relationships. Individual level indicators tended to be more quantitative, comparable, and attentive to equity considerations. Institutional and national–international level indicators were extremely diverse. Although linkage of activities through outputs to outcomes within evaluations was limited, across the evaluations we were able to construct potential pathways of change and assemble corresponding indicators. Conclusions Opportunities for improving health RCS evaluations include work on indicator measurement properties and development of indicators which better encompass relationships with knowledge users. Greater attention to evaluation design, prospective indicator measurement, and systematic linkage of indicators in keeping with theories of change could provide more robust evidence on outcomes of health RCS. PMID:24725961

Island-Model Genomic Selection for Long-Term Genetic Improvement of Autogamous Crops.

PubMed

Yabe, Shiori; Yamasaki, Masanori; Ebana, Kaworu; Hayashi, Takeshi; Iwata, Hiroyoshi

2016-01-01

Acceleration of genetic improvement of autogamous crops such as wheat and rice is necessary to increase cereal production in response to the global food crisis. Population and pedigree methods of breeding, which are based on inbred line selection, are used commonly in the genetic improvement of autogamous crops. These methods, however, produce a few novel combinations of genes in a breeding population. Recurrent selection promotes recombination among genes and produces novel combinations of genes in a breeding population, but it requires inaccurate single-plant evaluation for selection. Genomic selection (GS), which can predict genetic potential of individuals based on their marker genotype, might have high reliability of single-plant evaluation and might be effective in recurrent selection. To evaluate the efficiency of recurrent selection with GS, we conducted simulations using real marker genotype data of rice cultivars. Additionally, we introduced the concept of an "island model" inspired by evolutionary algorithms that might be useful to maintain genetic variation through the breeding process. We conducted GS simulations using real marker genotype data of rice cultivars to evaluate the efficiency of recurrent selection and the island model in an autogamous species. Results demonstrated the importance of producing novel combinations of genes through recurrent selection. An initial population derived from admixture of multiple bi-parental crosses showed larger genetic gains than a population derived from a single bi-parental cross in whole cycles, suggesting the importance of genetic variation in an initial population. The island-model GS better maintained genetic improvement in later generations than the other GS methods, suggesting that the island-model GS can utilize genetic variation in breeding and can retain alleles with small effects in the breeding population. The island-model GS will become a new breeding method that enhances the potential of genomic selection in autogamous crops, especially bringing long-term improvement.

Island-Model Genomic Selection for Long-Term Genetic Improvement of Autogamous Crops

PubMed Central

Yabe, Shiori; Yamasaki, Masanori; Ebana, Kaworu; Hayashi, Takeshi; Iwata, Hiroyoshi

2016-01-01

Acceleration of genetic improvement of autogamous crops such as wheat and rice is necessary to increase cereal production in response to the global food crisis. Population and pedigree methods of breeding, which are based on inbred line selection, are used commonly in the genetic improvement of autogamous crops. These methods, however, produce a few novel combinations of genes in a breeding population. Recurrent selection promotes recombination among genes and produces novel combinations of genes in a breeding population, but it requires inaccurate single-plant evaluation for selection. Genomic selection (GS), which can predict genetic potential of individuals based on their marker genotype, might have high reliability of single-plant evaluation and might be effective in recurrent selection. To evaluate the efficiency of recurrent selection with GS, we conducted simulations using real marker genotype data of rice cultivars. Additionally, we introduced the concept of an “island model” inspired by evolutionary algorithms that might be useful to maintain genetic variation through the breeding process. We conducted GS simulations using real marker genotype data of rice cultivars to evaluate the efficiency of recurrent selection and the island model in an autogamous species. Results demonstrated the importance of producing novel combinations of genes through recurrent selection. An initial population derived from admixture of multiple bi-parental crosses showed larger genetic gains than a population derived from a single bi-parental cross in whole cycles, suggesting the importance of genetic variation in an initial population. The island-model GS better maintained genetic improvement in later generations than the other GS methods, suggesting that the island-model GS can utilize genetic variation in breeding and can retain alleles with small effects in the breeding population. The island-model GS will become a new breeding method that enhances the potential of genomic selection in autogamous crops, especially bringing long-term improvement. PMID:27115872

A longitudinal study of children's outside play using family environment and perceived physical environment as predictors.

PubMed

Remmers, Teun; Broeren, Suzanne M L; Renders, Carry M; Hirasing, Remy A; van Grieken, Amy; Raat, Hein

2014-06-16

A natural and cheap way of increasing children's physical activity is stimulating unstructured outside play. This study examined whether characteristics of the family and perceived physical environment were associated with the duration of children's outside play. Parents participating in the "Be Active, Eat Right" cluster RCT control group (N = 2007) provided information on potential predictors of outside play (i.e. family and perceived physical environment) of their 5-year-old child by questionnaire. Child outside play was assessed by parental reports both at five and seven years. Linear regression analyses, adjusted for seasonality, were performed to evaluate associations between potential predictors and child outside play. Linear mixed models were fitted to evaluate the relationship between potential predictors and the development of outside play over two years, with season entered as a random factor. Family environment was the strongest construct predicting child outside play, while parent perceived physical environment had no significant association with child outside play. Parental habit strength and the presence of rules were the strongest predictors of increased outside play. Parent perceived difficulty in improving child outside play was the strongest predictor of decreased outside play. Family environment predicted child outside play and not perceived physical environment. Parental rules and habit strength regarding improving outside play were associated with an improvement of child's engagement in outside play.

AEROSOL PARTICLE COLLECTOR DESIGN STUDY

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

Lee, S; Richard Dimenna, R

2007-09-27

A computational evaluation of a particle collector design was performed to evaluate the behavior of aerosol particles in a fast flowing gas stream. The objective of the work was to improve the collection efficiency of the device while maintaining a minimum specified air throughput, nominal collector size, and minimal power requirements. The impact of a range of parameters was considered subject to constraints on gas flow rate, overall collector dimensions, and power limitations. Potential improvements were identified, some of which have already been implemented. Other more complex changes were identified and are described here for further consideration. In addition, fruitfulmore » areas for further study are proposed.« less

Perioperative hair removal: A review of best practice and a practice improvement opportunity.

PubMed

Spencer, Maureen; Barnden, Marsha; Johnson, Helen Boehm; Fauerbach, Loretta Litz; Graham, Denise; Edmiston, Charles E

2018-06-01

The current practice of perioperative hair removal reflects research-driven changes designed to minimize the risk of surgical wound infection. An aspect of the practice which has received less scrutiny is the clean-up of the clipped hair. This process is critical. The loose fibers represent a potential infection risk because of the micro-organisms they can carry, but their clean-up can pose a logistical problem because of the time required to remove them. Research has demonstrated that the most commonly employed means of clean-up, the use of adhesive tape or sticky mitts, can be both ineffective and time-consuming in addition to posing an infection risk from cross-contamination. Recently published research evaluating surgical clippers fitted with a vacuum-assisted hair collection device highlights the potential for significant practice improvement in the perioperative hair removal clean-up process. These improvements include not only further mitigation of potential infection risk but also substantial OR time and cost savings.

Strategies to Increase Adenoma Detection Rates.

PubMed

Brand, Eelco C; Wallace, Michael B

2017-03-01

The adenoma detection rate (ADR), i.e., the proportion of average risk patients with at least one adenoma detected during screening colonoscopy, is inversely associated with the development of interval colorectal cancer. Increasing the ADR is therefore an important proxy for increase in quality and efficacy of (screening) colonoscopy. Several potentially modifiable factors, such as, procedural and technological factors, and quality improvement programs, and their effect on the ADR will be reviewed. Procedural factors, such as, bowel preparation, withdrawal time, and position changes of the patient are associated with the ADR. While the relation of others, such as inspection during insertion, use of antispasmodic agents, and second inspection in the proximal colon, with the ADR is not completely clear. Many new colonoscopy technologies have been evaluated over recent years and are still under evaluation, but no unequivocal positive effect on the ADR has been observed in randomized trials that have mostly been performed by experienced endoscopists with high baseline ADRs. Several quality improvement programs have been evaluated and seem to have a positive effect on endoscopists' ADR. Increase in ADR is important for the protective benefit of colonoscopy. There are now extensive methods to measure, benchmark, and improve ADR but increased awareness of these is critical. We have provided an overview of potential factors that can be used to increase personal ADRs in every day practice.

Do the unique properties of nanometals affect leachability or efficacy against fungi and termites? International biodeterioration & biodegradation

Treesearch

S. N. Kartal; Frederick Green; Carol A. Clausen

2009-01-01

Nanotechnology has the potential to affect the field of wood preservation through the creation of new and unique metal biocides with improved properties. This study evaluated leachability and efficacy of southern yellow pine wood...

U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA), ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGAM: RESIDENTIAL NUTRIENT REDUCTION

EPA Science Inventory

The U.S. Environmental Protection Agency Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This technology ...

U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA) ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: ARSENIC MONITORING TECHNOLOGIES

EPA Science Inventory

The U.S. Environmental Protection Agency Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This technology ...

U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA) ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: ARSENIC TREATMENT TECHNOLOGIES

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

Evaluation of woodchip bioreactors for improved water quality

USDA-ARS?s Scientific Manuscript database

Woodchip bioreactors are gaining popularity with farmers because of their edge-of-field nitrate removal capabilities, which do not require changes in land management practices. However, limited research has been conducted to study the potential of these bioreactors to also reduce downstream transpor...

Development and Evaluation of a Compartmental Picture Archiving and Communications System Model for Integration and Visualization of Multidisciplinary Biomedical Data to Facilitate Student Learning in an Integrative Health Clinic

ERIC Educational Resources Information Center

Chow, Meyrick; Chan, Lawrence

2010-01-01

Information technology (IT) has the potential to improve the clinical learning environment. The extent to which IT enhances or detracts from healthcare professionals' role performance can be expected to affect both student learning and patient outcomes. This study evaluated nursing students' satisfaction with a novel compartmental Picture…

Automation and Preclinical Evaluation of a Dedicated Emission Mammotomography System for Fully 3-D Molecular Breast Imaging

DTIC Science & Technology

2009-10-01

molecular breast imaging, with the ability to dynamically contour any sized breast, will improve detection and potentially in vivo characterization of...Having flexible 3D positioning about the breast yielded minimal RMSD differences, which is important for high resolution molecular emission imaging. This...TITLE: Automation and Preclinical Evaluation of a Dedicated Emission Mammotomography System for Fully 3-D Molecular Breast Imaging PRINCIPAL

Mobile Health Technology Evaluation

PubMed Central

Kumar, Santosh; Nilsen, Wendy J.; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T.; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R. Craig; Mohr, David C.; Murphy, Susan A.; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

2013-01-01

Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and, (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, future possibilities and set a grand goal for the emerging field of mHealth research. PMID:23867031

Evaluation of a Web-Based Holistic Stress Reduction Pilot Program Among Nurse-Midwives.

PubMed

Wright, Erin M

2018-06-01

Work-related stress among midwives results in secondary traumatic stress, posttraumatic stress disorder, and job attrition. The purpose of this pilot project was to evaluate the effectiveness of a holistic, web-based program using holistic modalities for stress reduction and improved coping among certified nurse-midwives. A convenience sample of 10 midwives participated in a web-based holistic stress reduction intervention using yoga, mindfulness-based stress reduction, and meditation for four days each week over 4 weeks. Participants completed pre- and postintervention questionnaires (Perceived Stress Scale [PSS] and the Coping Self-Efficacy Scale [CSES]) for evaluation of effectiveness. The PSS means showed improvement in midwives' stress (16.4-12.3). The CSES means showed improvement in coping (174.8-214.5). Improvement was shown in each subscale of the CSES ("uses problem-focused coping": 19.2%; "stops unpleasant thoughts and emotions": 20.3%; and "gets support from family and friends": 16.6%). Findings suggest the potential for stress reduction and improved coping skills after using holistic techniques in a web-based format within a cohort of nurse-midwives. Further research of web-based, holistic intervention for stress reduction among midwives is warranted.

Study protocol for evaluating the implementation and effectiveness of an emergency department longitudinal patient monitoring system using a mixed-methods approach.

PubMed

Ward, Marie; McAuliffe, Eilish; Wakai, Abel; Geary, Una; Browne, John; Deasy, Conor; Schull, Michael; Boland, Fiona; McDaid, Fiona; Coughlan, Eoin; O'Sullivan, Ronan

2017-01-23

Early detection of patient deterioration is a key element of patient safety as it allows timely clinical intervention and potential rescue, thus reducing the risks of serious patient safety incidents. Longitudinal patient monitoring systems have been widely recommended for use to detect clinical deterioration. However, there is conflicting evidence on whether they improve patient outcomes. This may in part be related to variation in the rigour with which they are implemented and evaluated. This study aims to evaluate the implementation and effectiveness of a longitudinal patient monitoring system designed for adult patients in the unique environment of the Emergency Department (ED). A novel participatory action research (PAR) approach is taken where socio-technical systems (STS) theory and analysis informs the implementation through the improvement methodology of 'Plan Do Study Act' (PDSA) cycles. We hypothesise that conducting an STS analysis of the ED before beginning the PDSA cycles will provide for a much richer understanding of the current situation and possible challenges to implementing the ED-specific longitudinal patient monitoring system. This methodology will enable both a process and an outcome evaluation of implementing the ED-specific longitudinal patient monitoring system. Process evaluations can help distinguish between interventions that have inherent faults and those that are badly executed. Over 1.2 million patients attend EDs annually in Ireland; the successful implementation of an ED-specific longitudinal patient monitoring system has the potential to affect the care of a significant number of such patients. To the best of our knowledge, this is the first study combining PAR, STS and multiple PDSA cycles to evaluate the implementation of an ED-specific longitudinal patient monitoring system and to determine (through process and outcome evaluation) whether this system can significantly improve patient outcomes by early detection and appropriate intervention for patients at risk of clinical deterioration.

Process evaluation of a multifaceted health program aiming to improve physical activity levels and dietary patterns among construction workers.

PubMed

Viester, Laura; Verhagen, Evert A L M; Bongers, Paulien M; van der Beek, Allard J

2014-11-01

To evaluate the process of a health promotion program, aiming to improve physical activity levels and diet among construction workers. The process evaluation was conducted after the RE-AIM framework for the evaluation of the public health impact of health promotion interventions. Effectiveness was assessed on motivational stage-of-change, self-efficacy, and decisional balance for physical activity and dietary behavior. The external validity of the trial was satisfactory with representative reach of workers and adoption of workplace units in the participating construction company. The extent to which the program was implemented as intended was modest. The intervention was effective on participants' progress through stages of behavior change. Based on the RE-AIM dimensions, it is concluded that for construction workers, the program is feasible and potentially effective, but adjustments are required before widespread implementation.

Physiotherapy for poliomyelitis: a descriptive study in the Republic of Congo.

PubMed

Mancini, Silvia; Coldiron, Matthew E; Nicholas, Sarala; Llosa, Augusto E; Mouniaman-Nara, Isabelle; Ngala, Joseph; Grais, Rebecca F; Porten, Klaudia

2014-10-23

A large poliomyelitis outbreak occurred in 2010 in the Republic of Congo. This paper describes the demographic and clinical characteristics of poliomyelitis cases and their outcomes following physiotherapy. Demographic and clinical data were collected on 126 individuals between November 23, 2010 and March 23, 2011. The male/female ratio was 2.5 and the median age was 19 years (IQR: 13.5-23). The most severe forms of the disease were more common in older patients, 81 of the 126 patients (64.3%) had multiple evaluations of muscle strength. Among patients with multiple evaluations, 38.1% had improved strength at final evaluation, 48.3% were stable and 13.6% had decreased strength. Most acute poliomyelitis patients receiving physiotherapy had improved or stable muscle strength at their final evaluation. These descriptive results highlight the need for further research into the potential benefits of physiotherapy in polio affected patients.

Improving the health and safety of 911 emergency call centre agents: an evaluability assessment of a knowledge transfer strategy.

PubMed

Dagenais, Christian; Plouffe, Laurence; Gagné, Charles; Toulouse, Georges; Breault, Andrée-Anne; Dupont, Didier

2017-03-01

A knowledge transfer (KT) strategy was implemented by the IRSST, an occupational health and safety research institute established in Québec (Canada), to improve the prevention of psychological and musculoskeletal problems among 911 emergency call centre agents. An evaluability assessment was conducted in which each aspect of the KT approach was documented systematically to determine whether the strategy had the potential to be evaluated in terms of its impact on the targeted population. A review of the literature on KT in occupational health and safety and on the evaluation of such KT programmes, along with the development of a logic model based on documentary analysis and semi-structured interviews with key stakeholders, indicated that the KT strategy was likely to have had a positive impact in the 911 emergency call centre sector. Implications for future research are discussed.

[Will publication of quality indicators in the health service improve the quality? International experiences and Danish perspectives].

PubMed

Endahl, Lars A; Utzon, Jan

2002-09-16

It is well known that publication of hospital quality indicators may lead to improving of treatments. But the publication can also have some negative side effects: Focus may shift to the evaluated areas at the expense of non-evaluated areas. The most ill patients may be sorted out and high risk patients may be transferred to other hospitals or discharged in order to avoid their dying during hospitalisation and improve statistics. Overestimation of patient risk in order to improve relative treatment outcome. Increasing flow of patients to hospitals with high scores on quality indicators may cause imbalance between activities and budgets and hence longer waiting times and reduced quality of treatment. Negative publicity due to low scores on quality indicators may lead to under-utilisation of hospital capacity, patient and staff insecurity and staff wastage. Thus, publication of quality indicators may improve quality within the health sector, but it is very important to recognise potential pitfalls and negative side effects.

An Integrated Theatre Production for School Nutrition Promotion Program

PubMed Central

Bush, Robert; Box, Selina; McCallum, David; Khalil, Stephanie

2018-01-01

In the context of stubbornly high childhood obesity rates, health promotion activities in schools provide a potential avenue to improve children’s nutritional behaviours. Theatre production has a rich history as a health behaviour promotion strategy but lacks sound, outcome-based evaluation. This study evaluated the effect of an integrated, two-part, place-based theatre performance program with 212 students in five schools in a regional urban and semi-rural area. The program included a theatre performance and a healthy eating competition. A brief survey assessed student healthy eating knowledge and attitudes at three time points. Nutrition behaviour was measured by scoring the contents of children’s lunch boxes before, during and up to six weeks after the intervention. Statistical analysis tested change over time on five variables (Knowledge, Attitude, Sometimes foods, Everyday foods, Overall lunch box score). Results showed that both components of the integrated program improved nutrition knowledge and that the theatre performance improved children’s healthy eating attitudes. All three lunch box scores peaked after the integrated program and remained significantly higher than baseline at 4–6 weeks follow-up. Interaction effects were identified for school catchment area on four of the five dependent variables. Evaluation of this integrated theatre production program indicates the potential benefit of taking a “super-setting” approach. It demonstrates an effect from students taking home information they had learned and incorporating it into lunch box preparation. It also showed consistent effects for school geographical catchment. This study suggests that, with careful, theory-based design, theatre productions in schools can improve student nutritional activities. PMID:29498690

An Integrated Theatre Production for School Nutrition Promotion Program.

PubMed

Bush, Robert; Capra, Sandra; Box, Selina; McCallum, David; Khalil, Stephanie; Ostini, Remo

2018-03-02

In the context of stubbornly high childhood obesity rates, health promotion activities in schools provide a potential avenue to improve children's nutritional behaviours. Theatre production has a rich history as a health behaviour promotion strategy but lacks sound, outcome-based evaluation. This study evaluated the effect of an integrated, two-part, place-based theatre performance program with 212 students in five schools in a regional urban and semi-rural area. The program included a theatre performance and a healthy eating competition. A brief survey assessed student healthy eating knowledge and attitudes at three time points. Nutrition behaviour was measured by scoring the contents of children's lunch boxes before, during and up to six weeks after the intervention. Statistical analysis tested change over time on five variables (Knowledge, Attitude, Sometimes foods, Everyday foods, Overall lunch box score). Results showed that both components of the integrated program improved nutrition knowledge and that the theatre performance improved children's healthy eating attitudes. All three lunch box scores peaked after the integrated program and remained significantly higher than baseline at 4-6 weeks follow-up. Interaction effects were identified for school catchment area on four of the five dependent variables. Evaluation of this integrated theatre production program indicates the potential benefit of taking a "super-setting" approach. It demonstrates an effect from students taking home information they had learned and incorporating it into lunch box preparation. It also showed consistent effects for school geographical catchment. This study suggests that, with careful, theory-based design, theatre productions in schools can improve student nutritional activities.

Improving the wellbeing of staff who work in palliative care settings: A systematic review of psychosocial interventions.

PubMed

Hill, Rebecca C; Dempster, Martin; Donnelly, Michael; McCorry, Noleen K

2016-10-01

Staff in palliative care settings perform emotionally demanding roles which may lead to psychological distress including stress and burnout. Therefore, interventions have been designed to address these occupational risks. To investigate quantitative studies exploring the effectiveness of psychosocial interventions that attempt to improve psychological wellbeing of palliative care staff. A systematic review was conducted according to methodological guidance from UK Centre for Reviews and Dissemination. A search strategy was developed based on the initial scans of palliative care studies. Potentially eligible research articles were identified by searching the following databases: CINAHL, MEDLINE (Ovid), PsycINFO and Web of Science. Two reviewers independently screened studies against pre-set eligibility criteria. To assess quality, both researchers separately assessed the remaining studies using the Quality Assessment Tool for Quantitative Studies. A total of 1786 potentially eligible articles were identified - nine remained following screening and quality assessment. Study types included two randomised controlled trials, two non-randomised controlled trial designs, four one-group pre-post evaluations and one process evaluation. Studies took place in the United States and Canada (5), Europe (3) and Hong Kong (1). Interventions comprised a mixture of relaxation, education, support and cognitive training and targeted stress, fatigue, burnout, depression and satisfaction. The randomised controlled trial evaluations did not improve psychological wellbeing of palliative care staff. Only two of the quasi-experimental studies appeared to show improved staff wellbeing although these studies were methodologically weak. There is an urgent need to address the lack of intervention development work and high-quality research in this area. © The Author(s) 2016.

Antioxidant activity of omega-3 derivatives and their delivery via nanocages and nanocones: DFT and experimental in vivo investigation.

PubMed

Najafi, Houshang; Changizi-Ashtiyani, Saeed; Najafi, Meysam

2017-10-28

The antioxidant properties of omega-3 were investigated via experimental in vivo and theoretical methods. For experimental evaluation, oxidative stress was induced by 30 min bilateral renal ischemia and 24 h of reperfusion in male Sprague Dawley rats. The oxidative stress was evaluated through measuring malondialdehyde (MDA) and ferric reducing/antioxidant power (FRAP) levels in renal tissue. In theoretical methods, the reaction enthalpies of antioxidant mechanisms of omega-3 were calculated and the effects of NHMe, OMe, OH, Cl, and Me substituents on its antioxidant activity were investigated. Moreover, the omega-3 delivery potential by carbon and boron nitride nanocages and naocones were evaluated. The experimental results showed that omega-3 administration decreases MDA and increases FRAP levels after their changes by ischemia/reperfusion. Theoretical results indicated that NHMe and OMe substituents can significantly improve the antioxidant activity of omega-3. Also, boron nitride nanocone (BNNC) has higher |∆E ad | values, so it has higher potential for omega-3 delivery. Taken together, the new findings presented here indicate that omega-3 has anti-oxidative properties and NHMe and OMe substituents can improve its antioxidant activity. Moreover, adsorption of omega-3 on the surface of the studied nanostructures was exothermic, and BNNC with higher |∆Ead| values has higher potential for omega-3 delivery. Graphical abstract The interaction and adsorption of BNNC with omega-3 is exothermic and experimentally possible from the energetic viewpoint, so the BNNC with higher |∆E ad | and |∆G ad | values has higher potential for omega-3 delivery.

Towards universal potentials for (H2)2 and isotopic variants: post-Born-Oppenheimer contributions.

PubMed

Diniz, Leonardo G; Mohallem, José R

2008-06-07

Adiabatic corrections are evaluated for the interaction of two hydrogen molecules (H(2))(2) and isotopic variants. Their contribution to the cluster formation amount up to 10% of the interaction energy. Added to the best ab initio Born-Oppenheimer isotropic potential, they correct especially its short range repulsive part. Calculations of second virial coefficients are improved in general, with an impressive agreement with experiments for gaseous D(2) in a large range of temperatures. The potentials are available in both analytical and numerical forms.

Donor selection for adult-to-adult living donor liver transplantation: well begun is half done.

PubMed

Sharma, Amit; Ashworth, April; Behnke, Martha; Cotterell, Adrian; Posner, Marc; Fisher, Robert A

2013-02-15

Donor selection criteria for adult-to-adult living donor liver transplantation vary with the medical center of evaluation. Living donor evaluation uses considerable resources, and the nonmaturation of potential into actual donors may sometimes prove fatal for patients with end-stage liver disease. On the contrary, a thorough donor evaluation process is mandatory to ensure safe outcomes in otherwise healthy donors. We aimed to study the reasons for nonmaturation of potential right lobe liver donors at our transplant center. A retrospective data analysis of all potential living liver donors evaluated at our center from 1998 to 2010 was done. Overall, 324 donors were evaluated for 219 potential recipients, and 171 (52.7%) donors were disqualified. Common reasons for donor nonmaturation included the following: (1) donor reluctance, 21%; (2) greater than 10% macro-vesicular steatosis, 16%; (3) assisted donor withdrawal, 14%; (4) inadequate remnant liver volume, 13%; and (5) psychosocial issues, 7%, and thrombophilia, 7%. Ten donors (6%) were turned down because of anatomic variations (8 biliary and 2 arterial anomalies). Donors older than 50 years and those with body mass index of more than 25 were less likely to be accepted for donation. We conclude that donor reluctance, hepatic steatosis, and assisted donor withdrawal are major reasons for nonmaturation of potential into actual donors. Anatomic variations and underlying medical conditions were not a major cause of donor rejection. A system in practice to recognize these factors early in the course of donor evaluation to improve the efficiency of the selection process and ensure donor safety is proposed.

Donor Selection for Adult- to- Adult Living Donor Liver Transplantation: Well Begun is Half Done

PubMed Central

Sharma, Amit; Ashworth, April; Behnke, Martha; Cotterell, Adrian; Posner, Marc; Fisher, Robert A.

2012-01-01

Background Donor selection criteria for adult-to-adult living donor liver transplantation vary with the medical center of evaluation. Living donor evaluation utilizes considerable resources and the non-maturation of potential into actual donors may sometimes prove fatal for patients with end stage liver disease. On the contrary, a thorough donor evaluation process is mandatory to ensure safe outcomes in otherwise healthy donors. We aimed to study the reasons for non-maturation of potential right lobe liver donors at our transplant center. Methods A retrospective data analysis of all potential living liver donors evaluated at our center from 1998 to 2010 was done. Results Overall 324 donors were evaluated for 219 potential recipients and 171 (52.7%) donors were disqualified. Common reasons for donor non-maturation included: (1) Donor reluctance, 21% (2) >10% macro-vesicular steatosis, 16% (3) assisted donor withdrawal, 14% (4) inadequate remnant liver volume, 13% (5) psychosocial issues, 7% and thrombophilia, 7%. Ten donors (6%) were turned down due to anatomical variations (8 biliary and 2 arterial anomalies). Donors older than 50 years and those with BMI over 25 were less likely to be accepted for donation. Conclusions We conclude that donor reluctance, hepatic steatosis and assisted donor withdrawal are major reasons for non-maturation of potential into actual donors. Anatomical variations and underlying medical conditions were not a major cause of donor rejection. A system in practice to recognize these factors early in the course of donor evaluation to improve the efficiency of the selection process and ensure donor safety is proposed. PMID:23128999

Creatine and Caffeine: Considerations for Concurrent Supplementation.

PubMed

Trexler, Eric T; Smith-Ryan, Abbie E

2015-12-01

Nutritional supplementation is a common practice among athletes, with creatine and caffeine among the most commonly used ergogenic aids. Hundreds of studies have investigated the ergogenic potential of creatine supplementation, with consistent improvements in strength and power reported for exercise bouts of short duration (≤ 30 s) and high intensity. Caffeine has been shown to improve endurance exercise performance, but results are mixed in the context of strength and sprint performance. Further, there is conflicting evidence from studies comparing the ergogenic effects of coffee and caffeine anhydrous supplementation. Previous research has identified independent mechanisms by which creatine and caffeine may improve strength and sprint performance, leading to the formulation of multi-ingredient supplements containing both ingredients. Although scarce, research has suggested that caffeine ingestion may blunt the ergogenic effect of creatine. While a pharmacokinetic interaction is unlikely, authors have suggested that this effect may be explained by opposing effects on muscle relaxation time or gastrointestinal side effects from simultaneous consumption. The current review aims to evaluate the ergogenic potential of creatine and caffeine in the context of high-intensity exercise. Research directly comparing coffee and caffeine anhydrous is discussed, along with previous studies evaluating the concurrent supplementation of creatine and caffeine.

The Medical Treatment of New-Onset Peripartum Cardiomyopathy: A Systematic Review of Prospective Studies.

PubMed

Desplantie, Olivier; Tremblay-Gravel, Maxime; Avram, Robert; Marquis-Gravel, Guillaume; Ducharme, Anique; Jolicoeur, E Marc

2015-12-01

Peripartum cardiomyopathy (PPCM) is a rare disorder with potentially fatal consequences, which occurs mainly in previously healthy women. The aetiology of PPCM remains unknown and various pathologic mechanisms have been proposed, including immune-mediated injuries and impaired response to oxidative stress and inflammatory cytokines. Several therapies have been studied, but few have been validated in a well-designed randomized controlled trial. In the present study we sought to review the medical treatment intended for acute PPCM. To this end, we performed a systematic review of the literature of randomized and nonrandomized prospective clinical studies. We identified 2 randomized controlled trials that evaluated the dopamine agonist bromocriptine and the inotrope levosimendan, respectively, and 1 nonrandomized study that evaluated the nonselective phosphodiesterase inhibitor pentoxifylline. We reviewed the pathophysiological, pharmacological, and clinical properties for each treatment option identified. Bromocriptine and pentoxifylline both improved left ventricular systolic function and patient-oriented clinical end points and levosimendan did not improve mortality or echocardiographic findings of PPCM. In this review we identified bromocriptine and pentoxifylline, but not levosimendan, as potentially useful agents to improve left ventricle function and outcomes in PPCM. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Evaluation of a Pilot Project on Information and Communication Technology for Rural Education Development: A Cofimvaba Case Study on the Educational Use of Tablets

ERIC Educational Resources Information Center

Phiri, Acheson Charles; foko, Thato; Mahwai, Nare

2014-01-01

In an endeavour to find solutions to the country's improving but ailing education system the South African government through some of its departments is attempting to find out if the introduction of technology in the class room has the potential to improve teaching and learning. The paper is based on a pilot study currently underway in Cofimvaba…

A Group Wage Incentive System for Production Workers at Pearl Harbor Naval Shipyard: Test and Evaluation

DTIC Science & Technology

1985-09-01

assume they will result in a sweatshop atmosphere. Workers may have fears that management will tighten standards when performance improves or...the shop’s performance can have a major impact on overall shipyard performance. In addition, the potential for accurate performance measurement was... impact of this experimental productivity improvement technique on participants’ job attitudes is supported in the literature. White et al. (in

Bacon Production: Evaluating Potential Processing and Management Practices to Improve Product Quality of Industrial Sliced Bacon

ERIC Educational Resources Information Center

Scramlin, Stacy Maurine

2009-01-01

The objective of this research was to determine areas of improvement to bacon production. The first trial was conducted to determine differences in belly and bacon quality traits in pigs fed ractopamine (RAC) for various durations during finishing. A 2x3x2 factorial arrangement was used with barrows and gilts, fed RAC levels of 0.0, 5.0, or 7.4…

Formulation, evaluation and bioactive potential of Xylaria primorskensis terpenoid nanoparticles from its major compound xylaranic acid.

PubMed

Adnan, Mohd; Patel, Mitesh; Reddy, Mandadi Narsimha; Alshammari, Eyad

2018-01-29

In recent years, fungi have been shown to produce a plethora of new bioactive secondary metabolites of interest, as new lead structures for medicinal and other pharmacological applications. The present investigation was carried out to study the pharmacological properties of a potent and major bioactive compound: xylaranic acid, which was obtained from Xylaria primorskensis (X. primorskensis) terpenoids in terms of antibacterial activity, antioxidant potential against DPPH & H 2 O 2 radicals and anticancer activity against human lung cancer cells. Due to terpenoid nature, low water solubility and wretched bioavailability, its pharmacological use is limited. To overcome these drawbacks, a novel xylaranic acid silver nanoparticle system (AgNPs) is developed. In addition to improving its solubility and bioavailability, other advantageous pharmacological properties has been evaluated. Furthermore, enhanced anticancer activity of xylaranic acid and its AgNPs due to induced apoptosis were also confirmed by determining the expression levels of apoptosis regulatory genes p53, bcl-2 and caspase-3 via qRT PCR method. This is the first study developing the novel xylaranic acid silver nanoparticle system and enlightening its therapeutic significance with its improved physico-chemical properties and augmented bioactive potential.

Effect of electric arc furnace slag on growth and physiology of maize (Zea mays L.).

PubMed

Radić, Sandra; Crnojević, Helena; Sandev, Dubravka; Jelić, Sonja; Sedlar, Zorana; Glavaš, Katarina; Pevalek-Kozlina, Branka

2013-12-01

Basic slag, used in this study as a potential source of certain nutrients, is a byproduct of the production of steel in electric arc furnace (EAF). A pot experiment with two nutrient-poor substrates was conducted to investigate to compare the effect of EAF steel slag and fertilizers NPK + F e on growth and availability of specific nutrients to maize. Mineral content of both substrate and plant leaves, growth, chlorophyll fluorescence and photosynthetic pigments were measured following six weeks of cultivation. As steel slag also contains trace amounts of heavy metals, certain oxidative parameters (antioxidative enzyme activities and lipid peroxidation) were evaluated as well. The steel slag improved soil mineral composition, increased above ground maize biomass by providing Fe, Mn, Mg, K and partly P and improved photosynthetic parameters. The potential phytotoxicity of EAF slag containing substrates was not determined as evaluated by MDA (malondialdehyde), GR (glutathione reductase) and APX (ascorbate peroxidase) levels. The obtained results show that EAF steel slag is comparable to NPK + F e in supplying nutrients for maize growth, indicating the potential of EAF steel slag as an inexpensive and non-phytotoxic nutrient supplier especially in poor soils.

Potential for Imaging Engineered Tissues with X-Ray Phase Contrast

PubMed Central

Appel, Alyssa; Anastasio, Mark A.

2011-01-01

As the field of tissue engineering advances, it is crucial to develop imaging methods capable of providing detailed three-dimensional information on tissue structure. X-ray imaging techniques based on phase-contrast (PC) have great potential for a number of biomedical applications due to their ability to provide information about soft tissue structure without exogenous contrast agents. X-ray PC techniques retain the excellent spatial resolution, tissue penetration, and calcified tissue contrast of conventional X-ray techniques while providing drastically improved imaging of soft tissue and biomaterials. This suggests that X-ray PC techniques are very promising for evaluation of engineered tissues. In this review, four different implementations of X-ray PC imaging are described and applications to tissues of relevance to tissue engineering reviewed. In addition, recent applications of X-ray PC to the evaluation of biomaterial scaffolds and engineered tissues are presented and areas for further development and application of these techniques are discussed. Imaging techniques based on X-ray PC have significant potential for improving our ability to image and characterize engineered tissues, and their continued development and optimization could have significant impact on the field of tissue engineering. PMID:21682604

Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop

PubMed Central

Yardley, Lucy; West, Robert; Patrick, Kevin; Greaves, Felix

2017-01-01

Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom’s Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key conclusion was that sustained engagement is not always required and that for each intervention it is useful to establish what constitutes “effective engagement,” that is, sufficient engagement to achieve the intended outcomes. The potential of digital interventions for testing and advancing theories of behavior change by generating ecologically valid, real-time objective data was recognized. Evaluations should include all phases of the development cycle, designed for generalizability, and consider new experimental designs to make the best use of rich data streams. Future health economics analyses need to recognize and model the complex and potentially far-reaching costs and benefits of digital interventions. In terms of governance, developers of digital behavior interventions should comply with existing regulatory frameworks, but with consideration for emerging standards around information governance, ethics, and interoperability. PMID:28663162

Assessment and Optimization of Lidar Measurement Availability for Wind Turbine Control (Poster)

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

Scholbrock, F. A.; Fleming, P.; Wright, A.

2014-02-01

Integrating Lidar to improve wind turbine controls is a potential breakthrough for reducing the cost of wind energy. By providing undisturbed wind measurements up to 400m in front of the rotor, Lidar may provide an accurate update of the turbine inflow with a preview time of several seconds. Focusing on loads, several studies have evaluated potential reductions using integrated Lidar, either by simulation or full scale field testing.

Evaluating and Improving the SAMA (Segmentation Analysis and Market Assessment) Recruiting Model

DTIC Science & Technology

2015-06-01

and rewarding me with your love every day. xx THIS PAGE INTENTIONALLY LEFT BLANK 1 I. INTRODUCTION A. THE UNITED STATES ARMY RECRUITING...the relationship between the calculated SAMA potential and the actual 2014 performance. The scatterplot in Figure 8 shows a strong linear... relationship between the SAMA calculated potential and the contracting achievement for 2014, with an R-squared value of 0.871. Simple Linear Regression of

Improving public health evaluation: a qualitative investigation of practitioners' needs.

PubMed

Denford, Sarah; Lakshman, Rajalakshmi; Callaghan, Margaret; Abraham, Charles

2018-01-30

In 2011, the House of Lords published a report on Behaviour Change, in which they report that "a lot more could, and should, be done to improve the evaluation of interventions." This study aimed to undertake a needs assessment of what kind of evaluation training and materials would be of most use to UK public health practitioners by conducting interviews with practitioners about everyday evaluation practice and needed guidance and materials. Semi-structured interviews were conducted with 32 public health practitioners in two UK regions, Cambridgeshire and the South West. Participants included directors of public health, consultants in public health, health improvement advisors, public health intelligence, and public health research officers. A topic guide included questions designed to explore participants existing evaluation practice and their needs for further training and guidance. Data were analysed using thematic analyses. Practitioners highlighted the need for evaluation to defend the effectiveness of existing programs and protect funding provisions. However, practitioners often lacked training in evaluation, and felt unqualified to perform such a task. The majority of practitioners did not use, or were not aware of many existing evaluation guidance documents. They wanted quality-assured, practical guidance that relate to the real world settings in which they operate. Practitioners also mentioned the need for better links and support from academics in public health. Whilst numerous guidance documents supporting public health evaluation exist, these documents are currently underused by practitioners - either because they are not considered useful, or because practitioners are not aware of them. Integrating existing guides into a catalogue of guidance documents, and developing a new-quality assured, practical and useful document may support the evaluation of public health programs. This in turn has the potential to identify those programs that are effective; thus improving public health and reducing financial waste.

Development, evaluation, and demonstration of a tractor trailer intelligent communication and power link

DOT National Transportation Integrated Search

1998-01-01

Technology offers a significant potential to improve the productivity and safety of the motor carrier industry. To date, the application of new technology to commercial vehicles has been limited to single unit trucks and truck tractors because of con...

76 FR 37357 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... of cancer. The outcome of the evaluation will provide information to internal NCI committees that... of the potential therapeutic to improve the treatment of various forms of cancer. The research...

76 FR 66733 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... of cancer. The outcome of the evaluation will provide information to internal NCI committees that... of the potential therapeutic to improve the treatment of various forms of cancer. The research...

U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA) ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: MERCURY CONTINUOUS EMISSION MONITORS

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

Supplement : development of improved injury criteria for the assessment of advanced automotive restraint systems : II

DOT National Transportation Integrated Search

2000-03-01

In the Supplemental Notice of Proposed Rulemaking (SNPRM) on advanced air bags, the National Highway Traffic Safety Administration (NHTSA) proposed a comprehensive set of injury criteria for evaluating the potential for injury to the head, neck, ches...

Potential Crash Reduction Benefits of Safety Improvement Projects Part A : Shoulder Rumble Strips

DOT National Transportation Integrated Search

2012-06-01

This research provides a comprehensive evaluation of the safety benefits of shoulder rumble strips in rural highways in Idaho. The effectiveness of shoulder rumble strips in reducing the number and severity of run-off-the-road (ROR) crashes was exami...

Potential Crash Reduction Benefits of Safety Improvement Projects - Part A : Shoulder Rumble Strips

DOT National Transportation Integrated Search

2012-06-01

This research provides a comprehensive evaluation of the safety benefits of shoulder rumble strips in rural highways in Idaho. The effectiveness of shoulder rumble strips in reducing the number and severity of run-off-the-road (ROR) crashes was exami...

77 FR 43098 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...., as amended. The purpose of this meeting is to evaluate requests for preclinical development resources... contract resources for development of the potential therapeutic to improve the treatment of various forms...

77 FR 70170 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...., as amended. The purpose of this meeting is to evaluate requests for preclinical development resources... contract resources for development of the potential therapeutic to improve the treatment of various forms...

Changes in spatiotemporal gait parameters following intravenous immunoglobulin treatment for chronic inflammatory demyelinating polyneuropathy.

PubMed

Vo, Mary L; Chin, Russell L; Miranda, Caroline; Latov, Norman

2017-10-01

Gait impairment is a common presenting symptom in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). However, gait parameters have not previously been evaluated in detail as potential independent outcome measures. We prospectively measured changes in spatiotemporal gait parameters of 20 patients with CIDP at baseline and following treatment with intravenous immunoglobulin (IVIG), using GAITRite® a computerized walkway system with embedded sensors. Overall, study patients showed significant improvements in gait velocity, cadence, stride length, double support time, stance phase, and swing phase following IVIG treatment. Mean changes in velocity, stance phase, and swing phase, exhibited the greatest statistical significance among the subgroup that exhibited clinically meaningful improvement in Inflammatory Neuropathy Cause and Treatment disability score, Medical Research Council sum score, and grip strength. Assessment of gait parameters, in particular velocity, step phase and swing phase, is a potentially sensitive outcome measure for evaluating treatment response in CIDP. Muscle Nerve 56: 732-736, 2017. © 2017 Wiley Periodicals, Inc.

Reverse osmosis as a potential technique to improve antioxidant properties of fruit juices used for functional beverages.

PubMed

Gunathilake, K D P P; Yu, Li Juan; Rupasinghe, H P Vasantha

2014-04-01

Reverse osmosis (RO) as a potential technique to improve the antioxidant properties of cranberry, blueberry and apple juices was evaluated for the formulation of a functional beverage. The effects of temperature (20-40 °C) and trans-membrane pressure (25-35 bars) on physico-chemical and antioxidant properties of fruit juices were evaluated to optimize the operating parameters for each fruit juice. There was no significant effect on any quality parameters of fruit juices under studied operating parameters of RO. However, total soluble solid, total acidity and colour (a(∗)) of the concentrated juices increased in proportion to their volumetric concentrations. Antioxidant capacity measured by FRAP assay of concentrated apple, blueberry and cranberry juice was increased by 40%, 34%, and 30%, respectively. LDL oxidation inhibition by concentrated blueberry and cranberry juice was increased up to 41% and 45%, respectively. The results suggest that RO can be used for enhancing the health promoting properties of fruit juices. Copyright © 2013 Elsevier Ltd. All rights reserved.

Menstrual questionnaires for clinical and research use.

PubMed

Matteson, Kristen A

2017-04-01

Patient-reported outcome measures (PROMs) have the potential to be extremely valuable in the clinical care delivery for women who report heavy menstrual bleeding (HMB). Increasingly, studies on HMB have incorporated PROMs to evaluate the impact of bleeding on quality of life. These measures have included semiquantitative charts and pictograms, questionnaires to assess symptoms and impact on quality of life, and health-related quality of life questionnaires. Recent systematic reviews have highlighted inconsistency of outcome measurement across studies on HMB as a challenge limiting the interpretability of the body of literature and the ability to generate consensus on the relative effectiveness of treatment options. Consequently, research initiatives and international collaborations are working to harmonize outcome measurement. Harmonizing the use of questionnaires in research and clinical care has the potential to improve patient-centered care delivery for women with HMB and improve the generation of patient-focused evidence-based guidelines for the evaluation and treatment of HMB. Copyright © 2016. Published by Elsevier Ltd.

Evaluation of immunomodulatory activity of two potential probiotic Lactobacillus strains by in vivo tests.

PubMed

Ren, Dayong; Li, Chang; Qin, Yanqing; Yin, Ronglan; Du, Shouwen; Liu, Hongfeng; Zhang, Yanfang; Wang, Cuiyan; Rong, Fengjun; Jin, Ningyi

2015-10-01

Here we evaluate the immunomodulatory function of two potential probiotic strains, Lactobacillus salivarius CICC 23174 and Lactobacillus plantarum CGMCC 1.557. Mice were fed with each Lactobacillus strain at different doses for several consecutive days. The effects of the two probiotic strains on immune organs, immune cells and immune molecules were investigated on days 10 and 20. Both Lactobacillus strains increased the spleen index, improved the spleen lymphocyte transformation rate, enhanced sIgA production and improved the number of CD11c(+) CD80(+) double-positive cells. L. plantarum CGMCC 1.557 was the more active strain in enhancing the phagocytic activity of macrophages, while, L. salivarius CICC 23174 was the more effective strain at maintaining the Th1/Th2 balance. This study suggests that these two Lactobacillus strains have beneficial effects on regulation of immune responses, which has promising implications for the development of ecological agents and functional foods. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of plant biomass resources available for replacement of fossil oil

PubMed Central

Henry, Robert J

2010-01-01

The potential of plants to replace fossil oil was evaluated by considering the scale of production required, the area of land needed and the types of plants available. High yielding crops (50 tonnes/ha) that have a high conversion efficiency (75%) would require a global land footprint of around 100 million ha to replace current (2008) oil consumption. Lower yielding or less convertible plants would require a larger land footprint. Domestication of new species as dedicated energy crops may be necessary. A systematic analysis of higher plants and their current and potential uses is presented. Plant biotechnology provides tools to improve the prospects of replacing oil with plant-derived biomass by increasing the amount of biomass produced per unit area of land and improving the composition of the biomass to increase the efficiency of conversion to biofuel and biomaterials. Options for the production of high value coproducts and the expression of processing aids such as enzymes in the plant may add further value to plants as bioenergy resources. PMID:20070873

Process improvement methodologies uncover unexpected gaps in stroke care.

PubMed

Kuner, Anthony D; Schemmel, Andrew J; Pooler, B Dustin; Yu, John-Paul J

2018-01-01

Background The diagnosis and treatment of acute stroke requires timed and coordinated effort across multiple clinical teams. Purpose To analyze the frequency and temporal distribution of emergent stroke evaluations (ESEs) to identify potential contributory workflow factors that may delay the initiation and subsequent evaluation of emergency department stroke patients. Material and Methods A total of 719 sentinel ESEs with concurrent neuroimaging were identified over a 22-month retrospective time period. Frequency data were tabulated and odds ratios calculated. Results Of all ESEs, 5% occur between 01:00 and 07:00. ESEs were most frequent during the late morning and early afternoon hours (10:00-14:00). Unexpectedly, there was a statistically significant decline in the frequency of ESEs that occur at the 14:00 time point. Conclusion Temporal analysis of ESEs in the emergency department allowed us to identify an unexpected decrease in ESEs and through process improvement methodologies (Lean and Six Sigma) and identify potential workflow elements contributing to this observation.

Proposal of e-learning strategy to teach Atraumatic Restorative Treatment (ART) to undergraduate and graduate students.

PubMed

Camargo, Lucila Basto; Raggio, Daniela Prócida; Bonacina, Carlos Felipe; Wen, Chao Lung; Mendes, Fausto Medeiros; Bönecker, Marcelo José Strazzeri; Haddad, Ana Estela

2014-07-17

The aim of this study was to evaluate e-learning strategy in teaching Atraumatic Restorative Treatment (ART) to undergraduate and graduate students. The sample comprised 76 participants-38 dental students and 38 pediatric dentistry students-in a specialization course. To evaluate knowledge improvement, participants were subjected to a test performed before and after the course. A single researcher corrected the tests and intraexaminer reproducibility was calculated (CCI = 0.991; 95% IC = 0.975-0.996). All students improved their performances after the e-learning course (Paired t-tests p < 0.001). The means of undergraduate students were 4.7 (initial) and 6.4 (final) and those of graduate students were 6.8 (initial) and 8.2 (final). The comparison of the final evaluation means showed a statistically significant difference (t-tests p < 0.0001). The e-learning strategy has the potential of improving students' knowledge in ART. Mature students perform better in this teaching modality when it is applied exclusively via distance learning.

A program evaluation of the Patient CaringTouch System: A pre- and postimplementation assessment.

PubMed

Breckenridge-Sproat, Sara T; Swiger, Pauline A; Belew, Donna L; Raju, Dheeraj; Patrician, Patricia A; Loan, Lori A

The Patient CaringTouch System (PCTS) is an innovative, strategic and patient-centric framework developed by the Army Nurse Corps for nursing care delivery that is designed to reduce nursing care variation and improve patient and nurse outcomes. This manuscript describes a program evaluation of the PCTS. A pre and post design was used to describe changes in patient and nursing measures following PCTS implementation. Overall there was a good uptake of the PCTS; however, concurrent with initiation of the PCTS, declines in staffing levels and increases in patient acuity were noted. Medication administration error rates declined, but fall with injury rates increased. Pain reassessment following pain medication administration improved, as did several aspects of the nursing practice environment. Nurses' job dissatisfaction and intent to leave increased; however, potentially preventable losses decreased. The program evaluation results will be used to target areas for improvement so that the PCTS may be sustained. Published by Elsevier Inc.

Study of space shuttle orbiter system management computer function. Volume 1: Analysis, baseline design

NASA Technical Reports Server (NTRS)

1975-01-01

A system analysis of the shuttle orbiter baseline system management (SM) computer function is performed. This analysis results in an alternative SM design which is also described. The alternative design exhibits several improvements over the baseline, some of which are increased crew usability, improved flexibility, and improved growth potential. The analysis consists of two parts: an application assessment and an implementation assessment. The former is concerned with the SM user needs and design functional aspects. The latter is concerned with design flexibility, reliability, growth potential, and technical risk. The system analysis is supported by several topical investigations. These include: treatment of false alarms, treatment of off-line items, significant interface parameters, and a design evaluation checklist. An in-depth formulation of techniques, concepts, and guidelines for design of automated performance verification is discussed.

Feasibility of encoding the Institute for Clinical Systems Improvement Depression Guideline using the Omaha System.

PubMed

Monsen, Karen A; Neely, Claire; Oftedahl, Gary; Kerr, Madeleine J; Pietruszewski, Pam; Farri, Oladimeji

2012-08-01

Evidence-based clinical guidelines are being developed to bridge the gap between research and practice with the goals of improving health care quality and population health. However, disseminating, implementing, and ensuring ongoing use of clinical guidelines in practice settings is challenging. The purpose of this study was to demonstrate the feasibility of encoding evidence-based clinical guidelines using the Omaha System. Clinical documentation with Omaha System-encoded guidelines generates individualized, meaningful data suitable for program evaluation and health care quality research. The use of encoded guidelines within the electronic health record has potential to reinforce use of guidelines, and thus improve health care quality and population health. Research using Omaha System data generated by clinicians has potential to discover new knowledge related to guideline use and effectiveness. Copyright © 2012 Elsevier Inc. All rights reserved.

The use of digital PCR to improve the application of quantitative molecular diagnostic methods for tuberculosis.

PubMed

Devonshire, Alison S; O'Sullivan, Denise M; Honeyborne, Isobella; Jones, Gerwyn; Karczmarczyk, Maria; Pavšič, Jernej; Gutteridge, Alice; Milavec, Mojca; Mendoza, Pablo; Schimmel, Heinz; Van Heuverswyn, Fran; Gorton, Rebecca; Cirillo, Daniela Maria; Borroni, Emanuele; Harris, Kathryn; Barnard, Marinus; Heydenrych, Anthenette; Ndusilo, Norah; Wallis, Carole L; Pillay, Keshree; Barry, Thomas; Reddington, Kate; Richter, Elvira; Mozioğlu, Erkan; Akyürek, Sema; Yalçınkaya, Burhanettin; Akgoz, Muslum; Žel, Jana; Foy, Carole A; McHugh, Timothy D; Huggett, Jim F

2016-08-03

Real-time PCR (qPCR) based methods, such as the Xpert MTB/RIF, are increasingly being used to diagnose tuberculosis (TB). While qualitative methods are adequate for diagnosis, the therapeutic monitoring of TB patients requires quantitative methods currently performed using smear microscopy. The potential use of quantitative molecular measurements for therapeutic monitoring has been investigated but findings have been variable and inconclusive. The lack of an adequate reference method and reference materials is a barrier to understanding the source of such disagreement. Digital PCR (dPCR) offers the potential for an accurate method for quantification of specific DNA sequences in reference materials which can be used to evaluate quantitative molecular methods for TB treatment monitoring. To assess a novel approach for the development of quality assurance materials we used dPCR to quantify specific DNA sequences in a range of prototype reference materials and evaluated accuracy between different laboratories and instruments. The materials were then also used to evaluate the quantitative performance of qPCR and Xpert MTB/RIF in eight clinical testing laboratories. dPCR was found to provide results in good agreement with the other methods tested and to be highly reproducible between laboratories without calibration even when using different instruments. When the reference materials were analysed with qPCR and Xpert MTB/RIF by clinical laboratories, all laboratories were able to correctly rank the reference materials according to concentration, however there was a marked difference in the measured magnitude. TB is a disease where the quantification of the pathogen could lead to better patient management and qPCR methods offer the potential to rapidly perform such analysis. However, our findings suggest that when precisely characterised materials are used to evaluate qPCR methods, the measurement result variation is too high to determine whether molecular quantification of Mycobacterium tuberculosis would provide a clinically useful readout. The methods described in this study provide a means by which the technical performance of quantitative molecular methods can be evaluated independently of clinical variability to improve accuracy of measurement results. These will assist in ultimately increasing the likelihood that such approaches could be used to improve patient management of TB.

Ligand- and receptor-based docking with LiBELa

NASA Astrophysics Data System (ADS)

dos Santos Muniz, Heloisa; Nascimento, Alessandro S.

2015-08-01

Methodologies on molecular docking are constantly improving. The problem consists on finding an optimal interplay between the computational cost and a satisfactory physical description of ligand-receptor interaction. In pursuit of an advance in current methods we developed a mixed docking approach combining ligand- and receptor-based strategies in a docking engine, where tridimensional descriptors for shape and charge distribution of a reference ligand guide the initial placement of the docking molecule and an interaction energy-based global minimization follows. This hybrid docking was evaluated with soft-core and force field potentials taking into account ligand pose and scoring. Our approach was found to be competitive to a purely receptor-based dock resulting in improved logAUC values when evaluated with DUD and DUD-E. Furthermore, the smoothed potential as evaluated here, was not advantageous when ligand binding poses were compared to experimentally determined conformations. In conclusion we show that a combination of ligand- and receptor-based strategy docking with a force field energy model results in good reproduction of binding poses and enrichment of active molecules against decoys. This strategy is implemented in our tool, LiBELa, available to the scientific community.

Role of anaerobic fungi in wheat straw degradation and effects of plant feed additives on rumen fermentation parameters in vitro.

PubMed

Dagar, S S; Singh, N; Goel, N; Kumar, S; Puniya, A K

2015-01-01

In the present study, rumen microbial groups, i.e. total rumen microbes (TRM), total anaerobic fungi (TAF), avicel enriched bacteria (AEB) and neutral detergent fibre enriched bacteria (NEB) were evaluated for wheat straw (WS) degradability and different fermentation parameters in vitro. Highest WS degradation was shown for TRM, followed by TAF, NEB and least by AEB. Similar patterns were observed with total gas production and short chain fatty acid profiles. Overall, TAF emerged as the most potent individual microbial group. In order to enhance the fibrolytic and rumen fermentation potential of TAF, we evaluated 18 plant feed additives in vitro. Among these, six plant additives namely Albizia lebbeck, Alstonia scholaris, Bacopa monnieri, Lawsonia inermis, Psidium guajava and Terminalia arjuna considerably improved WS degradation by TAF. Further evaluation showed A. lebbeck as best feed additive. The study revealed that TAF plays a significant role in WS degradation and their fibrolytic activities can be improved by inclusion of A. lebbeck in fermentation medium. Further studies are warranted to elucidate its active constituents, effect on fungal population and in vivo potential in animal system.

A Natural Language Processing System That Links Medical Terms in Electronic Health Record Notes to Lay Definitions: System Development Using Physician Reviews.

PubMed

Chen, Jinying; Druhl, Emily; Polepalli Ramesh, Balaji; Houston, Thomas K; Brandt, Cynthia A; Zulman, Donna M; Vimalananda, Varsha G; Malkani, Samir; Yu, Hong

2018-01-22

Many health care systems now allow patients to access their electronic health record (EHR) notes online through patient portals. Medical jargon in EHR notes can confuse patients, which may interfere with potential benefits of patient access to EHR notes. The aim of this study was to develop and evaluate the usability and content quality of NoteAid, a Web-based natural language processing system that links medical terms in EHR notes to lay definitions, that is, definitions easily understood by lay people. NoteAid incorporates two core components: CoDeMed, a lexical resource of lay definitions for medical terms, and MedLink, a computational unit that links medical terms to lay definitions. We developed innovative computational methods, including an adapted distant supervision algorithm to prioritize medical terms important for EHR comprehension to facilitate the effort of building CoDeMed. Ten physician domain experts evaluated the user interface and content quality of NoteAid. The evaluation protocol included a cognitive walkthrough session and a postsession questionnaire. Physician feedback sessions were audio-recorded. We used standard content analysis methods to analyze qualitative data from these sessions. Physician feedback was mixed. Positive feedback on NoteAid included (1) Easy to use, (2) Good visual display, (3) Satisfactory system speed, and (4) Adequate lay definitions. Opportunities for improvement arising from evaluation sessions and feedback included (1) improving the display of definitions for partially matched terms, (2) including more medical terms in CoDeMed, (3) improving the handling of terms whose definitions vary depending on different contexts, and (4) standardizing the scope of definitions for medicines. On the basis of these results, we have improved NoteAid's user interface and a number of definitions, and added 4502 more definitions in CoDeMed. Physician evaluation yielded useful feedback for content validation and refinement of this innovative tool that has the potential to improve patient EHR comprehension and experience using patient portals. Future ongoing work will develop algorithms to handle ambiguous medical terms and test and evaluate NoteAid with patients. ©Jinying Chen, Emily Druhl, Balaji Polepalli Ramesh, Thomas K Houston, Cynthia A Brandt, Donna M Zulman, Varsha G Vimalananda, Samir Malkani, Hong Yu. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.01.2018.

Impact of the Z potential technique on reducing the sperm DNA fragmentation index, fertilization rate and embryo development.

PubMed

Duarte, Carlos; Núñez, Víctor; Wong, Yat; Vivar, Carlos; Benites, Elder; Rodriguez, Urso; Vergara, Carlos; Ponce, Jorge

2017-12-01

In assisted reproduction procedures, we need to develop and enhance new protocols to optimize sperm selection. The aim of this study is to evaluate the ability of the Z potential technique to select sperm with intact DNA in non-normospermic patients and evaluate the impact of this selection on embryonic development. We analyzed a total of 174 human seminal samples with at least one altered parameter. We measured basal, post density gradients, and post density gradients + Z potential DNA fragmentation index. To evaluate the impact of this technique on embryo development, 54 cases were selected. The embryo development parameters evaluated were fertilization rate, cleavage rate, top quality embryos at the third day and blastocysts rate. We found significant differences in the study groups when we compared the sperm fragmentation index by adding the Z potential technique to density gradient selection vs. density gradients alone. Furthermore, there was no significant difference in the embryo development parameters between the low sperm fragmentation index group vs. the moderate and high sperm fragmentation index groups, when selecting sperms with this new technique. The Z potential technique is a very useful tool for sperm selection; it significantly reduces the DNA fragmentation index and improves the parameters of embryo development. This technique could be considered routine for its simplicity and low cost.

How best management practices affect emissions in gas turbine power plants-An important factor to consider when strengthening emission standards.

PubMed

Zeng, Jinghai; Xing, Min; Hou, Min; England, Glenn C; Yan, Jing

2018-04-27

The Beijing Municipal Environmental Protection Bureau (EPB) is considering strengthening the Emission Standard of Air Pollutants for Stationary Gas Turbines, originally published in 2011 (DB11/847-2011), with a focus on reducing nitrogen oxides (NOx) emissions. A feasibility study was conducted to evaluate the current operation of 12 existing combined-cycle gas turbine power plants and the design of two new plants in Beijing and their emission reduction potential, in comparison with a state-of-the-art power plant in California. The study found that best management practices (BMPs) could potentially improve the emission level of the power plants, and should be implemented to minimize emissions under current design characteristics. These BMPs include (1) more frequent tuning of turbine combustors; (2) onsite testing of natural gas characteristics in comparison to turbine manufacturer's specifics and tuning of turbine to natural gas quality; (3) onsite testing of aqueous ammonia to ensure adequate ammonia concentration in the mixed solution, and the purity of the solution; (4) more careful inspection of the heat recovery steam generator (HRSG), and the selective catalytic reduction (SCR) during operation and maintenance; (5) annual testing of the catalyst coupon on the SCR to ensure catalyst effectiveness; and (6) annual ammonia injection grid (AIG) tuning. The study found that without major modification to the plants, improving the management of the Beijing gas turbine power plants may potentially reduce the current hourly average NOx emission level of 5-10 parts per million (ppm; ranges reflects plant variation) by up to 20%. The exact improvement associated with each BMP for each facility requires more detailed analysis, and requires engagement of turbine, HRSG, and SCR manufacturers. This potential improvement is an important factor to consider when strengthening the emission standard. However, note that with the continuous needs of improving air quality within the area, more expensive control measures, such as retrofitting the turbines or the HRSGs, may be considered. This study analyzed the potential emission reductions associated with implementing the best management practices (BMPs) on the combined cycle and cogeneration power plants in Beijing. It determined that implementing the BMPs could potentially achieve up to 580 metric tonnes, or 0.6%, reductions of all NOx emissions in Beijing. Many other cities in China and Asia battling air quality issues may find the information useful in order to evaluate the emission reduction potential of their own gas turbine power plants.

Integrating future scenario‐based crop expansion and crop conditions to map switchgrass biofuel potential in eastern Nebraska, USA

USGS Publications Warehouse

Gu, Yingxin; Wylie, Bruce K.

2018-01-01

Switchgrass (Panicum virgatum) has been evaluated as one potential source for cellulosic biofuel feedstocks. Planting switchgrass in marginal croplands and waterway buffers can reduce soil erosion, improve water quality, and improve regional ecosystem services (i.e. it serves as a potential carbon sink). In previous studies, we mapped high risk marginal croplands and highly erodible cropland buffers that are potentially suitable for switchgrass development, which would improve ecosystem services and minimally impact food production. In this study, we advance our previous study results and integrate future crop expansion information to develop a switchgrass biofuel potential ensemble map for current and future croplands in eastern Nebraska. The switchgrass biomass productivity and carbon benefits (i.e. NEP: net ecosystem production) for the identified biofuel potential ensemble areas were quantified. The future scenario‐based (‘A1B’) land use and land cover map for 2050, the US Geological Survey crop type and Compound Topographic Index (CTI) maps, and long‐term (1981–2010) averaged annual precipitation data were used to identify future crop expansion regions that are suitable for switchgrass development. Results show that 2528 km2 of future crop expansion regions (~3.6% of the study area) are potentially suitable for switchgrass development. The total estimated biofuel potential ensemble area (including cropland buffers, marginal croplands, and future crop expansion regions) is 4232 km2 (~6% of the study area), potentially producing 3.52 million metric tons of switchgrass biomass per year. Converting biofuel ensemble regions to switchgrass leads to potential carbon sinks (the total NEP for biofuel potential areas is 0.45 million metric tons C) and is environmentally sustainable. Results from this study improve our understanding of environmental conditions and ecosystem services of current and future cropland systems in eastern Nebraska and provide useful information to land managers to make land use decisions regarding switchgrass development.

Benefit evaluation of space processing of biological materials

NASA Technical Reports Server (NTRS)

1977-01-01

A rational analytical basis for the evaluation of potential benefits of space processing of biological materials is described. A preliminary evaluation of three candidate space processed biological materials was accomplished. Materials investigated were human lymphocytes, urokinase, and Beta cells. Separation of lymphocyte groups was considered in order to improve the matching of donors and recipients for kidney transplantation, while urokinase was examined in regard to treatment of thromboembolic diseases. Separation of Beta cells was studied since it could provide a highly effective means for the treatment of juvenile-onset diabetes.

Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork in the Emergency Department.

PubMed

Martin, Heather A; Ciurzynski, Susan M

2015-11-01

Thousands of people die annually in hospitals because of poor communication and teamwork between health care team members. Standardized tools and strategies help increase the amount and quality of communication. Two structured communication methods include implementing huddles and the use of the situation, background, assessment, and recommendation (SBAR) communication framework. To improve communication among nurse practitioners and registered nurses within a pediatric emergency department, a performance-improvement project with the structured processes of a joint patient evaluation and huddle was implemented. Data were gathered from 32 nurses and 2 nurse practitioners using structured observation and pre- and post-implementation surveys. The following outcomes were measured: presence or absence of joint patient evaluation and SBAR-guided huddle, verbalization of treatment plan, communication, teamwork, and nurse satisfaction. Eighty-three percent of patient encounters included a joint evaluation. A huddle structured with SBAR was conducted 86% of the time. Registered nurses and nurse practitioners verbalized patients' treatment plans in 89% of cases and 97% of cases, respectively. Improved teamwork, communication, and nursing satisfaction scores were demonstrated among the nurse practitioners and registered nurses. This project showed the feasibility of a simple and inexpensive joint nurse practitioner-registered nurse patient evaluation followed by a structured huddle, which improved communication, teamwork, and nurse satisfaction scores. This performance-improvement project has the potential to enhance efficiency by reducing redundancy, as well as to improve patient safety through the use of structured communication techniques. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Improving Causal Inferences in Meta-analyses of Longitudinal Studies: Spanking as an Illustration.

PubMed

Larzelere, Robert E; Gunnoe, Marjorie Lindner; Ferguson, Christopher J

2018-05-24

To evaluate and improve the validity of causal inferences from meta-analyses of longitudinal studies, two adjustments for Time-1 outcome scores and a temporally backwards test are demonstrated. Causal inferences would be supported by robust results across both adjustment methods, distinct from results run backwards. A systematic strategy for evaluating potential confounds is also introduced. The methods are illustrated by assessing the impact of spanking on subsequent externalizing problems (child age: 18 months to 11 years). Significant results indicated a small risk or a small benefit of spanking, depending on the adjustment method. These meta-analytic methods are applicable for research on alternatives to spanking and other developmental science topics. The underlying principles can also improve causal inferences in individual studies. © 2018 Society for Research in Child Development.

Study protocol of a mixed-methods evaluation of a cluster randomized trial to improve the safety of NSAID and antiplatelet prescribing: data-driven quality improvement in primary care.

PubMed

Grant, Aileen; Dreischulte, Tobias; Treweek, Shaun; Guthrie, Bruce

2012-08-28

Trials of complex interventions are criticized for being 'black box', so the UK Medical Research Council recommends carrying out a process evaluation to explain the trial findings. We believe it is good practice to pre-specify and publish process evaluation protocols to set standards and minimize bias. Unlike protocols for trials, little guidance or standards exist for the reporting of process evaluations. This paper presents the mixed-method process evaluation protocol of a cluster randomized trial, drawing on a framework designed by the authors. This mixed-method evaluation is based on four research questions and maps data collection to a logic model of how the data-driven quality improvement in primary care (DQIP) intervention is expected to work. Data collection will be predominately by qualitative case studies in eight to ten of the trial practices, focus groups with patients affected by the intervention and quantitative analysis of routine practice data, trial outcome and questionnaire data and data from the DQIP intervention. We believe that pre-specifying the intentions of a process evaluation can help to minimize bias arising from potentially misleading post-hoc analysis. We recognize it is also important to retain flexibility to examine the unexpected and the unintended. From that perspective, a mixed-methods evaluation allows the combination of exploratory and flexible qualitative work, and more pre-specified quantitative analysis, with each method contributing to the design, implementation and interpretation of the other.As well as strengthening the study the authors hope to stimulate discussion among their academic colleagues about publishing protocols for evaluations of randomized trials of complex interventions. DATA-DRIVEN QUALITY IMPROVEMENT IN PRIMARY CARE TRIAL REGISTRATION: ClinicalTrials.gov: NCT01425502.

Wildlife responses to brush management: a contemporary evaluation

USDA-ARS?s Scientific Manuscript database

Brush management has been widely practiced with the general intent of curtailing or reversing the proliferation of shrubs and trees in grasslands and savannas. The traditional aim of brush management has been to increase livestock forage or to improve water yield. Its potential role for restoring h...

Integrated database and analysis system for the evaluation of freeway corridors for potential ramp signaling : [summary].

DOT National Transportation Integrated Search

2011-01-01

Ramp signaling is the installation of traffic signals on freeway on-ramps. Studies have shown that in many locations, ramp signaling helped alleviate traffic congestion and improve safety. However, not all freeway locations are suitable for ramp sign...

Evaluating the effect of microalgal biomass on soil-plant-water systems

USDA-ARS?s Scientific Manuscript database

Exploring all possible applications of microalgal biomass is crucial to strengthen the current algal industry and reducing the environmental impacts of agriculture is a major global challenge. Microalgae can play a progressive role as they have the potential to improve soil structure, reduce erosion...

The Computer in Performance and Instruction: Or, How to Tell the True Color of a Chameleon.

ERIC Educational Resources Information Center

Davis, Richard

1979-01-01

Discusses such potential uses for the computer in employee training programs as management support for training and performance, training project control, improved design and development methods, training program implementation and delivery, and program evaluation, revision, and maintenance. (JEG)

Evaluation of Roadway Reallocation Projects: Analysis of Before-and-After Travel Speeds and Congestion Utilizing High-Resolution Bus Transit Data

DOT National Transportation Integrated Search

2017-11-01

The traditional process of identifying corridors for road diet improvements involves selecting potential corridors (mostly based on identifying fourlane roads) and conducting a traffic impact analysis of proposed changes on a selected roadway before ...

Pedestrian Access to Roundabouts: Assessment of Motorists' Yielding to Visually Impaired Pedestrians and Potential Treatments to Improve Access

DOT National Transportation Integrated Search

2006-05-01

This report describes two related studies intended to address double-lane roundabout accessibility issues for visually impaired pedestrians. The first study was conducted on a closed course to evaluate the feasibility of a pavement treatment to alert...

Assessment of Greenhouse Gas Retrofit Issues for Coal Fired Power Plants

EPA Science Inventory

Several studies have been published on carbon capture technology as an independent island. In contrast, this evaluation considered the impact on the existing plant and the potential improvements to ease the retrofit of a carbon capture process. This paper will provide insight i...

Integrated database and analysis system for the evaluation of freeway corridors for potential ramp signaling.

DOT National Transportation Integrated Search

2011-11-15

Ramp signaling is a relatively low-cost traffic management strategy that aims to improve the flow of : traffic by controlling the rate at which vehicles enter the freeway. While studies have shown that ramp : signaling helps to alleviate traffic cong...

Effect of neck warming and cooling on thermal comfort

NASA Technical Reports Server (NTRS)

Williams, B. A.; Chambers, A. B.

1972-01-01

The potential use of local neck cooling in an area superficial to the cerebral arteries was evaluated by circulating cold or hot water through two copper disks held firmly against the neck. Subjective responses indicated that neck cooling improves the thermal comfort in a hot environment.

Using Online Compound Interest Tools to Improve Financial Literacy

ERIC Educational Resources Information Center

Hubbard, Edward; Matthews, Percival; Samek, Anya

2016-01-01

The widespread use of personal computing presents the opportunity to design educational materials that can be delivered online, potentially addressing low financial literacy. The authors developed and evaluated three different educational tools focusing on interest compounding. In the authors' laboratory experiment, individuals were randomized to…

Evaluation and improvements of a mayfly, Neocloeon (Centroptilum) triangulifer ?(Ephemeroptera: Baetidae) toxicity test method

EPA Science Inventory

A recently published test method for Neocloeon triangulifer assessed the sensitivities of larval mayflies to several reference toxicants (NaCl, KCl, and CuSO4). Subsequent exposures have shown discrepancies from those results previously reported. To identify potential sources of ...

A Model Intervention for Elder Abuse and Dementia.

ERIC Educational Resources Information Center

Anetzberger, Georgia J.; Palmisano, Barbara R.; Sanders, Margaret; Bass, David; Dayton, Carol; Eckert, Sharen; Schimer, Maria R.

2000-01-01

Describes a two-year collaborative project that improved the reporting and management of potential and suspected elder abuse situations involving persons with dementia. The educational curriculum and cross training program as well as the handbook for caregivers are discussed. Project organization, implementation, and evaluation are also discussed…

Relationship between NDVI at early bloom and yield in germplasm evaluation trials

USDA-ARS?s Scientific Manuscript database

The use of high-throughput phenotyping (HTP) equipment is expanding as it offers the potential to increase the efficiency of making selections in cotton (Gossypium hirsutum L.) improvement programs. Measurements often being collected on HTP field equipment include normalized difference vegetative in...

Long term management practices influenced soil aggregation and carbon dynamics

USDA-ARS?s Scientific Manuscript database

Soil aggregation protects soil organic C (SOC) against rapid decomposition, improves soil quality, and reduces soil erosion potential. The objectives of this study are to evaluate the effects of long-term (21 yrs.) management practices on SOC, water stable aggregate (WSA), and aggregate-associated ...

Air pollutant emissions and mitigation potential through the adoption of semi-coke coals and improved heating stoves: Field evaluation of a pilot intervention program in rural China.

PubMed

Liu, Yafei; Zhang, You; Li, Chuang; Bai, Yun; Zhang, Daoming; Xue, Chunyu; Liu, Guangqing

2018-05-15

Pollutant emissions from incomplete combustion of raw coal in low-efficiency residential heating stoves greatly contribute to winter haze in China. Semi-coke coals and improved heating stoves are expected to lower air pollutant emissions and are vigorously promoted by the Chinese government in many national and local plans. In this study, the thermal performance and air pollutant emissions from semi-coke combustion in improved heating stoves were measured in a pilot rural county and compared to the baseline of burning raw coal to quantify the mitigation potential of air pollutant emissions. A total of five stove-fuel combinations were tested, and 27 samples from 27 different volunteered households were obtained. The heating efficiency of improved stoves increased, but fuel consumption appeared higher with more useful energy output compared to traditional stoves. The emission factors of PM 2.5 , SO 2 , and CO 2 of semi-coke burning in specified improved stoves were lower than the baseline of burning raw coal chunk, but no significant NOx and CO decreases were observed. The total amount of PM 2.5 and SO 2 emissions per household in one heating season was lower, but CO, CO 2 , and NOx increased when semi-coke coal and specified improved stoves were deployed. Most differences were not statistically significant due to the limited samples and large variation, indicating that further evaluation would be needed to make conclusions that could be considered for policy. Copyright © 2018 Elsevier Ltd. All rights reserved.

Practice-centred evaluation and the privileging of care in health information technology evaluation.

PubMed

Darking, Mary; Anson, Rachel; Bravo, Ferdinand; Davis, Julie; Flowers, Steve; Gillingham, Emma; Goldberg, Lawrence; Helliwell, Paul; Henwood, Flis; Hudson, Claire; Latimer, Simon; Lowes, Paul; Stirling, Ian

2014-06-05

Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes. Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts - can complement and in some instances offer advantages over, outcome-centric evaluation models. We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An 'action learning' approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these activities we asked: how can a practice-centred approach be embedded into evaluation of health information technologies? Organising EPR and telemedicine evaluation around predetermined outcome measures alone can be impractical given the complex and contingent nature of such projects. It also limits the extent to which unforeseen outcomes and new capabilities are recognised. Such evaluations often fail to improve understanding of 'when' and 'under what conditions' technology-enabled service improvements are realised, and crucially, how such innovation improves care. Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes.

Hardware Evaluation of the Horizontal Exercise Fixture with Weight Stack

NASA Technical Reports Server (NTRS)

Newby, Nate; Leach, Mark; Fincke, Renita; Sharp, Carwyn

2009-01-01

HEF with weight stack seems to be a very sturdy and reliable exercise device that should function well in a bed rest training setting. A few improvements should be made to both the hardware and software to improve usage efficiency, but largely, this evaluation has demonstrated HEF's robustness. The hardware offers loading to muscles, bones, and joints, potentially sufficient to mitigate the loss of muscle mass and bone mineral density during long-duration bed rest campaigns. With some minor modifications, the HEF with weight stack equipment provides the best currently available means of performing squat, heel raise, prone row, bench press, and hip flexion/extension exercise in a supine orientation.

Potential Bedside Utility of the Clock-Drawing Test in Evaluating Rapid Therapeutic Response in the Natural Course of Schizophrenia: A Preliminary Study.

PubMed

Ransing, Ramdas Sarjerao; Khairkar, Praveen Homdeorao; Mishra, Kshirod; Sakekar, Gajanan

2017-01-01

The Clock-Drawing Test (CDT) is a brief, relatively time-efficient, easy to administer at bedside, and well-proven cognitive screening test that assesses a broad range of cognitive abilities in stroke, delirium, and dementia. However, challenges of comprehensive therapeutic outcome evaluations in schizophrenia can also be potentially overcome using CDT. The authors aimed to measure the therapeutic outcome using CDT in 101 schizophrenia patients, irrespective of their diagnostic subtypes. A repeated measures analysis of variance found that improvements on CDT and the Positive and Negative Syndrome Scale were closely correlated, reflecting critical information about therapeutic response measures in schizophrenia.

Evidence-based practice: evaluation and management of unilateral vocal fold paralysis.

PubMed

Misono, Stephanie; Merati, Albert L

2012-10-01

This article discusses the causes and symptoms, evaluation, and management of unilateral vocal fold paralysis (UVFP). Cross-sectional imaging is appropriate in the work-up of idiopathic UVFP, but the routine use of serology is not well supported. The usefulness of laryngeal electromyography has remained controversial. Predictors of poor prognosis for functionally meaningful recovery include fibrillation potentials, positive sharp waves, and absent/reduced voluntary motor unit potentials. Voice therapy may be helpful. Injection and laryngeal framework surgery (medialization thyroplasty) improve vocal quality. The vocal impact of laryngeal reinnervation is comparable with that of medialization. Some patients may benefit from multiple procedures. Copyright © 2012 Elsevier Inc. All rights reserved.

Real-time monitoring through the use of technology to enhance performances throughout HIV cascades.

PubMed

Avery, Matthew; Mills, Stephen J; Stephan, Eric

2017-09-01

Controlling the HIV epidemic requires strong linkages across a 'cascade' of prevention, testing, and treatment services. Information and communications technology (ICT) offers the potential to monitor and improve the performance of this HIV cascade in real time. We assessed recent (<18 months) peer-reviewed publications regarding uses of ICT to improve performance through expanded and targeted reach, improved clinical service delivery, and reduced loss to follow-up. Research on ICT has tended to focus on a specific 'silo' of the HIV cascade rather than on tracking individuals or program performance across the cascade. Numerous innovations have been described, including use of social media to expand reach and improve programmatic targeting; technology in healthcare settings to strengthen coordination, guide clinical decision-making and improve clinical interactions; and telephone-based follow-up to improve treatment retention and adherence. With exceptions, publications have tended to be descriptive rather than evaluative, and the evidence-base for the effectiveness of ICT-driven interventions remains mixed. There is widespread recognition of the potential for ICT to improve HIV cascade performance, but with significant challenges. Successful implementation of real-time cascade monitoring will depend upon stakeholder engagement, compatibility with existing workflows, appropriate resource allocation, and managing expectations.

Evaluating a federated medical search engine: tailoring the methodology and reporting the evaluation outcomes.

PubMed

Saparova, D; Belden, J; Williams, J; Richardson, B; Schuster, K

2014-01-01

Federated medical search engines are health information systems that provide a single access point to different types of information. Their efficiency as clinical decision support tools has been demonstrated through numerous evaluations. Despite their rigor, very few of these studies report holistic evaluations of medical search engines and even fewer base their evaluations on existing evaluation frameworks. To evaluate a federated medical search engine, MedSocket, for its potential net benefits in an established clinical setting. This study applied the Human, Organization, and Technology (HOT-fit) evaluation framework in order to evaluate MedSocket. The hierarchical structure of the HOT-factors allowed for identification of a combination of efficiency metrics. Human fit was evaluated through user satisfaction and patterns of system use; technology fit was evaluated through the measurements of time-on-task and the accuracy of the found answers; and organization fit was evaluated from the perspective of system fit to the existing organizational structure. Evaluations produced mixed results and suggested several opportunities for system improvement. On average, participants were satisfied with MedSocket searches and confident in the accuracy of retrieved answers. However, MedSocket did not meet participants' expectations in terms of download speed, access to information, and relevance of the search results. These mixed results made it necessary to conclude that in the case of MedSocket, technology fit had a significant influence on the human and organization fit. Hence, improving technological capabilities of the system is critical before its net benefits can become noticeable. The HOT-fit evaluation framework was instrumental in tailoring the methodology for conducting a comprehensive evaluation of the search engine. Such multidimensional evaluation of the search engine resulted in recommendations for system improvement.

Prostate Dose Escalation by Innovative Inverse Planning-Driven IMRT

DTIC Science & Technology

2007-11-01

The image data can also, potentially , be used for dose reconstruction in combination with the fluence maps from treatment plan. Here we evaluate the...a course of radiation therapy, the accuracy of the patient setup can potentially be improved. Furthermore, the CBCT provides a pre-treatment patient...of breathing on the movement and modeling of lung tumors Int. J. Radiat. Oncol. Biol. Phys. 58 1251–7 Balter J M, Wright J N, Newell L J, Friemel B

Business Case Analysis of the Towed Gilder Air Launched System (TGALS)

NASA Technical Reports Server (NTRS)

Webb, Darryl W.; Nguyen, McLinton B.; Seibold, Robert W.; Wong, Frank C.; Budd, Gerald D.

2017-01-01

The Aerospace Corporation developed an integrated Business Case Analysis (BCA) model on behalf of the NASA Armstrong Flight Research Center (AFRC). This model evaluated the potential profitability of the Towed Glider Air Launched System (TGALS) concept, under development at AFRC, identifying potential technical, programmatic, and business decisions that could improve its business viability. The model addressed system performance metrics; development, production and operation cost estimates; market size and product service positioning; pricing alternatives; and market share.

Octa-arginine modified poly(amidoamine) dendrimers for improved delivery and cytotoxic effect of paclitaxel in cancer.

PubMed

Rompicharla, Sri Vishnu Kiran; Kumari, Preeti; Ghosh, Balaram; Biswas, Swati

2018-05-23

Cell penetrating peptides (CPP) have the ability to penetrate the cell membrane and have been associated with various cargos for their facile intracellular translocation. The current study involves the synthesis of a CPP, octa-arginine (R8)-modified poly(amidoamine) dendrimer of generation 4 (G4), which has additionally been PEGylated and conjugated to the poorly soluble anticancer drug, paclitaxel (PTX). The synthesized dendrimer conjugates were characterized by proton nuclear magnetic resonance (1H-NMR) Spectroscopy and zeta potential measurements and evaluated in vitro in cell monolayers and 3D spheroids. Cellular uptake study in human cervical cancer cell line (HeLa) revealed that R8 modification significantly improved the cell association of conjugates. G4-PTX- polyethylene glycol (PEG)-R8 conjugate demonstrated enhanced cytotoxic potential and higher induction of apoptosis compared to free PTX and G4-PTX-PEG. Further, the penetrability of fluorescently labeled F-G4-PTX-PEG-R8 was evaluated in 3D spheroids of HeLa at various depths by using confocal microscopy. G4-PTX-PEG-R8 induced cell death and inhibited the growth in 3D spheroids as competently as in monolayers. The enhanced intracellular translocation of R8-modified dendrimers resulted in improved anticancer efficacy of PTX. Therefore, the newly developed dendrimer system is efficient for the intracellular delivery of PTX in cancer cells and has a strong potential to be utilized as an effective chemotherapeutic agent for cancer.

Beta-glucan-loaded nanofiber dressing improves wound healing in diabetic mice.

PubMed

Grip, Jostein; Engstad, Rolf Einar; Skjæveland, Ingrid; Škalko-Basnet, Nataša; Isaksson, Johan; Basnet, Purusotam; Holsæter, Ann Mari

2018-06-01

The increased prevalence of chronic wounds requires novel treatment options. The aim of this study was to develop a beta-glucan (βG)-loaded nanofiber wound dressing. Nanofibers were prepared using the needle-free Nanospider™ technology, an electrospinning method which enables the production of nanofibers at an industrial scale. The βG was selected as active ingredient based on its confirmed wound healing potential in both animals and humans. Hydroxypropyl methylcellulose (HPMC) and polyethylene oxide (PEO) were included as copolymers. Rheological profiles of spinning solutions containing HPMC, PEO, βG, ethanol and water, were optimized. The nanofiber formation was confirmed by Field Emission Scanning Electron Microscopy (FE-SEM), and both nanofibers with (βG-nanofibers) or without βG (NoβG-nanofibers) were evaluated by their swelling index and FT-IR spectroscopy. The formulations, active ingredient and excipients were tested for their possible in vitro toxicity in keratinocytes. Finally, the wound healing potential of the nanofibers was tested in externally induced excisional wounds in male diabetic db/db mice. Three different doses of βG-nanofibers and the βG-free, NoβG-nanofibers, were evaluated for their in vivo wound healing efficacy. All nanofiber-treatments provided improved wound healing as compared to the negative control (water). All βG-nanofiber treated groups exhibited significantly improved wound healing as compared to the NoβG-nanofiber treated group, indicating the potential of βG-nanofibers as wound dressing. Copyright © 2018 Elsevier B.V. All rights reserved.

Influence of organic matter on arsenic removal by continuous flow electrocoagulation treatment of weakly mineralized waters.

PubMed

Pallier, Virginie; Feuillade-Cathalifaud, Geneviève; Serpaud, Bernard

2011-03-01

The aim of this study is to evaluate and understand the electrocoagulation/flocculation (ECF) process to remove arsenic from both model and natural waters with low mineral content and to compare its performances to the coagulation/flocculation (CF) process already optimized. Experiments were thus conducted with iron electrodes in the same specific treatment conditions (4≤current density (mAcm(-2))≤33) to study the influence of organic matter on arsenic removal in conditions avoiding the oxidation step usually required to improve As(III) removal. The process performance was evaluated by combining quantification of arsenic residual concentrations and speciation and dissolved organic carbon residual concentrations with zeta potential and turbidity measurements. When compared to CF, ECF presented several disadvantages: (i) lower As(V) removal yield because of the ferrous iron dissolved from the anode and the subsequent negative zeta potential of the colloidal suspension, (ii) higher residual DOC concentrations because of the fractionation of high molecular weight compounds during the treatment leading to compounds less prone to coagulate and (iii) higher residual turbidities because of the charge neutralization mechanisms involved. However, during this process, As(III) was oxidized to As(V) improving considerably its removal whatever the matrix conditions. ECF thus allowed to improve As(III) removal without applying an oxidation step that could potentially lead to the formation of toxic oxidation by-products. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effects of Limited Hydrolysis and High-Pressure Homogenization on Functional Properties of Oyster Protein Isolates.

PubMed

Yu, Cuiping; Cha, Yue; Wu, Fan; Xu, Xianbing; Du, Ming

2018-03-22

In this study, the effects of limited hydrolysis and/or high-pressure homogenization (HPH) treatment in acid conditions on the functional properties of oyster protein isolates (OPI) were studied. Protein solubility, surface hydrophobicity, particle size distribution, zeta potential, foaming, and emulsifying properties were evaluated. The results showed that acid treatment led to the dissociation and unfolding of OPI. Subsequent treatment such as limited proteolysis, HPH, and their combination remarkably improved the functional properties of OPI. Acid treatment produced flexible aggregates, as well as reduced particle size and solubility. On the contrary, limited hydrolysis increased the solubility of OPI. Furthermore, HPH enhanced the effectiveness of the above treatments. The emulsifying and foaming properties of acid- or hydrolysis-treated OPI significantly improved. In conclusion, a combination of acid treatment, limited proteolysis, and HPH improved the functional properties of OPI. The improvements in the functional properties of OPI could potentiate the use of oyster protein and its hydrolysates in the food industry.

The Water Reuse project: Sustainable waste water re-use technologies for irrigated land in NIS and southern European states; project overview and results.

NASA Astrophysics Data System (ADS)

van den Elsen, E.; Doerr, S.; Ritsema, C. J.

2009-04-01

In irrigated areas in the New Independent States (NIS) and southern European States, inefficient use of conventional water resources occurs through incomplete wetting of soils, which causes accelerated runoff and preferential flow, and also through excessive evaporation associated with unhindered capillary rise. Furthermore, a largely unexploited potential exists to save conventional irrigation water by supplementation with organic-rich waste water, which, if used appropriately, can also lead to improvements to soil physical properties and soil nutrient and organic matter content. This project aims to (a) reduce irrigation water losses by developing, evaluating and promoting techniques that improve the wetting properties of soils, and (b) investigate the use of organic-rich waste water as a non-conventional water resource in irrigation and, in addition, as a tool in improving soil physical properties and soil nutrient and organic matter content. Key activities include (i) identifying, for the NIS and southern European partner countries, the soil type/land use combinations, for which the above approaches are expected to be most effective and their implementation most feasible, using physical and socio-economic research methods, and (ii) examining the water saving potential, physical, biological and chemical effects on soils of the above approaches, and also their impact on performance. Expected outputs include techniques for sustainable improvements in soil wettability management as a novel approach in water saving, detailed evaluation of the prospects and effects of using supplemental organic-rich waste waters in irrigation, an advanced process-based numerical hydrological model, fully adapted to quantify and upscale resulting water savings and nutrient and potential contaminant fluxes for irrigated areas, and identification of suitable areas in the NIS and Mediterranean (in soil, land use, legislative and socio-economic terms) for implementation.

Familiar auditory sensory training in chronic traumatic brain injury: a case study.

PubMed

Sullivan, Emily Galassi; Guernon, Ann; Blabas, Brett; Herrold, Amy A; Pape, Theresa L-B

2018-04-01

The evaluation and treatment for patients with prolonged periods of seriously impaired consciousness following traumatic brain injury (TBI), such as a vegetative or minimally conscious state, poses considerable challenges, particularly in the chronic phases of recovery. This blinded crossover study explored the effects of familiar auditory sensory training (FAST) compared with a sham stimulation in a patient seven years post severe TBI. Baseline data were collected over 4 weeks to account for variability in status with neurobehavioral measures, including the Disorders of Consciousness scale (DOCS), Coma Near Coma scale (CNC), and Consciousness Screening Algorithm. Pre-stimulation neurophysiological assessments were completed as well, namely Brainstem Auditory Evoked Potentials (BAEP) and Somatosensory Evoked Potentials (SSEP). Results revealed that a significant improvement in the DOCS neurobehavioral findings after FAST, which was not maintained during the sham. BAEP findings also improved with maintenance of these improvements following sham stimulation as evidenced by repeat testing. The results emphasize the importance for continued evaluation and treatment of individuals in chronic states of seriously impaired consciousness with a variety of tools. Further study of auditory stimulation as a passive treatment paradigm for this population is warranted. Implications for Rehabilitation Clinicians should be equipped with treatment options to enhance neurobehavioral improvements when traditional treatment methods fail to deliver or maintain functional behavioral changes. Routine assessment is crucial to detect subtle changes in neurobehavioral function even in chronic states of disordered consciousness and determine potential preserved cognitive abilities that may not be evident due to unreliable motor responses given motoric impairments. Familiar Auditory Stimulation Training (FAST) is an ideal passive stimulation that can be supplied by families, allied health clinicians and nursing staff of all levels.

A Case Study on Improving Intensive Care Unit (ICU) Services Reliability: By Using Process Failure Mode and Effects Analysis (PFMEA)

PubMed Central

Yousefinezhadi, Taraneh; Jannesar Nobari, Farnaz Attar; Goodari, Faranak Behzadi; Arab, Mohammad

2016-01-01

Introduction: In any complex human system, human error is inevitable and shows that can’t be eliminated by blaming wrong doers. So with the aim of improving Intensive Care Units (ICU) reliability in hospitals, this research tries to identify and analyze ICU’s process failure modes at the point of systematic approach to errors. Methods: In this descriptive research, data was gathered qualitatively by observations, document reviews, and Focus Group Discussions (FGDs) with the process owners in two selected ICUs in Tehran in 2014. But, data analysis was quantitative, based on failures’ Risk Priority Number (RPN) at the base of Failure Modes and Effects Analysis (FMEA) method used. Besides, some causes of failures were analyzed by qualitative Eindhoven Classification Model (ECM). Results: Through FMEA methodology, 378 potential failure modes from 180 ICU activities in hospital A and 184 potential failures from 99 ICU activities in hospital B were identified and evaluated. Then with 90% reliability (RPN≥100), totally 18 failures in hospital A and 42 ones in hospital B were identified as non-acceptable risks and then their causes were analyzed by ECM. Conclusions: Applying of modified PFMEA for improving two selected ICUs’ processes reliability in two different kinds of hospitals shows that this method empowers staff to identify, evaluate, prioritize and analyze all potential failure modes and also make them eager to identify their causes, recommend corrective actions and even participate in improving process without feeling blamed by top management. Moreover, by combining FMEA and ECM, team members can easily identify failure causes at the point of health care perspectives. PMID:27157162

A high performing brain-machine interface driven by low-frequency local field potentials alone and together with spikes

NASA Astrophysics Data System (ADS)

Stavisky, Sergey D.; Kao, Jonathan C.; Nuyujukian, Paul; Ryu, Stephen I.; Shenoy, Krishna V.

2015-06-01

Objective. Brain-machine interfaces (BMIs) seek to enable people with movement disabilities to directly control prosthetic systems with their neural activity. Current high performance BMIs are driven by action potentials (spikes), but access to this signal often diminishes as sensors degrade over time. Decoding local field potentials (LFPs) as an alternative or complementary BMI control signal may improve performance when there is a paucity of spike signals. To date only a small handful of LFP decoding methods have been tested online; there remains a need to test different LFP decoding approaches and improve LFP-driven performance. There has also not been a reported demonstration of a hybrid BMI that decodes kinematics from both LFP and spikes. Here we first evaluate a BMI driven by the local motor potential (LMP), a low-pass filtered time-domain LFP amplitude feature. We then combine decoding of both LMP and spikes to implement a hybrid BMI. Approach. Spikes and LFP were recorded from two macaques implanted with multielectrode arrays in primary and premotor cortex while they performed a reaching task. We then evaluated closed-loop BMI control using biomimetic decoders driven by LMP, spikes, or both signals together. Main results. LMP decoding enabled quick and accurate cursor control which surpassed previously reported LFP BMI performance. Hybrid decoding of both spikes and LMP improved performance when spikes signal quality was mediocre to poor. Significance. These findings show that LMP is an effective BMI control signal which requires minimal power to extract and can substitute for or augment impoverished spikes signals. Use of this signal may lengthen the useful lifespan of BMIs and is therefore an important step towards clinically viable BMIs.

Evaluating a Federated Medical Search Engine

PubMed Central

Belden, J.; Williams, J.; Richardson, B.; Schuster, K.

2014-01-01

Summary Background Federated medical search engines are health information systems that provide a single access point to different types of information. Their efficiency as clinical decision support tools has been demonstrated through numerous evaluations. Despite their rigor, very few of these studies report holistic evaluations of medical search engines and even fewer base their evaluations on existing evaluation frameworks. Objectives To evaluate a federated medical search engine, MedSocket, for its potential net benefits in an established clinical setting. Methods This study applied the Human, Organization, and Technology (HOT-fit) evaluation framework in order to evaluate MedSocket. The hierarchical structure of the HOT-factors allowed for identification of a combination of efficiency metrics. Human fit was evaluated through user satisfaction and patterns of system use; technology fit was evaluated through the measurements of time-on-task and the accuracy of the found answers; and organization fit was evaluated from the perspective of system fit to the existing organizational structure. Results Evaluations produced mixed results and suggested several opportunities for system improvement. On average, participants were satisfied with MedSocket searches and confident in the accuracy of retrieved answers. However, MedSocket did not meet participants’ expectations in terms of download speed, access to information, and relevance of the search results. These mixed results made it necessary to conclude that in the case of MedSocket, technology fit had a significant influence on the human and organization fit. Hence, improving technological capabilities of the system is critical before its net benefits can become noticeable. Conclusions The HOT-fit evaluation framework was instrumental in tailoring the methodology for conducting a comprehensive evaluation of the search engine. Such multidimensional evaluation of the search engine resulted in recommendations for system improvement. PMID:25298813

Active drug safety surveillance: a tool to improve public health.

PubMed

Platt, Richard; Madre, Leanne; Reynolds, Robert; Tilson, Hugh

2008-12-01

Ensuring that drugs have an acceptable safety profile and are used safely is a major public health priority. The Centers for Education and Research on Therapeutics (CERTs) convened experts from academia, government, and industry to assess strategies to increase the speed and predictive value of generating and evaluating safety signals, and to identify next steps to improve the US system for identifying and evaluating potential safety signals. The CERTs convened a think tank comprising representatives of the groups noted above to address these goals. Participants observed that, with the increasing availability of electronic health data, opportunities have emerged to more accurately characterize and confirm potential safety issues. The gain for public health from a highly coordinated network of population-based databases for active surveillance is great and within reach, although operational questions remain. A collaborative network must create a working definition of a safety signal, screening algorithms, and criteria and strategies to confirm or refute a signal once identified through screening. Guidelines are needed for when and how to communicate a signal exists and is being evaluated, as well as the outcome of that evaluation. A public-private partnership to create a network of government and private databases to routinely evaluate and prioritize safety questions is in the public interest. Better methods are needed, and a knowledgeable workforce is required to conduct the surveillance and understand how to interpret the results. The international community will benefit from the availability of better methods and more experts. Copyright (c) 2008 John Wiley & Sons, Ltd.

Impaired growth and development of Colorado potato beetle larvae on potato plants overexpressing the oryzacystatin II gene

USDA-ARS?s Scientific Manuscript database

Plant proteinase inhibitors are attractive tools for crop improvement and their heterologous expression can enhance insect resistance in transgenic plants. Oryzacystatins I and II (OCI and OCII) show potential in controlling pests that utilize cysteine proteinases for protein digestion. To evaluate ...

Biodiesel from corn distillers dried grains with solubles: preparation, evaluation and properties

USDA-ARS?s Scientific Manuscript database

Corn distillers’ dried grains with solubles (DDGS) is a co-product of dry-grind ethanol fermentation and represents a low-cost feedstock with potential to improve process economics and logistics of biodiesel manufacture through integration of biodiesel and ethanol production. Oil extracted from DDGS...

Applying isozyme analyses in tree-breeding programs

Treesearch

W. T. Adams

1981-01-01

Four examples illustrate the potential for practical use of isozyme analyses in applied breeding programs. These include identifying parent trees and clones, seed sources, and parentage of controlled crosses, and evaluating the effectiveness of different procedures involving open-pollination to produce seed of specific crosses. The improved ability to assess the true...

Femoral and carotid subclinical atherosclerosis association with risk factors and coronary calcium: the AWHS study

USDA-ARS?s Scientific Manuscript database

BACKGROUND: Early subclinical atherosclerosis has been mainly researched in carotid arteries. The potential value of femoral arteries for improving the predictive capacity of traditional risk factors is an understudied area. OBJECTIVES: This study sought to evaluate the association of subclinical ca...

Methods for identifying high collision concentration locations (HCCL) for potential safety improvements : phase II, Evaluation of alternative methods for identifying HCCL.

DOT National Transportation Integrated Search

2011-01-01

The objective of network screening should ideally be to not only identify sites for safety : investigation but also to prioritize those sites efficiently. Using roadway, intersection, and : collision data from California, this study compared the perf...

Oral Health Promotion in Schools: Rationale and Evaluation

ERIC Educational Resources Information Center

Kizito, Alex; Caitlin, Meredith; Wang, Yili; Kasangaki, Arabat; Macnab, Andrew J.

2014-01-01

Purpose: The purpose of this paper is to explain the rationale and potential for the WHO health promoting schools (HPS) to improve children's oral health, and describe validated quantitative methodologies and qualitative approaches to measure program impact. Design/Methodology/Approach: Critical discussion of the impact of poor oral health and…

Spatial and temporal variation of fecal indicator organisms in two creeks in Beltsville, Maryland

USDA-ARS?s Scientific Manuscript database

Evaluation of microbial water quality is commonly achieved by monitoring populations of indicator bacteria such as E. coli and enterococci. Monitoring data are utilized by water managers to predict potential fecal contaminations as well as a decision tool to improve microbial water quality. Both te...

Current limitations and a path forward to improve testing for the environmental assessment of endocrine active substances-presentation

EPA Science Inventory

To assess the hazards and risks of possible endocrine active chemicals (EACs), there is a need for robust, validated test methods that detect perturbations of endocrine pathways and provide reliable information for evaluating potential adverse effects on apical endpoints. One iss...

A Role for Technology in Enhancing Students' Engagement with Feedback

ERIC Educational Resources Information Center

Parkin, Helen J.; Hepplestone, Stuart; Holden, Graham; Irwin, Brian; Thorpe, Louise

2012-01-01

This paper explores the potential of technology-enabled feedback to improve student learning. "Technology, Feedback, Action!: The impact of learning technology upon students' engagement with their feedback" aimed to evaluate how a range of technical interventions might encourage students to engage with feedback and formulate actions to…

20171130_Ind Ergo Report_631 DI Water Movement Process.

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

Rivera, Cynthia R.

Perform an industrial ergonomic assessment to evaluate the new procedures for filling, lifting, and delivering high purity de-ionized water to building 9925. The goal was to improve on the previous method by minimizing/eliminating as much lifting and bending as possible to reduce the potential for overexertion-related injuries.

Soil health, crop productivity, microbial transport, and mine spoil response to biochars

USDA-ARS?s Scientific Manuscript database

Biochar is being evaluated by scientists from the United States Department of Agriculture (USDA) Agricultural Research Service (ARS) for its potential to sequester soil C, to improve soil health, and to increase crop yields. ARS scientists from multiple locations such as Florence, SC, Kimberly, ID,...

Improving trapping systems for early detection and eradication of fruit flies (Diptera: Tephritidae) in California

USDA-ARS?s Scientific Manuscript database

Solid Mallet TMR (trimedlure [TML], methyl eugenol [ME], raspberry ketone [RK]) wafers and Mallet CMR (ceralure, ME, RK, benzyl acetate) wafers impregnated with DDVP insecticide were evaluated in traps as potential detection and male annihilation devices. Comparisons were made with 1) liquid lure an...

WETLANDS AND WATER QUALITY TRADING: REVIEW OF CURRENT SCIENCE AND ECONOMIC PRACTICES WITH SELECTED CASE STUDIES

EPA Science Inventory

The study evaluates the technical, economic, and administrative aspects of establishing water quality trading (WQT) programs where the nutrient removal capacity of wetlands is used to improve water quality. WQT is a potentially viable approach for wastewater dischargers to cost-e...

Evaluation of factors affecting nitrous oxide emission and N transformation in a sandy loam soil

USDA-ARS?s Scientific Manuscript database

A better understanding of the complex factors affecting nitrous oxide (N2O) emission and potential mitigation practices will assist in developing strategies to improve the sustainability of agricultural production systems. Using surface soil collected from a pomegranate orchard, a series of laborato...

Description of recovery method used for curdlan produced by Agrobacterium sp. IFO 13140 and its relation to the morphology and physicochemical and technological properties of the polysaccharide

PubMed Central

Mangolim, Camila Sampaio; da Silva, Thamara Thaiane; Fenelon, Vanderson Carvalho; Koga, Luciana Numata; Ferreira, Sabrina Barbosa de Souza; Bruschi, Marcos Luciano; Matioli, Graciette

2017-01-01

Curdlan is a linear polysaccharide considered a dietary fiber and with gelation properties. This study evaluated the structure, morphology and the physicochemical and technological properties of curdlan produced by Agrobacterium sp. IFO 13140 recovered by pre-gelation and precipitation methods. Commercial curdlan submitted or otherwise to the pre-gelation process was also evaluated. The data obtained from structural analysis revealed a similarity between the curdlan produced by Agrobacterium sp. IFO 13140 (recovered by both methods) and the commercial curdlans. The results showed that the curdlans evaluated differed significantly in terms of dispersibility and gelation, and only the pre-gelled ones had significant potential for food application, because this method influence on the size of the particles and in the presence of NaCl. In terms of technological properties, the curdlan produced by Agrobacterium sp. IFO 13140 (pre-gelation method) had a greater water and oil holding capacity (64% and 98% greater, respectively) and a greater thickening capacity than the pre-gelled commercial curdlan. The pre-gelled commercial curdlan displayed a greater gelling capacity at 95°C than the others. When applied to food, only the pre-gelled curdlans improved the texture parameters of yogurts and reduced syneresis. The curdlan gels, which are rigid and stable in structure, demonstrated potential for improving the texture of food products, with potential industrial use. PMID:28245244

Description of recovery method used for curdlan produced by Agrobacterium sp. IFO 13140 and its relation to the morphology and physicochemical and technological properties of the polysaccharide.

PubMed

Mangolim, Camila Sampaio; Silva, Thamara Thaiane da; Fenelon, Vanderson Carvalho; Koga, Luciana Numata; Ferreira, Sabrina Barbosa de Souza; Bruschi, Marcos Luciano; Matioli, Graciette

2017-01-01

Curdlan is a linear polysaccharide considered a dietary fiber and with gelation properties. This study evaluated the structure, morphology and the physicochemical and technological properties of curdlan produced by Agrobacterium sp. IFO 13140 recovered by pre-gelation and precipitation methods. Commercial curdlan submitted or otherwise to the pre-gelation process was also evaluated. The data obtained from structural analysis revealed a similarity between the curdlan produced by Agrobacterium sp. IFO 13140 (recovered by both methods) and the commercial curdlans. The results showed that the curdlans evaluated differed significantly in terms of dispersibility and gelation, and only the pre-gelled ones had significant potential for food application, because this method influence on the size of the particles and in the presence of NaCl. In terms of technological properties, the curdlan produced by Agrobacterium sp. IFO 13140 (pre-gelation method) had a greater water and oil holding capacity (64% and 98% greater, respectively) and a greater thickening capacity than the pre-gelled commercial curdlan. The pre-gelled commercial curdlan displayed a greater gelling capacity at 95°C than the others. When applied to food, only the pre-gelled curdlans improved the texture parameters of yogurts and reduced syneresis. The curdlan gels, which are rigid and stable in structure, demonstrated potential for improving the texture of food products, with potential industrial use.

Empowerment evaluation: a collaborative approach to evaluating and transforming a medical school curriculum.

PubMed

Fetterman, David M; Deitz, Jennifer; Gesundheit, Neil

2010-05-01

Medical schools continually evolve their curricula to keep students abreast of advances in basic, translational, and clinical sciences. To provide feedback to educators, critical evaluation of the effectiveness of these curricular changes is necessary. This article describes a method of curriculum evaluation, called "empowerment evaluation," that is new to medical education. It mirrors the increasingly collaborative culture of medical education and offers tools to enhance the faculty's teaching experience and students' learning environments. Empowerment evaluation provides a method for gathering, analyzing, and sharing data about a program and its outcomes and encourages faculty, students, and support personnel to actively participate in system changes. It assumes that the more closely stakeholders are involved in reflecting on evaluation findings, the more likely they are to take ownership of the results and to guide curricular decision making and reform. The steps of empowerment evaluation include collecting evaluation data, designating a "critical friend" to communicate areas of potential improvement, establishing a culture of evidence, encouraging a cycle of reflection and action, cultivating a community of learners, and developing reflective educational practitioners. This article illustrates how stakeholders used the principles of empowerment evaluation to facilitate yearly cycles of improvement at the Stanford University School of Medicine, which implemented a major curriculum reform in 2003-2004. The use of empowerment evaluation concepts and tools fostered greater institutional self-reflection, led to an evidence-based model of decision making, and expanded opportunities for students, faculty, and support staff to work collaboratively to improve and refine the medical school's curriculum.

Fermentation of cacao (Theobroma cacao L.) seeds with a hybrid Kluyveromyces marxianus strain improved product quality attributes.

PubMed

Leal, Gildemberg Amorim; Gomes, Luiz Humberto; Efraim, Priscilla; de Almeida Tavares, Flavio Cesar; Figueira, Antonio

2008-08-01

Fermentation of Theobroma cacao (cacao) seeds is an absolute requirement for the full development of chocolate flavor precursors. An adequate aeration of the fermenting cacao seed mass is a fundamental prerequisite for a satisfactory fermentation. Here, we evaluated whether a controlled inoculation of cacao seed fermentation using a Kluyveromyces marxianus hybrid yeast strain, with an increased pectinolytic activity, would improve an earlier liquid drainage ('sweatings') from the fermentation mass, developing a superior final product quality. Inoculation with K. marxianus increased by one third the volume of drained liquid and affected the microorganism population structure during fermentation, which was detectable up to the end of the process. Introduction of the hybrid yeast affected the profile of total seed protein degradation evaluated by polyacrylamide gel electrophoresis, with improved seed protein degradation, and reduction of titrable acidity. Sensorial evaluation of the chocolate obtained from beans fermented with the K. marxianus inoculation was more accepted by analysts in comparison with the one from cocoa obtained through natural fermentation. The increase in mass aeration during the first 24 h seemed to be fundamental for the improvement of fermentation quality, demonstrating the potential application of this improved hybrid yeast strain with superior exogenous pectinolytic activity.

An evaluation of the use of ERTS-1 satellite imagery for grizzly bear habitat analysis. [Montana

NASA Technical Reports Server (NTRS)

Varney, J. R.; Craighead, J. J.; Sumner, J. S.

1974-01-01

Improved classification and mapping of grizzly habitat will permit better estimates of population density and distribution, and allow accurate evaluation of the potential effects of changes in land use, hunting regulation, and management policies on existing populations. Methods of identifying favorable habitat from ERTS-1 multispectral scanner imagery were investigated and described. This technique could reduce the time and effort required to classify large wilderness areas in the Western United States.

Summary of gas bearing applications in the field of space electric power systems

NASA Technical Reports Server (NTRS)

Dunn, J. H.; Ream, L. W.

1972-01-01

The testing and evaluation of different bearing systems to be used in the turbine-alternator-compressor of a closed Brayton cycle electric power system are described. A specification of each bearing is presented along with the results of the evaluation and a comparison of the merits and limitations of each bearing. The contribution of improved bearings to the power supply reliability, potential life, and ability to accept shock and vibration is examined.

Study of unconventional aircraft engines designed for low energy consumption

NASA Technical Reports Server (NTRS)

Gray, D. E.

1976-01-01

Declining U.S. oil reserves and escalating energy costs underline the need for reducing fuel consumption in aircraft engines. The most promising unconventional aircraft engines based on their potential for fuel savings and improved economics are identified. The engines installed in both a long-range and medium-range aircraft were evaluated. Projected technology advances are identified and evaluated for their state-of-readiness for application to a commercial transport. Programs are recommended for developing the necessary technology.

Mobile health technology evaluation: the mHealth evidence workshop.

PubMed

Kumar, Santosh; Nilsen, Wendy J; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R Craig; Mohr, David C; Murphy, Susan A; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

2013-08-01

Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

[Study on method and its optimization of improving seed germination of Astragalus membranaceus as gansu traditional medicinal herb].

PubMed

Shi, Li-Ping; Ou, Qiao-Ming; Cui, Wen-Juan; Chen, Yu-Liang

2014-04-01

To break the hard testa and improve seed germination situation of Astragalus membranaceus var. mongholicus, in order to solve the problems of low success rate of seed germination and seedling. Longxi Astragalus membranaceus var. mongholicus seed was treated by soaking seed with 75% alcohol and concentrated sulfuric acid, warm-water incubating, grinding and comprehensive treating with warm-water incubating, grinding and sand culture. Its seed germination situation was evaluated by germination potential, germination rate and germination index. Different processing methods significantly improved seed germination with different effect. Comprehensive treatment with warm-water incubating, grinding and sand culture was the best one on Astragalus membranaceus var. mongholicus seed germination. Its germination potential, germination rate and germination index was 66.04%, 87.70% and 1.34,respectively. Comprehensive treatment with warm-water incubating, grinding and sand culture is an economic and effective processing method, which is suitable for actual production.

Critical steps in learning from incidents: using learning potential in the process from reporting an incident to accident prevention.

PubMed

Drupsteen, Linda; Groeneweg, Jop; Zwetsloot, Gerard I J M

2013-01-01

Many incidents have occurred because organisations have failed to learn from lessons of the past. This means that there is room for improvement in the way organisations analyse incidents, generate measures to remedy identified weaknesses and prevent reoccurrence: the learning from incidents process. To improve that process, it is necessary to gain insight into the steps of this process and to identify factors that hinder learning (bottlenecks). This paper presents a model that enables organisations to analyse the steps in a learning from incidents process and to identify the bottlenecks. The study describes how this model is used in a survey and in 3 exploratory case studies in The Netherlands. The results show that there is limited use of learning potential, especially in the evaluation stage. To improve learning, an approach that considers all steps is necessary.

Potential Utility of the Real-Time TMPA-RT Precipitation Estimates in Streamflow Prediction

NASA Technical Reports Server (NTRS)

Su, Fengge; Gao, Huilin; Huffman, George J.; Lettenmaier, Dennis P.

2010-01-01

We investigate the potential utility of the real-time Tropical Rainfall Measuring Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA-RT) data for streamflow prediction, both through direct comparisons of TMPA-RT estimates with a gridded gauge product, and through evaluation of streamflow simulations over four tributaries of La Plata Basin (LPB) in South America using the two precipitation products. Our assessments indicate that the relative accuracy and the hydrologic performance of TMPA-RT-based streamflow simulations generally improved after February 2005. The improvements in TMPA-RT since 2005 are closely related to upgrades in the TMPA-RT algorithm in early February, 2005 which include use of additional microwave sensors (AMSR-E and AMSU-B) and implementation of different calibration schemes. Our work suggests considerable potential for hydrologic prediction using purely satellite-derived precipitation estimates (no adjustments by in situ gauges) in parts of the globe where in situ observations are sparse.

The impact of advertising patient and public involvement on trial recruitment: embedded cluster randomised recruitment trial.

PubMed

Hughes-Morley, Adwoa; Hann, Mark; Fraser, Claire; Meade, Oonagh; Lovell, Karina; Young, Bridget; Roberts, Chris; Cree, Lindsey; More, Donna; O'Leary, Neil; Callaghan, Patrick; Waheed, Waquas; Bower, Peter

2016-12-08

Patient and public involvement in research (PPIR) may improve trial recruitment rates, but it is unclear how. Where trials use PPIR to improve design and conduct, many do not communicate this clearly to potential participants. Better communication of PPIR might encourage patient enrolment, as trials may be perceived as more socially valid, relevant and trustworthy. We aimed to evaluate the impact on recruitment of directly advertising PPIR to potential trial participants. This is a cluster trial, embedded within a host trial ('EQUIP') recruiting service users diagnosed with severe mental illness. The intervention was informed by a systematic review, a qualitative study, social comparison theory and a stakeholder workshop including service users and carers. Adopting Participatory Design approaches, we co-designed the recruitment intervention with PPIR partners using a leaflet to advertise the PPIR in EQUIP and sent potential participants invitations with the leaflet (intervention group) or not (control group). Primary outcome was the proportion of patients enrolled in EQUIP. Secondary outcomes included the proportions of patients who positively responded to the trial invitation. Thirty-four community mental health teams were randomised and 8182 service users invited. For the primary outcome, 4% of patients in the PPIR group were enrolled versus 5.3% of the control group. The intervention was not effective for improving recruitment rates (adjusted OR = 0.75, 95% CI = 0.53 to 1.07, p = 0.113). For the secondary outcome of positive response, the intervention was not effective, with 7.3% of potential participants in the intervention group responding positively versus 7.9% of the control group (adjusted OR = 0.74, 95% CI = 0.53 to 1.04, p = 0.082). We did not find a positive impact of directly advertising PPIR on any other outcomes. To our knowledge, this is the largest ever embedded trial to evaluate a recruitment or PPIR intervention. Advertising PPIR did not improve enrolment rates or any other outcome. It is possible that rather than advertising PPIR being the means to improve recruitment, PPIR may have an alternative impact on trials by making them more attractive, acceptable and patient-centred. We discuss potential reasons for our findings and implications for recruitment practice and research. ISRCTN, ISRCTN16488358 . Registered on 14 May 2014. Study Within A Trial, SWAT-26 . Registered on 21 January 2016.

Resveratrol Protects and Restores Endothelium-Dependent Relaxation in Hypercholesterolemic Rabbit Corpus Cavernosum.

PubMed

Murat, Nergiz; Korhan, Peyda; Kizer, Onur; Evcim, Sinem; Kefi, Aykut; Demir, Ömer; Gidener, Sedef; Atabey, Neşe; Esen, Ahmet Adil

2016-01-01

Oxidative stress dependent-decrease in nitric oxide (NO) bioavailability plays an integral role in hypercholesterolemia-induced erectile dysfunction (ED). Resveratrol has been demonstrated to exert beneficial effects against oxidative stress and improve NO bioavailability. The protective and restorative potentials of resveratrol on endothelium-dependent relaxations were evaluated in hypercholesterolemic rabbit corpus cavernosum (CC). Hypercholesterolemia was induced by administering 2% cholesterol diet (CD) (w/w) to the rabbits for 6 weeks. Two different protocols were applied to test the effects of resveratrol on hypercholesterolemia-induced ED. In Protocol-1 (P1), resveratrol was administrated to the rabbits simultaneously with CD in order to evaluate the protective effect, and for Protocol-2 (P2), resveratrol was administrated for 6 weeks after termination of CD in order to evaluate the restorative effect. Endothelium-dependent relaxations of CC were evaluated by using organ bath studies. In order to elucidate the possible molecular mechanisms, we measured endothelial NO synthase (eNOS) and phosphovasodilator-stimulated phosphoprotein (VASP) expressions and activations, NADPH oxidase, superoxide dismutase (SOD), and catalase (CAT) and glutathione peroxidase (GPx) activity in cavernosal tissues obtained at the end of the study. Resveratrol showed an improvement in the endothelium-dependent relaxation responses in vitro. We demonstrated significantly increased activatory-phosphorylation (p[S1177]-eNOS) and activated phosphovasodilator-stimulated phosphoprotein (phospho-VASP) levels, but reduced phosphorylation (p[T495]-eNOS) of eNOS and NADPH oxidase activity in the resveratrol-administered HC animals compared with hypercholesterolemic control rabbits in the P1. In the P2, resveratrol exhibited an improvement in endothelium-dependent relaxation responses and more pronounced effects on eNOS activation. Resveratrol administration, either simultaneously with HC diet or after HC, caused an improvement in the endothelium-dependent relaxation responses in the CC, suggesting its potential in both protective and restorative purposes in hypercholesterolemic rabbit CC. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Additional Development and Systems Analyses of Pneumatic Technology for High Speed Civil Transport Aircraft

NASA Technical Reports Server (NTRS)

Englar, Robert J.; Willie, F. Scott; Lee, Warren J.

1999-01-01

In the Task I portion of this NASA research grant, configuration development and experimental investigations have been conducted on a series of pneumatic high-lift and control surface devices applied to a generic High Speed Civil Transport (HSCT) model configuration to determine their potential for improved aerodynamic performance, plus stability and control of higher performance aircraft. These investigations were intended to optimize pneumatic lift and drag performance; provide adequate control and longitudinal stability; reduce separation flowfields at high angle of attack; increase takeoff/climbout lift-to-drag ratios; and reduce system complexity and weight. Experimental aerodynamic evaluations were performed on a semi-span HSCT generic model with improved fuselage fineness ratio and with interchangeable plain flaps, blown flaps, pneumatic Circulation Control Wing (CCW) high-lift configurations, plain and blown canards, a novel Circulation Control (CC) cylinder blown canard, and a clean cruise wing for reference. Conventional tail power was also investigated for longitudinal trim capability. Also evaluated was unsteady pulsed blowing of the wing high-lift system to determine if reduced pulsed mass flow rates and blowing requirements could be made to yield the same lift as that resulting from steady-state blowing. Depending on the pulsing frequency applied, reduced mass flow rates were indeed found able to provide lift augmentation at lesser blowing values than for the steady conditions. Significant improvements in the aerodynamic characteristics leading to improved performance and stability/control were identified, and the various components were compared to evaluate the pneumatic potential of each. Aerodynamic results were provided to the Georgia Tech Aerospace System Design Lab. to conduct the companion system analyses and feasibility study (Task 2) of theses concepts applied to an operational advanced HSCT aircraft. Results and conclusions from these experimental evaluations are presented herein, as are recommendations for further development and follow-on investigations. Also provided as an Appendix for reference are the basic results from the previous pneumatic HSCT investigations.

Fluorescence spectroscopy for the detection of potentially malignant disorders of the oral cavity: analysis of 30 cases

NASA Astrophysics Data System (ADS)

Francisco, A. L. N.; Correr, W. R.; Azevedo, L. H.; Galletta, V. K.; Pinto, C. A. L.; Kowalski, L. P.; Kurachi, C.

2014-01-01

Oral cancer is a major health problem worldwide and although early diagnosis of potentially malignant and malignant diseases is associated with better treatment results, a large number of cancers are initially misdiagnosed, with unfortunate consequences for long-term survival. Fluorescence spectroscopy is a noninvasive modality of diagnostic approach using induced fluorescence emission in tumors that can improve diagnostic accuracy. The objective of this study was to determine the ability to discriminate between normal oral mucosa and potentially malignant disorders by fluorescence spectroscopy. Fluorescence investigation under 408 and 532 nm excitation wavelengths was performed on 60 subjects, 30 with potentially malignant disorders and 30 volunteers with normal mucosa. Data was analyzed to correlate fluorescence patterns with clinical and histopathological diagnostics. Fluorescence spectroscopy used as a point measurement technique resulted in a great variety of spectral information. In a qualitative analysis of the fluorescence spectral characteristics of each type of injury evaluated, it was possible to discriminate between normal and abnormal oral mucosa. The results show the potential use of fluorescence spectroscopy for an improved discrimination of oral disorders.

Evaluation of emission control strategies for airfield operations at the Los Angeles and San Francisco International Airports. Final report

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

Gelinas, C.G.

1978-08-01

This report reviews potential air pollutant emission reductions which could be achieved by various strategies to control airfield operations at Los Angeles and San Francisco International Airports, and examines safety problems, cost impacts, potential fuel savings, time frame for strategy implementation, and potential regulatory and jurisdictional conflicts associated with each strategy. Airfield emission sources studied included aircraft operation in the idle, taxi, takeoff, and landing modes; ground service vehicles; fuel handling and storage; and aircraft engine maintenance. Nineteen potential strategies were identified, and seven strategies were selected for detailed analysis and examination after a preliminary evaluation. Two strategies, aircraft towingmore » and reducing the number of operating engines on the ground, appear to provide the most significant emission reduction. Both of these strategies offer potential reductions in the range of 20 to 40 percent of the carbon monoxide and nitrogen oxides which are currently emitted by ground operations. The aircraft towing strategy also offers a comparable improvement in suspended particulate matter emissions. When the overall feasibility of each strategy is evaluated, the strategy to reduce the number of operating engines appears to be the most viable since its implementation would result in fuel savings, no apparent safety problems, and it can be implemented immediately.« less

A structured framework improves clinical patient assessment and nontechnical skills of early career emergency nurses: a pre-post study using full immersion simulation.

PubMed

Munroe, Belinda; Curtis, Kate; Murphy, Margaret; Strachan, Luke; Considine, Julie; Hardy, Jennifer; Wilson, Mark; Ruperto, Kate; Fethney, Judith; Buckley, Thomas

2016-08-01

The aim of this study was to evaluate the effect of the new evidence-informed nursing assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on the quality of patient assessment and fundamental nontechnical skills including communication, decision making, task management and situational awareness. Assessment is a core component of nursing practice and underpins clinical decisions and the safe delivery of patient care. Yet there is no universal or validated system used to teach emergency nurses how to comprehensively assess and care for patients. A pre-post design was used. The performance of thirty eight emergency nurses from five Australian hospitals was evaluated before and after undertaking education in the application of the HIRAID assessment framework. Video recordings of participant performance in immersive simulations of common presentations to the emergency department were evaluated, as well as participant documentation during the simulations. Paired parametric and nonparametric tests were used to compare changes from pre to postintervention. From pre to postintervention, participant performance increases were observed in the percentage of patient history elements collected, critical indicators of urgency collected and reported to medical officers, and patient reassessments performed. Participants also demonstrated improvement in each of the four nontechnical skills categories: communication, decision making, task management and situational awareness. The HIRAID assessment framework improves clinical patient assessments performed by emergency nurses and has the potential to enhance patient care. HIRAID should be considered for integration into clinical practice to provide nurses with a systematic approach to patient assessment and potentially improve the delivery of safe patient care. © 2016 John Wiley & Sons Ltd.

The cost-effectiveness of three interventions for providing preventive services to low-income children.

PubMed

Johnson, Ben; Serban, Nicoleta; Griffin, Paul M; Tomar, Scott L

2017-12-01

We evaluated the impact of loan repayment programmes, revising Medicaid fee-for-service rates, and changing dental hygienist supervision requirements on access to preventive dental care for children in Georgia. We estimated cost savings from the three interventions of preventive care for young children after netting out the intervention cost. We used a regression model to evaluate the impact of changing the Medicaid reimbursement rates. The impact of supervision was evaluated by comparing general and direct supervision in school-based dental sealant programmes. Federal loan repayments to dentists and school-based sealant programmes (SBSPs) had lower intervention costs (with higher potential cost savings) than raising the Medicaid reimbursement rate. General supervision had costs 56% lower than direct supervision of dental hygienists for implementing a SBSP. Raising the Medicaid reimbursement rate by 10 percentage points would improve utilization by <1% and cost over $38 million. Given one parameter set, SBSPs could serve over 27 000 children with an intervention cost between $500 000 and $1.3 million with a potential cost saving of $1.1 million. Loan repayment could serve almost 13 000 children for a cost of $400 000 and a potential cost saving of $176 000. The three interventions all improved met need for preventive dental care. Raising the reimbursement rate alone would marginally affect utilization of Medicaid services but would not substantially increase acceptance of Medicaid by providers. Both loan repayment programmes and amending supervision requirements are potentially cost-saving interventions. Loan repayment programmes provide complete care to targeted areas, while amending supervision requirements of dental hygienists could provide preventive care across the state. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improved self-confidence was a mechanism of action in two geriatric trials evaluating physical interventions.

PubMed

Peduzzi, Peter; Guo, Zhenchao; Marottoli, Richard A; Gill, Thomas M; Araujo, Katy; Allore, Heather G

2007-01-01

To evaluate the mechanisms of action in two successful geriatric clinical trials that tested multicomponent physical conditioning programs and to determine whether the pathways for overall benefit were through improvement in physical ability and/or self-confidence. PREHAB and DRIVER were conducted by the Yale Pepper Center. PREHAB participants received an individualized program that focused on the impairments present (standardly tailored design); DRIVER participants received the entire intervention (global design). PREHAB enrolled 188 community-living persons, aged 75 years or older, who were physically frail but ambulatory; DRIVER enrolled 178 drivers aged 70 years or older with physical impairments associated with poor driving performance. The primary outcome for PREHAB was a disability score and for DRIVER it was a driving score; potential mediators were measures of physical ability and self-confidence. In PREHAB, pathways for the intervention were established through improvement in physical ability and self-confidence. In DRIVER, there was some evidence for a pathway through improved driving self-confidence but not through physical ability; however, the intervention effect was largely unexplained. Multicomponent physical interventions may operate through psychological mechanisms, and these mechanisms should be anticipated in trial designs so that the component effects can be suitably evaluated.

Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications.

PubMed

Novignon, Jacob; Nonvignon, Justice

2017-06-12

Health centers in Ghana play an important role in health care delivery especially in deprived communities. They usually serve as the first line of service and meet basic health care needs. Unfortunately, these facilities are faced with inadequate resources. While health policy makers seek to increase resources committed to primary healthcare, it is important to understand the nature of inefficiencies that exist in these facilities. Therefore, the objectives of this study are threefold; (i) estimate efficiency among primary health facilities (health centers), (ii) examine the potential fiscal space from improved efficiency and (iii) investigate the efficiency disparities in public and private facilities. Data was from the 2015 Access Bottlenecks, Cost and Equity (ABCE) project conducted by the Institute for Health Metrics and Evaluation. The Stochastic Frontier Analysis (SFA) was used to estimate efficiency of health facilities. Efficiency scores were then used to compute potential savings from improved efficiency. Outpatient visits was used as output while number of personnel, hospital beds, expenditure on other capital items and administration were used as inputs. Disparities in efficiency between public and private facilities was estimated using the Nopo matching decomposition procedure. Average efficiency score across all health centers included in the sample was estimated to be 0.51. Also, average efficiency was estimated to be about 0.65 and 0.50 for private and public facilities, respectively. Significant disparities in efficiency were identified across the various administrative regions. With regards to potential fiscal space, we found that, on average, facilities could save about GH₵11,450.70 (US$7633.80) if efficiency was improved. We also found that fiscal space from efficiency gains varies across rural/urban as well as private/public facilities, if best practices are followed. The matching decomposition showed an efficiency gap of 0.29 between private and public facilities. There is need for primary health facility managers to improve productivity via effective and efficient resource use. Efforts to improve efficiency should focus on training health workers and improving facility environment alongside effective monitoring and evaluation exercises.

Evaluating the Potential of Tributary Restoration to Increase the Overall Survival of Salmon

NASA Astrophysics Data System (ADS)

Budy, P.; Schaller, H.

2006-12-01

Stream restoration has become a major focus of conservation efforts with millions of dollars spent each year on efforts aimed at recovering imperiled species; however, for animals with complex life-history strategies, this reliance on stream restoration for increasing overall survival requires that several key assumptions be met. We addressed fundamental uncertainties of the current focus on tributary restoration for recovery of endangered Snake River spring/summer Chinook salmon (Oncorhynchus tshawytscha): 1) is there potential for improving habitat in tributary streams, 2) what magnitude of early survival improvement can be expected based on stream restoration, and 3) will incremental increases in early survival be sufficient to ensure viability of the populations that compose the Evolutionarily Significant Unit (ESU)? We combined simple mechanistic habitat models, population viability measures, and categorical filters to quantify the potential for increasing total life-cycle survival (TLCS) across all 32 populations (ESU), based on increases to early freshwater survival, predicted to occur in response to restored tributary condition. A wide gap remains between how much survival improvement is needed, versus what is likely to occur under tributary restoration; tributary restoration has the potential to increase survival to the necessary minimum for only four populations in the ESU while the remaining populations (84%) still fall far below the survival needed for future viability. In addition, across the ESU; on average, a 171% increase in TLCS is necessary, whereas only ~106% appears possible. A recovery strategy for these salmon that relies largely on tributary restoration, to mitigate for known mortality imposed at other life stages (e.g., migration through hydropower dams) is risky and has a low probability of success. For animals with complex life cycles and exhibiting long migrations, stream restoration efforts may be ineffective and misplaced, if the targeted life stage is not limiting or unresponsive, and/or if there is little potential for increasing survival overall. We demonstrate both an approach for, and the importance of, completing a comprehensive a prior evaluation of restoration potential, such that scarce resources can be allocated to efforts with the greatest potential and the least amount of risk.

The effect of oxytocin nasal spray on social interaction deficits observed in young children with autism: a randomized clinical crossover trial.

PubMed

Yatawara, C J; Einfeld, S L; Hickie, I B; Davenport, T A; Guastella, A J

2016-09-01

Interventions for autism are limited. The synthetic hormone oxytocin may provide a potential treatment to improve core social and behavioral difficulties in autism, but its efficacy has yet to be evaluated in young children who potentially may benefit to a greater extent. We investigated the efficacy, tolerability and safety of oxytocin treatment in young children with autism using a double-blind, randomized, placebo-controlled, crossover, clinical trial. Thirty-one children with autism received 12 International Units (IU) of oxytocin and placebo nasal spray morning and night (24 IU per day) for 5 weeks, with a 4-week washout period between each treatment. Compared with placebo, oxytocin led to significant improvements on the primary outcome of caregiver-rated social responsiveness. Overall, nasal spray was well tolerated, and the most common reported adverse events were thirst, urination and constipation. This study is the first clinical trial to support the potential of oxytocin as an early intervention for young children with autism to help improve social interaction deficits.

The effect of oxytocin nasal spray on social interaction deficits observed in young children with autism: a randomized clinical crossover trial

PubMed Central

Yatawara, C J; Einfeld, S L; Hickie, I B; Davenport, T A; Guastella, A J

2016-01-01

Interventions for autism are limited. The synthetic hormone oxytocin may provide a potential treatment to improve core social and behavioral difficulties in autism, but its efficacy has yet to be evaluated in young children who potentially may benefit to a greater extent. We investigated the efficacy, tolerability and safety of oxytocin treatment in young children with autism using a double-blind, randomized, placebo-controlled, crossover, clinical trial. Thirty-one children with autism received 12 International Units (IU) of oxytocin and placebo nasal spray morning and night (24 IU per day) for 5 weeks, with a 4-week washout period between each treatment. Compared with placebo, oxytocin led to significant improvements on the primary outcome of caregiver-rated social responsiveness. Overall, nasal spray was well tolerated, and the most common reported adverse events were thirst, urination and constipation. This study is the first clinical trial to support the potential of oxytocin as an early intervention for young children with autism to help improve social interaction deficits. PMID:26503762

OSSE Evaluation of Aircraft Reconnaissance Observations and their Impact on Hurricane Analyses and Forecasts

NASA Astrophysics Data System (ADS)

Ryan, K. E.; Bucci, L. R.; Delgado, J.; Atlas, R. M.; Murillo, S.; Dodge, P.

2016-12-01

NOAA/AOML's Hurricane Research Division (HRD) annually conducts its Hurricane Field Program during which observations are collected via NOAA aircraft to improve the understanding and prediction of hurricanes. Mission experiments suggest a variety of flight patterns and sampling strategies aimed towards their respective goals described by the Intensity Forecasting Experiment (IFEX; Rogers et al., BAMS, 2006, 2013), a collaborative effort among HRD, NHC, and EMC. Evaluating the potential impact of various trade-offs in track design is valuable for determining the optimal air reconnaissance flight pattern for a prospective mission. AOML's HRD has developed a system for performing regional Observing System Simulation Experiments (OSSEs) to assess the potential impact of proposed observing systems on hurricane track and intensity forecasts and analyses. This study focuses on investigating the potential impact of proposed aircraft reconnaissance observing system designs. Aircraft instrument and flight level retrievals were simulated from a regional WRF ARW Nature Run (Nolan et al., 2013) spanning 13 days, covering the life cycle of a rapidly intensifying Atlantic tropical cyclone. The aircraft trajectories of NOAA aircraft are simulated in a variety of ways and are evaluated to examine the potential impact of aircraft reconnaissance observations on hurricane track and intensity forecasts.

OSSE Evaluation of Prospective Aircraft Reconnaissance Flight Patterns and their Impact on Hurricane Forecasts

NASA Astrophysics Data System (ADS)

Ryan, K. E.; Bucci, L. R.; Christophersen, H.; Atlas, R. M.; Murillo, S.; Dodge, P.

2015-12-01

Each year, NOAA/AOML's Hurricane Research Division (HRD) conducts its Hurricane field Program in which observations are collected via NOAA aircraft to improve the understanding and prediction of hurricanes. Mission experiments suggest a variety of flight patterns and sampling strategies aimed towards their respective goals described by the Intensity Forecasting Experiment (IFEX; Rogers et al., BAMS, 2006, 2013), a collaborative effort among HRD, NHC, and EMC. Evaluating the potential impact of various trade-offs in design is valuable for determining the optimal air reconnaissance flight pattern for a given prospective mission. AOML's HRD has developed a system for performing regional Observing System Simulation Experiments (OSSEs) to assess the potential impact of proposed observing systems on hurricane track and intensity forecasts and analyses. This study focuses on investigating the potential impact of proposed aircraft reconnaissance observing system designs. Aircraft instrument and flight level retrievals were simulated from a regional WRF ARW Nature Run (Nolan et al., 2013) spanning 13 days, covering the life cycle of a rapidly intensifying Atlantic tropical cyclone. The aircraft trajectories are simulated in a variety of ways and are evaluated to investigate the potential impact of aircraft reconnaissance observations on hurricane track and intensity forecasts.

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

Strickland, Christopher E.; Johnson, Christian D.; Lee, Brady D.

Iodine-129 (129I) generated at the U.S. Department of Energy (DOE) Hanford Site during plutonium production was released to the subsurface, resulting in several large, though dilute, plumes in the groundwater, including the plume in the 200-UP-1 operable unit (OU). Because 129I is an uncommon contaminant, relevant remediation experience and scientific literature are limited, though work is under way to better understand the fate and transport of 129I in the environment and the effectiveness of potential remediation technologies. The recent UP-1 Evaluation Plan for Iodine and report on the Conceptual Model of Iodine Behavior in the Subsurface at the Hanford Sitemore » provide information on the history of contamination in the 200-UP-1 OU, relevant controlling processes (biological and geochemical), risk, the conceptual site model, and potential remedial options, which provided a foundation for this study. In this study, available information was compiled and used to categorize potential remediation technologies, culminating in a recommendation of promising technologies for further evaluation. Approaches to improve the technical information about promising technologies are also recommended in this study so that a subsequent evaluation of potential remediation alternatives can assess these technologies.« less

Innovative simulation strategies in education.

PubMed

Aebersold, Michelle; Tschannen, Dana; Bathish, Melissa

2012-01-01

The use of simulation in the undergraduate nursing curriculum is gaining popularity and is becoming a foundation of many nursing programs. The purpose of this paper is to highlight a new simulation teaching strategy, virtual reality (VR) simulation, which capitalizes on the technological skills of the new generation student. This small-scale pilot study focused on improving interpersonal skills in senior level nursing students using VR simulation. In this study, a repeated-measure design was used to evaluate the effectiveness of VR simulation on improving student's performance over a series of two VR scenarios. Using the Emergency Medicine Crisis Resource Management (EMCRM) tool, student performance was evaluated. Overall, the total EMCRM score improved but not significantly. The subscale areas of communication (P = .047, 95% CI: - 1.06, -.007) and professional behavior (P = .003, 95% CI: - 1.12, -.303) did show a significant improvement between the two scenario exposures. Findings from this study show the potential for virtual reality simulations to have an impact on nursing student performance.

Clinical pathways for acute coronary syndromes in China: protocol for a hospital quality improvement initiative.

PubMed

Rong, Ye; Turnbull, Fiona; Patel, Anushka; Du, Xin; Wu, Yangfeng; Gao, Runlin

2010-09-01

Clinical pathways have been shown to be effective in improving quality of care for patients admitted to hospital for acute coronary syndromes (ACS) in high-income countries. However, their utility has not formally been evaluated in low- or middle-income countries. The Clinical Pathways for Acute Coronary Syndromes in China program is a 7-year study with the overall goal of reducing evidence-practice gaps in the management of patients admitted to hospitals in China with suspected ACS. The program comprises 2 phases: a prospective survey of current management of ACS patients to identify the areas that evidence-based patient care can be potentially improved, and a quality care initiative to maximize the use of evidence-based investigations and treatments for ACS patients in China. In this article, we outline the details of the study protocol, including key aspects of the development, implementation, and evaluation of the quality improvement initiative (clinical pathway) for management of patients with suspected ACS.

Efficacy of critical incident monitoring for evaluating disaster medical readiness and response during the Sydney 2000 Olympic Games.

PubMed

Flabouris, Arthas; Nocera, Antony; Garner, Alan

2004-01-01

Multiple casualty incidents (MCI) are infrequent events for medical systems. This renders audit and quality improvement of the medical responses difficult. Quality tools and use of such tools for improvement is necessary to ensure that the design of medical systems facilitates the best possible response to MCI. To describe the utility of incident reporting as a quality monitoring and improvement tool during the deployment of medical teams for mass gatherings and multiple casualty incidents. Voluntary and confidential reporting of incidents was provided by members of the disaster medical response teams during the period of disaster medical team deployment for the 2000 Sydney Olympic Games. Qualitative evaluations were conducted of reported incidents. The main outcome measures included the nature of incident and associated contributing factors, minimization factors, harm potential, and comparison with the post-deployment, cold debriefings. A total of 53 incidents were reported. Management-based decisions, poor or non-existent protocols, and equipment and communication-related issues were the principal contributing factors. Eighty nine percent of the incidents were considered preventable. A potential for harm to patients and/or team members was documented in 58% of reports, of which 76% were likely to cause at least significant harm. Of equipment incidents, personal protective equipment (33%), medical equipment (27%), provision of equipment (22%), and communication equipment (17%) predominated. Personal protective equipment (50%) was reported as the most frequent occupational health and safety incident followed by fatigue (25%). Pre-deployment planning was the most important factor for future incident impact minimization. Incident monitoring was efficacious as a quality tool in identifying incident contributing factors. Incident monitoring allowed for greater systems evaluation. Further evaluation of this quality tool within different disaster settings is required.

Global high-resolution simulations of tropospheric nitrogen dioxide using CHASER V4.0

NASA Astrophysics Data System (ADS)

Sekiya, Takashi; Miyazaki, Kazuyuki; Ogochi, Koji; Sudo, Kengo; Takigawa, Masayuki

2018-03-01

We evaluate global tropospheric nitrogen dioxide (NO2) simulations using the CHASER V4.0 global chemical transport model (CTM) at horizontal resolutions of 0.56, 1.1, and 2.8°. Model evaluation was conducted using satellite tropospheric NO2 retrievals from the Ozone Monitoring Instrument (OMI) and the Global Ozone Monitoring Experiment-2 (GOME-2) and aircraft observations from the 2014 Front Range Air Pollution and Photochemistry Experiment (FRAPPÉ). Agreement against satellite retrievals improved greatly at 1.1 and 0.56° resolutions (compared to 2.8° resolution) over polluted and biomass burning regions. The 1.1° simulation generally captured the regional distribution of the tropospheric NO2 column well, whereas 0.56° resolution was necessary to improve the model performance over areas with strong local sources, with mean bias reductions of 67 % over Beijing and 73 % over San Francisco in summer. Validation using aircraft observations indicated that high-resolution simulations reduced negative NO2 biases below 700 hPa over the Denver metropolitan area. These improvements in high-resolution simulations were attributable to (1) closer spatial representativeness between simulations and observations and (2) better representation of large-scale concentration fields (i.e., at 2.8°) through the consideration of small-scale processes. Model evaluations conducted at 0.5 and 2.8° bin grids indicated that the contributions of both these processes were comparable over most polluted regions, whereas the latter effect (2) made a larger contribution over eastern China and biomass burning areas. The evaluations presented in this paper demonstrate the potential of using a high-resolution global CTM for studying megacity-scale air pollutants across the entire globe, potentially also contributing to global satellite retrievals and chemical data assimilation.

Analysis of power sector efficiency improvements for an integrated utility planning process in Costa Rica

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

Waddle, D.B.; MacDonald, J.M.

1990-01-01

In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results ofmore » the study. 14 refs., 4 figs., 5 tabs.« less

Evaluation of epididymis storage temperature and cryopreservation conditions for improved mitochondrial membrane potential, membrane integrity, sperm motility and in vitro fertilization in bovine epididymal sperm.

PubMed

Nichi, M; Rijsselaere, T; Losano, Jda; Angrimani, Dsr; Kawai, Gkv; Goovaerts, Igf; Van Soom, A; Barnabe, V H; De Clercq, Jbp; Bols, Pej

2017-04-01

The maintaining of the epididymis at lower temperatures during storage and transport improves sperm quality. Our study aimed to test whether epididymis storage temperature (post-mortem) and sperm cryopreservation affect sperm kinetics, membrane integrity, mitochondrial potential and fertility capacity. Thirty-six epididymides were collected from 18 bulls after slaughter and divided into two groups: at 4 or 34°C for 2-3 hr. The sperm was collected from the epididymis cauda. The evaluation consisted of computer-assisted sperm analysis (CASA), SYBR14/PI/JC1 to evaluate membrane integrity, mitochondrial membrane potential (MMP) and measurement of lipid peroxidation (TBARS). The sperm was then frozen using an automatic device. After thawing, sperm samples were evaluated by the same variables and further in vitro fertilization rates. Cryopreservation negatively affected sperm motility in samples stored at 4 and 34°C. Nevertheless, the 4°C samples yielded higher rates of blastocyst formation. Pre-freeze sperm motility, progressive motility and velocity were higher in sperm from epididymis stored at 4°C while post-thaw sperm motility, progressive motility and velocity remained the same among samples from epididymis stored at 4 or 34°C. However, with regard to the kinetic patterns, samples collected from epididymis stored at 34°C had lower values when compared to those stored at 4°C prior the cryopreservation process. Our results indicate that epididymis handling conditions after cryopreservation may affect sperm quality after thawing, especially due to compromised MMP in sperm collected from epididymis stored at higher temperatures. © 2016 Blackwell Verlag GmbH.

Cortical Auditory Evoked Potentials to Evaluate Cochlear Implant Candidacy in an Ear With Long-standing Hearing Loss: A Case Report.

PubMed

Patel, Tirth R; Shahin, Antoine J; Bhat, Jyoti; Welling, D Bradley; Moberly, Aaron C

2016-10-01

We describe a novel use of cortical auditory evoked potentials in the preoperative workup to determine ear candidacy for cochlear implantation. A 71-year-old male was evaluated who had a long-deafened right ear, had never worn a hearing aid in that ear, and relied heavily on use of a left-sided hearing aid. Electroencephalographic testing was performed using free field auditory stimulation of each ear independently with pure tones at 1000 and 2000 Hz at approximately 10 dB above pure-tone thresholds for each frequency and for each ear. Mature cortical potentials were identified through auditory stimulation of the long-deafened ear. The patient underwent successful implantation of that ear. He experienced progressively improving aided pure-tone thresholds and binaural speech recognition benefit (AzBio score of 74%). Findings suggest that use of cortical auditory evoked potentials may serve a preoperative role in ear selection prior to cochlear implantation. © The Author(s) 2016.

The potential of coordinated reservoir operation for flood mitigation in large basins - A case study on the Bavarian Danube using coupled hydrological-hydrodynamic models

NASA Astrophysics Data System (ADS)

Seibert, S. P.; Skublics, D.; Ehret, U.

2014-09-01

The coordinated operation of reservoirs in large-scale river basins has great potential to improve flood mitigation. However, this requires large scale hydrological models to translate the effect of reservoir operation to downstream points of interest, in a quality sufficient for the iterative development of optimized operation strategies. And, of course, it requires reservoirs large enough to make a noticeable impact. In this paper, we present and discuss several methods dealing with these prerequisites for reservoir operation using the example of three major floods in the Bavarian Danube basin (45,000 km2) and nine reservoirs therein: We start by presenting an approach for multi-criteria evaluation of model performance during floods, including aspects of local sensitivity to simulation quality. Then we investigate the potential of joint hydrologic-2d-hydrodynamic modeling to improve model performance. Based on this, we evaluate upper limits of reservoir impact under idealized conditions (perfect knowledge of future rainfall) with two methods: Detailed simulations and statistical analysis of the reservoirs' specific retention volume. Finally, we investigate to what degree reservoir operation strategies optimized for local (downstream vicinity to the reservoir) and regional (at the Danube) points of interest are compatible. With respect to model evaluation, we found that the consideration of local sensitivities to simulation quality added valuable information not included in the other evaluation criteria (Nash-Sutcliffe efficiency and Peak timing). With respect to the second question, adding hydrodynamic models to the model chain did, contrary to our expectations, not improve simulations, despite the fact that under idealized conditions (using observed instead of simulated lateral inflow) the hydrodynamic models clearly outperformed the routing schemes of the hydrological models. Apparently, the advantages of hydrodynamic models could not be fully exploited when fed by output from hydrological models afflicted with systematic errors in volume and timing. This effect could potentially be reduced by joint calibration of the hydrological-hydrodynamic model chain. Finally, based on the combination of the simulation-based and statistical impact assessment, we identified one reservoir potentially useful for coordinated, regional flood mitigation for the Danube. While this finding is specific to our test basin, the more interesting and generally valid finding is that operation strategies optimized for local and regional flood mitigation are not necessarily mutually exclusive, sometimes they are identical, sometimes they can, due to temporal offsets, be pursued simultaneously.

A guide to evaluating linkage quality for the analysis of linked data.

PubMed

Harron, Katie L; Doidge, James C; Knight, Hannah E; Gilbert, Ruth E; Goldstein, Harvey; Cromwell, David A; van der Meulen, Jan H

2017-10-01

Linked datasets are an important resource for epidemiological and clinical studies, but linkage error can lead to biased results. For data security reasons, linkage of personal identifiers is often performed by a third party, making it difficult for researchers to assess the quality of the linked dataset in the context of specific research questions. This is compounded by a lack of guidance on how to determine the potential impact of linkage error. We describe how linkage quality can be evaluated and provide widely applicable guidance for both data providers and researchers. Using an illustrative example of a linked dataset of maternal and baby hospital records, we demonstrate three approaches for evaluating linkage quality: applying the linkage algorithm to a subset of gold standard data to quantify linkage error; comparing characteristics of linked and unlinked data to identify potential sources of bias; and evaluating the sensitivity of results to changes in the linkage procedure. These approaches can inform our understanding of the potential impact of linkage error and provide an opportunity to select the most appropriate linkage procedure for a specific analysis. Evaluating linkage quality in this way will improve the quality and transparency of epidemiological and clinical research using linked data. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association.

Shuttle Upgrade Using 5-Segment Booster (FSB)

NASA Technical Reports Server (NTRS)

Sauvageau, Donald R.; Huppi, Hal D.; McCool, A. A. (Technical Monitor)

2000-01-01

In support of NASA's continuing effort to improve the over-all safety and reliability of the Shuttle system- a 5-segment booster (FSB) has been identified as an approach to satisfy that overall objective. To assess the feasibility of a 5-segment booster approach, NASA issued a feasibility study contract to evaluate the potential of a 5-segment booster to improve the overall capability of the Shuttle system, especially evaluating the potential to increase the system reliability and safety. In order to effectively evaluate the feasibility of the 5-segment concept, a four-member contractor team was established under the direction of NASA Marshall Space Flight Center (MSFC). MSFC provided the overall program oversight and integration as well as program contractual management. The contractor team consisted of Thiokol, Boeing North American Huntington Beach (BNA), Lockheed Martin Michoud Space Systems (LMMSS) and United Space Alliance (USA) and their subcontractor bd Systems (Control Dynamics Division, Huntsville, AL). United Space Alliance included the former members of United Space Booster Incorporated (USBI) who managed the booster element portion of the current Shuttle solid rocket boosters. Thiokol was responsible for the overall integration and coordination of the contractor team across all of the booster elements. They were also responsible for all of the motor modification evaluations. Boeing North American (BNA) was responsible for all systems integration analyses, generation of loads and environments. and performance and abort mode capabilities. Lockheed Martin Michoud Space Systems (LMMSS) was responsible for evaluating the impacts of any changes to the booster on the external tank (ET), and evaluating any design changes on the external tank necessary to accommodate the FSB. USA. including the former USBI contingent. was responsible for evaluating any modifications to facilities at the launch site as well as any booster component design modifications.

Artificial Intelligence in Medicine and Radiation Oncology

PubMed Central

Weidlich, Vincent

2018-01-01

Artifical Intelligence (AI) was reviewed with a focus on its potential applicability to radiation oncology. The improvement of process efficiencies and the prevention of errors were found to be the most significant contributions of AI to radiation oncology. It was found that the prevention of errors is most effective when data transfer processes were automated and operational decisions were based on logical or learned evaluations by the system. It was concluded that AI could greatly improve the efficiency and accuracy of radiation oncology operations. PMID:29904616

Artificial Intelligence in Medicine and Radiation Oncology.

PubMed

Weidlich, Vincent; Weidlich, Georg A

2018-04-13

Artifical Intelligence (AI) was reviewed with a focus on its potential applicability to radiation oncology. The improvement of process efficiencies and the prevention of errors were found to be the most significant contributions of AI to radiation oncology. It was found that the prevention of errors is most effective when data transfer processes were automated and operational decisions were based on logical or learned evaluations by the system. It was concluded that AI could greatly improve the efficiency and accuracy of radiation oncology operations.

New Content Addressable Memory (CAM) Technologies for Big Data and Intelligent Electronics Enabled by Magneto-Electric Ternary CAM

DTIC Science & Technology

2017-12-11

provides ultra-low energy search operations. To improve throughput, the in-array pipeline scheme has been developed, allowing the MeTCAM to operate at a...controlled magnetic tunnel junction (VC-MTJ), which not only reduces cell area (thus achieving higher density) but also eliminates standby energy . This...Variations of the cell design are presented and evaluated. The results indicated a potential 90x improvement in the energy efficiency and a 50x

Coating processes for increasing the moisture resistance of polyurethane baffle material

NASA Technical Reports Server (NTRS)

Bilow, N.; Sawko, P.

1974-01-01

An investigation was conducted with the objective to improve the hydrolytic stability of reticulated polyurethane baffle material. This material is used in fuel tanks of aircraft and ground vehicles. The most commonly used foam of this type is hydrolytically unstable. Potential moisture barrier coatings which were evaluated include Parylene, epoxy-polysulfide, polyether based polyurethanes, polysulfides, polyolefin rubbers, and several other materials. Parylene coatings of at least 0.2 mil were found to provide the greatest improvement in hydrolytic stability.

Assessing the potential risk of Zika virus epidemics in temperate areas with established Aedes albopictus populations.

PubMed

Guzzetta, Giorgio; Poletti, Piero; Montarsi, Fabrizio; Baldacchino, Frederic; Capelli, Gioia; Rizzoli, Annapaola; Rosà, Roberto; Merler, Stefano

2016-04-14

Based on 2015 abundance of Aedes albopictus in nine northern Italian municipalities with temperate continental/oceanic climate, we estimated the basic reproductive number R0 for Zika virus (ZIKV) to be systematically below the epidemic threshold in most scenarios. Results were sensitive to the value of the probability of mosquito infection after biting a viraemic host. Therefore, further studies are required to improve models and predictions, namely evaluating vector competence and potential non-vector transmissions.

Evaluating the Potential of NASA's Earth Science Research Results for Improving Future Operational Systems

NASA Astrophysics Data System (ADS)

Frederick, M. E.; Cox, E. L.; Friedl, L. A.

2006-12-01

NASA's Earth Science Theme is charged with implementing NASA Strategic Goal 3A to "study Earth from space to advance scientific understanding and meet societal needs." In the course of meeting this objective, NASA produces research results, such as scientific observatories, research models, advanced sensor and space system technology, data active archives and interoperability technology, high performance computing systems, and knowledge products. These research results have the potential to serve society beyond their intended purpose of answering pressing Earth system science questions. NASA's Applied Sciences Program systematically evaluates the potential of the portfolio of research results to serve society by conducting projects in partnership with regional/national scale operational partners with the statutory responsibility to inform decision makers. These projects address NASA's National Applications and the societal benefit areas under the IEOS and GEOSS. Prototyping methods are used in two ways in NASA's Applied Sciences Program. The first is part of the National Applications program element, referred to as Integrated Systems Solutions (ISS) projects. The approach for these projects is to use high fidelity prototypes to benchmark the assimilation of NASA research results into our partners' decision support systems. The outcome from ISS projects is a prototype system that has been rigorously tested with the partner to understand the scientific uncertainty and improved value of their modified system. In many cases, these completed prototypes are adopted or adapted for use by the operational partners. The second falls under the Crosscutting Solutions program element, referred to as Rapid Prototyping (RP) experiments. The approach for RP experiments is to use low fidelity prototypes that are low cost and quickly produced to evaluate the potential of the breadth of NASA research results to serve society. The outcome from the set of RP experiments is an evaluation of many and varied NASA research results for their potential to be candidates for further development as an ISS project. The intention is to seed the community with many creative ideas for projects that use "un-applied" NASA research results to serve society, such as simulations of future missions.

National Cancer Patient Registry--a patient registry/clinical database to evaluate the health outcomes of patients undergoing treatment for cancers in Malaysia.

PubMed

Lim, G C C; Azura, D

2008-09-01

Cancer burden in Malaysia is increasing. Although there have been improvements in cancer treatment, these new therapies may potentially cause an exponential increase in the cost of cancer treatment. Therefore, justification for the use of these treatments is mandated. Availability of local data will enable us to evaluate and compare the outcome of our patients. This will help to support our clinical decision making and local policy, improve access to treatment and improve the provision and delivery of oncology services in Malaysia. The National Cancer Patient Registry was proposed as a database for cancer patients who seek treatment in Malaysia. It will be a valuable tool to provide timely and robust data on the actual setting in oncology practice, safety and cost effectiveness of treatment and most importantly the outcome of these patients.

Galantamine improves olfactory learning in the Ts65Dn mouse model of Down syndrome

PubMed Central

Simoes de Souza, Fabio M.; Busquet, Nicolas; Blatner, Megan; Maclean, Kenneth N.; Restrepo, Diego

2011-01-01

Down syndrome (DS) is the most common form of congenital intellectual disability. Although DS involves multiple disturbances in various tissues, there is little doubt that in terms of quality of life cognitive impairment is the most serious facet and there is no effective treatment for this aspect of the syndrome. The Ts65Dn mouse model of DS recapitulates multiple aspects of DS including cognitive impairment. Here the Ts65Dn mouse model of DS was evaluated in an associative learning paradigm based on olfactory cues. In contrast to disomic controls, trisomic mice exhibited significant deficits in olfactory learning. Treatment of trisomic mice with the acetylcholinesterase inhibitor galantamine resulted in a significant improvement in olfactory learning. Collectively, our study indicates that olfactory learning can be a sensitive tool for evaluating deficits in associative learning in mouse models of DS and that galantamine has therapeutic potential for improving cognitive abilities. PMID:22355654

Galantamine improves olfactory learning in the Ts65Dn mouse model of Down syndrome.

PubMed

de Souza, Fabio M Simoes; Busquet, Nicolas; Blatner, Megan; Maclean, Kenneth N; Restrepo, Diego

2011-01-01

Down syndrome (DS) is the most common form of congenital intellectual disability. Although DS involves multiple disturbances in various tissues, there is little doubt that in terms of quality of life cognitive impairment is the most serious facet and there is no effective treatment for this aspect of the syndrome. The Ts65Dn mouse model of DS recapitulates multiple aspects of DS including cognitive impairment. Here the Ts65Dn mouse model of DS was evaluated in an associative learning paradigm based on olfactory cues. In contrast to disomic controls, trisomic mice exhibited significant deficits in olfactory learning. Treatment of trisomic mice with the acetylcholinesterase inhibitor galantamine resulted in a significant improvement in olfactory learning. Collectively, our study indicates that olfactory learning can be a sensitive tool for evaluating deficits in associative learning in mouse models of DS and that galantamine has therapeutic potential for improving cognitive abilities.

Thiolated xyloglucan: Synthesis, characterization and evaluation as mucoadhesive in situ gelling agent.

PubMed

Mahajan, Hitendra S; Tyagi, Vinod Kumar; Patil, Ravindra R; Dusunge, Sanket B

2013-01-16

The objective of present study was to enhance bioadhesive potential of xyloglucan by thiolation. Thiolation of xyloglucan was achieved with esterification with thioglycolic acid. Thiolated xyloglucan was characterized by NMR, DSC, and XRD analysis. Thiolated xyloglucan was determined to possess 4mmol of thiol groups/g of polymer by Ellman's method. Comparative evaluation of mucoadhesive property of ondansetron containing in situ gel system of xyloglucan and thiolated xyloglucan using sheep nasal mucosa revealed higher ex vivo bioadhesion time of thiolated xyloglucan as compared to xyloglucan. Improved mucoadhesive property of thiolated xyloglucan over the xyloglucan can be attributed to the formation of disulfide bond between mucus and thiolated xyloglucan. Ex vivo permeation study conducted using sheep nasal showed improved drug permeation in formulation based on thiolated xyloglucan. In conclusion, thiolation of xyloglucan improves its bioadhesion and drug permeation without affecting the resultant gel properties. Copyright © 2012 Elsevier Ltd. All rights reserved.

Spray sealing: A breakthrough in integral fuel tank sealing technology

NASA Astrophysics Data System (ADS)

Richardson, Martin D.; Zadarnowski, J. H.

1989-11-01

In a continuing effort to increase readiness, a new approach to sealing integral fuel tanks is being developed. The technique seals potential leak sources by spraying elastomeric materials inside the tank cavity. Laboratory evaluations project an increase in aircraft supportability and reliability, an improved maintainability, decreasing acquisition and life cycle costs. Increased usable fuel volume and lower weight than conventional bladders improve performance. Concept feasibility was demonstrated on sub-scale aircraft fuel tanks. Materials were selected by testing sprayable elastomers in a fuel tank environment. Chemical stability, mechanical properties, and dynamic durability of the elastomer are being evaluated at the laboratory level and in sub-scale and full scale aircraft component fatigue tests. The self sealing capability of sprayable materials is also under development. Ballistic tests show an improved aircraft survivability, due in part to the elastomer's mechanical properties and its ability to damp vibrations. New application equipment, system removal, and repair methods are being investigated.

Symptom management in HIV-infected patients.

PubMed

Hughes, Anne

2004-01-01

Symptom management has always been a focus of nursing care. Assessing and managing symptoms is an important component of HIV nursing practice. When effective, interventions to relieve symptoms may improve quality of life (QoL), potentially increase adherence to highly active antiretroviral therapy, and improve other outcomes such as functional status. Common underrecognized and/or undertreated symptoms that may influence the QoL of persons living with HIV include fatigue, pain, anxiety/depression, and sleep disturbances. These symptoms may also contribute to the difficulty of adhering to HAART When evaluating a patient's symptoms, the nurse attempts to understand the symptom experience from the patient's perspective because symptoms are subjective experiences. Together, the nurse and patient work to determine feasible interventions. Symptom management plans are evaluated frequently. Fundamentally, symptom management aims to decrease the frequency, intensity, and distress of symptoms, with the ultimate goal of improving QoL.

Fluorescence spectroscopy for the detection of potentially malignant disorders and squamous cell carcinoma of the oral cavity.

PubMed

Francisco, Ana Lucia Noronha; Correr, Wagner Rafael; Azevedo, Luciane Hiramatsu; Kern, Vivian Galletta; Pinto, Clóvis Antônio Lopes; Kowalski, Luiz Paulo; Kurachi, Cristina

2014-06-01

Oral cancer is a public health problem with relevant incidence in the world population. The affected patient usually presents advanced stage disease and the consequence of this delay is a reduction in survival rates. Given this, it is essential to detect oral cancer at early stages. Fluorescence spectroscopy is a non-invasive diagnostic tool that can improve cancer detection in real time. It is a fast and accurate technique, relatively simple, which evaluates the biochemical composition and structure using the tissue fluorescence spectrum as interrogation data. Several studies have positive data regarding the tools for differentiating between normal mucosa and cancer, but the difference between cancer and potentially malignant disorders is not clear. The aim of this study was to evaluate the efficacy of fluorescence spectroscopy in the discrimination of normal oral mucosa, oral cancer, and potentially malignant disorders. The fluorescence spectroscopy was evaluated in 115 individuals, of whom 55 patients presented oral squamous cell carcinoma, 30 volunteers showing normal oral mucosa, and 30 patients having potentially malignant disorders. The spectra were classified and compared to histopathology to evaluate the efficiency in diagnostic discrimination employing fluorescence. In order to classify the spectra, a decision tree algorithm (C4.5) was applied. Despite of the high variance observed in spectral data, the specificity and sensitivity obtained were 93.8% and 88.5%, respectively at 406 nm excitation. These results point to the potential use of fluorescence spectroscopy as an important tool for oral cancer diagnosis and potentially malignant disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

Health worker perspectives on barriers to delivery of routine tuberculosis diagnostic evaluation services in Uganda: a qualitative study to guide clinic-based interventions.

PubMed

Cattamanchi, Adithya; Miller, Cecily R; Tapley, Asa; Haguma, Priscilla; Ochom, Emmanuel; Ackerman, Sara; Davis, J Lucian; Katamba, Achilles; Handley, Margaret A

2015-01-22

Studies of the quality of tuberculosis (TB) diagnostic evaluation of patients in high burden countries have generally shown poor adherence to international or national guidelines. Health worker perspectives on barriers to improving TB diagnostic evaluation are critical for developing clinic-level interventions to improve guideline implementation. We conducted structured, in-depth interviews with staff at six district-level health centers in Uganda to elicit their perceptions regarding barriers to TB evaluation. Interviews were transcribed, coded with a standardized framework, and analyzed to identify emergent themes. We used thematic analysis to develop a logic model depicting health system and contextual barriers to recommended TB evaluation practices. To identify possible clinic-level interventions to improve TB evaluation, we categorized findings into predisposing, enabling, and reinforcing factors as described by the PRECEDE model, focusing on potentially modifiable behaviors at the clinic-level. We interviewed 22 health center staff between February 2010 and November 2011. Participants identified key health system barriers hindering TB evaluation, including: stock-outs of drugs/supplies, inadequate space and infrastructure, lack of training, high workload, low staff motivation, and poor coordination of health center services. Contextual barrier challenges to TB evaluation were also reported, including the time and costs borne by patients to seek and complete TB evaluation, poor health literacy, and stigma against patients with TB. These contextual barriers interacted with health system barriers to contribute to sub-standard TB evaluation. Examples of intervention strategies that could address these barriers and are related to PRECEDE model components include: assigned mentors/peer coaching for new staff (targets predisposing factor of low motivation and need for support to conduct job duties); facilitated workshops to implement same day microscopy (targets enabling factor of patient barriers to completing TB evaluation), and recognition/incentives for good TB screening practices (targets low motivation and self-efficacy). Our findings suggest that health system and contextual barriers work together to impede TB diagnosis at health centers and, if not addressed, could hinder TB case detection efforts. Qualitative research that improves understanding of the barriers facing TB providers is critical to developing targeted interventions to improve TB care.

Voriconazole-Loaded Nanostructured Lipid Carriers for Ocular Drug Delivery.

PubMed

Andrade, Lígia M; Rocha, Kamilla A D; De Sá, Fernando A P; Marreto, Ricardo N; Lima, Eliana M; Gratieri, Tais; Taveira, Stephânia F

2016-06-01

To design and evaluate the potential of a topical delivery system for ocular administration of voriconazole, based on cationic nanostructured lipid carriers (NLCs). NLC dispersions composed of glyceryl behenate/capric caprylic triglyceride, polysorbate 80, sorbitan trioleate, and cetylpyridinium chloride were obtained and characterized. Ex vivo permeations experiments were performed to evaluate their drug delivery potential. NLCs presented a mean diameter of 250.2 ± 03.1 nm, narrow polydispersity index (0.288 ± 0.03), positive zeta potential (31.22 ± 3.8 mV), and over 75% encapsulation efficiency. Ex vivo ocular experiments proved that NLCs were able to deliver therapeutically relevant drug amounts to the cornea after only 30 minutes (13.88 ± 0.24 μg/cm). The formulation was nonexpensive, easy to prepare, and composed of well-tolerated and accepted excipients. Further in vivo experiments are necessary to confirm the improved performance and tolerability of the formulation.

Standard Operational Protocols in professional nursing practice: use, weaknesses and potentialities.

PubMed

Sales, Camila Balsero; Bernardes, Andrea; Gabriel, Carmen Silvia; Brito, Maria de Fátima Paiva; Moura, André Almeida de; Zanetti, Ariane Cristina Barboza

2018-01-01

to evaluate the use of Standard Operational Protocols (SOPs) in the professional practice of the nursing team based on the theoretical framework of Donabedian, as well as to identify the weaknesses and potentialities from its implementation. Evaluative research, with quantitative approach performed with nursing professionals working in the Health Units of a city of São Paulo, composed of two stages: document analysis and subsequent application of a questionnaire to nursing professionals. A total of 247 nursing professionals participated and reported changes in the way the interventions were performed. The main weaknesses were the small number of professionals, inadequate physical structure and lack of materials. Among the potentialities were: the standardization of materials and concern of the manager and professional related to patient safety. The reassessment of SOPs is necessary, as well as the adoption of a strategy of permanent education of professionals aiming at improving the quality of care provided.

Mitochondria-targeting for improved photodynamic therapy

NASA Astrophysics Data System (ADS)

Ngen, Ethel J.

Photodynamic therapy (PDT) is an emerging cancer therapeutic modality, with great potential to selectively treat surface cancers, thus minimizing systemic side effects. In this dissertation, two approaches to deliver photosensitizers to mitochondria were investigated: 1) Reducing photosensitizer sizes to improve endocytosis and lysosomal localization. Upon irradiation the photosensitizers would then produce singlet oxygen which could rupture the lysosomal membrane releasing the lysosomally trapped photosensitizers to the cytosol, from where they could relocalize to mitochondria by passive diffusion (photochemical internalization). 2) Using delocalized lipophilic cationic dyes (DLCs) to exploit membrane potential differences between the cytoplasm and mitochondria in delivering photosensitizers to mitochondria. To investigate the effects of steric hindrance on mitochondrial localization and photodynamic response, a series of eight thiaporphyrins were studied. Two new thiaporphyrin analogues 6 and 8 with reduced steric hindrance at the 10- and 15- meso positions were studied in comparison to 5,20-diphenyl-10,15-bis[4 (carboxymethyleneoxy)-phenyl]-21,23-dithiaporphyrin 1, previously validated as a potential second generation photosensitizer. Although 6 showed an extraordinarily high uptake (7.6 times higher than 1), it was less potent than 1 (IC 50 = 0.18 muM versus 0.13 muM) even though they both showed similar sub-cellular localization patterns. This low potency was attributed to its high aggregation tendency in aqueous media (4 times higher than 1), which might have affected its ability to generate singlet oxygen in vitro . 8 on the other hand showed an even lower potency than 6 (2.28 vs 0.18 muM). However this was attributed to its low cellular uptake (20 times less than 6) and inefficient generation of singlet oxygen. Overall, although the structural modifications did improve the cellular uptake of 6, 6 was still less potent than the lead photosensitizers 1. Thus, other strategies to target mitochondria for improved photodynamic activity were investigated. In a continuing project, we evaluated the ability of delocalized lipophilic cationic dyes to deliver photosensitizers to mitochondria by exploiting the membrane potential difference between the cytoplasm and mitochondria. Two conjugates: a porphyrin--rhodamine B conjugate (TPP--Rh) and a porphyrin-acridine orange conjugate (TPP--AO), each possessing a single delocalized lipophilic cation, were designed and synthesized. The conjugates were synthesized by conjugating a monohydroxy porphyrin (TPP-OH) to rhodamine B (Rh B) and acridine orange base (AO), respectively, via saturated hydrocarbon linkers. To evaluate the efficiency of the conjugates as photosensitizers, their photophysical properties and in vitro photodynamic activities were studied in comparison to those of TPP-OH, the parent porphyrin photosensitizer. Although fluorescence energy transfer (FRET) was observed in the conjugates, they were capable of generating singlet oxygen at rates comparable to TPP-OH. In a final project, we evaluated the photophysical potential of TPP-Rh to act as a two-photon photosensitizer for PDT. Two-photon PDT is a rational approach used to improve light penetration through the skin. Rhodamine B is an effective two-photon chromophore and could significantly improve the two-photon absorption of the porphyrin photosensitizer in the TPP-Rh dyad system following energy transfer. Thus the porphyrin--rhodamine B dyad (TPP--Rh), previously demonstrated to preferentially accumulate in the mitochondria, was photophysically evaluated as a potential two-photon photosensitizer. To evaluate the efficiency of TPP-Rh as a two-photon photosensitizer, its two-photon photophysical properties were compared with those of its individual components (Rh B and TPP-OH). This included: the two-photon cross sections (sigma 2), RET kinetics and dynamics and rates of singlet oxygen generation. A FRET efficiency of ~99 % was observed from the Rh moiety (donor) to the TPP moiety (acceptor) of the system. This significantly enhanced the sigma 2 of TPP-Rh by ˜ 100 % (20 GM) compared to the parent TPP-OH. Furthermore, TPP-Rh produced singlet oxygen at a significantly faster rate than TPP-OH upon two-photon excitation. Thus, this indicates that conjugating photosensitizers to Rh B via short saturated hydrocarbon linkers could provide deeper tissue penetration, in addition to preferential mitochondrial accumulation for improved photodynamic response. (Abstract shortened by UMI.)

Human abuse liability evaluation of CNS stimulant drugs.

PubMed

Romach, Myroslava K; Schoedel, Kerri A; Sellers, Edward M

2014-12-01

Psychoactive drugs that increase alertness, attention and concentration and energy, while also elevating mood, heart rate and blood pressure are referred to as stimulants. Despite some overlapping similarities, stimulants cannot be easily categorized by their chemical structure, mechanism of action, receptor binding profile, effects on monoamine uptake, behavioral pharmacology (e.g., effects on locomotion, temperature, and blood pressure), therapeutic indication or efficacy. Because of their abuse liability, a pre-market assessment of abuse potential is required for drugs that show stimulant properties; this review article focuses on the clinical aspects of this evaluation. This includes clinical trial adverse events, evidence of diversion or tampering, overdoses and the results of a human abuse potential study. While there are different types of human experimental studies that can be employed to evaluate stimulant abuse potential (e.g., drug discrimination, self-administration), only the human abuse potential study and clinical trial adverse event data are required for drug approval. The principal advances that have improved human abuse potential studies include using study enrichment strategies (pharmacologic qualification), larger sample sizes, better selection of endpoints and measurement strategies and more carefully considered interpretation of data. Because of the methodological advances, comparisons of newer studies with historical data is problematic and may contribute to a biased regulatory framework for the evaluation of newer stimulant-like drugs, such as A2 antagonists. This article is part of the Special Issue entitled 'CNS Stimulants'. Copyright © 2014 Elsevier Ltd. All rights reserved.

Can biosimilars help achieve the goals of US health care reform?

PubMed

Boccia, Ralph; Jacobs, Ira; Popovian, Robert; de Lima Lopes, Gilberto

2017-01-01

The US Patient Protection and Affordable Care Act (ACA) aims to expand health care coverage, contain costs, and improve health care quality. Accessibility and affordability of innovative biopharmaceuticals are important to the success of the ACA. As it is substantially more difficult to manufacture them compared with small-molecule drugs, many of which have generic alternatives, biologics may increase drug costs. However, biologics offer demonstrated improvements in patient care that can reduce expensive interventions, thus lowering net health care costs. Biosimilars, which are highly similar to their reference biologics, cost less than the originators, potentially increasing access through reduced prescription drug costs while providing equivalent therapeutic results. This review evaluates 1) the progress made toward enacting health care reform since the passage of the ACA and 2) the role of biosimilars, including the potential impact of expanded biosimilar use on access, health care costs, patient management, and outcomes. Barriers to biosimilar adoption in the USA are noted, including low awareness and financial disincentives relating to reimbursement. The evaluated evidence suggests that the ACA has partly achieved some of its aims; however, the opportunity remains to transform health care to fully achieve reform. Although the future is uncertain, increased use of biosimilars in the US health care system could help achieve expanded access, control costs, and improve the quality of care.

Screening for obstructive sleep apnoea in cardiac rehabilitation: A position statement from the Australian Centre for Heart Health and the Australian Cardiovascular Health and Rehabilitation Association.

PubMed

Le Grande, Michael R; Neubeck, Lis; Murphy, Barbara M; McIvor, Dawn; Lynch, Dianna; McLean, Helen; Jackson, Alun C

2016-09-01

Obstructive sleep apnoea is highly prevalent in acute coronary syndrome patients eligible for enrolment in cardiac rehabilitation programmes. This condition is an independent predictor of increased morbidity and comorbid conditions in the general population and can lead to an increase in major adverse cardiac events such as revascularization, heart failure and hospital readmission in cardiac patients. There is convincing evidence that treatments such as continuous positive airway pressure or mandibular advancement devices can successfully treat obstructive sleep apnoea and these conditions can be improved or negated resulting in improved cardiac rehabilitation outcomes and improved health related quality of life. Given the potential benefits of obstructive sleep apnoea treatment it would make sense to screen for this condition upon entry to out-patient cardiac rehabilitation programmes. A two-stage approach to screening is recommended, where patients are initially evaluated for the probability of having obstructive sleep apnoea using a brief questionnaire (The STOP-Bang) and then followed up with objective evaluation (portable home monitor or polysomnography) where necessary. Potential barriers to further referral and treatment could be partly mitigated by the training of cardiac rehabilitation staff in sleep disorders and screening. © The European Society of Cardiology 2016.

Can we address cancer disparities in immigrants by improving cancer literacy through English as a second language instruction?

PubMed

Hughes, Donna L; Flight, Ingrid; Chapman, Janine; Wilson, Carlene

2018-03-27

In many Western countries, immigrants exhibit disparities in cancer incidence and mortality, and variable uptake of cancer prevention services. New immigrants may not be aware of cancer risks pertinent to their new country, or prevention resources. Traditional cancer prevention health messaging may not be accessible for cultural, language, or literacy reasons. New methods are needed. In North America, health message delivery via English classes for immigrants is showing potential as an efficacious and a feasible way to reach immigrants at the same time improving language skills. Interventions published to date are promising but limited in their ability to generalize or be adapted to a variety of populations and settings. This concept paper aims to synthesize previous findings and identify ways to improve and advance the translation potential of this approach. We propose that this could be achieved by (i) using a translation framework to guide intervention planning, development, implementation, and evaluation; (ii) encouraging and evaluating health message spread throughout language learners' social networks; and (iii) incorporating cultural sensitivity into the curriculum. A pilot project following these recommendations is planned for Australia and will be discussed. These recommendations could serve as a framework to fit the requirements of immigrant language programs in other countries and other health topics.

Souvenaid reduces behavioral deficits and improves social cognition skills in frontotemporal dementia: a proof-of-concept study.

PubMed

Pardini, Matteo; Serrati, Carlo; Guida, Silvia; Mattei, Chiara; Abate, Lucia; Massucco, Davide; Sassos, Davide; Amore, Mario; Krueger, Frank; Cocito, Leonardo; Emberti Gialloreti, Leonardo

2015-01-01

Souvenaid™ is a nutraceutical compound thought to positively enhance synaptic function. In line with this mechanism of action, Souvenaid™ has been shown to improve cognitive function in subjects with mild Alzheimer's disease in randomized clinical trials. To date, however, the potential of Souvenaid™ to improve cognitive functioning in subjects with other neurodegenerative conditions also characterized by synaptic loss has not been explored. To evaluate the impact of Souvenaid™ on executive functions, social cognition and behavioral disturbances in subjects with the behavioral variant of frontotemporal dementia (bv-FTD). Twenty-six subjects with bv-FTD were enrolled in the study and randomized to Souvenaid™ (125 ml/day) or placebo groups. After 12 weeks, subjects were switched between the two groups. All subjects, blinded to treatment, underwent clinical and cognitive evaluations at enrollment, after 12 weeks and after 24 weeks. Treatment with Souvenaid™ was associated with a significant reduction of behavioral symptoms and an increase in Theory of Mind skills compared to placebo, which both returned to baseline when Souvenaid™ was discontinued. Souvenaid™ did not have an effect on executive functions. Our results provide evidence of the potential of Souvenaid™ therapy for the treatment of behavioral disturbances and social cognition skills in FTD. © 2015 S. Karger AG, Basel.

Public health nurse perceptions of Omaha System data visualization.

PubMed

Lee, Seonah; Kim, Era; Monsen, Karen A

2015-10-01

Electronic health records (EHRs) provide many benefits related to the storage, deployment, and retrieval of large amounts of patient data. However, EHRs have not fully met the need to reuse data for decision making on follow-up care plans. Visualization offers new ways to present health data, especially in EHRs. Well-designed data visualization allows clinicians to communicate information efficiently and effectively, contributing to improved interpretation of clinical data and better patient care monitoring and decision making. Public health nurse (PHN) perceptions of Omaha System data visualization prototypes for use in EHRs have not been evaluated. To visualize PHN-generated Omaha System data and assess PHN perceptions regarding the visual validity, helpfulness, usefulness, and importance of the visualizations, including interactive functionality. Time-oriented visualization for problems and outcomes and Matrix visualization for problems and interventions were developed using PHN-generated Omaha System data to help PHNs consume data and plan care at the point of care. Eleven PHNs evaluated prototype visualizations. Overall PHNs response to visualizations was positive, and feedback for improvement was provided. This study demonstrated the potential for using visualization techniques within EHRs to summarize Omaha System patient data for clinicians. Further research is needed to improve and refine these visualizations and assess the potential to incorporate visualizations within clinical EHRs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Single pass tangential flow filtration to debottleneck downstream processing for therapeutic antibody production.

PubMed

Dizon-Maspat, Jemelle; Bourret, Justin; D'Agostini, Anna; Li, Feng

2012-04-01

As the therapeutic monoclonal antibody (mAb) market continues to grow, optimizing production processes is becoming more critical in improving efficiencies and reducing cost-of-goods in large-scale production. With the recent trends of increasing cell culture titers from upstream process improvements, downstream capacity has become the bottleneck in many existing manufacturing facilities. Single Pass Tangential Flow Filtration (SPTFF) is an emerging technology, which is potentially useful in debottlenecking downstream capacity, especially when the pool tank size is a limiting factor. It can be integrated as part of an existing purification process, after a column chromatography step or a filtration step, without introducing a new unit operation. In this study, SPTFF technology was systematically evaluated for reducing process intermediate volumes from 2× to 10× with multiple mAbs and the impact of SPTFF on product quality, and process yield was analyzed. Finally, the potential fit into the typical 3-column industry platform antibody purification process and its implementation in a commercial scale manufacturing facility were also evaluated. Our data indicate that using SPTFF to concentrate protein pools is a simple, flexible, and robust operation, which can be implemented at various scales to improve antibody purification process capacity. Copyright © 2011 Wiley Periodicals, Inc.

Potential of hypocotyl diameter in family selection aiming at plant architecture improvement of common bean.

PubMed

Oliveira, A M C; Batista, R O; Carneiro, P C S; Carneiro, J E S; Cruz, C D

2015-09-28

Cultivars of common bean with more erect plant architecture and greater tolerance to degree of lodging are required by producers. Thus, to evaluate the potential of hypocotyl diameter (HD) in family selection for plant architecture improvement of common bean, the HDs of 32 F2 plants were measured in 3 distinct populations, and the characteristics related to plant architecture were analyzed in their progenies. Ninety-six F2:3 families and 4 controls were evaluated in a randomized block design, with 3 replications, analyzing plant architecture grade, HD, and grain yield during the winter 2010 and drought 2011 seasons. We found that the correlation between the HD of F2 plants and traits related to plant architecture of F2:3 progenies were of low magnitude compared to the estimates for correlations considering the parents, indicating a high environmental influence on HD in bean plants. There was a predominance of additive genetic effects on the determination of hypocotyl diameter, which showed higher precision and accuracy compared to plant architecture grade. Thus, this characteristic can be used to select progenies in plant architecture improvement of common beans; however, selection must be based on the means of at least 39 plants in the plot, according to the results of repeatability analysis.

A Framework for Assessing Health Risk of Environmental ...

EPA Pesticide Factsheets

EPA released the final report entitled, A Framework for Assessing Health Risk of Environmental Exposures to Children, which examines the impact of potential exposures during developmental lifestages and subsequent lifestages, while emphasizing the iterative nature of the analysis phase with a multidisciplinary team. Major findings and conclusions: This report outlines the framework in which mode of action(s) (MOA) can be considered across life stages. The framework is based upon existing approaches adopted in the Framework on Cumulative Risk Assessment and identifies existing guidance, guidelines and policy papers that relate to children's health risk assessment. It emphasizes the importance of an iterative approach between hazard, dose response, and exposure analyses. In addition, it includes discussion of principles for weight of evidence consideration across life stages for the hazard characterization database.Key science/assessment issues:This framework addresses the questions of why and how an improved children's health risk assessment will strengthen the overall risk assessment process across the Agency. This approach improves the scientific explanation of children's risk and will add value by: 1) providing for a more complete evaluation of the potential for vulnerability at different life stages, including a focus on the underlying biological events and critical developmental periods for incorporating MOA considerations; 2) evaluating of the potential fo

Recent advances in multidisciplinary management of hepatocellular carcinoma

PubMed Central

Gomaa, Asmaa I; Waked, Imam

2015-01-01

The incidence of hepatocellular carcinoma (HCC) is increasing, and it is currently the second leading cause of cancer-related death worldwide. Potentially curative treatment options for HCC include resection, transplantation, and percutaneous ablation, whereas palliative treatments include trans-arterial chemoembolization (TACE), radioembolization, and systemic treatments. Due to the diversity of available treatment options and patients’ presentations, a multidisciplinary team should decide clinical management of HCC, according to tumor characteristics and stage of liver disease. Potentially curative treatments are suitable for very-early- and early-stage HCC. However, the vast majority of HCC patients are diagnosed in later stages, where the tumor characteristics or progress of liver disease prevent curative interventions. For patients with intermediate-stage HCC, TACE and radioembolization improve survival and are being evaluated in addition to potentially curative therapies or with systemic targeted therapy. There is currently no effective systemic chemotherapy, immunologic, or hormonal therapy for HCC, and sorafenib is the only approved molecular-targeted treatment for advanced HCC. Other targeted agents are under investigation; trials comparing new agents in combination with sorafenib are ongoing. Combinations of systemic targeted therapies with local treatments are being evaluated for further improvements in HCC patient outcomes. This article provides an updated and comprehensive overview of the current standards and trends in the treatment of HCC. PMID:25866604

Evaluating Digital Health Interventions: Key Questions and Approaches.

PubMed

Murray, Elizabeth; Hekler, Eric B; Andersson, Gerhard; Collins, Linda M; Doherty, Aiden; Hollis, Chris; Rivera, Daniel E; West, Robert; Wyatt, Jeremy C

2016-11-01

Digital health interventions have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization. Achieving these improvements requires a cumulative knowledge base to inform development and deployment of digital health interventions. However, evaluations of digital health interventions present special challenges. This paper aims to examine these challenges and outline an evaluation strategy in terms of the research questions needed to appraise such interventions. As they are at the intersection of biomedical, behavioral, computing, and engineering research, methods drawn from all of these disciplines are required. Relevant research questions include defining the problem and the likely benefit of the digital health intervention, which in turn requires establishing the likely reach and uptake of the intervention, the causal model describing how the intervention will achieve its intended benefit, key components, and how they interact with one another, and estimating overall benefit in terms of effectiveness, cost effectiveness, and harms. Although RCTs are important for evaluation of effectiveness and cost effectiveness, they are best undertaken only when: (1) the intervention and its delivery package are stable; (2) these can be implemented with high fidelity; and (3) there is a reasonable likelihood that the overall benefits will be clinically meaningful (improved outcomes or equivalent outcomes at lower cost). Broadening the portfolio of research questions and evaluation methods will help with developing the necessary knowledge base to inform decisions on policy, practice, and research. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Improving agreement in assessment of synovitis in rheumatoid arthritis.

PubMed

Cheung, Peter P; Dougados, Maxime; Andre, Vincent; Balandraud, Nathalie; Chales, Gérard; Chary-Valckenaere, Isabelle; Chatelus, Emmanuel; Dernis, Emmanuelle; Gill, Ghislaine; Gilson, Mélanie; Guis, Sandrine; Mouterde, Gael; Pavy, Stephan; Pouyol, François; Marhadour, Thierry; Richette, Pascal; Ruyssen-Witrand, Adeline; Soubrier, Martin; Gossec, Laure

2013-03-01

Synovitis assessment through evaluation of swollen joints is integral in steering treatment decisions in rheumatoid arthritis (RA). However, there is high inter-observer variation. The objective was to assess if a short collegiate consensus would improve swollen joint agreement between rheumatologists and whether this was affected by experience. Eighteen rheumatologists from French university rheumatology units participated in three 30 minutes rounds over a half day meeting evaluating joint counts of RA patients in small groups, followed by short consensus discussions. Agreement was evaluated at the end of each round as follows: (i) global agreement of swollen joints (ii) swollen joint agreement according to level of experience of the rheumatologist (iii) swollen joint count and (iv) agreement of disease activity state according to the Disease Activity Score (DAS28). Agreement was calculated using percentage agreement and kappa. Global agreement of swollen joints failed to improve (kappa 0.50 to 0.52) at the joint level. Agreement between seniors did not improve but agreement between newly qualified rheumatologists and their senior peer, which was initially poor (kappa 0.28), improved significantly (to 0.54) at the end of the consensus exercises. Concordance of DAS28 activity states improved from 71% to 87%. Consensus exercises for swollen joint assessment is worthwhile and may potentially improve agreement between clinicians in clinical synovitis and disease activity state, benefit was mostly observed in newly qualified rheumatologists. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Evaluation of a BCMA’s Electronic Medication Administration Record

PubMed Central

Staggers, Nancy; Iribarren, Sarah; Guo, Jia-Wen; Weir, Charlene

2015-01-01

Barcode medication administration (BCMA) systems can reduce medication errors, but sociotechnical issues are quite common. Although crucial to nurses’ work, few usability evaluations are available for electronic medication administration record screens (eMARs). The purpose of this research was to identify current usability problems in the VA’s eMAR/BCMA system and explore how these might impact nurses’ situation awareness. Three expert evaluators used 10 tasks/elements, heuristic evaluation techniques and explored potential impacts using a situation awareness perspective. The results yielded 99 usability problems categorized into 440 heuristic violations with the largest volume in the category of Match with the Real World. Fifteen usability issues were rated as catastrophic with the Administer/Chart medications task having the most. Situational awareness was impacted at all levels, especially at Level 2, Comprehension. Usability problems point to important areas for improvement because these issues have the potential to impact nurses’ situation awareness, “at a glance” information, nurse productivity and patient safety. PMID:25601936

Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool.

PubMed

Leung, Alexander A; Keohane, Carol; Lipsitz, Stuart; Zimlichman, Eyal; Amato, Mary; Simon, Steven R; Coffey, Michael; Kaufman, Nathan; Cadet, Bismarck; Schiff, Gordon; Seger, Diane L; Bates, David W

2013-06-01

The Leapfrog CPOE evaluation tool has been promoted as a means of monitoring computerized physician order entry (CPOE). We sought to determine the relationship between Leapfrog scores and the rates of preventable adverse drug events (ADE) and potential ADE. A cross-sectional study of 1000 adult admissions in five community hospitals from October 1, 2008 to September 30, 2010 was performed. Observed rates of preventable ADE and potential ADE were compared with scores reported by the Leapfrog CPOE evaluation tool. The primary outcome was the rate of preventable ADE and the secondary outcome was the composite rate of preventable ADE and potential ADE. Leapfrog performance scores were highly related to the primary outcome. A 43% relative reduction in the rate of preventable ADE was predicted for every 5% increase in Leapfrog scores (rate ratio 0.57; 95% CI 0.37 to 0.88). In absolute terms, four fewer preventable ADE per 100 admissions were predicted for every 5% increase in overall Leapfrog scores (rate difference -4.2; 95% CI -7.4 to -1.1). A statistically significant relationship between Leapfrog scores and the secondary outcome, however, was not detected. Our findings support the use of the Leapfrog tool as a means of evaluating and monitoring CPOE performance after implementation, as addressed by current certification standards. Scores from the Leapfrog CPOE evaluation tool closely relate to actual rates of preventable ADE. Leapfrog testing may alert providers to potential vulnerabilities and highlight areas for further improvement.

Systems study for an Integrated Digital-Electric Aircraft (IDEA)

NASA Technical Reports Server (NTRS)

Tagge, G. E.; Irish, L. A.; Bailey, A. R.

1985-01-01

The results of the Integrated Digital/Electric Aircraft (IDEA) Study are presented. Airplanes with advanced systems were, defined and evaluated, as a means of identifying potential high payoff research tasks. A baseline airplane was defined for comparison, typical of a 1990's airplane with advanced active controls, propulsion, aerodynamics, and structures technology. Trade studies led to definition of an IDEA airplane, with extensive digital systems and electric secondary power distribution. This airplane showed an improvement of 3% in fuel use and 1.8% in DOC relative to the baseline configuration. An alternate configuration, an advanced technology turboprop, was also evaluated, with greater improvement supported by digital electric systems. Recommended research programs were defined for high risk, high payoff areas appropriate for implementation under NASA leadership.

Improving Our Ability to Evaluate Underlying Mechanisms of Behavioral Onset and Other Event Occurrence Outcomes: A Discrete-Time Survival Mediation Model

PubMed Central

Fairchild, Amanda J.; Abara, Winston E.; Gottschall, Amanda C.; Tein, Jenn-Yun; Prinz, Ronald J.

2015-01-01

The purpose of this article is to introduce and describe a statistical model that researchers can use to evaluate underlying mechanisms of behavioral onset and other event occurrence outcomes. Specifically, the article develops a framework for estimating mediation effects with outcomes measured in discrete-time epochs by integrating the statistical mediation model with discrete-time survival analysis. The methodology has the potential to help strengthen health research by targeting prevention and intervention work more effectively as well as by improving our understanding of discretized periods of risk. The model is applied to an existing longitudinal data set to demonstrate its use, and programming code is provided to facilitate its implementation. PMID:24296470

National Aeronautics and Space Administration fundamental research program. Information utilization and evaluation

NASA Technical Reports Server (NTRS)

Estes, J. E.; Eisgruber, L.

1981-01-01

In the second half of the 1980's NASA can expect to face difficult choices among alternative fundamental and applied research, and development projects that could potentially lead to improvements in the information systems used to manage renewable resources. The working group on information utilization and evaluation believes that effective choices cannot be made without a better understanding of the current and prospective problems and opportunities involved in the application of remote sensing to improve renewable research information systems. A renewable resources information system is defined in a broad context to include a flow of data/information from: acquisition through processing, storage, integration with other data, analysis, graphic presentation, decision making, and assessment of the affects of those decisions.

Role of the independent donor advocacy team in ethical decision making.

PubMed

Rudow, Dianne LaPointe; Brown, Robert S

2005-09-01

Adult living donor liver transplantation has developed as a direct result of the critical shortage of deceased donors. Recent regulations passed by New York State require transplant programs to appoint an Independent Donor Advocacy Team to evaluate, educate, and consent to all potential living liver donors. Ethical issues surround the composition of the team, who appoints them, and the role the team plays in the process. Critics of living liver donation have questioned issues surrounding motivation and the ability of donors to provide true informed consent during a time of family crisis. This article will address issues surrounding the controversies and discuss how using the team can effectively evaluate and educate potential living liver donors and improve practice to ensure safety of living donors.

Evaluation of food drying with air dehumidification system: a short review

NASA Astrophysics Data System (ADS)

Djaeni, M.; Utari, F. D.; Sasongko, S. B.; Kumoro, A. C.

2018-01-01

Energy efficient drying for food and agriculture products resulting high quality products has been an important issue. Currently, about 50% of total energy for postharvest treatment was used for drying. This paper presents the evaluation of new approach namely air dehumidification system with zeolite for food drying. Zeolite is a material having affinity to water in which reduced the moisture in air. With low moisture content and relative humidity, the air can improve driving force for drying even at low temperature. Thus, the energy efficiency can be potentially enhanced and the product quality can be well retained. For proving the hypothesis, the paddy and onion have been dried using dehumidified air. As performance indicators, the drying time, product quality, and heat efficiency were evaluated. Results indicated that the drying with zeolite improved the performances significantly. At operating temperature ranging 50 - 60°C, the efficiency of drying system can reach 75% with reasonable product quality.

Improved Geothermometry Through Multivariate Reaction-path Modeling and Evaluation of Geomicrobiological Influences on Geochemical Temperature Indicators: Final Report

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

Mattson, Earl; Smith, Robert; Fujita, Yoshiko

2015-03-01

The project was aimed at demonstrating that the geothermometric predictions can be improved through the application of multi-element reaction path modeling that accounts for lithologic and tectonic settings, while also accounting for biological influences on geochemical temperature indicators. The limited utilization of chemical signatures by individual traditional geothermometer in the development of reservoir temperature estimates may have been constraining their reliability for evaluation of potential geothermal resources. This project, however, was intended to build a geothermometry tool which can integrate multi-component reaction path modeling with process-optimization capability that can be applied to dilute, low-temperature water samples to consistently predict reservoirmore » temperature within ±30 °C. The project was also intended to evaluate the extent to which microbiological processes can modulate the geochemical signals in some thermal waters and influence the geothermometric predictions.« less

Health Impact Assessment as a framework for evaluation of local complex projects.

PubMed

Heath, Lucy

2007-07-01

Health impact assessment (HIA) has been used to predict effects of a local parenting strategy and develop an evaluation framework. Methods used included literature searches, inequalities profiling, interviews with key informants and a review of available cost data. Four priority areas, where parenting can potentially impact, were identified: education, antisocial behaviour, lifestyle choices and mental health. The results concerning mental health are presented here. Improving the quality of parenting can impact on a child's mental health. The costs relating to the mental health outcomes are high and parenting is a cost-effective method to address the family dynamics that impact on this. Intermediary indicators, including clear boundaries, time spent as a family and parental involvement can be used to evaluate the intervention in the short-term, although there are difficulties in their measurement. The HIA process can improve cross-sectorial working, increased community participation and keep inequalities on the agenda.

Tribal Energy Program for California Indian Tribes

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

Singer, S.

A strategic plan is needed to catalyze clean energy in the more than 100 California Indian tribal communities with varying needs and energy resources. We propose to conduct a scoping study to identify tribal lands with clean energy potential, as well as communities with lack of grid-tied energy and communications access. The research focus would evaluate the energy mixture and alternatives available to these tribal communities, and evaluate greenhouse gas emissions associated with accessing fossil fuel used for heat and power. Understanding the baseline of energy consumption and emissions of communities is needed to evaluate improvements and advances from technology.more » Based on this study, we will develop a strategic plan that assesses solutions to address high energy fuel costs due to lack of electricity access and inform actions to improve economic opportunities for tribes. This could include technical support for tribes to access clean energy technologies and supporting collaboration for on-site demonstrations.« less

Effectiveness of a visual attention retraining program on the driving performance of clients with stroke.

PubMed

Mazer, Barbara L; Sofer, Susan; Korner-Bitensky, Nicol; Gelinas, Isabelle; Hanley, James; Wood-Dauphinee, Sharon

2003-04-01

To compare the effectiveness of a visual attention retraining program using the Useful Field of View (UFOV) with a traditional visuoperception treatment program on the driving performance of clients with stroke. Randomized controlled trial. Rehabilitation hospital located in Quebec, Canada. Ninety-seven individuals referred for driving evaluation after a stroke. Participants were randomized to receive 20 sessions of either UFOV training of visual processing speed, divided attention, and selective attention or traditional computerized visuoperception retraining. Subjects were evaluated with an on-road driving evaluation, visuoperception tests, and the Test of Everyday Attention. An occupational therapist unaware of group assignment conducted all evaluations. Eighty-four participants completed the outcome evaluation. There were no significant differences between groups on any of the outcome measures. There was, however, almost a 2-fold increase (52.4% vs 28.6%) in the rate of success on the on-road driving evaluation after UFOV training for subjects with right-sided lesions. Rehabilitation that targets visual attention skills was not significantly more beneficial than traditional perceptual training in improving the outcome of an on-road driving evaluation. However, results suggest a potential improvement for subjects with right-sided lesions, indicating that training must target specific skills.

GOAT ROCKS WILDERNESS AND ADJACENT ROADLESS AREAS, WASHINGTON.

USGS Publications Warehouse

Church, S.E.; Close, T.J.

1984-01-01

The Goat Rocks Wilderness and adjacent roadless areas are a rugged, highly forested, scenic area located on the crest of the Cascade Range in south-central Washington. Several mineral claims have been staked in the area. Mineral surveys were conducted. Geochemical, geophysical, and geologic investigations indicate that three areas have probable mineral-resource potential for base metals in porphyry-type deposits. Available data are not adequate to permit definition of the potential for oil and gas. There is little likelihood for the occurrence of other kinds of energy resources in the area. Evaluation of resource potential in the three areas identified as having probable mineral-resource potential could be improved by more detailed geochemical studies and geologic mapping.

Design and evaluation of experimental ceramic automobile thermal reactors

NASA Technical Reports Server (NTRS)

Stone, P. L.; Blankenship, C. P.

1974-01-01

The paper summarizes the results obtained in an exploratory evaluation of ceramics for automobile thermal reactors. Candidate ceramic materials were evaluated in several reactor designs using both engine dynamometer and vehicle road tests. Silicon carbide contained in a corrugated metal support structure exhibited the best performance, lasting 1100 hours in engine dynamometer tests and for more than 38,600 kilimeters (24,000 miles) in vehicle road tests. Although reactors containing glass-ceramic components did not perform as well as silicon carbide, the glass-ceramics still offer good potential for reactor use with improved reactor designs.

Design and evaluation of experimental ceramic automobile thermal reactors

NASA Technical Reports Server (NTRS)

Stone, P. L.; Blankenship, C. P.

1974-01-01

The results obtained in an exploratory evaluation of ceramics for automobile thermal reactors are summarized. Candidate ceramic materials were evaluated in several reactor designs by using both engine-dynamometer and vehicle road tests. Silicon carbide contained in a corrugated-metal support structure exhibited the best performance, lasting 1100 hr in engine-dynamometer tests and more than 38,600 km (24000 miles) in vehicle road tests. Although reactors containing glass-ceramic components did not perform as well as those containing silicon carbide, the glass-ceramics still offer good potential for reactor use with improved reactor designs.

Flight test evaluation of a separate surface attitude command control system on a Beech 99 airplane

NASA Technical Reports Server (NTRS)

Gee, S. W.; Jenks, G. E.; Roskam, J.; Stone, R. L.

1976-01-01

A joint NASA/university/industry program was conducted to flight evaluate a potentially low cost separate surface implementation of attitude command in a Beech 99 airplane. Saturation of the separate surfaces was the primary cause of many problems during development. Six experienced professional pilots who made simulated instrument flight evaluations experienced improvements in airplane handling qualities in the presence of turbulence and a reduction in pilot workload. For ride quality, quantitative data show that the attitude command control system results in all cases of airplane motion being removed from the uncomfortable ride region.

Model evaluation of the phytoextraction potential of heavy metal hyperaccumulators and non-hyperaccumulators.

PubMed

Liang, Hong-Ming; Lin, Ting-Hsiang; Chiou, Jeng-Min; Yeh, Kuo-Chen

2009-06-01

Evaluation of the remediation ability of zinc/cadmium in hyper- and non-hyperaccumulator plant species through greenhouse studies is limited. To bridge the gap between greenhouse studies and field applications for phytoextraction, we used published data to examine the partitioning of heavy metals between plants and soil (defined as the bioconcentration factor). We compared the remediation ability of the Zn/Cd hyperaccumulators Thlaspi caerulescens and Arabidopsis halleri and the non-hyperaccumulators Nicotiana tabacum and Brassica juncea using a hierarchical linear model (HLM). A recursive algorithm was then used to evaluate how many harvest cycles were required to clean a contaminated site to meet Taiwan Environmental Protection Agency regulations. Despite the high bioconcentration factor of both hyperaccumulators, metal removal was still limited because of the plants' small biomass. Simulation with N. tabacum and the Cadmium model suggests further study and development of plants with high biomass and improved phytoextraction potential for use in environmental cleanup.

A challenge-response endoscopic sinus surgery specific checklist as an add-on to standard surgical checklist: an evaluation of potential safety and quality improvement issues.

PubMed

Sommer, Doron D; Arbab-Tafti, Sadaf; Farrokhyar, Forough; Tewfik, Marc; Vescan, Allan; Witterick, Ian J; Rotenberg, Brian; Chandra, Rakesh; Weitzel, Erik K; Wright, Erin; Ramakrishna, Jayant

2018-02-27

The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery-specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the checklist on surgical times during, before, and after surgery. This initiative is designed to be utilized in conjunction with the "standard" World Health Organization (WHO) surgical checklist. Although endoscopic sinus surgery is generally considered a safe procedure, avoidable complications and potential safety concerns continue to occur. The WHO surgical checklist does not directly address certain surgery-specific issues, which may be of particular relevance for endoscopic sinus surgery. This prospective observational pilot study monitored compliance with and compared the occurrence of safety and equipment issues before and after implementation of the checklist. Forty-seven consecutive endoscopic surgeries were audited; the first 8 without the checklist and the following 39 with the checklist. The checklist was compiled by evaluating the patient journey, utilizing the available literature, expert consensus, and finally reevaluation with audit type cases. The final checklist was developed with all relevant stakeholders involved in a Delphi method. Implementing this specific surgical checklist in 39 cases at our institution, allowed us to identify and rectify 35 separate instances of potentially unsafe, improper or inefficient preoperative setup. These incidents included issues with labeling of topical vasoconstrictor or injectable anesthetics (3, 7.7%) and availability, function and/or position of video monitors (2, 5.1%), endoscope (6, 15.4%), microdebrider (6, 15.4%), bipolar cautery (6, 15.4%), and suctions (12, 30.8%). The design and integration of this checklist for endoscopic sinus surgery, has helped improve efficiency and patient safety in the operating room setting. © 2018 ARS-AAOA, LLC.

Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop.

PubMed

Michie, Susan; Yardley, Lucy; West, Robert; Patrick, Kevin; Greaves, Felix

2017-06-29

Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom's Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key conclusion was that sustained engagement is not always required and that for each intervention it is useful to establish what constitutes "effective engagement," that is, sufficient engagement to achieve the intended outcomes. The potential of digital interventions for testing and advancing theories of behavior change by generating ecologically valid, real-time objective data was recognized. Evaluations should include all phases of the development cycle, designed for generalizability, and consider new experimental designs to make the best use of rich data streams. Future health economics analyses need to recognize and model the complex and potentially far-reaching costs and benefits of digital interventions. In terms of governance, developers of digital behavior interventions should comply with existing regulatory frameworks, but with consideration for emerging standards around information governance, ethics, and interoperability. ©Susan Michie, Lucy Yardley, Robert West, Kevin Patrick, Felix Greaves. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 29.06.2017.

Effects of a home-based participatory play intervention on infant and young child nutrition: a randomised evaluation among low-income households in El Alto, Bolivia.

PubMed

Martinez, Sebastian; Johannsen, Julia; Gertner, Gaston; Franco, Jorge; Perez Exposito, Ana B; Bartolini, Rosario M; Condori, Irma; Ayllón, Jhovanna Flores; Llanque, Ramiro; Alvarado, Nohora; Lunstedt, Christian; Ferrufino, Cecilia; Reinaga, Teresa; Chumacero, Mauricio; Foronda, Carlos; Albarracin, Santiago; Aguilar, Ana Maria

2018-01-01

Stunting affects child survival and is a key indicator of child well-being. Therefore, reducing stunting is a global goal. Improving infant and young child feeding (IYCF) practices is a recommended approach to reduce the risk of mortality and ameliorate nutritional status. Behavioural change interventions have the potential to improve IYCF practices. We evaluated the effectiveness of an innovative behavioural change strategy on caregiver's knowledge, IYCF practices and nutritional status of children from low-income households in El Alto, Bolivia. Home visits used culturally adapted participatory play strategies to promote recommended IYCF practices. A total of 2014 households with children younger than 12 months at baseline were randomly assigned to treatment and control groups. Caregiver knowledge and IYCF practices improved by 0.2 SD, as did food expenditures on recommended foods and dietary diversity. No significant effects were detected on anthropometric indicators or anaemia. Treatment compliance was 88% of households at enrolment and 66% at completion. Participatory play-based behavioural change strategies are a promising delivery model to improve recommended IYCF practices. After 30 months of intervention, we found sustained positive effects on caregiver's knowledge and IYCF practices but no effect on nutritional status. Despite the lack of effect on linear growth and anaemia, our results highlight the relevance of implementing interventions that improve IYCF practices due to their importance for early development and prevention of obesity. Other contextual variables, apart from diet, that could be limiting children's growth potential in this population need to be identified to design holistic approaches that improve child well-being and human capital.

Clinical Mechanism of the Cystic Fibrosis Transmembrane Conductance Regulator Potentiator Ivacaftor in G551D-mediated Cystic Fibrosis

PubMed Central

Heltshe, Sonya L.; Gonska, Tanja; Donaldson, Scott H.; Borowitz, Drucy; Gelfond, Daniel; Sagel, Scott D.; Khan, Umer; Mayer-Hamblett, Nicole; Van Dalfsen, Jill M.; Joseloff, Elizabeth; Ramsey, Bonnie W.

2014-01-01

Rationale: Ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator recently approved for patients with CF age 6 and older with the G551D mutation. Objectives: To evaluate ivacaftor in a postapproval setting and determine mechanism of action and response of clinically relevant markers. Methods: We conducted a longitudinal cohort study in 2012–2013 in G551D CF patients age 6 and older with no prior exposure to ivacaftor. Study assessments were performed at baseline, 1, 3, and 6 months after ivacaftor initiation. Substudies evaluated mucociliary clearance, β-adrenergic sweat secretion rate, gastrointestinal pH, and sputum inflammation and microbiology Measurements and Main Results: A total of 151 of 153 subjects were prescribed ivacaftor and 88% completed the study through 6 months. FEV1 % predicted improved from baseline to 6 months (mean absolute change, 6.7%; P < 0.001). Similarly, body mass index improved from baseline to 6 months (mean change, 0.8 kg/m2; P < 0.001). Sweat chloride decreased from baseline to 6 months (mean change, −53.8 mmol/L; 95% confidence interval, −57.7 to −49.9; P < 0.001), reflecting augmented CFTR function. There was significant improvement in hospitalization rate (P < 0.001) and Pseudomonas aeruginosa burden (P < 0.01). Significant improvements in mucociliary clearance (P < 0.001), gastrointestinal pH (P = 0.001), and microbiome were also observed, providing clinical mechanisms underlying the therapeutic benefit of ivacaftor. Conclusions: Significant clinical and physiologic improvements were observed on initiation of ivacaftor in a broad patient population, including reduced infection with P. aeruginosa. Biomarker studies substantially improve the understanding of the mechanistic consequences of CFTR modulation on pulmonary and gastrointestinal physiology. PMID:24927234

Changing Operating Room Culture: Implementation of a Postoperative Debrief and Improved Safety Culture.

PubMed

Magill, Stephen T; Wang, Doris D; Rutledge, W Caleb; Lau, Darryl; Berger, Mitchel S; Sankaran, Sujatha; Lau, Catherine Y; Imershein, Sarah G

2017-11-01

Patient safety is foundational to neurosurgical care. Postprocedural "debrief" checklists have been proposed to improve patient safety, but data about their use in neurosurgery are limited. Here, we implemented an initiative to routinely perform postoperative debriefs and evaluated the impact of debriefing on operating room (OR) safety culture. A 10-question safety attitude questionnaire (SAQ) was sent to neurosurgical OR staff at a major academic medical center before and 18 months after the implementation of a postoperative debriefing initiative. Rates of debrief compliance and changes in attitudes before and after the survey were evaluated. The survey used a Likert scale and analyzed with standard statistical methods. After the debrief initiative, the rate of debriefing increased from 51% to 86% of cases for the neurosurgery service. Baseline SAQ responses found that neurosurgeons had a more favorable perception of OR safety than did anesthesiologists and nurses. After implementation of the postoperative debriefing process, perceptions of OR safety significantly improved for neurosurgeons, anesthesiologists, and nurses. Furthermore, the disparity between nurses and surgeons was no longer significant. After debrief implementation, neurosurgical OR staff had improved perceptions of patient safety compared with surgical services that did not commonly perform debriefing. Debriefing identified OR efficiency concerns in 26.9% of cases, and prevention of potential adverse events/near misses was reported in 8% of cases. Postoperative debriefing can be effectively introduced into the OR and improves the safety culture after implementation. Debriefing is an effective tool to identify OR inefficiencies and potential adverse events. Copyright © 2017 Elsevier Inc. All rights reserved.

Effective intervention or child's play? A review of video games for diabetes education.

PubMed

DeShazo, Jonathan; Harris, Lynne; Pratt, Wanda

2010-10-01

The purpose of this study is (1) to identify diabetes education video games and pilot studies in the literature, (2) to review themes in diabetes video game design and evaluation, and (3) to evaluate the potential role of educational video games in diabetes self-management education. Studies were systematically identified for inclusion from Medline, Web of Science, CINAHL, EMBASE, Psychinfo, IEEE Xplore, and ACM Digital Library. Features of each video game intervention were reviewed and coded based on an existing taxonomy of diabetes interventions framework. Nine studies featuring 11 video games for diabetes care were identified. Video games for diabetes have typically targeted children with type 1 diabetes mellitus and used situation problem-solving methods to teach diet, exercise, self-monitored blood glucose, and medication adherence. Evaluations have shown positive outcomes in knowledge, disease management adherence, and clinical outcomes. Video games for diabetes education show potential as effective educational interventions. Yet we found that improvements are needed in expanding the target audience, tailoring the intervention, and using theoretical frameworks. In the future, the reach and effectiveness of educational video games for diabetes education could be improved by expanding the target audience beyond juvenile type 1 diabetes mellitus, the use of tailoring, and increased use of theoretical frameworks.

[Physical, chemical and morphological urine examination guidelines for the Analytical Phase from the Intersociety Urinalysis Group].

PubMed

Manoni, Fabio; Gessoni, Gianluca; Fogazzi, Giovanni Battista; Alessio, Maria Grazia; Caleffi, Alberta; Gambaro, Giovanni; Epifani, Maria Grazia; Pieretti, Barbara; Perego, Angelo; Ottomano, Cosimo; Saccani, Graziella; Valverde, Sara; Secchiero, Sandra

2016-01-01

With these guidelines the Intersociety Urinalysis Group (GIAU) aims to stimulate the following aspects: Improvement and standardization of the analytical approach to physical, chemical and morphological urine examination (ECMU). Improvement of the chemical analysis of urine with particular regard to the reconsideration of the diagnostic significance of the parameters that are traditionally evaluated in dipstick analysis together with an increasing awareness of the limits of sensitivity and specificity of this analytical method. Increase the awareness of the importance of professional skills in the field of urinary morphology and the relationship with the clinicians. Implement a policy of evaluation of the analytical quality by using, in addition to traditional internal and external controls, a program for the evaluation of morphological competence. Stimulate the diagnostics industry to focus research efforts and development methodology and instrumental catering on the needs of clinical diagnosis. The hope is to revalue the enormous diagnostic potential of 'ECMU, implementing a urinalysis on personalized diagnostic needs for each patient. Emphasize the value added to ECMU by automated analyzers for the study of the morphology of the corpuscular fraction urine. The hope is to revalue the enormous potential diagnostic of 'ECMU, implementing a urinalysis on personalized diagnostic needs that each patient brings with it.

PRONTO training for obstetric and neonatal emergencies in Mexico.

PubMed

Walker, Dilys M; Cohen, Susanna R; Estrada, Fatima; Monterroso, Marcia E; Jenny, Alisa; Fritz, Jimena; Fahey, Jenifer O

2012-02-01

To evaluate the acceptability, feasibility, rating, and potential impact of PRONTO, a low-tech and high-fidelity simulation-based training for obstetric and neonatal emergencies and teamwork using the PartoPants low-cost birth simulator. A pilot project was conducted from September 21, 2009, to April 9, 2010, to train interprofessional teams from 5 community hospitals in the states of Mexico and Chiapas. Module I (teamwork, neonatal resuscitation, and obstetric hemorrhage) was followed 3 months later by module II (dystocia and pre-eclampsia/eclampsia) and an evaluation. Four elements were assessed: acceptability; feasibility and rating; institutional goal achievement; teamwork improvement; and knowledge and self-efficacy. The program was rated highly both by trainees and by non-trainees who completed a survey and interview. Hospital goals identified by participants in the module I strategic-planning sessions were achieved for 65% of goals in 3 months. Teamwork, knowledge, and self-efficacy scores improved. PRONTO brings simulation training to low-resource settings and can empower interprofessional teams to respond more effectively within their institutional limitations to emergencies involving women and newborns. Further study is warranted to evaluate the potential impact of the program on obstetric and neonatal outcome. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Titania nanotube arrays as interfaces for blood-contacting implantable devices: a study evaluating the nanotopography-associated activation and expression of blood plasma components.

PubMed

Smith, Barbara S; Popat, Ketul C

2012-08-01

The constant exposure of implantable biomaterials such as titanium and titanium alloys to blood-introducesserious and ongoing concerns regarding poor blood-material interactions. To date, all blood-contacting materials have been shown to initiate immunological events in the form of inflammation, thrombosis, fibrosis and infection; potentially leading to complete implant failure. Material surfaces that provide biomimetic cues such as nanoscale architectures have been shown to elicit improved cellular interaction; and thus, may provide possible solutions for enhancing blood-compatibility. However, limited information exists about the thrombogenicityof nanoscalesurface architectures. In this study, we have evaluated the efficacy of titania nanotube arrays as interfaces for blood contacting devices by investigating the thrombogenic effects using whole blood plasma. Thus, platelet/leukocyte adhesion, activation and interaction, morphology, complement activation, contact activation, platelet release reaction, fibrinogen expression and material cytotoxicity were evaluated to determine the in vitro thrombogenicity. The results presented here indicate a decrease in thrombogenic effects of titania nanotube arrays as compared to biomedical grade titanium after 2 hours of contact with whole blood plasma. This work shows the improved blood-compatibility of titania nanotube arrays, identifying this specific nanoarchitecture as a potentially optimal interface for promoting the long-term success of blood contacting biomaterials.

Evaluation of methods for the assay of radium-228 in water

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

Noyce, J.R.

1981-02-01

The technical literature from 1967 to May 1980 was searched for methods for assaying radium-228 in water. These methods were evaluated for their suitability as potential EPA reference methods for drinking water assays. The authors suggest the present EPA reference method (Krieger, 1976) be retained but improved, and a second method (McCurdy and Mellor, 1979), which employs beta-gamma coincidence counting, be added. Included in this report is a table that lists the principal features of 17 methods for radium-228 assays.

Evaluation of Consideration and Incorporation of Green and Sustainable Remediation (GSR) Practices in Army Environmental Remediation. Volume 2. Pilot Project GSR Evaluation Reports

DTIC Science & Technology

2012-08-27

Project Team. This option involves the use of on-site wind turbines to provide all of the approximately 73,800 MWh of the electricity estimated to...and improves the GSR parameter for percentage of energy from renewable resources. Footprint for constructing the wind turbines is not considered...the potential for wind turbines at the site, and an FS is currently being conducted. The National Guard may also be interested in sustainable

A progressive 5-week exercise therapy program leads to significant improvement in knee function early after anterior cruciate ligament injury.

PubMed

Eitzen, Ingrid; Moksnes, Håvard; Snyder-Mackler, Lynn; Risberg, May Arna

2010-11-01

Prospective cohort study without a control group. Firstly, to present our 5-week progressive exercise therapy program in the early stage after anterior cruciate ligament (ACL) injury. Secondly, to evaluate changes in knee function after completion of the program for patients with ACL injury in general and also when classified as potential copers or noncopers, and, finally, to examine potential adverse events. Few studies concerning early-stage ACL rehabilitation protocols exist. Consequently, little is known about the tolerance for, and outcomes from, short-term exercise therapy programs in the early stage after injury. One-hundred patients were included in a 5-week progressive exercise therapy program, within 3 months after injury. Knee function before and after completion of the program was evaluated from isokinetic quadriceps and hamstrings muscle strength tests, 4 single-leg hop tests, 2 different self-assessment questionnaires, and a global rating of knee function. A 2-way mixed-model analysis of variance was conducted to evaluate changes from pretest to posttest for the limb symmetry index for muscle strength and single-leg hop tests, and the change in scores for the patient-reported questionnaires. In addition, absolute values and the standardized response mean for muscle strength and single-leg hop tests were calculated at pretest and posttest for the injured and uninjured limb. Adverse events during the 5-week period were recorded. The progressive 5-week exercise therapy program led to significant improvements (P<.05) in knee function from pretest to posttest both for patients classified as potential copers and noncopers. Standardized response mean values for changes in muscle strength and single-leg hop performance from pretest to posttest for the injured limb were moderate to strong (0.49-0.84), indicating the observed improvements to be clinically relevant. Adverse events occurred in 3.9% of the patients. Short-term progressive exercise therapy programs are well tolerated and should be incorporated in early-stage ACL rehabilitation, either to improve knee function before ACL reconstruction or as a first step in further nonoperative management. Therapy, level 2b.

Priority setting in Indigenous health: assessing priority setting process and criteria that should guide the health system to improve Indigenous Australian health

PubMed Central

2014-01-01

Introduction The health of Indigenous Australians is worse than that of other Australians. Most of the determinants of health are preventable and the poor health outcomes are inequitable. The Australian Government recently pledged to close that health gap. One possible way is to improve the priority setting process to ensure transparency and the use of evidence such as epidemiology, equity and economic evaluation. The purpose of this research was to elicit the perceptions of Indigenous and non-Indigenous decision-makers on several issues related to priority setting in Indigenous-specific health care services. Specifically, we aimed to: 1. identify the criteria used to set priorities in Indigenous-specific health care services; 2. determine the level of uptake of economic evaluation evidence by decision-makers and how to improve its uptake; and 3. identify how the priority setting process can be improved from the perspective of decision-makers. Methods We used a paper survey instrument, adapted from Mitton and colleagues’ work, and a face-to-face interview approach to elicit decision-makers’ perceptions in Indigenous-specific health care in Victoria, Australia. We used mixed methods to analyse data from the survey. Responses were summarised using descriptive statistics and content analysis. Results were reported as numbers and percentages. Results The size of the health burden; sustainability and acceptability of interventions; historical trends/patterns; and efficiency are key criteria for making choices in Indigenous health in Victoria. There is a need for an explicit priority setting approach, which is systematic, and is able to use available data/evidence, such as economic evaluation evidence. The involvement of Indigenous Australians in the process would potentially make the process acceptable. Conclusions An economic approach to priority setting is a potentially acceptable and useful tool for Aboriginal Community Controlled Health Services (ACCHS). It has the ability to use evidence and ensure due process at the same time. The use of evidence can ensure that health outcomes for Indigenous peoples can be maximised – hence, increase the potential for ‘closing the gap’ between Indigenous and other Australians. PMID:24906391

The economics of medicines optimization: policy developments, remaining challenges and research priorities

PubMed Central

Faria, Rita; Barbieri, Marco; Light, Kate; Elliott, Rachel A.; Sculpher, Mark

2014-01-01

Background This review scopes the evidence on the effectiveness and cost-effectiveness of interventions to improve suboptimal use of medicines in order to determine the evidence gaps and help inform research priorities. Sources of data Systematic searches of the National Health Service (NHS) Economic Evaluation Database, the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. Areas of agreement The majority of the studies evaluated interventions to improve adherence, inappropriate prescribing and prescribing errors. Areas of controversy Interventions tend to be specific to a particular stage of the pathway and/or to a particular disease and have mostly been evaluated for their effect on intermediate or process outcomes. Growing points Medicines optimization offers an opportunity to improve health outcomes and efficiency of healthcare. Areas timely for developing research The available evidence is insufficient to assess the effectiveness and cost-effectiveness of interventions to address suboptimal medicine use in the UK NHS. Decision modelling, evidence synthesis and elicitation have the potential to address the evidence gaps and help prioritize research. PMID:25190760

Quantitative evaluation of pairs and RS steganalysis

NASA Astrophysics Data System (ADS)

Ker, Andrew D.

2004-06-01

We give initial results from a new project which performs statistically accurate evaluation of the reliability of image steganalysis algorithms. The focus here is on the Pairs and RS methods, for detection of simple LSB steganography in grayscale bitmaps, due to Fridrich et al. Using libraries totalling around 30,000 images we have measured the performance of these methods and suggest changes which lead to significant improvements. Particular results from the project presented here include notes on the distribution of the RS statistic, the relative merits of different "masks" used in the RS algorithm, the effect on reliability when previously compressed cover images are used, and the effect of repeating steganalysis on the transposed image. We also discuss improvements to the Pairs algorithm, restricting it to spatially close pairs of pixels, which leads to a substantial performance improvement, even to the extent of surpassing the RS statistic which was previously thought superior for grayscale images. We also describe some of the questions for a general methodology of evaluation of steganalysis, and potential pitfalls caused by the differences between uncompressed, compressed, and resampled cover images.

Screening studies of advanced control concepts for airbreathing engines

NASA Technical Reports Server (NTRS)

Ouzts, Peter J.; Lorenzo, Carl F.; Merrill, Walter C.

1993-01-01

The application of advanced control concepts to airbreathing engines may yield significant improvements in aircraft/engine performance and operability. Accordingly, the NASA Lewis Research Center has conducted screening studies of advanced control concepts for airbreathing engines to determine their potential impact on turbine engine performance and operability. The purpose of the studies was to identify concepts which offered high potential yet may incur high research and development risk. A target suite of proposed concepts was formulated by NASA and industry. These concepts were evaluated in a two phase study to quantify each concept's impact on desired engine characteristics. To aid in the evaluation, three target aircraft/engine combinations were considered: a military high performance fighter mission, a high speed civil transport mission, and a civil tiltrotor mission. Each of the advanced control concepts considered in the study were defined and described. The concept's potential impact on engine performance was determined. Relevant figures of merit on which to evaluate the concepts were also determined. Finally, the concepts were ranked with respect to the target aircraft/engine missions.

Cationic nanoemulsions as potential carriers for intracellular delivery

PubMed Central

Khachane, P.V.; Jain, A.S.; Dhawan, V.V.; Joshi, G.V.; Date, A.A.; Mulherkar, R.; Nagarsenker, M.S.

2014-01-01

Successful cytosolic delivery enables opportunities for improved treatment of various genetic disorders, infectious diseases and cancer. Cationic nanoemulsions were designed using alternative excipients and evaluated for particle size, charge, effect of sterilization on its stability, DNA condensation potential and cellular uptake efficiency. Various concentrations of non-ionic and ionic stabilizers were evaluated to design formula for colloidally stable cationic nanoemulsion. The nanoemulsion comprised of 5% Capmul MCM, 0.5% didodecyldimethylammonium bromide (DDAB), 1% phospholipid, 1% Poloxamer 188 and 2.25% glycerol and possessed particle size of 81.6 ± 3.56 nm and 137.1 ± 1.57 nm before and after steam sterilization, respectively. DNA condensation studies were carried out at various nanoemulsion: DNA ratios ranging from 1:1 to 10:1. Cell uptake studies were conducted on human embryonic kidney (HEK) cell lines which are widely reported for transfection studies. The nanoemulsions showed excellent cellular uptake as evaluated by fluorescence microscopy and flow cytometry. Overall, a colloidally stable cationic nanoemulsion with good DNA condensation ability was successfully fabricated for efficient cytosolic delivery and potential for in vivo effectiveness. PMID:25972740

Design of telehealth trials--introducing adaptive approaches.

PubMed

Law, Lisa M; Wason, James M S

2014-12-01

The field of telehealth and telemedicine is expanding as the need to improve efficiency of health care becomes more pressing. The decision to implement a telehealth system is generally an expensive undertaking that impacts a large number of patients and other stakeholders. It is therefore extremely important that the decision is fully supported by accurate evaluation of telehealth interventions. Numerous reviews of telehealth have described the evidence base as inconsistent. In response they call for larger, more rigorously controlled trials, and trials which go beyond evaluation of clinical effectiveness alone. The aim of this paper is to discuss various ways in which evaluation of telehealth could be improved by the use of adaptive trial designs. We discuss various adaptive design options, such as sample size reviews and changing the study hypothesis to address uncertain parameters, group sequential trials and multi-arm multi-stage trials to improve efficiency, and enrichment designs to maximise the chances of obtaining clear evidence about the telehealth intervention. There is potential to address the flaws discussed in the telehealth literature through the adoption of adaptive approaches to trial design. Such designs could lead to improvements in efficiency, allow the evaluation of multiple telehealth interventions in a cost-effective way, or accurately assess a range of endpoints that are important in the overall success of a telehealth programme. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Effect of Improving the Usability of an E-Learning Resource: A Randomized Trial

ERIC Educational Resources Information Center

Davids, Mogamat Razeen; Chikte, Usuf M. E.; Halperin, Mitchell L.

2014-01-01

Optimizing the usability of e-learning materials is necessary to reduce extraneous cognitive load and maximize their potential educational impact. However, this is often neglected, especially when time and other resources are limited. We conducted a randomized trial to investigate whether a usability evaluation of our multimedia e-learning…

Dynamics of Team Reflexivity after Feedback

ERIC Educational Resources Information Center

Gabelica, Catherine; Van den Bossche, Piet; Segers, Mien; Gijselaers, Wim

2014-01-01

A great deal of work has been generated on feedback in teams and has shown that giving performance feedback to teams is not sufficient to improve performance. To achieve the potential of feedback, it is stated that teams need to proactively process this feedback and thus collectively evaluate their performance and strategies, look for…

Farmers' Knowledge Attributes Contribute to Attaining Higher Farm Technical Efficiency: A Transition Economy Case

ERIC Educational Resources Information Center

Manevska-Tasevska, Gordana

2013-01-01

Purpose: This study sought to explore how farmers' knowledge attributes influence the technical efficiency of their farms. In addition, farm efficiency was compared to the actual Macedonian Rural Development Programme (RDP) (2007-2013) and instruments considered to improve Macedonian education potential were evaluated. Design/methodology/approach:…

Interseeding forage kochia into established Conservation Reserve Program (CRP) to improve fall and winter grazing potential

USDA-ARS?s Scientific Manuscript database

Highly erodible farm acres coming out of Conservation Reserve Program (CRP) contracts could remain in perennial species and be used for fall and winter grazing if wheatgrass monocultures could be renovated by interseeding nutritious forage species. This on-farm study evaluated the success of inters...

An Implementation and Outcome Evaluation of a Multicomponent Sexuality Education Programme for High School Students

ERIC Educational Resources Information Center

Berglas, Nancy F.; Jerman, Petra; Rohrbach, Louise A.; Angulo-Olaiz, Francisca; Chou, Chih-Ping; Constantine, Norman A.

2016-01-01

Numerous classroom-based interventions have aimed to improve sexual health outcomes for young people, yet few have shown strong, lasting effects. Ecological approaches that address multiple levels of a young person's environment offer largely untapped potential to positively change sexual behaviour. This paper presents results of a…

Evaluation of feed grade sodium bisulfate impact on gastrointestinal tract microbiota ecology in broilers via a pyrosequencing platform

USDA-ARS?s Scientific Manuscript database

The gastrointestinal microbial community in broiler chicken consists of many different species of bacteria and the overall microbiota can be various from bird to bird. In order to control pathogenic bacteria in broiler and improve gut health, numerous potential dietary amendments such as prebiotics...

The chloroplast psbK-psbI intergenic region, a potential genetic marker for broad sectional relationships in Anthurium

USDA-ARS?s Scientific Manuscript database

Nuclear and chloroplast genetic markers have been extensively used for plant identification and molecular taxonomy studies. The efficacy of genetic markers to be used as DNA barcodes is under constant evaluation and improvement, with identification of new barcodes that provide greater resolution an...

Evaluation of designer biochars to ameliorate select chemical and physical characteristics of degraded soils

USDA-ARS?s Scientific Manuscript database

Sandy Coastal Plain soils of the southeastern US have low water holding capacities that can reduce crop yields. Water holding capacities and thus potential yields can be improved by amendments of soils with biochar if it has the right characteristics. Biochars were produced by slow and fast pyrolysi...

The Potential of Environmental Sensors for Improving the Mobility Performance of Mainstream Blind Students. Final Report.

ERIC Educational Resources Information Center

Weisgerber, Robert A.; deHaas, Carla

The report describes an effort to develop and test instructional materials, techniques and procedures - ESSETS (environmental sensing, selection, evaluation and training system) - for teaching functionally blind young adults to use electronic travel aids (ETAs). Considered are development of training guidelines, field site selection and instructor…

Invasive species and biofuels: evaluating the risks of perennial crop breeding using reed canarygrass as a case study

USDA-ARS?s Scientific Manuscript database

Breeding efforts will play a critical role in meeting the increasing demand for cellulosic bioenergy feedstocks. However, a major concern is the potential development of novel invasive species that result from breeder’s efforts to improve agronomic traits in perennial crops. We use reed canarygrass ...

Estimation of Frequency Noise in Semiconductor Lasers Due to Mechanical Thermal Noise

NASA Technical Reports Server (NTRS)

Numata, Kenji; Camp, Jordan

2012-01-01

We evaluate mechanical thermal noise in semiconductor lasers, applying a methodology developed for fixed-spacer cavities for laser frequency stabilization. Our simple model determines an underlying fundamental limit for the frequency noise of free-running semiconductor laser, and provides a framework: where the noise may be potentially reduced with improved design.

Marketing therapeutic recreation services.

PubMed

Thorn, B E

1984-01-01

The use of marketing strategies can enhance the delivery of therapeutic recreation services. This article discusses how agencies can adapt marketing techniques and use them to identify potential markets, improve image, evaluate external pressures, and maximize internal strengths. Four variables that can be controlled and manipulated in a proposed marketing plan are product, price, place and promotion.

Evaluation of drug interaction potential of Labisia pumila (Kacip Fatimah) and its constituents

USDA-ARS?s Scientific Manuscript database

Labisia pumila (Kacip Fatimah) is a popular herb in Malaysia that has been traditionally used in a number of women's health applications such as to improve libido, relieve postmenopausal symptoms, and to facilitate or hasten delivery in childbirth. In addition, the constituents of this plant have be...

Further Analysis of the Effects of Positive Reinforcement on Working Memory in Children with Autism

ERIC Educational Resources Information Center

Baltruschat, Lisa; Hasselhorn, Marcus; Tarbox, Jonathan; Dixon, Dennis R.; Najdowski, Adel C.; Mullins, Ryan D.; Gould, Evelyn R.

2011-01-01

Individuals with autism spectrum disorders (ASD) often exhibit impaired executive function (EF) performance, including difficulty with working memory (WM), in particular. While research has documented the existence of these deficits, surprisingly little research exists that evaluates potential treatment strategies for improving EF or WM. One…

Working Your Way through College: A New Look at an Old Idea.

ERIC Educational Resources Information Center

Christoffel, Pamela

The potential for expanding job opportunities for college students to help cover expenses and provide valuable experiences was evaluated, based on an informal survey of federal, state, and institutional work-study programs. The focus is on recent innovations and possibilities for improvement. The U.S. Department of Education administers two…

Clear Expectations, Communication, and Flexibility: Unlocking the Potential of an Education Department through a Nontraditional Staffing Structure

ERIC Educational Resources Information Center

Flax, Corinne; Holko, Kathleen; Stricker, Laura

2017-01-01

After an outside evaluator identified key areas of improvement, the Education Department at the Bruce Museum refocused staff responsibilities in order to meet audience needs. To utilize staff effectively, the department underwent a radical restructuring, transitioning from a traditional vertical structure to a horizontal, integrated management…

Renewing America's Progress: A Positive Solution to School Reform.

ERIC Educational Resources Information Center

Genck, Fredric H.

This book was designed to help citizens evaluate and improve their local schools. It contends that the solution to the potential end of America's progress is through positive school reform--the public management of schools. It presents a system of participative and results-oriented management that is implemented by boards, administrators, and…

Life-Cycle Inventory Analysis of Bioproducts from a Modular Advanced Biomass Pyrolysis System

Treesearch

Richard Bergman; Hongmei Gu

2014-01-01

Expanding bioenergy production has the potential to reduce net greenhouse gas (GHG) emissions and improve energy security. Science-based assessments of new bioenergy technologies are essential tools for policy makers dealing with expanding renewable energy production. Using life cycle inventory (LCI) analysis, this study evaluated a 200-kWe...

The Relationship between Instructor Servant Leadership Behaviors and Satisfaction with Instructors in an Online Setting

ERIC Educational Resources Information Center

Sahawneh, Faris George; Benuto, Lorraine T.

2018-01-01

Servant leadership has the potential to improve student satisfaction within online learning. However, the relationship between servant leadership and student satisfaction in an online environment had not yet been understood at the level of the individual instructor. The purpose of this quantitative, correlational study was to evaluate the…

Evaluation and improvements of a mayfly, Neocloeon (Centroptilum) triangulifer (Ephemeroptera: Baetidae) toxicity test method - SETAC Europe 2016

EPA Science Inventory

A recently published test method for Neocloeon triangulifer assessed the survival and growth of larval mayflies exposed to several reference toxicants (NaCl, KCl, and CuSO4). Results were not able to be replicated in subsequent experiments. To identify potential sources of variab...

Brief Report: Emerging Services for Children with Autism Spectrum Disorders in Hong Kong (1960-2004)

ERIC Educational Resources Information Center

Wong, Virginia C. N.; Hui, Stella L. H.

2008-01-01

Early identification of autistic features in any child is important because there is potential for improvement by means of interventional, educational, or rehabilitative programs. Appropriate diagnosis of autism requires a dual-level approach--routine developmental surveillance and screening, and diagnosis and evaluation of autism. The historical…

An Evaluation of a Peer Support Program to Improve Quality of Life with Breast Cancer

DTIC Science & Technology

1999-07-01

educated women there was no difference between the two groups. In addition we investigated the potential for heterogeneity in the intervention effect by...therapy than women in the control group (p=.005) (Table 28). This relationship only existed among the less educated women. Among the more highly

Accounting for genotype–by-environment interactions and non-additive genetic variation in genomic selection for water-soluble carbohydrate concentration in wheat

USDA-ARS?s Scientific Manuscript database

Abiotic stress tolerance traits are often complex and recalcitrant targets for conventional breeding improvement in many crop species. This study evaluated the potential of genomic selection to predict water-soluble carbohydrate concentration (WSCC), an important drought tolerance trait, in wheat un...

An Initial Evaluation of Direct Care Staff Resilience Workshops in Intellectual Disabilities Services

ERIC Educational Resources Information Center

Ingham, Barry; Riley, Jenny; Nevin, Helen; Evans, Gemma; Gair, Elodie

2013-01-01

The emotional responses to challenging behaviour of direct care staff who support people with intellectual disabilities is thought to be an important mediating factor within the stress experienced by staff and a potential maintaining factor in challenging behaviour. A brief workshop to improve direct care staff resilience was developed and…

Assessment of long-term peach evaluation data reveals fruit trait distribution and selection tendencies

USDA-ARS?s Scientific Manuscript database

Conventional plant breeding has a long history of success. Although it is often a daunting job, it is still the most common approach used in today’s variety improvement programs. Efficient production of hybrids with potential for release as new varieties with desired traits relies on optimal selecti...

Improving operative flow during pediatric airway evaluation: a quality-improvement initiative.

PubMed

Prager, Jeremy D; Ruiz, Amanda G; Mooney, Kristin; Gao, Dexiang; Szolnoki, Judit; Shah, Rahul K

2015-03-01

Microlaryngoscopy and bronchoscopy procedures (MLBs) are short-duration, high-acuity procedures that carry risk. Poor case flow and communication exacerbate such potential risk. Efficient operative flow is critical for patient safety and resource expenditure. To identify areas for improvement and evaluate the effectiveness of a multidisciplinary quality-improvement (QI) initiative. A QI project using the "Plan-Do-Study-Act" (PDSA) cycle was implemented to assess MLBs performed on pediatric patients in a tertiary academic children's hospital. Forty MLBs were audited using a QI evaluation tool containing 144 fields. Each MLB was evaluated for flow, communication, and timing. Opportunities for improvement were identified. Subsequently, QI interventions were implemented in an iterative cycle, and 66 MLBs were audited after the intervention. Specific QI interventions addressed issues of personnel frequently exiting the operating room (OR) and poor preoperative preparation, identified during QI audit as areas for improvement. Interventions included (1) conducting "huddles" between surgeon and OR staff to discuss needed equipment; (2) implementing improvements to surgeon case ordering and preference cards review; (3) posting an OR door sign to limit traffic during airway procedures; and (4) discouraging personnel breaks during airway procedures. Operating room exiting behavior of OR personnel, preoperative preparation, and case timing were assessed and compared before and after the QI intervention. Personnel exiting the OR during the MLB was identified as a preintervention issue, with the surgical technologist, circulator, or surgeon exiting the room in 55% of cases (n = 22). The surgical technologist and circulator left the room to retrieve equipment in 40% of cases (n = 16), which indicated the need for increased preoperative preparation to improve case timing and operative flow. The QI interventions implemented to address these concerns included education regarding break timing, improvements in communication, and improvements in ordering and preparation of equipment. After the QI intervention, the surgical technologist exiting rate decreased from 20% (n = 8) to 8% (n = 5), and the circulator exiting rate decreased from 38% (n = 15) to 27% (n = 17). In addition, the rate of surgeon exiting decreased significantly (from 25% [n = 10 of 40] to 9% [n = 6 of 66]) (P = .03). The surgical technologist and circulating nurse remaining in the room were significantly associated with decreased operating time (1.84-minute decrease for surgical technologist [P = .04] and 1.95-minute decrease for circulating nurse [P = .001]). Gains were made in personnel exiting behavior and case timing after implementation of the QI interventions, potentially leading to decreased risk. This process is easily reproduced and is widely accepted by stakeholders.

Promotional communications for influenza vaccination: a systematic review.

PubMed

Macdonald, Laura; Cairns, Georgina; Angus, Kathryn; de Andrade, Marisa

2013-01-01

The authors conducted a systematic review that aimed to map current practice and identify effective practice in promotional communications for seasonal influenza vaccination in Europe. They identified 22 studies from 7 European countries. Included studies were primarily outcome evaluations of communications promoting vaccination to health care workers and elderly adults. Evidence on communications to improve public acceptance was sparse. A range of communication approaches, methods, materials, and channels were used, frequently in combination. All forms of promotional communications have the potential to increase uptake in health care workers and can also improve uptake among patients. There was promising evidence that mass communication methods, delivered as standalone activities or as one component of a communication mix, can improve uptake in target populations. Education for health care workers and improved service delivery are common adjuncts to promotional communications that were associated with effectiveness. The evidence suggests that personalized communications, combined with improved service delivery, might boost rates of uptake among elderly adults. Future development of good practice could be enhanced by more systematic, theory-based intervention design and more detailed reporting of process and outcome evaluations. Vaccine hesitancy is increasingly prevalent; more policy and research to improve public acceptance should therefore be considered.

Physiotherapy rehabilitation for whiplash associated disorder II: a systematic review and meta-analysis of randomised controlled trials

PubMed Central

Wright, Chris; Heneghan, Nicola; Eveleigh, Gillian; Calvert, Melanie; Freemantle, Nick

2011-01-01

Objective To evaluate effectiveness of physiotherapy management in patients experiencing whiplash associated disorder II, on clinically relevant outcomes in the short and longer term. Design Systematic review and meta-analysis. Two reviewers independently searched information sources, assessed studies for inclusion, evaluated risk of bias and extracted data. A third reviewer mediated disagreement. Assessment of risk of bias was tabulated across included trials. Quantitative synthesis was conducted on comparable outcomes across trials with similar interventions. Meta-analyses compared effect sizes, with random effects as primary analyses. Data sources Predefined terms were employed to search electronic databases. Additional studies were identified from key journals, reference lists, authors and experts. Eligibility criteria for selecting studies Randomised controlled trials (RCTs) published in English before 31 December 2010 evaluating physiotherapy management of patients (>16 years), experiencing whiplash associated disorder II. Any physiotherapy intervention was included, when compared with other types of management, placebo/sham, or no intervention. Measurements reported on ≥1 outcome from the domains within the international classification of function, disability and health, were included. Results 21 RCTs (2126 participants, 9 countries) were included. Interventions were categorised as active physiotherapy or a specific physiotherapy intervention. 20/21 trials were evaluated as high risk of bias and one as unclear. 1395 participants were incorporated in the meta-analyses on 12 trials. In evaluating short term outcome in the acute/sub-acute stage, there was some evidence that active physiotherapy intervention reduces pain and improves range of movement, and that a specific physiotherapy intervention may reduce pain. However, moderate/considerable heterogeneity suggested that treatments may differ in nature or effect in different trial patients. Differences between participants, interventions and trial designs limited potential meta-analyses. Conclusions Inconclusive evidence exists for the effectiveness of physiotherapy management for whiplash associated disorder II. There is potential benefit for improving range of movement and pain short term through active physiotherapy, and for improving pain through a specific physiotherapy intervention. PMID:22102642

Can sensory attention focused exercise facilitate the utilization of proprioception for improved balance control in PD?

PubMed

Lefaivre, Shannon C; Almeida, Quincy J

2015-02-01

Impaired sensory processing in Parkinson's disease (PD) has been argued to contribute to balance deficits. Exercises aimed at improving sensory feedback and body awareness have the potential to ameliorate balance deficits in PD. Recently, PD SAFEx™, a sensory and attention focused rehabilitation program, has been shown to improve motor deficits in PD, although balance control has never been evaluated. The objective of this study was to measure the effects of PD SAFEx™ on balance control in PD. Twenty-one participants with mild to moderate idiopathic PD completed 12 weeks of PD SAFEx™ training (three times/week) in a group setting. Prior to training, participants completed a pre-assessment evaluating balance in accordance with an objective, computerized test of balance (modified clinical test of sensory integration and balance (m-CTSIB) and postural stability testing (PST)) protocols. The m-CTSIB was our primary outcome measure, which allowed assessment of balance in both eyes open and closed conditions, thus enabling evaluation of specific sensory contributions to balance improvement. At post-test, a significant interaction between time of assessment and vision condition (p=.014) demonstrated that all participants significantly improved balance control, specifically when eyes were closed. Balance control did not change from pre to post with eyes open. These results provide evidence that PD SAFEx™ is effective at improving the ability to utilize proprioceptive information, resulting in improved balance control in the absence of vision. Enhancing the ability to utilize proprioception for individuals with PD is an important intermediary to improving balance deficits. Copyright © 2015. Published by Elsevier B.V.