Impact of Performance Contracts on the Utilization of Teaching and Learning Resources in Technical Institutes in Kenya

ERIC Educational Resources Information Center

Mosomi, Biutha Manwa; Kindiki, Jonah N.; Boit, John M.

2014-01-01

Performance contracting has been acclaimed as an effective and promising means of improving the performance of public enterprises as well as government departments. The government of Kenya introduced performance contract signing in 2004. The aim of performance contracts was to improve resource utilization in public institutions among other…

Simulator-Based Angiography and Endovascular Neurosurgery Curriculum: A Longitudinal Evaluation of Performance Following Simulator-Based Angiography Training.

PubMed

Pannell, J Scott; Santiago-Dieppa, David R; Wali, Arvin R; Hirshman, Brian R; Steinberg, Jeffrey A; Cheung, Vincent J; Oveisi, David; Hallstrom, Jon; Khalessi, Alexander A

2016-08-29

This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded. Image quality was rated, and the absolute value of technically unsafe events was recorded. The trainees' device selection, macrovascular access, microvascular access, clinical management, and the overall performance of the trainee was rated during each procedure based on a traditional Likert scale score of 1=fail, 2=poor, 3=satisfactory, 4=good, and 5=excellent. These ordinal values correspond with published assessment scales on surgical technique. After performing five diagnostic angiograms and five embolectomies, all participants demonstrated marked decreases in procedure time, fluoroscopy doses, contrast doses, and adverse technical events; marked improvements in image quality, device selection, access scores, and overall technical performance were additionally observed (p < 0.05). Similarly, trainees demonstrated marked improvement in technical performance and clinical management after five coiling procedures (p < 0.05). However, trainees with less prior experience deploying coils continued to experience intra-procedural ruptures up to the eighth embolization procedure; this observation likely corresponded with less tactile procedural experience to an exertion of greater force than appropriate for coil placement. Trainees across all levels of training and prior experience demonstrated a significant performance improvement after completion of our simulator curriculum consisting of five diagnostic angiograms, five embolectomy cases, and 10 aneurysm coil embolizations.

Gigabit Ethernet: A Technical Assessment.

ERIC Educational Resources Information Center

Axner, David

1997-01-01

Describes gigabit ethernet for LAN (local area network) technology that will expand ethernet bandwidth. Technical details are discussed, including protocol stacks, optical fiber, deployment strategy for performance improvement, ATM (Asynchronous Transfer Mode), real-time protocol, reserve reservation protocol, and standards. (LRW)

Surgeons' and trainees' perceived self-efficacy in operating theatre non-technical skills.

PubMed

Pena, G; Altree, M; Field, J; Thomas, M J W; Hewett, P; Babidge, W; Maddern, G J

2015-05-01

An important factor that may influence an individual's performance is self-efficacy, a personal judgement of capability to perform a particular task successfully. This prospective study explored newly qualified surgeons' and surgical trainees' self-efficacy in non-technical skills compared with their non-technical skills performance in simulated scenarios. Participants undertook surgical scenarios challenging non-technical skills in two simulation sessions 6 weeks apart. Some participants attended a non-technical skills workshop between sessions. Participants completed pretraining and post-training surveys about their perceived self-efficacy in non-technical skills, which were analysed and compared with their performance in surgical scenarios in two simulation sessions. Change in performance between sessions was compared with any change in participants' perceived self-efficacy. There were 40 participants in all, 17 of whom attended the non-technical skills workshop. There was no significant difference in participants' self-efficacy regarding non-technical skills from the pretraining to the post-training survey. However, there was a tendency for participants with the highest reported self-efficacy to adjust their score downwards after training and for participants with the lowest self-efficacy to adjust their score upwards. Although there was significant improvement in non-technical skills performance from the first to second simulation sessions, a correlation between participants' self-efficacy and performance in scenarios in any of the comparisons was not found. The results suggest that new surgeons and surgical trainees have poor insight into their non-technical skills. Although it was not possible to correlate participants' self-belief in their abilities directly with their performance in a simulation, in general they became more critical in appraisal of their abilities as a result of the intervention. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Goddard Geophysical and Astronomical Observatory

NASA Technical Reports Server (NTRS)

Redmond, Jay; Kodak, Charles

2004-01-01

This report summarizes the technical parameters and the technical staff of the VLBI system at the fundamental station GGAO. It also gives an overview about the VLBI activities during the previous year. The outlook lists the outstanding tasks to improve the performance of GGAO.

A systematic review of evidence for education and training interventions in microsurgery.

PubMed

Ghanem, Ali M; Hachach-Haram, Nadine; Leung, Clement Chi Ming; Myers, Simon Richard

2013-07-01

Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

The Effect of Technical Performance on Patient Outcomes in Surgery: A Systematic Review.

PubMed

Fecso, Andras B; Szasz, Peter; Kerezov, Georgi; Grantcharov, Teodor P

2017-03-01

Systematic review of the effect of intraoperative technical performance on patient outcomes. The operating room is a high-stakes, high-risk environment. As a result, the quality of surgical interventions affecting patient outcomes has been the subject of discussion and research for years. MEDLINE, EMBASE, PsycINFO, and Cochrane databases were searched. All surgical specialties were eligible for inclusion. Data were reviewed in regards to the methods by which technical performance was measured, what patient outcomes were assessed, and how intraoperative technical performance affected patient outcomes. Quality of evidence was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Of the 12,758 studies initially identified, 24 articles (7775 total participants) were ultimately included in this review. Seventeen studies assessed the performance of the faculty alone, 2 assessed both the faculty and trainees, 1 assessed trainees alone, and in 4 studies, the level of the operating surgeon was not specified. In 18 studies, a performance assessment tool was used. Patient outcomes were evaluated using intraoperative complications, short-term morbidity, long-term morbidity, short-term mortality, and long-term mortality. The average MERSQI score was 11.67 (range 9.5-14.5). Twenty-one studies demonstrated that superior technical performance was related to improved patient outcomes. The results of this systematic review demonstrated that superior technical performance positively affects patient outcomes. Despite this initial evidence, more robust research is needed to directly assess intraoperative technical performance and its effect on postoperative patient outcomes using meaningful assessment instruments and reliable processes.

Simulated lumbar minimally invasive surgery educational model with didactic and technical components.

PubMed

Chitale, Rohan; Ghobrial, George M; Lobel, Darlene; Harrop, James

2013-10-01

The learning and development of technical skills are paramount for neurosurgical trainees. External influences and a need for maximizing efficiency and proficiency have encouraged advancements in simulator-based learning models. To confirm the importance of establishing an educational curriculum for teaching minimally invasive techniques of pedicle screw placement using a computer-enhanced physical model of percutaneous pedicle screw placement with simultaneous didactic and technical components. A 2-hour educational curriculum was created to educate neurosurgical residents on anatomy, pathophysiology, and technical aspects associated with image-guided pedicle screw placement. Predidactic and postdidactic practical and written scores were analyzed and compared. Scores were calculated for each participant on the basis of the optimal pedicle screw starting point and trajectory for both fluoroscopy and computed tomographic navigation. Eight trainees participated in this module. Average mean scores on the written didactic test improved from 78% to 100%. The technical component scores for fluoroscopic guidance improved from 58.8 to 52.9. Technical score for computed tomography-navigated guidance also improved from 28.3 to 26.6. Didactic and technical quantitative scores with a simulator-based educational curriculum improved objectively measured resident performance. A minimally invasive spine simulation model and curriculum may serve a valuable function in the education of neurosurgical residents and outcomes for patients.

Chemical Durability Improvement and Static Fatigue of Glasses.

DTIC Science & Technology

1982-08-01

Afl-Alla 837 RENSSELAER POLYIECmfJ!C INST TRtOY NY DEPT OF MATERIAL--ETC F/6 ii/ CHEMICAL DURABILITY IMPROVEMENT AND STATIC FATIGUE OF GLASSESW AUC2...82 M TOMOZAWA NOGGIN 7A-C-0315 UNC LASS IF IED N ENEEEEEE FINAL TECHNICAL REPORT For the period April 1, 1978 "u March 31, 198200 CHEMICAL DURABILITY...REPORT A PERIOD COVERED Chemical Durability Improvement and Static Final Technical Report Fatiue o GlasesApril 1, 1978"’,March 31, 1982 S. PERFORMING ORG

Improving Fatigue Performance of AHSS Welds

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

Feng, Zhili; Yu, Xinghua; Erdman, III, Donald L.

Reported herein is technical progress on a U.S. Department of Energy CRADA project with industry cost-share aimed at developing the technical basis and demonstrate the viability of innovative in-situ weld residual stresses mitigation technology that can substantially improve the weld fatigue performance and durability of auto-body structures. The developed technology would be costeffective and practical in high-volume vehicle production environment. Enhancing weld fatigue performance would address a critical technology gap that impedes the widespread use of advanced high-strength steels (AHSS) and other lightweight materials for auto body structure light-weighting. This means that the automotive industry can take full advantage ofmore » the AHSS in strength, durability and crashworthiness without the concern of the relatively weak weld fatigue performance. The project comprises both technological innovations in weld residual stress mitigation and due-diligence residual stress measurement and fatigue performance evaluation. Two approaches were investigated. The first one was the use of low temperature phase transformation (LTPT) weld filler wire, and the second focused on novel thermo-mechanical stress management technique. Both technical approaches have resulted in considerable improvement in fatigue lives of welded joints made of high-strength steels. Synchrotron diffraction measurement confirmed the reduction of high tensile weld residual stresses by the two weld residual stress mitigation techniques.« less

Final Report of Technical Assistance Provided to Guarantee Agencies with Recommendations for Further Improving Program Performance.

ERIC Educational Resources Information Center

Touche Ross and Co., Washington, DC.

Technical assistance provided to loan guarantee agencies by Touche Ross and Co. under contract to the U.S. Office of Education (OE) is described. Objectives of the report are: to summarize the work performed and the results of each of the projects that were conducted; to describe certain prototype systems that were developed for the guarantee…

Development and implementation of a clinical pathway approach to simulation-based training for foregut surgery

PubMed Central

Miyasaka, Kiyoyuki W; Buchholz, Joseph; LaMarra, Denise; Karakousis, Giorgos C; Aggarwal, Rajesh

2015-01-01

Introduction Contemporary demands on resident education call for integration of simulation. We designed and implemented a simulation-based curriculum for PGY1 surgery residents to teach technical and non-technical skills within a clinical pathway approach for a foregut surgical patient, from outpatient visit through surgery and post-op follow-up. Methods The three-day curriculum for groups of six residents comprises a combination of standardized patient (SP) encounters, didactic sessions, and hands-on training. The curriculum is underpinned by a summative simulation “pathway” repeated on days 1 and 3. The “pathway” is a series of simulated pre-op, intra-op, and post-op encounters following a single patient through a disease process. The resident sees an SP in clinic presenting with distal gastric cancer, then enters an operating room to perform a gastro-jejunostomy on a porcine tissue model. Finally, the resident engages in a simulated post-operative visit. All encounters are rated by faculty members and the residents themselves, using standardized assessment forms endorsed by the American Board of Surgery. Results 18 first-year residents underwent this curriculum. Faculty ratings of overall operative performance significantly improved following the three-day module. Ratings of preoperative and postoperative performance were not significantly changed in three days. Resident self-ratings significantly improved for all encounters assessed, as did reported confidence in meeting defined learning objectives. Conclusions Conventional surgical simulation training focuses on technical skills in isolation. Our novel “pathway” curriculum targets an important gap in training methodologies by placing both technical and non-technical skills in their clinical context as part of managing a surgical patient. Results indicate consistent improvements in assessments of performance as well as confidence and support its continued usage to educate surgery residents in foregut surgery. PMID:25869238

Metrology Standards for Quantitative Imaging Biomarkers

PubMed Central

Obuchowski, Nancy A.; Kessler, Larry G.; Raunig, David L.; Gatsonis, Constantine; Huang, Erich P.; Kondratovich, Marina; McShane, Lisa M.; Reeves, Anthony P.; Barboriak, Daniel P.; Guimaraes, Alexander R.; Wahl, Richard L.

2015-01-01

Although investigators in the imaging community have been active in developing and evaluating quantitative imaging biomarkers (QIBs), the development and implementation of QIBs have been hampered by the inconsistent or incorrect use of terminology or methods for technical performance and statistical concepts. Technical performance is an assessment of how a test performs in reference objects or subjects under controlled conditions. In this article, some of the relevant statistical concepts are reviewed, methods that can be used for evaluating and comparing QIBs are described, and some of the technical performance issues related to imaging biomarkers are discussed. More consistent and correct use of terminology and study design principles will improve clinical research, advance regulatory science, and foster better care for patients who undergo imaging studies. © RSNA, 2015 PMID:26267831

Evaluating SPP/APR Improvement Activities

ERIC Educational Resources Information Center

National Early Childhood Technical Assistance Center (NECTAC), 2009

2009-01-01

This document is intended to assist State Education Agency (SEA) and Lead Agency (LA) staff and technical assistance providers in designing a meaningful evaluation for the State Performance Plan (SPP)/Annual Performance Report (APR) improvement activities. It provides: (1) information about the relevance of evaluation in the context of improvement…

Debriefing after simulation-based non-technical skill training in healthcare: a systematic review of effective practice.

PubMed

Garden, A L; Le Fevre, D M; Waddington, H L; Weller, J M

2015-05-01

Non-technical skills training in healthcare frequently uses high-fidelity simulation followed by a facilitated discussion known as debriefing. This type of training is mandatory for anaesthesia training in Australia and New Zealand. Debriefing by a skilled facilitator is thought to be essential for new learning through feedback and reflective processes. Key elements of effective debriefing need to be clearly identified to ensure that the training is evidence-based. We undertook a systematic review of empirical studies where elements of debriefing have been systematically manipulated during non-technical skills training. Eight publications met the inclusion criteria, but seven of these were of limited generalisability. The only study that was generalisable found that debriefing by novice instructors using a script improved team leader performance in paediatric resuscitation. The remaining seven publications were limited by the small number of debriefers included in each study and these reports were thus analogous to case reports. Generally, performance improved after debriefing by a skilled facilitator. However, the debriefer provided no specific advantage over other post-experience educational interventions. Acknowledging their limitations, these studies found that performance improved after self-led debrief, no debrief (with experienced practitioners), standardised multimedia debrief or after reviewing a DVD of the participants' own eye-tracking. There was no added performance improvement when review of a video recording was added to facilitator-led debriefing. One study reported no performance improvement after debriefing. Without empirical evidence that is specific to the healthcare domain, theories of learning from education and psychology should continue to inform practices and teaching for effective debriefing.

Improved self-contained breathing apparatus concept. Final report Oct 80-Jun 82

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

White, L.; Walker, J.

1982-08-01

Past operational experiences of USAF fire fighting and rescue teams have indicated the need for an improved self-contained breathing apparatus (SCBA). In October 1980, a contract was awarded to Electronic Data Systems, Panama City, Florida, to design and develop a prototype SCBA that would meet Air Force technical requirements. A prototype was designed, developed, and tested through a subcontract with Reimers Consultants, Falls Church, Virginia. This report describes the technical requirements, a detailed technical description of the unit, and the unmanned test procedures and results. The unmanned testing demonstrate that the prototype SCBA meets all performance requirements, except for weight.more » The fully charged prototype weights 34 pounds, the maximum acceptable weight is 30 pounds. With the other performance requirements either met or exceeded, manned testing of the SCBA can proceed.« less

77 FR 46658 - Proposed Priority; Technical Assistance To Improve State Data Capacity-National Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

... percent of youth with individualized education programs (IEPs) graduating with a regular high school... 100,000 schools through EDFacts. \\4\\ Education Department General Administrative Regulations (EDGAR... Department programs (e.g., Consolidated State Performance Report under the Elementary and Secondary Education...

Efficiency and productivity of hospitals in Vietnam.

PubMed

Pham, Thuy Linh

2011-01-01

The purpose of this paper is to examine the relative efficiency and productivity of hospitals during the health reform process. Data envelopment analyses method (DEA) with the input-oriented variable-returns-to-scale model was used to calculate efficiency scores. Malmquist total factor productivity index approach was then employed to calculate productivity of hospitals. Data of 101 hospitals was extracted from databases of the Ministry of Health, Vietnam from the years 1998 to 2006. There was evidence of improvement in overall technical efficiency from 65 per cent in 1998 to 76 per cent in 2006. Hospitals' productivity progressed around 1.4 per cent per year, which was mainly due to the technical efficiency improvement. Furthermore, provincial hospitals were more technically efficient than their central counterparts and hospitals located in different regions performed differently. The paper provides an insight in the performance of Vietnamese public hospitals that has been rarely examined before and contributes to the existing literature of hospital performance in developing countries

Goddard Geophysical and Astronomical Observatory

NASA Technical Reports Server (NTRS)

Redmond, Jay; Kodak, Charles

2001-01-01

This report summarizes the technical parameters and the technical staff of the Very Long Base Interferometry (VLBI) system at the fundamental station Goddard Geophysical and Astronomical Observatory (GGAO). It also gives an overview about the VLBI activities during the previous year. The outlook lists the outstanding tasks to improve the performance of GGAO.

Rating teams' non-technical skills in the emergency department: A qualitative study of nurses' experience.

PubMed

Porter, Joanne E; Cant, Robyn P; Cooper, Simon J

2018-05-01

Non-technical skills (NTS) teamwork training can enhance clinicians' understanding of roles and improve communication. We evaluated a quality improvement project rating teams' NTS performance to determine the value of formal rating and debriefing processes. In two Australian emergency departments the NTS of resuscitation teams were rated by senior nurses and medical staff. Key measures were leadership, teamwork, and task management using a valid instrument: Team Emergency Assessment Measure (TEAM™). Emergency nurses were asked to attend a focus group from which key themes around the quality improvement process were identified. Main themes were: 'Team composition' (allocation of resuscitation team roles), 'Resuscitation leadership' (including both nursing and medical leadership roles) and 'TEAM™ ratings promote reflective practice' (providing staff a platform to discuss team effectiveness). Objective ratings were seen as enabling staff to provide feedback to other team members. Reflection on practice and debriefing were thought to improve communication, help define roles and responsibilities, and clarify leadership roles. Use of a non-technical skills rating scheme such as TEAM™ after team-based clinical resuscitation events was seen by emergency department nurses as feasible and a useful process for examining and improving multi-disciplinary practice, while improving team performance. Copyright © 2018 Elsevier Ltd. All rights reserved.

Laparoscopic skills suffer on the first shift of sequential night shifts: program directors beware and residents prepare.

PubMed

Leff, Daniel R; Aggarwal, Rajesh; Rana, Mariam; Nakhjavani, Batool; Purkayastha, Sanjay; Khullar, Vik; Darzi, Ara W

2008-03-01

Research evaluating fatigue-induced skills decline has focused on acute sleep deprivation rather than the effects of circadian desynchronization associated with multiple shifts. As a result, the number of consecutive night shifts that residents can safely be on duty without detrimental effects to their technical skills remains unknown. A prospective observational cohort study was conducted to assess the impact of 7 successive night shifts on the technical surgical performance of junior residents. The interventional strategy included training 21 residents from surgery and allied disciplines on a virtual reality surgical simulator, towards the achievement of preset benchmark scores, followed by 294 technical skills assessments conducted over 1764 manpower night shift hours. Primary outcomes comprised serial technical skills assessments on 2 tasks of a virtual reality surgical simulator. Secondary outcomes included assessments of introspective fatigue, duration of sleep, and prospective recordings of activity (number of "calls" received, steps walked, and patients evaluated). Maximal deterioration in performance was observed following the first night shift. Residents took significantly longer to complete the first (P = 0.002) and second tasks (P = 0.005) compared with baseline. They also committed significantly greater numbers of errors (P = 0.025) on the first task assessed. Improved performance was observed across subsequent shifts towards baseline levels. Newly acquired technical surgical skills deteriorate maximally after the first night shift, emphasizing the importance of adequate preparation for night rotas. Performance improvements across successive shifts may be due to ongoing learning or adaptation to chronic fatigue. Further research should focus on assessments of both technical procedural skills and cognitive abilities to determine the rotas that best minimize errors and maximize patient safety.

Learning curves for transapical transcatheter aortic valve replacement in the PARTNER-I trial: Technical performance, success, and safety.

PubMed

Suri, Rakesh M; Minha, Sa'ar; Alli, Oluseun; Waksman, Ron; Rihal, Charanjit S; Satler, Lowell P; Greason, Kevin L; Torguson, Rebecca; Pichard, Augusto D; Mack, Michael; Svensson, Lars G; Rajeswaran, Jeevanantham; Lowry, Ashley M; Ehrlinger, John; Mick, Stephanie L; Tuzcu, E Murat; Thourani, Vinod H; Makkar, Raj; Holmes, David; Leon, Martin B; Blackstone, Eugene H

2016-09-01

Introduction of hybrid techniques, such as transapical transcatheter aortic valve replacement (TA-TAVR), requires skills that a heart team must master to achieve technical efficiency: the technical performance learning curve. To date, the learning curve for TA-TAVR remains unknown. We therefore evaluated the rate at which technical performance improved, assessed change in occurrence of adverse events in relation to technical performance, and determined whether adverse events after TA-TAVR were linked to acquiring technical performance efficiency (the learning curve). From April 2007 to February 2012, 1100 patients, average age 85.0 ± 6.4 years, underwent TA-TAVR in the PARTNER-I trial. Learning curves were defined by institution-specific patient sequence number using nonlinear mixed modeling. Mean procedure time decreased from 131 to 116 minutes within 30 cases (P = .06) and device success increased to 90% by case 45 (P = .0007). Within 30 days, 354 patients experienced a major adverse event (stroke in 29, death in 96), with possibly decreased complications over time (P ∼ .08). Although longer procedure time was associated with more adverse events (P < .0001), these events were associated with change in patient risk profile, not the technical performance learning curve (P = .8). The learning curve for TA-TAVR was 30 to 45 procedures performed, and technical efficiency was achieved without compromising patient safety. Although fewer patients are now undergoing TAVR via nontransfemoral access, understanding TA-TAVR learning curves and their relationship with outcomes is important as the field moves toward next-generation devices, such as those to replace the mitral valve, delivered via the left ventricular apex. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Service use and financial performance in a replication program on adult day centers.

PubMed

Reifler, B V; Cox, N J; Jones, B N; Rushing, J; Yates, K

1999-01-01

The authors describe results from Partners in Caregiving: The Dementia Services Program, and present information on service utilization and financial performance among a group of 48 adult day centers across the United States from 1992 to 1996. Centers, with nonrandom assignment, received either grant support (average value: $93,000) or intensive technical assistance (average value: $39,000). Sites reported baseline data and submitted utilization information (enrollment and census) and financial data (revenue and expenses) quarterly. Overall, there were significant increases in enrollment, census, and financial performance (percent of cash expenses met through operating revenue) over the 4-year period. The grant-supported and technical-assistance sites had similar rates of improvement. Results provide data on service utilization and financial performance and demonstrate gains that can be achieved in these areas through improved marketing and financial management.

[Value of ultrasonically-guided liver puncture biopsy in the diagnosis of primary liver cancer. Apropos of 84 cases].

PubMed

Peghini, M; Eynard, J P; Vergne, R; Seurat, P; Barabe, P; Aubry, P; Diallo, A; Gueye, P M

1987-01-01

Ultrasonographicaly guided fine needle aspiration of liver was performed in 84 patients having a confirmed HCC. This technics utilizes a CHIBA type fine needle, after blood coagulation tests have been checked. Out of 84 fine needle aspirations performed: 64 were positive (76,2%), 9 negative (10,7%), 11 (13,19%) were questionable (6) or nonanalysable (5). It is ascertained that the sensibility of this technics is over 75%. It should be possible to improve it by repeating such an exam in previously negative patients. The causes of failure are discussed. Tolerance of the technics is good. It is attraumatic, and of very easily performance. No accident, no mishap was noted.

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

PubMed Central

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

2017-01-01

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

Software Engineering Improvement Plan

NASA Technical Reports Server (NTRS)

2006-01-01

In performance of this task order, bd Systems personnel provided support to the Flight Software Branch and the Software Working Group through multiple tasks related to software engineering improvement and to activities of the independent Technical Authority (iTA) Discipline Technical Warrant Holder (DTWH) for software engineering. To ensure that the products, comments, and recommendations complied with customer requirements and the statement of work, bd Systems personnel maintained close coordination with the customer. These personnel performed work in areas such as update of agency requirements and directives database, software effort estimation, software problem reports, a web-based process asset library, miscellaneous documentation review, software system requirements, issue tracking software survey, systems engineering NPR, and project-related reviews. This report contains a summary of the work performed and the accomplishments in each of these areas.

76 FR 48822 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-09

... improved student performance on standardized measures of math and literacy achievement (Pearson, Sawyer... skills in context: Testing the value of enhanced math learning in CTE (Final study). St. Paul, Minnesota...

Cricothyroidotomy In Situ Simulation Curriculum (CRIC Study): Training Residents for Rare Procedures.

PubMed

Petrosoniak, Andrew; Ryzynski, Agnes; Lebovic, Gerald; Woolfrey, Karen

2017-04-01

Technical skill acquisition for rare procedures can be challenging given the few real-life training opportunities. In situ simulation (ISS), a training technique that takes place in the actual workplace, is a promising method to promote environmental fidelity for rare procedures. This study evaluated a simulation-based technical skill curriculum for cricothyroidotomy using deliberate practice, followed by an ISS evaluation session. Twenty emergency medicine residents participated in a two-part curriculum to improve cricothryoidotomy performance. A pretest established participant baseline technical skill. The training session consisted of two parts, didactic teaching followed by deliberate practice using a task-training manikin. A posttest consisted of an unannounced, high-fidelity ISS, during an emergency department shift. The primary outcome was the mean performance time between the pretest and posttest sessions. Skill performance was also evaluated using a checklist scale and global rating scale. Cricothyroidotomy performance time improved significantly from pretest to posttest sessions (mean difference, 59 seconds; P < 0.0001). Both checklist and global rating scales improved significantly from the pretest to the posttest with a mean difference of 1.82 (P = 0.002) and 6.87 (P = 0.0025), respectively. Postcourse survey responses were favorable for both the overall curriculum experience and the unannounced ISS. This pilot study demonstrated that unannounced ISS is feasible and can be used to effectively measure cricothyroidotomy performance among EM residents. After a two-part training session consisting of didactic learning and deliberate practice, improved cricothyroidotomy skill performance was observed during an unannounced ISS in the emergency department. The integration of ISS in cricothyroidotomy training represents a promising approach; however, further study is needed to establish its role.

Initial assessment of strategic plans for improving the performance of veterinary services in developing countries: a review of OIE PVS gap analysis reports.

PubMed

Weaver, J; Leon, E; Edan, M; D'Alessio, F

2012-08-01

The World Organisation for Animal Health (OIE) carries out Gap Analysis missions (if a country so wishes) as part of its programme to assess and improve the Performance of Veterinary Services (the 'PVS Pathway') in Member Countries. These Gap Analysis missions have found that many national Veterinary Services comply to only a limited extent with the international standards established by the OIE and that their competence is compromised by poor governance. This failure threatens animal and public health not only nationally but also internationally. The OIE PVS Gap Analysis reports reviewed found that all the Veterinary Services have a strong vision and commitmentto improvement but are held back by a weak chain of command, inadequate and outdated legislation, insufficient funding, weak technical competencies, compromised technical independence, poor communications and limited joint programmes. There are weaknesses across all the core technical areas of trade, animal health, veterinary public health and veterinary laboratories and also in the overall management of the Veterinary Services. The OIE PVS Gap Analysis missions recommend significant increases in budget in all countries.

Peer coaching to teach faculty surgeons an advanced laparoscopic skill: A randomized controlled trial.

PubMed

Palter, Vanessa N; Beyfuss, Kaitlyn A; Jokhio, Adam R; Ryzynski, Agnes; Ashamalla, Shady

2016-11-01

Preliminary evidence suggests that coaching is an effective adjunct in resident training. The learning needs of faculty, however, are different from those of trainees. Assessing the effectiveness of peer coaching at improving the technical proficiency of practicing surgeons is an area that remains largely unexplored. The purpose of this study was to assess the efficacy of a peer coaching program that teaches laparoscopic suturing to faculty surgeons. Surgeons inexperienced in laparoscopic suturing were randomized to either conventional training or peer coaching. Both groups performed a pretest on a box trainer. The conventional training group then received a web link to a tutorial for teaching laparoscopic suturing and a box trainer for independent practice. In addition to the web link and the box trainer, the peer coaching group received 2 half hour peer coaching sessions. Both groups then performed a stitch on the box trainer that was video recorded. The primary outcome measure was technical performance, which was assessed by a global rating scale. Eighteen faculty were randomized (conventional training n = 9; peer coaching n = 9). Initially, there was no difference in technical skills between the groups (conventional training median score 10 [interquartile range 8.5-15]; peer coaching 13 [10.5-14]; P = .64). After the intervention, the peer coaching group had improved technical performance (conventional training 11 [8.5-12.5]; peer coaching 18 [17-19]; P < .01). Comparing the pre- and postintervention scores within both groups, there was an improvement in technical proficiency in the peer coaching group, yet none in the conventional training group (before conventional training 10 [8.5-15], after conventional training 11 [8.5-12.5]; P = .56; before peer coaching 13 [10.5-14], after peer coaching 18 [17-19]; P < .01). This trial demonstrates that a structured peer coaching program can facilitate faculty surgeons learning a novel procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

A University Engagement Model for Achieving Technology Adoption and Performance Improvement Impacts in Healthcare, Manufacturing, and Government

ERIC Educational Resources Information Center

McKinnis, David R.; Sloan, Mary Anne; Snow, L. David; Garimella, Suresh V.

2014-01-01

The Purdue Technical Assistance Program (TAP) offers a model of university engagement and service that is achieving technology adoption and performance improvement impacts in healthcare, manufacturing, government, and other sectors. The TAP model focuses on understanding and meeting the changing and challenging needs of those served, always…

76 FR 71568 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

... control number); Title of Information Collection: Nursing Home Quality Improvement Questionnaire; Use: The information obtained via the Nursing Home Quality Improvement Questionnaire will be utilized by CMS staff in... and performance improvement (QAPI) technical assistance (TA) that will be useful to nursing facilities...

Technical Performance as a Predictor of Clinical Outcomes in Laparoscopic Gastric Cancer Surgery.

PubMed

Fecso, Andras B; Bhatti, Junaid A; Stotland, Peter K; Quereshy, Fayez A; Grantcharov, Teodor P

2018-03-23

The purpose of this study was to evaluate the relationship between technical performance and patient outcomes in laparoscopic gastric cancer surgery. Laparoscopic gastrectomy for cancer is an advanced procedure with high rate of postoperative morbidity and mortality. Many variables including patient, disease, and perioperative management factors have been shown to impact postoperative outcomes; however, the role of surgical performance is insufficiently investigated. A retrospective review was performed for all patients who had undergone laparoscopic gastrectomy for cancer at 3 teaching institutions between 2009 and 2015. Patients with available, unedited video-recording of their procedure were included in the study. Video files were rated for technical performance, using Objective Structured Assessments of Technical Skills (OSATS) and Generic Error Rating Tool instruments. The main outcome variable was major short-term complications. The effect of technical performance on patient outcomes was assessed using logistic regression analysis with backward selection strategy. Sixty-one patients with available video recordings were included in the study. The overall complication rate was 29.5%. The mean Charlson comorbidity index, type of procedure, and the global OSATS score were included in the final predictive model. Lower performance score (OSATS ≤29) remained an independent predictor for major short-term outcomes (odds ratio 6.49), while adjusting for comorbidities and type of procedure. Intraoperative technical performance predicts major short-term outcomes in laparoscopic gastrectomy for cancer. Ongoing assessment and enhancement of surgical skills using modern, evidence-based strategies might improve short-term patient outcomes. Future work should focus on developing and studying the effectiveness of such interventions in laparoscopic gastric cancer surgery.

A combined teamwork training and work standardisation intervention in operating theatres: controlled interrupted time series study.

PubMed

Morgan, Lauren; Pickering, Sharon P; Hadi, Mohammed; Robertson, Eleanor; New, Steve; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

2015-02-01

Teamwork training and system standardisation have both been proposed to reduce error and harm in surgery. Since the approaches differ markedly, there is potential for synergy between them. Controlled interrupted time series with a 3 month intervention and observation phases before and after. Operating theatres conducting elective orthopaedic surgery in a single hospital system (UK Hospital Trust). Teamwork training based on crew resource management plus training and follow-up support in developing standardised operating procedures. Focus of subsequent standardisation efforts decided by theatre staff. Paired observers watched whole procedures together. We assessed non-technical skills using NOTECHS II, technical performance using glitch rate and compliance with WHO checklist using a simple quality tool. We measured complication and readmission rates and hospital stay using hospital administrative records. Before/after change was compared in the active and control groups using two-way ANOVA and regression models. 1121 patients were operated on before and 1100 after intervention. 44 operations were observed before and 50 afterwards. Non-technical skills (p=0.002) and WHO compliance (p<0.001) improved significantly after the intervention in the active versus the control group. Glitch count improved in both groups and there was no significant effect on clinical outcomes. Combined training in teamwork and system improvement causes marked improvements in team behaviour and WHO performance, but not technical performance or outcome. These findings are consistent with the synergistic hypothesis, but larger controlled studies with a strong implementation strategy are required to test potential outcome effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effects of kinesthetic versus visual imagery practice on two technical dance movements: a pilot study.

PubMed

Girón, Elizabeth Coker; McIsaac, Tara; Nilsen, Dawn

2012-03-01

Motor imagery is a type of mental practice that involves imagining the body performing a movement in the absence of motor output. Dance training traditionally incorporates mental practice techniques, but quantitative effects of motor imagery on the performance of dance movements are largely unknown. This pilot study compared the effects of two different imagery modalities, external visual imagery and kinesthetic imagery, on pelvis and hip kinematics during two technical dance movements, plié and sauté. Each of three female dance students (mean age = 19.7 years, mean years of training = 10.7) was assigned to use a type of imagery practice: visual imagery, kinesthetic imagery, or no imagery. Effects of motor imagery on peak external hip rotation varied by both modality and task. Kinesthetic imagery increased peak external hip rotation for pliés, while visual imagery increased peak external hip rotation for sautés. Findings suggest that the success of motor imagery in improving performance may be task-specific. Dancers may benefit from matching imagery modality to technical tasks in order to improve alignment and thereby avoid chronic injury.

Tactical and operational response to major incidents: feasibility and reliability of skills assessment using novel virtual environments.

PubMed

Cohen, Daniel; Sevdalis, Nick; Patel, Vishal; Taylor, Michael; Lee, Henry; Vokes, Mick; Heys, Mick; Taylor, David; Batrick, Nicola; Darzi, Ara

2013-07-01

To determine feasibility and reliability of skills assessment in a multi-agency, triple-site major incident response exercise carried out in a virtual world environment. Skills assessment was carried out across three scenarios. The pre-hospital scenario required paramedics to triage and treat casualties at the site of an explosion. Technical skills assessment forms were developed using training syllabus competencies and national guidelines identified by pre-hospital response experts. Non-technical skills were assessed using a seven-point scale previously developed for use by pre-hospital paramedics. The two in-hospital scenarios, focusing on a trauma team leader and a silver/clinical major incident co-ordinator, utilised the validated Trauma-NOTECHS scale to assess five domains of performance. Technical competencies were assessed using an ATLS-style competency scale for the trauma scenario. For the silver scenario, the assessment document was developed using competencies described from a similar role description in a real-life hospital major incident plan. The technical and non-technical performance of all participants was assessed live by two experts in each of the three scenarios and inter-assessor reliability was computed. Participants also self-assessed their performance using identical proformas immediately after the scenarios were completed. Self and expert assessments were correlated (assessment cross-validation). Twenty-three participants underwent all scenarios and assessments. Performance assessments were feasible for both experts as well as the participants. Non-technical performance was generally scored higher than technical performance. Very good inter-rater reliability was obtained between expert raters across all scenarios and both technical and non-technical aspects of performance (reliability range 0.59-0.90, Ps<0.01). Significant positive correlations were found between self and expert assessment in technical skills across all three scenarios (correlation range 0.52-0.84, Ps<0.05), although no such correlations were observed in non-technical skills. This study establishes feasibility and reliability of virtual environment technical and non-technical skills assessment in major incident scenarios for the first time. The development for further scenarios and validated assessment scales will enable major incident planners to utilise virtual technologies for improved major incident preparation and training. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

21st Century Educators: Developing and Supporting Great Career and Technical Education Teachers. Special Issues Brief. Revised Edition

ERIC Educational Resources Information Center

Jacques, Catherine; Potemski, Amy

2014-01-01

This Special Issues Brief from the Center on Great Teachers and Leaders (GTL Center) offers insight into three human capital management policies that are critical for career and technical education (CTE) teachers: certification, performance evaluation, and professional development. CTE teachers are uniquely positioned to improve college and career…

Performance enhancement effects of Fédération Internationale de Football Association's "The 11+" injury prevention training program in youth futsal players.

PubMed

Reis, Ivan; Rebelo, António; Krustrup, Peter; Brito, João

2013-07-01

To evaluate if Fédération Internationale de Football Association's "The 11+" injury prevention program improves physical fitness and technical performance in youth futsal players. Randomized cohort study. Futsal club. Thirty-six futsal players (17.3 ± 0.7 years). Players were randomized to an intervention group (n = 18) or a control group (n = 18). Intervention group performed "The 11+" twice per week for 12 weeks. Isokinetic testing to access maximal quadriceps (Q) and hamstring (H) strength, vertical jump (squat jump, SJ; countermovement jump, CMJ), 5-m and 30-m sprint, agility, slalom, and balance performances were also measured. Intervention group increased (P < 0.05) quadriceps concentric (14.7%-27.3%) and hamstrings concentric (9.3%-13.3%) and eccentric (12.7%) peak torque. Intervention group improved functional H:Q ratio by 1.8% to 8.5% (P < 0.05). Intervention group improved (P < 0.05) SJ (13.8%) and CMJ (9.9%) and 5-m and 30-m sprint (8.9% and 3.3%, respectively), agility (4.7%), and slalom (4.8%) performances. Intervention group also improved balance, by decreasing the number of falls by 30% in the nondominant limb. No changes were observed in control group. The results suggest that 'The 11+' can be used as an effective conditioning means for improving physical fitness and technical performance of youth futsal players.

The effects of an enrichment training program for youth football attackers

PubMed Central

Santos, Sara; Gonçalves, Bruno; Travassos, Bruno; Wong, Del P.; Schöllhorn, Wolfgang; Sampaio, Jaime

2018-01-01

The aim of this study was to identify the effects of a complementary training program based on differential learning approach in the physical, technical, creative and positioning performance of youth football attackers. Fifteen players were allocated into the control (U15C = 9, age: 13.9±0.5 years; U17C = 6, age: 16.1±0.7 years) and the experimental (U15E = 9, age: 14.2±0.8 years; U17E = 6, age: 15.8±0.5 years) groups. The experimental groups participated in 10-weeks of a complementary training program based on differential learning approach to improve physical literacy and players’ tactical behavior. Variables studied encompassed: motor (vertical jump, speed and repeated change-of direction), technical (pass, dribble and shot), creative (fluency, attempts, versatility) and positioning-related variables (stretch index, spatial exploration index and regularity of the lateral and longitudinal movements). Results revealed that U15E improved both the jump and repeated change-of-direction performance, while the U17E have only improved the jump performance. The U15E showed improvements in all technical variables (small to large effects), and in the fluency and versatility (moderate effects), while the U17 have only improved the successful shots (large effects). From a positional perspective, there was a moderate increase in the stretch index, and decreased longitudinal and lateral regularity (small to moderate effects) in the U15E compared to the U15C. In turn, the U17E revealed a moderate increase of the spatial exploration index and a small decrease in the stretch index. Overall, the results suggest that the complementary training program was effective for the development of the overall performance of the U15E attackers, while more time and/or variability may be needed for older age groups. Nevertheless, the overall higher values found in experimental groups, may suggest that this type of complementary training program improves performance. PMID:29897985

Improving Space Project Cost Estimating with Engineering Management Variables

NASA Technical Reports Server (NTRS)

Hamaker, Joseph W.; Roth, Axel (Technical Monitor)

2001-01-01

Current space project cost models attempt to predict space flight project cost via regression equations, which relate the cost of projects to technical performance metrics (e.g. weight, thrust, power, pointing accuracy, etc.). This paper examines the introduction of engineering management parameters to the set of explanatory variables. A number of specific engineering management variables are considered and exploratory regression analysis is performed to determine if there is statistical evidence for cost effects apart from technical aspects of the projects. It is concluded that there are other non-technical effects at work and that further research is warranted to determine if it can be shown that these cost effects are definitely related to engineering management.

The Power of Process Improvement

ERIC Educational Resources Information Center

Fairfield-Sonn, James W.; Morgan, Sandra; Sumukadas, Narendar

2004-01-01

Over the last several decades many systematic management approaches, such as Total Quality Management, aimed at improving organizational performance and employee satisfaction have captured organizations' attention. Given their origins in statistics, operations management, and engineering, many of the concepts and techniques are technical. When…

Final Technical Report

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

Stoessel, Chris

2013-11-13

This project developed a new high-performance R-10/high SHGC window design, reviewed market positioning and evaluated manufacturing solutions required for broad market adoption. The project objectives were accomplished by: identifying viable technical solutions based on modeling of modern and potential coating stacks and IGU designs; development of new coating material sets for HM thin film stacks, as well as improved HM IGU designs to accept multiple layers of HM films; matching promising new coating designs with new HM IGU designs to demonstrate performance gains; and, in cooperation with a window manufacturer, assess the potential for high-volume manufacturing and cost efficiency ofmore » a HM-based R-10 window with improved solar heat gain characteristics. A broad view of available materials and design options was applied to achieve the desired improvements. Gated engineering methodologies were employed to guide the development process from concept generation to a window demonstration. The project determined that a slightly de-rated window performance allows formulation of a path to achieve the desired cost reductions to support end consumer adoption.« less

CF6 jet engine performance improvement program. Task 1: Feasibility analysis

NASA Technical Reports Server (NTRS)

Fasching, W. A.

1979-01-01

Technical and economic engine improvement concepts selected for subsequent development include: (1) fan improvement; (2) short core exhaust; (3) HP turbine aerodynamic improvement; (4) HP turbine roundness control; (5) HP turbine active clearance control; and (6) cabin air recirculation. The fuel savings for the selected engine modification concepts for the CF6 fleet are estimated.

A strawman SLR program plan for the 1990s

NASA Technical Reports Server (NTRS)

Degnan, John J.

1994-01-01

A series of programmatic and technical goals for the satellite laser ranging (SLR) network are presented. They are: (1) standardize the performance of the global SLR network; (2) improve the geographic distribution of stations; (3) reduce costs of field operations and data processing; (4) expand the 24 hour temporal coverage to better serve the growing constellation of satellites; (5) improve absolute range accuracy to 2 mm at key stations; (6) improve satellite force, radiative propagation, and station motion models and investigate alternative geodetic analysis techniques; (7) support technical intercomparison and the Terrestrial Reference Frame through global collocations; (8) investigate potential synergisms between GPS and SLR.

History and future technical innovation in positron emission tomography

PubMed Central

Jones, Terry; Townsend, David

2017-01-01

Abstract. Instrumentation for positron emission tomography (PET) imaging has experienced tremendous improvements in performance over the past 60 years since it was first conceived as a medical imaging modality. Spatial resolution has improved by a factor of 10 and sensitivity by a factor of 40 from the early designs in the 1970s to the high-performance scanners of today. Multimodality configurations have emerged that combine PET with computed tomography (CT) and, more recently, with MR. Whole-body scans for clinical purposes can now be acquired in under 10 min on a state-of-the-art PET/CT. This paper will review the history of these technical developments over 40 years and summarize the important clinical research and healthcare applications that have been made possible by these technical advances. Some perspectives for the future of this technology will also be presented that promise to bring about new applications of this imaging modality in clinical research and healthcare. PMID:28401173

Financial technical indicator based on chaotic bagging predictors for adaptive stock selection in Japanese and American markets

NASA Astrophysics Data System (ADS)

Suzuki, Tomoya; Ohkura, Yuushi

2016-01-01

In order to examine the predictability and profitability of financial markets, we introduce three ideas to improve the traditional technical analysis to detect investment timings more quickly. Firstly, a nonlinear prediction model is considered as an effective way to enhance this detection power by learning complex behavioral patterns hidden in financial markets. Secondly, the bagging algorithm can be applied to quantify the confidence in predictions and compose new technical indicators. Thirdly, we also introduce how to select more profitable stocks to improve investment performance by the two-step selection: the first step selects more predictable stocks during the learning period, and then the second step adaptively and dynamically selects the most confident stock showing the most significant technical signal in each investment. Finally, some investment simulations based on real financial data show that these ideas are successful in overcoming complex financial markets.

Achievement Trends of Schools and Students in Arizona's Title I School Improvement Program. REL Technical Brief. REL 2011-No. 017

ERIC Educational Resources Information Center

Crane, Eric W.; Barrat, Vanessa X.; Huang, Min

2011-01-01

This technical brief responds to an Arizona Department of Education request to study academic performance in schools receiving funding through the federal Title I compensatory education program, the section of the No Child Left Behind Act of 2001 governing resources for schools and districts serving disadvantaged populations. The brief describes…

Using Examinations To Improve Education: A Study in Fourteen African Countries. World Bank Technical Paper Number 165. Africa Technical Department Series.

ERIC Educational Resources Information Center

Kellaghan, Thomas; Greaney, Vincent

A detailed description is presented of the types, functions, performance levels, governance, administration, and funding of public examinations in 14 Sub-Saharan African countries with different educational traditions, based on English, French, or other backgrounds. The countries are: (1) Kenya; (2) Lesotho; (3) Mauritius; (4) Swaziland; (5)…

Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components.

PubMed

Ghobrial, George M; Anderson, Paul A; Chitale, Rohan; Campbell, Peter G; Lobel, Darlene A; Harrop, James

2013-10-01

In the era of surgical resident work hour restrictions, the traditional apprenticeship model may provide fewer hours for neurosurgical residents to hone technical skills. Spinal dura mater closure or repair is 1 skill that is infrequently encountered, and persistent cerebrospinal fluid leaks are a potential morbidity. To establish an educational curriculum to train residents in spinal dura mater closure with a novel durotomy repair model. The Congress of Neurological Surgeons has developed a simulation-based model for durotomy closure with the ongoing efforts of their simulation educational committee. The core curriculum consists of didactic training materials and a technical simulation model of dural repair for the lumbar spine. Didactic pretest scores ranged from 4/11 (36%) to 10/11 (91%). Posttest scores ranged from 8/11 (73%) to 11/11 (100%). Overall, didactic improvements were demonstrated by all participants, with a mean improvement between pre- and posttest scores of 1.17 (18.5%; P = .02). The technical component consisted of 11 durotomy closures by 6 participants, where 4 participants performed multiple durotomies. Mean time to closure of the durotomy ranged from 490 to 546 seconds in the first and second closures, respectively (P = .66), whereby the median leak rate improved from 14 to 7 (P = .34). There were also demonstrative technical improvements by all. Simulated spinal dura mater repair appears to be a potentially valuable tool in the education of neurosurgery residents. The combination of a didactic and technical assessment appears to be synergistic in terms of educational development.

AEL Continuous School Improvement Questionnaire. User Manual and Technical Report.

ERIC Educational Resources Information Center

Meehan, Merrill L.; Cowley, Kimberly S.; Craig, James R.; Balow, Nancy; Childers, Robert D.

The Continuous School Improvement Questionnaire (CSIQ) developed by the AEL helps a school staff gauge its performance on six dimensions related to continuous school improvement. Each member of the staff responds to the CSIQ individually. Although results might be used at the district or regional level, the most widely intended unit for applying…

Can a senior house officer's time be used more effectively?

PubMed

Mitchell, J; Hayhurst, C; Robinson, S M

2004-09-01

To determine the amount of time senior house officers (SHO) spent performing tasks that could be delegated to a technician or administrative assistant and therefore to quantify the expected benefit that could be obtained by employing such physicians' assistants (PA). SHOs working in the emergency department were observed for one week by pre-clinical students who had been trained to code and time each task performed by SHOs. Activity was grouped into four categories (clinical, technical, administrative, and other). Those activities in the technical and administrative categories were those we believed could be performed by a PA. The SHOs worked 430 hours in total, of which only 25 hours were not coded due to lack of an observer. Of the 405 hours observed 86.2% of time was accounted for by the various codes. The process of taking a history and examining patients accounted for an average of 22% of coded time. Writing the patient's notes accounted for an average of 20% of coded time. Discussion with relatives and patients accounted for 4.7% of coded time and performing procedures accounted for 5.2% of coded time. On average across all shifts, 15% of coded time was spent doing either technical or administrative tasks. In this department an average of 15% of coded SHOs working time was spent performing administrative and technical tasks, rising to 17% of coded time during a night shift. This is equivalent to an average time of 78 minutes per 10 hour shift/SHO. Most tasks included in these categories could be performed by PAs thus potentially decreasing patient waiting times, improving risk management, allowing doctors to spend more time with their patients, and possibly improving doctors' training.

Digital electronic engine control history

NASA Technical Reports Server (NTRS)

Putnam, T. W.

1984-01-01

Full authority digital electronic engine controls (DEECs) were studied, developed, and ground tested because of projected benefits in operability, improved performance, reduced maintenance, improved reliability, and lower life cycle costs. The issues of operability and improved performance, however, are assessed in a flight test program. The DEEC on a F100 engine in an F-15 aircraft was demonstrated and evaluated. The events leading to the flight test program are chronicled and important management and technical results are identified.

Developing a coaching mechanism for practicing surgeons.

PubMed

Stefanidis, Dimitrios; Anderson-Montoya, Brittany; Higgins, Robert V; Pimentel, Manuel E; Rowland, Patrick; Scarborough, Madison O; Higgins, Danelle

2016-09-01

While performance feedback and assessment are hallmarks of surgical training, they abruptly cease after training is completed. In their absence, performance may stagnate and poor habits persist. Our aim was to develop a coaching mechanism for practicing surgeons with feedback provision based on objective performance assessment. Technical and nontechnical intraoperative video recordings from laparoscopic or robotic cholecystectomies, colectomies, and hysterectomies were assessed by a blinded surgeon and a human factors expert, respectively. Aspects of performance in need of improvement were noted, and a coaching session was developed for feedback provision to participating surgeons. This 4-hour coaching session consisted of a didactic lecture with video review and hands-on practice using procedural and mannequin-based simulation. Thirty-two practicing surgeons (18 general; 14 gynecologists) from 6 different hospitals were assessed, and 9 of them participated in coaching. Technical aspects identified for performance improvement included suboptimal trocar placement, inadequate critical view achievement during laparoscopic cholecystectomies, poor visualization of the operating field, bimanual dexterity, and dissection techniques, while nontechnical aspects included inappropriate handling of distractions and interruptions, poor ergonomic positioning and situational awareness, and inadequate mitigation of delays. Most surgeons appropriately accomplished some of the objectives of the distraction scenario, but none was able to achieve expert levels on Fundamentals of Laparoscopy tasks. Participants perceived the coaching sessions as highly valuable. Our study identified several technical and nontechnical skill sets of practicing surgeons in need of improvement and provided support for the implementation of coaching programs for surgeons on an ongoing basis. Copyright © 2016 Elsevier Inc. All rights reserved.

Testing the performance of technical trading rules in the Chinese markets based on superior predictive test

NASA Astrophysics Data System (ADS)

Wang, Shan; Jiang, Zhi-Qiang; Li, Sai-Ping; Zhou, Wei-Xing

2015-12-01

Technical trading rules have a long history of being used by practitioners in financial markets. The profitable ability and efficiency of technical trading rules are yet controversial. In this paper, we test the performance of more than seven thousand traditional technical trading rules on the Shanghai Securities Composite Index (SSCI) from May 21, 1992 through June 30, 2013 and China Securities Index 300 (CSI 300) from April 8, 2005 through June 30, 2013 to check whether an effective trading strategy could be found by using the performance measurements based on the return and Sharpe ratio. To correct for the influence of the data-snooping effect, we adopt the Superior Predictive Ability test to evaluate if there exists a trading rule that can significantly outperform the benchmark. The result shows that for SSCI, technical trading rules offer significant profitability, while for CSI 300, this ability is lost. We further partition the SSCI into two sub-series and find that the efficiency of technical trading in sub-series, which have exactly the same spanning period as that of CSI 300, is severely weakened. By testing the trading rules on both indexes with a five-year moving window, we find that during the financial bubble from 2005 to 2007, the effectiveness of technical trading rules is greatly improved. This is consistent with the predictive ability of technical trading rules which appears when the market is less efficient.

Effects of Short-Interval and Long-Interval Swimming Protocols on Performance, Aerobic Adaptations, and Technical Parameters: A Training Study.

PubMed

Dalamitros, Athanasios A; Zafeiridis, Andreas S; Toubekis, Argyris G; Tsalis, George A; Pelarigo, Jailton G; Manou, Vasiliki; Kellis, Spiridon

2016-10-01

Dalamitros, AA, Zafeiridis, AS, Toubekis, AG, Tsalis, GA, Pelarigo, JG, Manou, V, and Kellis, S. Effects of short-interval and long-interval swimming protocols on performance, aerobic adaptations, and technical parameters: A training study. J Strength Cond Res 30(10): 2871-2879, 2016-This study compared 2-interval swimming training programs of different work interval durations, matched for total distance and exercise intensity, on swimming performance, aerobic adaptations, and technical parameters. Twenty-four former swimmers were equally divided to short-interval training group (INT50, 12-16 × 50 m with 15 seconds rest), long-interval training group (INT100, 6-8 × 100 m with 30 seconds rest), and a control group (CON). The 2 experimental groups followed the specified swimming training program for 8 weeks. Before and after training, swimming performance, technical parameters, and indices of aerobic adaptations were assessed. ΙΝΤ50 and ΙΝΤ100 improved swimming performance in 100 and 400-m tests and the maximal aerobic speed (p ≤ 0.05); the performance in the 50-m swim did not change. Posttraining V[Combining Dot Above]O2max values were higher compared with pretraining values in both training groups (p ≤ 0.05), whereas peak aerobic power output increased only in INT100 (p ≤ 0.05). The 1-minute heart rate and blood lactate recovery values decreased after training in both groups (p < 0.01). Stroke length increased in 100 and 400-m swimming tests after training in both groups (p ≤ 0.05); no changes were observed in stroke rate after training. Comparisons between groups on posttraining mean values, after adjusting for pretraining values, revealed no significant differences between ΙΝΤ50 and ΙΝΤ100 for all variables; however, all measures were improved vs. the respective values in the CON (p < 0.001-0.05). In conclusion, when matched for distance and exercise intensity, the short-interval (50 m) and long-interval (100 m) protocols confer analogous improvements in swimming performance, in stroke cycle parameters, and in indices of aerobic adaptations after 8 weeks of training.

Testing of state roadside safety systems. Volume I, Technical report

DOT National Transportation Integrated Search

1999-04-01

The purpose of this study is to crash test and evaluate new or modified roadside safety hardware and, where necessary, redesign the devices to improve their impact performance. The three major areas addressed in this study are the impact performance ...

Accomplishments and challenges of surgical simulation.

PubMed

Satava, R M

2001-03-01

For nearly a decade, advanced computer technologies have created extraordinary educational tools using three-dimensional (3D) visualization and virtual reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical education and certification. However, enormous challenges remain, which include improvement of technical fidelity, standardization of accurate metrics for performance evaluation, integration of simulators into a robust educational curriculum, stringent evaluation of simulators for effectiveness and value added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to implement and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simulators, their accomplishments, and the challenges that remain.

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

PubMed Central

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

2015-01-01

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

Technical- and environmental-efficiency analysis of irrigated cotton-cropping systems in Punjab, Pakistan using data envelopment analysis.

PubMed

Ullah, Asmat; Perret, Sylvain R

2014-08-01

Cotton cropping in Pakistan uses substantial quantities of resources and adversely affects the environment with pollutants from the inputs, particularly pesticides. A question remains regarding to what extent the reduction of such environmental impact is possible without compromising the farmers' income. This paper investigates the environmental, technical, and economic performances of selected irrigated cotton-cropping systems in Punjab to quantify the sustainability of cotton farming and reveal options for improvement. Using mostly primary data, our study quantifies the technical, cost, and environmental efficiencies of different farm sizes. A set of indicators has been computed to reflect these three domains of efficiency using the data envelopment analysis technique. The results indicate that farmers are broadly environmentally inefficient; which primarily results from poor technical inefficiency. Based on an improved input mix, the average potential environmental impact reduction for small, medium, and large farms is 9, 13, and 11 %, respectively, without compromising the economic return. Moreover, the differences in technical, cost, and environmental efficiencies between small and medium and small and large farm sizes were statistically significant. The second-stage regression analysis identifies that the entire farm size significantly affects the efficiencies, whereas exposure to extension and training has positive effects, and the sowing methods significantly affect the technical and environmental efficiencies. Paradoxically, the formal education level is determined to affect the efficiencies negatively. This paper discusses policy interventions that can improve the technical efficiency to ultimately increase the environmental efficiency and reduce the farmers' operating costs.

Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures

PubMed Central

Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

2016-01-01

Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of performance suggest that efficiency may be achieved without sacrificing quality. PMID:26803655

Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures.

PubMed

Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

2016-02-01

Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of performance suggest that efficiency may be achieved without sacrificing quality. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The health sector reforms and the efficiency of public hospitals in Turkey: provincial markets.

PubMed

Sulku, Seher Nur

2012-10-01

Turkey initiated the 'Health Transformation Programme' (HTP) in 2003 to align its health care system with the European Union and OECD countries. This study investigates the impact of these reforms on the efficiency of public hospitals. Our study would contribute to the existing literature with a comprehensive analysis of the health system in a developing country. We employ the data envelopment approach and the Malmquist index to comparatively examine before and after the reform years. Our analyses compare the performances of public hospitals served in provincial markets. Inputs of number of beds, number of primary care physician, and number of specialists, and how they are used to produce outputs of inpatient discharges, outpatient visits and surgical operations are investigated. Indeed, as the performance indicators dead rate, hospital bed occupation rate and average length of stay are considered. The HTP was generally successful in boosting productivity due to advancements in technology and technical efficiency but in the socio-economically disadvantaged provinces productivity gains have not been achieved. The average technical efficiency gains took place because of the significantly improved scale efficiencies, as the average pure technical efficiency slightly improved. Lastly, the hospital performance indicators have not improved in the short run. It appears that the expected benefits from the health reforms in Turkey have been partially achieved in the short run.

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

PubMed

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

2017-01-05

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

Assessing Technical Performance and Determining the Learning Curve in Cleft Palate Surgery Using a High-Fidelity Cleft Palate Simulator.

PubMed

Podolsky, Dale J; Fisher, David M; Wong Riff, Karen W; Szasz, Peter; Looi, Thomas; Drake, James M; Forrest, Christopher R

2018-06-01

This study assessed technical performance in cleft palate repair using a newly developed assessment tool and high-fidelity cleft palate simulator through a longitudinal simulation training exercise. Three residents performed five and one resident performed nine consecutive endoscopically recorded cleft palate repairs using a cleft palate simulator. Two fellows in pediatric plastic surgery and two expert cleft surgeons also performed recorded simulated repairs. The Cleft Palate Objective Structured Assessment of Technical Skill (CLOSATS) and end-product scales were developed to assess performance. Two blinded cleft surgeons assessed the recordings and the final repairs using the CLOSATS, end-product scale, and a previously developed global rating scale. The average procedure-specific (CLOSATS), global rating, and end-product scores increased logarithmically after each successive simulation session for the residents. Reliability of the CLOSATS (average item intraclass correlation coefficient (ICC), 0.85 ± 0.093) and global ratings (average item ICC, 0.91 ± 0.02) among the raters was high. Reliability of the end-product assessments was lower (average item ICC, 0.66 ± 0.15). Standard setting linear regression using an overall cutoff score of 7 of 10 corresponded to a pass score for the CLOSATS and the global score of 44 (maximum, 60) and 23 (maximum, 30), respectively. Using logarithmic best-fit curves, 6.3 simulation sessions are required to reach the minimum standard. A high-fidelity cleft palate simulator has been developed that improves technical performance in cleft palate repair. The simulator and technical assessment scores can be used to determine performance before operating on patients.

Simulator training and non-technical factors improve laparoscopic performance among OBGYN trainees.

PubMed

Ahlborg, Liv; Hedman, Leif; Nisell, Henry; Felländer-Tsai, Li; Enochsson, Lars

2013-10-01

To investigate how simulator training and non-technical factors affect laparoscopic performance among residents in obstetrics and gynecology. In this prospective study, trainees were randomized into three groups. The first group was allocated to proficiency-based training in the LapSimGyn(®) virtual reality simulator. The second group received additional structured mentorship during subsequent laparoscopies. The third group served as control group. At baseline an operation was performed and visuospatial ability, flow and self-efficacy were assessed. All groups subsequently performed three tubal occlusions. Self-efficacy and flow were assessed before and/or after each operation. Simulator training was conducted at the Center for Advanced Medical Simulation and Training, Karolinska University Hospital. Sterilizations were performed at each trainee's home clinic. Twenty-eight trainees/residents from 21 hospitals in Sweden were included. Visuospatial ability was tested by the Mental Rotation Test-A. Flow and self-efficacy were assessed by validated scales and questionnaires. Laparoscopic performance was measured as the duration of surgery. Visuospatial ability, self-efficacy and flow were correlated to the laparoscopic performance using Spearman's correlations. Differences between groups were analyzed by the Mann-Whitney U-test. No differences across groups were detected at baseline. Self-efficacy scores before and flow scores after the third operation were significantly higher in the trained groups. Duration of surgery was significantly shorter in the trained groups. Flow and self-efficacy correlate positively with laparoscopic performance. Simulator training and non-technical factors appear to improve the laparoscopic performance among trainees/residents in obstetrics and gynecology. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Clinical audit training improves undergraduates' performance in root canal therapy.

PubMed

Fong, J Y M; Tan, V J H; Lee, J R; Tong, Z G M; Foong, Y K; Tan, J M E; Parolia, A; Pau, A

2017-12-20

To evaluate the effectiveness of clinical audit-feedback cycle as an educational tool in improving the technical quality of root canal therapy (RCT) and compliance with record keeping performed by dental undergraduates. Clinical audit learning was introduced in Year 3 of a 5-year curriculum for dental undergraduates. During classroom activities, students were briefed on clinical audit, selected their audit topics in groups of 5 or 6 students, and prepared and presented their audit protocols. One chosen topic was RCT, in which 3 different cohorts of Year 3 students conducted retrospective audits of patients' records in 2012, 2014 and 2015 for their compliance with recommended record keeping criteria and their performance in RCT. Students were trained by and calibrated against an endodontist (κ ≥ 0.8). After each audit, the findings were reported in class, and recommendations were made for improvement in performance of RCT and record keeping. Students' compliance with published guidelines was presented and their RCT performances in each year were compared using the chi-square test. Overall compliance with of record keeping guidelines was 44.1% in 2012, 79.6% in 2014 and 94.6% in 2015 (P = .001). In the 2012 audit, acceptable extension, condensation and the absence of mishap were observed in 72.4, 75.7% and 91.5%; in the 2014 audit, 95.1%, 64.8% and 51.4%; and in 2015 audit, 96.4%, 82.1% and 92.8% of cases, respectively. In 2015, 76.8% of root canal fillings met all 3 technical quality criteria when compared to 48.6% in 2014 and 44.7% in 2012 (P = .001). Clinical audit-feedback cycle is an effective educational tool for improving dental undergraduates' compliance with record keeping and performance in the technical quality of RCT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Correction of a Technical Error in the Golf Swing: Error Amplification Versus Direct Instruction.

PubMed

Milanese, Chiara; Corte, Stefano; Salvetti, Luca; Cavedon, Valentina; Agostini, Tiziano

2016-01-01

Performance errors drive motor learning for many tasks. The authors' aim was to determine which of two strategies, method of amplification of error (MAE) or direct instruction (DI), would be more beneficial for error correction during a full golfing swing with a driver. Thirty-four golfers were randomly assigned to one of three training conditions (MAE, DI, and control). Participants were tested in a practice session in which each golfer performed 7 pretraining trials, 6 training-intervention trials, and 7 posttraining trials; and a retention test after 1 week. An optoeletronic motion capture system was used to measure the kinematic parameters of each golfer's performance. Results showed that MAE is an effective strategy for correcting the technical errors leading to a rapid improvement in performance. These findings could have practical implications for sport psychology and physical education because, while practice is obviously necessary for improving learning, the efficacy of the learning process is essential in enhancing learners' motivation and sport enjoyment.

Evolution of Toxoplasma-PCR methods and practices: a French national survey and proposal for technical guidelines.

PubMed

Roux, Guillaume; Varlet-Marie, Emmanuelle; Bastien, Patrick; Sterkers, Yvon

2018-06-08

The molecular diagnosis of toxoplasmosis lacks standardisation due to the use of numerous methods with variable performance. This diversity of methods also impairs robust performance comparisons between laboratories. The harmonisation of practices by diffusion of technical guidelines is a useful way to improve these performances. The knowledge of methods and practices used for this molecular diagnosis is an essential step to provide guidelines for Toxoplasma-PCR. In the present study, we aimed (i) to describe the methods and practices of Toxoplasma-PCR used by clinical microbiology laboratories in France and (ii) to propose technical guidelines to improve molecular diagnosis of toxoplasmosis. To do so, a yearly self-administered questionnaire-based survey was undertaken in proficient French laboratories from 2008 to 2015, and guidelines were proposed based on the results of those as well as previously published work. This period saw the progressive abandonment of conventional PCR methods, of Toxoplasma-PCR targeting the B1 gene and of the use of two concomitant molecular methods for this diagnosis. The diversity of practices persisted during the study, in spite of the increasing use of commercial kits such as PCR kits, DNA extraction controls and PCR inhibition controls. We also observed a tendency towards the automation of DNA extraction. The evolution of practices did not always go together with an improvement in those, as reported notably by the declining use of Uracil-DNA Glycosylase to avoid carry-over contamination. We here propose technical recommendations which correspond to items explored during the survey, with respect to DNA extraction, Toxoplasma-PCR and good PCR practices. Copyright © 2018 Australian Society for Parasitology. Published by Elsevier Ltd. All rights reserved.

Improvement of technical purpose materials performance characteristics with the radio frequency low pressure plasma

NASA Astrophysics Data System (ADS)

Makhotkina, L. Yu; Khristoliubova, V. I.

2017-11-01

The main aim of the work is to solve the actual problem of increasing the competitiveness of tanning products by reducing the prime cost and improving the quality of finished products due to the increased durability of the working elements of tanneries. The impact of the low pressure radio frequency (RF) plasma in the processes of treating for modification of the materials for special purposes is considered in the article. The results of working elements of tanneries and the materials for special purposes sample processing by a RF low pressure plasma are described. As a result of leather materials nano structuring and nano modifying physical, mechanical and hygienic characteristics were increased. Processing of the technical purpose materials allows to increase operational performance of products and extend their lifespan.

Observation of behavioural markers of non-technical skills in the operating room and their relationship to intra-operative incidents.

PubMed

Siu, Joey; Maran, Nikki; Paterson-Brown, Simon

2016-06-01

The importance of non-technical skills in improving surgical safety and performance is now well recognised. Better understanding is needed of the impact that non-technical skills of the multi-disciplinary theatre team have on intra-operative incidents in the operating room (OR) using structured theatre-based assessment. The interaction of non-technical skills that influence surgical safety of the OR team will be explored and made more transparent. Between May-August 2013, a range of procedures in general and vascular surgery in the Royal Infirmary of Edinburgh were performed. Non-technical skills behavioural markers and associated intra-operative incidents were recorded using established behavioural marking systems (NOTSS, ANTS and SPLINTS). Adherence to the surgical safety checklist was also observed. A total of 51 procedures were observed, with 90 recorded incidents - 57 of which were considered avoidable. Poor situational awareness was a common area for surgeons and anaesthetists leading to most intra-operative incidents. Poor communication and teamwork across the whole OR team had a generally large impact on intra-operative incidents. Leadership was shown to be an essential set of skills for the surgeons as demonstrated by the high correlation of poor leadership with intra-operative incidents. Team-working and management skills appeared to be especially important for anaesthetists in the recovery from an intra-operative incident. A significant number of avoidable incidents occur during operative procedures. These can all be linked to failures in non-technical skills. Better training of both individual and team in non-technical skills is needed in order to improve patient safety in the operating room. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Mental practice enhances surgical technical skills: a randomized controlled study.

PubMed

Arora, Sonal; Aggarwal, Rajesh; Sirimanna, Pramudith; Moran, Aidan; Grantcharov, Teodor; Kneebone, Roger; Sevdalis, Nick; Darzi, Ara

2011-02-01

To assess the effects of mental practice on surgical performance. Increasing concerns for patient safety have highlighted a need for alternative training strategies outside the operating room. Mental practice (MP), "the cognitive rehearsal of a task before performance," has been successful in sport and music to enhance skill. This study investigates whether MP enhances performance in laparoscopic surgery. After baseline skills testing, 20 novice surgeons underwent training on an evidence-based virtual reality curriculum. After randomization using the closed envelope technique, all participants performed 5 Virtual Reality (VR) laparoscopic cholecystectomies (LC). Mental practice participants performed 30 minutes of MP before each LC; control participants viewed an online lecture. Technical performance was assessed using video Objective Structured Assessment of Technical Skills-based global ratings scale (scored from 7 to 35). Mental imagery was assessed using a previously validated Mental Imagery Questionnaire. Eighteen participants completed the study. There were no intergroup differences in baseline technical ability. Learning curves were demonstrated for both MP and control groups. Mental practice was superior to control (global ratings) for the first LC (median 20 vs 15, P = 0.005), second LC (20.5 vs 13.5, P = 0.001), third LC (24 vs 15.5, P < 0.001), fourth LC (25.5 vs 15.5, P < 0.001) and the fifth LC (27.5 vs 19.5, P = 0.00). The imagery for the MP group was also significantly superior to the control group across all sessions (P < 0.05). Improved imagery significantly correlated with better quality of performance (ρ 0.51–0.62, Ps < 0.05). This is the first randomized controlled study to show that MP enhances the quality of performance based on VR laparoscopic cholecystectomy. This may be a time- and cost-effective strategy to augment traditional training in the OR thus potentially improving patient care.

Dredging Operations Technical Support Program. Design and Management of Dredged Material Containment Areas to Improve Hydraulic Performance.

DTIC Science & Technology

1987-06-01

in chlorine contact chambers were not sensit ive to experimentil procedure, and ’"When the dye test was repeated on the same hsin undcr ident i ; I I...neither YA t 1idth nor Ienzth ar’ 1n t -r,1ined i u , nd i t ion, costs are , iunti , t ion I .< and N . ( u yen % and Iltl ;I<,, r[i,. hte used tc com...DREDGING OPERATIONS TECHNICAL SUPPORT PROGRAM TEHIA REPORT D-87-2 DESIGN AND MANAGEMENT OF DREDGED MATERIAL CONTAINMENT AREAS TO% N IMPROVE

Efficacy of simulation-based trauma team training of non-technical skills. A systematic review.

PubMed

Gjeraa, K; Møller, T P; Østergaard, D

2014-08-01

Trauma resuscitation is a complex situation, and most organisations have multi-professional trauma teams. Non-technical skills are challenged during trauma resuscitation, and they play an important role in the prevention of critical incidents. Simulation-based training of these is recommended. Our research question was: Does simulation-based trauma team training of non-technical skills have effect on reaction, learning, behaviour or patient outcome? The authors searched PubMed, EMBASE and the Cochrane Library and found 13 studies eligible for analysis. We described and compared the educational interventions and the evaluations of effect according to the four Kirkpatrick levels: reaction, learning (knowledge, skills, attitudes), behaviour (in a clinical setting) and patient outcome. No studies were randomised, controlled and blinded, resulting in a moderate to high risk of bias. The multi-professional trauma teams had positive reactions to simulation-based training of non-technical skills. Knowledge and skills improved in all studies evaluating the effect on learning. Three studies found improvements in team performance (behaviour) in the clinical setting. One of these found difficulties in maintaining these skills. Two studies evaluated on patient outcome, of which none showed improvements in mortality, complication rate or duration of hospitalisation. A significant effect on learning was found after simulation-based training of the multi-professional trauma team in non-technical skills. Three studies demonstrated significantly increased clinical team performance. No effect on patient outcome was found. All studies had a moderate to high risk of bias. More comprehensive randomised studies are needed to evaluate the effect on patient outcome. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

34 CFR 200.22 - National Technical Advisory Council.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED... National TAC's performance of its responsibilities under this section. (c) The Secretary shall use the...

34 CFR 200.22 - National Technical Advisory Council.

Code of Federal Regulations, 2011 CFR

2011-07-01

... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED... National TAC's performance of its responsibilities under this section. (c) The Secretary shall use the...

Performance Assessment Assistance Activities in the DOE Complex - 12325

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

Seitz, Roger R.; Phifer, Mark A.; Letourneau, Martin J.

The United States Department of Energy Office of Environmental Management (DOE-EM) has established a Performance Assessment Community of Practice (PA CoP) to foster the sharing of information among performance assessment (PA) and risk assessment practitioners, regulators and oversight personnel. The general intent is to contribute to continuous improvement in the consistency, technical adequacy and quality of implementation of PAs and risk assessments around the DOE Complex. The PA CoP activities have involved commercial disposal facilities and international participants to provide a global perspective. The PA CoP has also sponsored annual technical exchanges as a means to foster improved communication andmore » to share lessons learned from on-going modelling activities. The PA CoP encourages activities to provide programmatic and technical assistance in the form of sharing experience and lessons learned with practitioners during the development of PAs and risk assessments. This assistance complements DOE-EM reviews through the Low-Level Waste Disposal Facility Federal Review Group (LFRG) that are conducted after modelling efforts are completed. Such up-front assistance is providing additional value in terms of improving consistency and sharing of information. There has been a substantial increase in the amount of assistance being provided. The assistance has been well received by practitioners and regulators that have been involved. The paper highlights assistance and sharing of information that has been conducted in the last two years to support activities underway in support of proposed disposal facilities at Paducah, Portsmouth, and the Idaho National Laboratory and tank closure at Hanford. DOE-EM established the PA CoP to help improve the consistency and quality of implementation of modelling activities around the DOE Complex. The PA CoP has sponsored annual technical exchanges as a means to foster improved communication and to share lessons learned from ongoing modelling activities. Practitioners; project managers; oversight personnel; and regulators from United States and international facilities have participated in the three technical exchanges that have been held to date. At the working level, the PA CoP has sponsored technical assistance in support of modelling activities that are currently underway. The assistance concept provides a means to share specific experience, good practices, and lessons learned on topics of interest at a given site while the modelling is being conducted. Such up-front assistance complements the sharing of information that occurs via regular LFRG meetings and independent LFRG reviews that are conducted when the modelling effort is completed. Examples from assistance activities that have been conducted at Idaho, Paducah, Portsmouth and Hanford were highlighted in this paper. There were differences in the types of assistance provided at each site. In some cases the assistance was focused on technical support for the practitioners and management responsible for the development of the PAs. At other sites, the assistance included working with the developers and regulators/stakeholders involved in the process to help with reaching consensus on critical assumptions. Such interactions have proven to be very effective to help all parties get a chance to discuss their perspectives and better understand the different points of view. In all cases, the assistance was used as a means to share broader perspectives, experiences and lessons learned with personnel engaged in a modelling activities at a given site. The combination of technical exchanges and targeted technical assistance has provided additional means to encourage the sharing of information around the DOE Complex and globally. Feedback from practitioners, oversight personnel, regulators and stakeholders that have been involved has been overwhelmingly positive. It is believed that such sharing of information and experiences is contributing to continuous improvement in the consistency, technical adequacy, and quality of modelling activities. Although different approaches are still being used, there is an improvement in the awareness of lessons learned and implementation of practices that have proven to be effective. (authors)« less

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

PubMed

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

2015-01-01

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

Can branding by health care provider organizations drive the delivery of higher technical and service quality?

PubMed

Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric

2009-01-01

Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.

76 FR 35864 - Proposed Priority; Special Demonstration Programs-National Technical Assistance Projects To...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

... have national significance and improve the performance of State vocational rehabilitation (VR) agencies... that State VR agencies and their partners, need national TA opportunities to improve program management and to keep informed about current effective and promising practices and research in the field of VR...

The Field Program Associate in the Partnership for Rural Improvement.

ERIC Educational Resources Information Center

Jongeward, Ray E.; Druian, Janice M.

To describe how Partnership for Rural Improvement (PRI) field program associates perceive themselves performing their role functions, three associates and two assistants responded to questions about: their tasks, responsibilities, and roles; how they got started; what skills they needed; and what materials or technical assistance could benefit…

RL-34 ring laser gyro laboratory evaluation for the Deep Space Network antenna application

NASA Technical Reports Server (NTRS)

1991-01-01

The overall results of this laboratory evaluation are quite encouraging. The gyro data is in good agreement with the system's overall pointing performance, which is quite close to the technical objectives for the Deep Space Network (DSN) application. The system can be calibrated to the levels required for millidegree levels of pointing performance, and initialization performance is within the required 0.001 degree objective. The blind target acquisition performance is within a factor of two of the 0.0001 degree objective, limited only by a combination of the slow rate (0.5 deg/sec) and the existing production quantization logic (0.38 arc-sec/pulse). Logic circuitry exists to better this performance such that it will better the objective by 50 percent. Representative data with this circuitry has been provided for illustration. Target tracking performance is about twice the one millidegree objective, with several factors contributing. The first factor is the bias stability of the gyros, which is exceptional, but will limit performance to the 0.001 and 0.002 degree range for long tracking periods. The second contributing factor is the accelerometer contributions when the system is elevated. These degrade performance into the 0.003 to 0.004 degree range, which could be improved upon with some additional changes. Finally, we have provided a set of recommendations to improve performance closer to the technical objectives. These recommendations include gyro, electronics, and system configurational changes that form the basis for additional work to achieve the desired performance. In conclusion, we believe that the RL-34 ring laser gyro-based advanced navigation system demonstrated performance consistent with expectations and technical objectives, and it has the potential for even further enhancement for the DSN application.

Effectiveness of facilitated introduction of a standard operating procedure into routine processes in the operating theatre: a controlled interrupted time series.

PubMed

Morgan, Lauren; New, Steve; Robertson, Eleanor; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; Pickering, Sharon P; Hadi, Mohammed; Griffin, Damian; McCulloch, Peter

2015-02-01

Standard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. In a controlled interrupted time series, we evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs. Process measures were evaluated by direct observation, using Oxford Non-Technical Skills II for non-technical skills and the 'glitch count' for technical performance. All staff in two orthopaedic operating theatres were trained in the principles of SOPs and then assisted to develop standardised procedures. Staff in a control operating theatre underwent the same observations but received no training. The change in difference between active and control groups was compared before and after the intervention using repeated measures analysis of variance. We observed 50 operations before and 55 after the intervention and analysed clinical data on 1022 and 861 operations, respectively. The staff chose to structure their efforts around revising the 'whiteboard' which documented and prompted tasks, rather than directly addressing specific task problems. Although staff preferred and sustained the new system, we found no significant differences in process or outcome measures before/after intervention in the active versus the control group. There was a secular trend towards worse outcomes in the postintervention period, seen in both active and control theatres. SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A mixed methods investigation into the use of non-technical skills by community and hospital pharmacists.

PubMed

Irwin, A; Weidmann, A E

2015-01-01

Non-technical skills refer to the social and cognitive factors that may influence efficient and safe job performance. Non-technical skills are an important element of patient safety in a variety of health care disciplines, including surgery, anesthesia and nursing. However, the use of non-technical skills in pharmacy practice has not yet been fully assessed. To examine attitudes toward, and use of, non-technical skills by pharmacy personnel. A mixed methods approach was used: An attitude survey explored pharmacy personnel attitudes towards non-technical skills and inter-professional collaboration, with community and hospital pharmacy staff (n = 62). Qualitative interviews were then conducted using the critical incident technique, with community pharmacists (n = 11). The survey results demonstrated differences in the opinions of community and hospital pharmacists on three non-technical skill constructs: team structure, mutual support, and situation monitoring, with community pharmacists reporting significantly more positive attitudes about all three constructs. Both groups reported low levels of collaboration with primary care physicians. The interviews identified five non-technical skills as key elements of successful pharmacist performance from the interview transcripts: teamwork; leadership; task management; situation awareness; decision-making. The survey and interviews identified the non-technical skills that are important to pharmacists. This represents the first step towards the development of a behavioral rating system for training purposes that could potentially improve the non-technical skills of pharmacists and enhance patient safety. Copyright © 2015 Elsevier Inc. All rights reserved.

Technical refinement and learning curve for attenuating neurapraxia during robotic-assisted radical prostatectomy to improve sexual function.

PubMed

Alemozaffar, Mehrdad; Duclos, Antoine; Hevelone, Nathanael D; Lipsitz, Stuart R; Borza, Tudor; Yu, Hua-Yin; Kowalczyk, Keith J; Hu, Jim C

2012-06-01

While radical prostatectomy surgeon learning curves have characterized less blood loss, shorter operative times, and fewer positive margins, there is a dearth of studies characterizing learning curves for improving sexual function. Additionally, while learning curve studies often define volume thresholds for improvement, few of these studies demonstrate specific technical modifications that allow reproducibility of improved outcomes. Demonstrate and quantify the learning curve for improving sexual function outcomes based on technical refinements that reduce neurovascular bundle displacement during nerve-sparing robot-assisted radical prostatectomy (RARP). We performed a retrospective study of 400 consecutive RARPs, categorized into groups of 50, performed after elimination of continuous surgeon/assistant neurovascular bundle countertraction. Our approach to RARP has been described previously. A single-console robotic system was used for all cases. Expanded Prostate Cancer Index Composite sexual function was measured within 1 yr of RARP. Linear regression was performed to determine factors influencing the recovery of sexual function. Greater surgeon experience was associated with better 5-mo sexual function (p = 0.007) and a trend for better 12-mo sexual function (p = 0.061), with improvement plateauing after 250-300 cases. Additionally, younger patient age (both p<0.02) and better preoperative sexual function (<0.001) were associated with better 5- and 12-mo sexual function. Moreover, trainee robotic console time during nerve sparing was associated with worse 12-mo sexual function (p=0.021), while unilateral nerve sparing/non-nerve sparing was associated with worse 5-mo sexual function (p = 0.009). Limitations include the retrospective single-surgeon design. With greater surgeon experience, attenuating lateral displacement of the neurovascular bundle and resultant neurapraxia improve postoperative sexual function. However, to maximize outcomes, appropriate patient selection must be exercised when allowing trainee nerve-sparing involvement. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Company Training. A Key Strategy for Success. Workforce Brief #2.

ERIC Educational Resources Information Center

Bergman, Terri

General research and anecdotal reports have confirmed that both technical and basic skills training offer many benefits to companies of all sizes. Company training can improve employee performance, firm productivity, product quality, and company profitability. Training supports "high-performance" work practices such as the following: total quality…

Field test method to determine presence and quantity of modifiers in liquid asphalt - follow-up data analysis : [technical summary].

DOT National Transportation Integrated Search

2015-09-01

Asphalt modified with styrene butadiene styrene (SBS) polymer and/or ground tire rubber : (GTR) is widely used in the U.S. to improve asphalt concrete performance. The high cost and : proven performance benefits of modified binders make it important ...

Comparison of the Booster Interface Temperature in Stainless Steel (SS) V-Channel versus the Aluminum (Al) Y-Channel Primer Chamber Assemblies (PCAs). Volume 1; Technical Assessment Report

NASA Technical Reports Server (NTRS)

Garcia, Roberto; Saulsberry, Regor L.

2011-01-01

NASA's Technical Fellow for Propulsion, requested a technical assessment of the performance improvement achieved by the introduction of the stainless steel (SS) V-channel compared to the aluminum (Al) Y-channel Primer Chamber Assembly (PCA) design. The SS V-channel PCA was developed for NASA's Mars Science Laboratory (MSL) Project. The principle focus of the assessment was to measure the transient temperature at the booster interface with both designs. This document contains the findings of the assessment.

Employment of telemedicine in emergency medicine. Clinical requirement analysis, system development and first test results.

PubMed

Czaplik, M; Bergrath, S; Rossaint, R; Thelen, S; Brodziak, T; Valentin, B; Hirsch, F; Beckers, S K; Brokmann, J C

2014-01-01

Demographic change, rising co-morbidity and an increasing number of emergencies are the main challenges that emergency medical services (EMS) in several countries worldwide are facing. In order to improve quality in EMS, highly trained personnel and well-equipped ambulances are essential. However several studies have shown a deficiency in qualified EMS physicians. Telemedicine emerges as a complementary system in EMS that may provide expertise and improve quality of medical treatment on the scene. Hence our aim is to develop and test a specific teleconsultation system. During the development process several use cases were defined and technically specified by medical experts and engineers in the areas of: system administration, start-up of EMS assistance systems, audio communication, data transfer, routine tele-EMS physician activities and research capabilities. Upon completion, technical field tests were performed under realistic conditions to test system properties such as robustness, feasibility and usability, providing end-to-end measurements. Six ambulances were equipped with telemedical facilities based on the results of the requirement analysis and 55 scenarios were tested under realistic conditions in one month. The results indicate that the developed system performed well in terms of usability and robustness. The major challenges were, as expected, mobile communication and data network availability. Third generation networks were only available in 76.4% of the cases. Although 3G (third generation), such as Universal Mobile Telecommunications System (UMTS), provides beneficial conditions for higher bandwidth, system performance for most features was also acceptable under adequate 2G (second generation) test conditions. An innovative concept for the use of telemedicine for medical consultations in EMS was developed. Organisational and technical aspects were considered and practical requirements specified. Since technical feasibility was demonstrated in these technical field tests, the next step would be to prove medical usefulness and technical robustness under real conditions in a clinical trial.

Impact of IQ, computer-gaming skills, general dexterity, and laparoscopic experience on performance with the da Vinci surgical system.

PubMed

Hagen, Monika E; Wagner, Oliver J; Inan, Ihsan; Morel, Philippe

2009-09-01

Due to improved ergonomics and dexterity, robotic surgery is promoted as being easily performed by surgeons with no special skills necessary. We tested this hypothesis by measuring IQ elements, computer gaming skills, general dexterity with chopsticks, and evaluating laparoscopic experience in correlation to performance ability with the da Vinci robot. Thirty-four individuals were tested for robotic dexterity, IQ elements, computer-gaming skills and general dexterity. Eighteen surgically inexperienced and 16 laparoscopically trained surgeons were included. Each individual performed three different tasks with the da Vinci surgical system and their times were recorded. An IQ test (elements: logical thinking, 3D imagination and technical understanding) was completed by each participant. Computer skills were tested with a simple computer game (hand-eye coordination) and general dexterity was evaluated by the ability to use chopsticks. We found no correlation between logical thinking, 3D imagination and robotic skills. Both computer gaming and general dexterity showed a slight but non-significant improvement in performance with the da Vinci robot (p > 0.05). A significant correlation between robotic skills, technical understanding and laparoscopic experience was observed (p < 0.05). The data support the conclusion that there are no significant correlations between robotic performance and logical thinking, 3D understanding, computer gaming skills and general dexterity. A correlation between robotic skills and technical understanding may exist. Laparoscopic experience seems to be the strongest predictor of performance with the da Vinci surgical system. Generally, it appears difficult to determine non-surgical predictors for robotic surgery.

Improving non-technical skills (teamwork) in post-partum haemorrhage: A grouped randomised trial.

PubMed

Letchworth, Pippa M; Duffy, Shane P; Phillips, Dan

2017-10-01

To determine the effect of a decision support technology on teamwork and associated non-technical (NTS) and technical skills when teams manage post-partum haemorrhage (PPH) in the simulated environment. Multidisciplinary (MDT) maternity teams were taught how to manage post partum haemorrhage. They were randomised to the intervention: using a decision support mobile digital platform or a control group. Each team managed a post-partum simulation, which was recorded and reviewed by assessors. Primary outcome measures to assess teams NTS were the validated Global Assessment of Obstetric Team Performance (GAOTP) and Clinical Teamwork Scale (CTS). Secondary outcome measures were the 'friends and family test', technical skills, and the System Usability Scale (SUS). Sample size estimation was calculated by using 80% power 5% significance two tailed test (p1=85% p2=40%) n=34. 38 teams from August 2014-February 2016, were recruited, technical issues with failure of recording equipment meant 4 teams were excluded from teamwork analysis (1 intervention 3 control). Teamwork improved across all domains with the intervention (using a decision support mobile digital platform) p <0.01. CTS improved between 6.7-16.8% (average 14.2%) and GAOTP between 8.6-17.1% (average 13.5%) for all domains. Using the control group as baseline, the intervention improved teamwork by 25% using CTS and 22% using GAOTP. Fewer technical skills were missed with the intervention (p<0.01). There was no statistical difference in the time technical skills were achieved. Assessors were more likely to recommend intervention teams 87.5% (77/88) than control teams 63.6% (56/88) p<0.01 to their friends or family. The SUS was 'Good' (69) becoming excellently 'Usable' (81.6) over the study period. We report a decision support system, which improved NTS when managing PPH. Lack of teamwork is often cited as the cause of failures in care and we report a usable technology that assists with and improves teamwork during an emergency. Copyright © 2017 Elsevier B.V. All rights reserved.

Randomized controlled trial of multidisciplinary team stress and performance in immersive simulation for management of infant in shock: study protocol.

PubMed

Ghazali, Daniel Aiham; Ragot, Stéphanie; Breque, Cyril; Guechi, Youcef; Boureau-Voultoury, Amélie; Petitpas, Franck; Oriot, Denis

2016-03-25

Human error and system failures continue to play a substantial role in adverse outcomes in healthcare. Simulation improves management of patients in critical condition, especially if it is undertaken by a multidisciplinary team. It covers technical skills (technical and therapeutic procedures) and non-technical skills, known as Crisis Resource Management. The relationship between stress and performance is theoretically described by the Yerkes-Dodson law as an inverted U-shaped curve. Performance is very low for a low level of stress and increases with an increased level of stress, up to a point, after which performance decreases and becomes severely impaired. The objectives of this randomized trial are to study the effect of stress on performance and the effect of repeated simulation sessions on performance and stress. This study is a single-center, investigator-initiated randomized controlled trial including 48 participants distributed in 12 multidisciplinary teams. Each team is made up of 4 persons: an emergency physician, a resident, a nurse, and an ambulance driver who usually constitute a French Emergency Medical Service team. Six multidisciplinary teams are planning to undergo 9 simulation sessions over 1 year (experimental group), and 6 multidisciplinary teams are planning to undergo 3 simulation sessions over 1 year (control group). Evidence of the existence of stress will be assessed according to 3 criteria: biological, electrophysiological, and psychological stress. The impact of stress on overall team performance, technical procedure and teamwork will be evaluated. Participant self-assessment of the perceived impact of simulations on clinical practice will be collected. Detection of post-traumatic stress disorder will be performed by self-assessment questionnaire on the 7(th) day and after 1 month. We will concomitantly evaluate technical and non-technical performance, and the impact of stress on both. This is the first randomized trial studying repetition of simulation sessions and its impact on both clinical performance and stress, which is explored by objective and subjective assessments. We expect that stress decreases team performance and that repeated simulation will increase it. We expect no variation of stress parameters regardless of the level of performance. ClinicalTrials.gov registration number NCT02424890.

Defense Research: Improved Management of DOD’s Technical Corrosion Collaboration Program Needed

DTIC Science & Technology

2014-05-01

Education and Research on Corrosion and Material Performance TCC Technical Corrosion Collaboration UCC University Corrosion Collaboration This is...is the successor to the University Corrosion Collaboration ( UCC ) pilot program, established in 2008. The TCC program builds on efforts of the UCC ...going from a pilot to a full program. They indicated that the UCC pilot program naturally evolved into the TCC pilot program in 2011, and the pilot

Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction.

PubMed

Warner, Courtney J; Horvath, Alexander J; Powell, Richard J; Columbo, Jesse A; Walsh, Teri R; Goodney, Philip P; Walsh, Daniel B; Stone, David H

2015-08-01

Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform. All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127). Procedures were included if they met standard commercial instructions for use guidelines, used a single manufacturer, and were billed to Medicare diagnosis-related group 238 (n = 49). By use of DMAIC (define, measure, analyze, improve, and control) quality improvement methodology (define, measure, analyze, improve, control), targets for EVAR quality improvement were identified and high-yield changes were implemented. Procedure technical costs were calculated before and after process redesign. Perioperative services and clinic visits were identified as targets for quality improvement efforts and cost reduction. Mean technical costs before the intervention were $31,672, with endograft implants accounting for 52%. Pricing redesign in collaboration with hospital purchasing reduced mean EVAR technical costs to $28,607, a 10% reduction in overall cost, with endograft implants now accounting for 46%. Perioperative implementation of instrument tray redesign reduced instrument use by 32% (184 vs 132 instruments), saving $50,000 annually. Unnecessary clinic visits were reduced by 39% (1.6 vs 1.1 clinic visits per patient) through implementation of a preclinic imaging protocol. There was no difference in mean length of stay after the intervention. Comprehensive EVAR delivery redesign leads to cost reduction and waste elimination while preserving quality. Future efforts to achieve more competitive and transparent device pricing will make EVAR more cost neutral and enhance its financial sustainability for health care systems. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction

PubMed Central

Warner, Courtney J.; Horvath, Alexander J.; Powell, Richard J.; Columbo, Jesse A.; Walsh, Teri R.; Goodney, Philip P.; Walsh, Daniel B.; Stone, David H.

2017-01-01

Objective Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform. Methods All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127). Procedures were included if they met standard commercial instructions for use guidelines, used a single manufacturer, and were billed to Medicare diagnosis-related group 238 (n = 49). By use of DMAIC (define, measure, analyze, improve, and control) quality improvement methodology (define, measure, analyze, improve, control), targets for EVAR quality improvement were identified and high-yield changes were implemented. Procedure technical costs were calculated before and after process redesign. Results Perioperative services and clinic visits were identified as targets for quality improvement efforts and cost reduction. Mean technical costs before the intervention were $31,672, with endograft implants accounting for 52%. Pricing redesign in collaboration with hospital purchasing reduced mean EVAR technical costs to $28,607, a 10% reduction in overall cost, with endograft implants now accounting for 46%. Perioperative implementation of instrument tray redesign reduced instrument use by 32% (184 vs 132 instruments), saving $50,000 annually. Unnecessary clinic visits were reduced by 39% (1.6 vs 1.1 clinic visits per patient) through implementation of a preclinic imaging protocol. There was no difference in mean length of stay after the intervention. Conclusions Comprehensive EVAR delivery redesign leads to cost reduction and waste elimination while preserving quality. Future efforts to achieve more competitive and transparent device pricing will make EVAR more cost neutral and enhance its financial sustainability for health care systems. PMID:25935271

Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models.

PubMed

Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; Araújo, Thiago Cavalcante Vila Nova de; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S

2015-01-01

Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

PubMed Central

Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; de Araújo, Thiago Cavalcante Vila Nova; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S.

2015-01-01

OBJECTIVE Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art. PMID:26735604

Farm-economic analysis of reducing antimicrobial use whilst adopting improved management strategies on farrow-to-finish pig farms.

PubMed

Rojo-Gimeno, Cristina; Postma, Merel; Dewulf, Jeroen; Hogeveen, Henk; Lauwers, Ludwig; Wauters, Erwin

2016-07-01

Due to increasing public health concerns that food animals could be reservoirs for antibiotic resistant organisms, calls for reduced current antibiotic use on farms are growing. Nevertheless, it is challenging for farmers to perform this reduction without negatively affecting technical and economic performance. As an alternative, improved management practices based on biosecurity and vaccinations have been proven useful to reduce antimicrobial use without lowering productivity, but issues with insufficient experimental design possibilities have hindered economic analysis. In the present study a quasi-experimental approach was used for assessing the economic impact of reduction of antimicrobial use coupled with improved management strategies, particularly biosecurity strategies. The research was performed on farrow-to-finish pig farms in Flanders (northern region of Belgium). First, to account for technological progress and to avoid selection bias, propensity score analysis was used to compare data on technical parameters. The treatment group (n=48) participated in an intervention study whose aim was to improve management practices to reduce the need for use of antimicrobials. Before and after the change in management, data were collected on the technical parameters, biosecurity status, antimicrobial use, and vaccinations. Treated farms were matched without replacement with control farms (n=69), obtained from the Farm Accountancy Data Network, to estimate the difference in differences (DID) of the technical parameters. Second, the technical parameters' DID, together with the estimated costs of the management intervention and the price volatility of the feed, meat of the finisher pigs, and piglets served as a basis for modelling the profit of 11 virtual farrow-to-finish pig farms representative of the Flemish sector. Costs incurred by new biosecurity measures (median +€3.96/sow/year), and new vaccinations (median €0.00/sow/year) did not exceed the cost reduction achieved by lowering the use of antimicrobials (median -€7.68/sow/year). No negative effect on technical parameters was observed and mortality of the finishers was significantly reduced by -1.1%. Even after a substantial reduction of the antimicrobial treatments, the difference of the enterprise profit increased by +€2.67/finisher pig/year after implementing the interventions. This result proved to be robust after stochastic modelling of input and output price volatility. The results of this study can be used by veterinarians and other stakeholders to incentivise managers of farrow-to-finish operations to use biosecurity practices as a cost-effective way to reduce antimicrobial use. Copyright © 2016 Elsevier B.V. All rights reserved.

Improved technical performance of a multifunctional prehospital telemedicine system between the research phase and the routine use phase - an observational study.

PubMed

Felzen, Marc; Brokmann, Jörg C; Beckers, Stefan K; Czaplik, Michael; Hirsch, Frederik; Tamm, Miriam; Rossaint, Rolf; Bergrath, Sebastian

2017-04-01

Introduction Telemedical concepts in emergency medical services (EMS) lead to improved process times and patient outcomes, but their technical performance has thus far been insufficient; nevertheless, the concept was transferred into EMS routine care in Aachen, Germany. This study evaluated the system's technical performance and compared it to a precursor system. Methods The telemedicine system was implemented on seven ambulances and a teleconsultation centre staffed with experienced EMS physicians was established in April 2014. Telemedical applications included mobile vital data, 12-lead, picture transmission and video streaming from inside the ambulances. The tele-EMS physician filled in a questionnaire regarding the technical performance of the applications, background noise and assessed clinical values of the transmitted pictures and videos after each mission between 15 May 2014-15 October 2014. Results Teleconsultation was established during 539 emergency cases. In 83% of the cases ( n = 447), only the paramedics and the tele-EMS physician were involved. Transmission success rates ranged from 98% (audio connection) to 93% (12-lead electrocardiogram (ECG) transmission). All functionalities, except video transmission, were significantly better than the pilot project ( p < 0.05). Severe background noise was detected to a lesser extent ( p = 0.0004) and the clinical value of the pictures and videos were considered significantly more valuable. Discussion The multifunctional system is now sufficient for routine use and is the most reliable mobile emergency telemedicine system compared to other published projects. Dropouts were due to user errors and network coverage problems. These findings enable widespread use of this system in the future, reducing the critical time intervals until medical therapy is started.

Factors influencing private health providers' technical quality of care for acute respiratory infections among under-five children in rural West Bengal, India.

PubMed

Chakraborty, Sarbani; Frick, Kevin

2002-11-01

In many developing countries, private health practitioners provide a significant portion of curative care for diseases which are of public health importance. Currently, health sector reform efforts in these countries are fostering increased participation of private providers in the delivery of health services, including those of public health importance. Guaranteeing good technical quality of care is critical to the process. However, little is known about private providers' technical quality of care (disease management practices) and the factors influencing these services. The purpose of this study was to contribute information on this topic. The study was conducted among private providers in rural West Bengal, India and focused on providers' disease management practices for acute respiratory infections (ARI) among under-five children. World Health Organization (WHO) guidelines for ARI case management were used as the expected standard of care. Observations of patient-provider encounters and interviews with the providers and mothers were the main sources of data. The study found that private health providers in rural West Bengal have inadequate technical quality of care. The problem was related both to low levels of performance (limited potential) and inconsistency in performance (within-provider variation). Limited potential for good technical quality for ARI among the providers was related to lack of knowledge (technical incompetence). One of the important factors influencing within-provider variation was patient load. Since rural private providers operate on a fee-for-service payment system, there are incentives related to seeing many patients. The study concluded that to bring about sustainable improvements in private providers' ARI disease management practices, training programs and interventions that improved compliance were necessary.

Minimally Invasive Implantable Fetal Micropacemaker: Mechanical Testing and Technical Refinements

PubMed Central

Zhou, Li; Vest, Adriana N.; Peck, Raymond A.; Sredl, Jonathan P.; Huang, Xuechen; Bar-Cohen, Yaniv; Silka, Michael J.; Pruetz, Jay D.; Chmait, Ramen H.; Loeb, Gerald E.

2016-01-01

This paper discusses the technical and safety requirements for cardiac pacing of a human fetus with heart failure and hydrops fetalis secondary to complete heart block. Engineering strategies to meet specific technical requirements were integrated into a systematic design and implementation consisting of a novel fetal micropacemaker, a percutaneous implantation system, and a sterile package that enables device storage and recharging maintenance in a clinical setting. We further analyzed observed problems on myocardial fixation and pacing lead fatigue previously reported in earlier preclinical trials. This paper describes the technical refinements of the implantable fetal micropacemaker to overcome these challenges. The mechanical performance has been extensively tested to verify the improvement of reliability and safety margins of the implantation system. PMID:27021067

Paying It Forward: A Technical Assistance Guide for Developing and Implementing Performance-Based Scholarships. The Performance-Based Scholarship Demonstration

ERIC Educational Resources Information Center

Welbeck, Rashida; Ware, Michelle; Cerna, Oscar; Valenzuela, Ireri

2014-01-01

Difficulties in paying for college and in maintaining good academic performance are two major hurdles to college graduation for low-income students. In recent years, state and federal budgets for postsecondary education have been cut significantly, limiting the options policymakers, education leaders, and communities have to improve rates of…

Analytical procedures for determining the impacts of reliability mitigation strategies. [supporting datasets

DOT National Transportation Integrated Search

2012-11-30

The objective of this project was to develop technical relationships between reliability improvement strategies and reliability performance metrics. This project defined reliability, explained the importance of travel time distributions for measuring...

The back squat: A proposed assessment of functional deficits and technical factors that limit performance

PubMed Central

Myer, Gregory D.; Kushner, Adam M.; Brent, Jensen L.; Schoenfeld, Brad J.; Hugentobler, Jason; Lloyd, Rhodri S.; Vermeil, Al; Chu, Donald A.; Harbin, Jason; McGill, Stuart M.

2014-01-01

Fundamental movement competency is essential for participation in physical activity and for mitigating the risk of injury, which are both key elements of health throughout life. The squat movement pattern is arguably one of the most primal and critical fundamental movements necessary to improve sport performance, to reduce injury risk and to support lifelong physical activity. Based on current evidence, this first (1 of 2) report deconstructs the technical performance of the back squat as a foundation training exercise and presents a novel dynamic screening tool that incorporates identification techniques for functional deficits that limit squat performance and injury resilience. The follow-up report will outline targeted corrective methodology for each of the functional deficits presented in the assessment tool. PMID:25506270

STDAC: Solar thermal design assistance center annual report fiscal year 1994

NASA Astrophysics Data System (ADS)

The Solar Thermal Design Assistance Center (STDAC) at Sandia is a resource provided by the DOE Solar Thermal Program. The STDAC's major objective is to accelerate the use of solar thermal systems by providing direct technical assistance to users in industry, government, and foreign countries; cooperating with industry to test, evaluate, and develop renewable energy systems and components; and educating public and private professionals, administrators, and decision makers. This FY94 report highlights the activities and accomplishments of the STDAC. In 1994, the STDAC continued to provide significant direct technical assistance to domestic and international organizations in industry, government, and education, Applying solar thermal technology to solve energy problems is a vital element of direct technical assistance. The STDAC provides information on the status of new, existing, and developing solar technologies; helps users screen applications; predicts the performance of components and systems; and incorporates the experience of Sandia's solar energy personnel and facilities to provide expert guidance. The STDAC directly enhances the US solar industry's ability to successfully bring improved systems to the marketplace. By collaborating with Sandia's Photovoltaic Design Assistance Center and the National Renewable Energy Laboratory the STDAC is able to offer each customer complete service in applying solar thermal technology. At the National Solar Thermal Test Facility the STDAC tests and evaluates new and innovative solar thermal technologies. Evaluations are conducted in dose cooperation with manufacturers, and the results are used to improve the product and/or quantify its performance characteristics. Manufacturers, in turn, benefit from the improved design, economic performance, and operation of their solar thermal technology. The STDAC provides cost sharing and in-kind service to manufacturers in the development and improvement of solar technology.

Simulation center training as a means to improve resident performance in percutaneous noncontinuous CT-guided fluoroscopic procedures with dose reduction.

PubMed

Mendiratta-Lala, Mishal; Williams, Todd R; Mendiratta, Vivek; Ahmed, Hafeez; Bonnett, John W

2015-04-01

The purpose of this study was to evaluate the effectiveness of a multifaceted simulation-based resident training for CT-guided fluoroscopic procedures by measuring procedural and technical skills, radiation dose, and procedure times before and after simulation training. A prospective analysis included 40 radiology residents and eight staff radiologists. Residents took an online pretest to assess baseline procedural knowledge. Second-through fourth-year residents' baseline technical skills with a procedural phantom were evaluated. First-through third-year residents then underwent formal didactic and simulation-based procedural and technical training with one of two interventional radiologists and followed the training with 1 month of supervised phantom-based practice. Thereafter, residents underwent final written and practical examinations. The practical examination included essential items from a 20-point checklist, including site and side marking, consent, time-out, and sterile technique along with a technical skills portion assessing pedal steps, radiation dose, needle redirects, and procedure time. The results indicated statistically significant improvement in procedural and technical skills after simulation training. For residents, the median number of pedal steps decreased by three (p=0.001), median dose decreased by 15.4 mGy (p<0.001), median procedure time decreased by 4.0 minutes (p<0.001), median number of needle redirects decreased by 1.0 (p=0.005), and median number of 20-point checklist items successfully completed increased by three (p<0.001). The results suggest that procedural skills can be acquired and improved by simulation-based training of residents, regardless of experience. CT simulation training decreases procedural time, decreases radiation dose, and improves resident efficiency and confidence, which may transfer to clinical practice with improved patient care and safety.

Structured training on the da Vinci Skills Simulator leads to improvement in technical performance of robotic novices.

PubMed

Walliczek-Dworschak, U; Mandapathil, M; Förtsch, A; Teymoortash, A; Dworschak, P; Werner, J A; Güldner, C

2017-02-01

The increasing use of minimally invasive techniques such as robotic-assisted devices raises the question of how to acquire robotic surgery skills. The da Vinci Skills Simulator has been demonstrated to be an effective training tool in previous reports. To date, little data are available on how to acquire proficiency through simulator training. We investigated the outcome of a structured training programme for robotic surgical skills by robotic novices. This prospective study was conducted from January to December 2013 using the da Vinci Skills Simulator. Twenty participants, all robotic novices, were enrolled in a 4-week training curriculum. After a brief introduction to the simulator system, three consecutive repetitions of five selected exercises (Match Board 1, 2, 3 and Ring and Rail 1, 2) were performed in a defined order on days 1, 8, 15 and 22. On day 22, one repetition of a previously unpractised more advanced module (Needle Targeting) was also performed. After completion of each study day, the overall performance, time to completion, economy in motion, instrument collisions, excessive instrument force, instruments out of view, master workspace range and number of drops were analysed. Comparing the first and final repetition, overall score and time needed to complete all exercises, economy of motion and instrument collisions were significantly improved in nearly all exercises. Regarding the new exercise, a positive training effect could be demonstrated. While its overall entry score was significantly higher, the time to completion and economy of motion were significantly lower than the scores on the first repetition of the previous 5 exercises. It could be shown that training on the da Vinci Skills Simulator led to an improvement in technical performance of robotic novices. With regard to a new exercise, the training had a positive effect on the technical performance. © 2016 John Wiley & Sons Ltd.

Review of Literature for Model Assisted Probability of Detection

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

Meyer, Ryan M.; Crawford, Susan L.; Lareau, John P.

This is a draft technical letter report for NRC client documenting a literature review of model assisted probability of detection (MAPOD) for potential application to nuclear power plant components for improvement of field NDE performance estimations.

Simulation For Task Practice in Technical Training.

ERIC Educational Resources Information Center

Mallory, W. J.

1981-01-01

Describes two programs used by the Ford Motor Company to train manufacturing skilled trades personnel. Programmable Controller Maintenance Training Program for Industrial Technicians and Troubleshooting Strategy Program use simulation and provide improved task performance after training. (JOW)

Efficiency Assessment of a Blended-Learning Educational Methodology in Engineering

NASA Astrophysics Data System (ADS)

Rogado, Ana Belén González; Conde, Ma José Rodríguez; Migueláñez, Susana Olmos; Riaza, Blanca García; Peñalvo, Francisco José García

The content of this presentation highlights the importance of an active learning methodology in engineering university degrees in Spain. We present of some of the outcomes from an experimental study carried out during the academic years 2007/08 and 2008/09 with engineering students (Technical Industrial Engineering: Mechanics, Civical Design Engineering: Civical building, Technical Architecture and Technical Engineering on Computer Management.) at the University of Salamanca. In this research we select a subject which is common for the four degrees: Computer Science. This study has the aim of contributing to the improvement of education and teaching methods for a better performance of students in Engineering.

Development and validation of trauma surgical skills metrics: Preliminary assessment of performance after training.

PubMed

Shackelford, Stacy; Garofalo, Evan; Shalin, Valerie; Pugh, Kristy; Chen, Hegang; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark; Mackenzie, Colin F

2015-07-01

Maintaining trauma-specific surgical skills is an ongoing challenge for surgical training programs. An objective assessment of surgical skills is needed. We hypothesized that a validated surgical performance assessment tool could detect differences following a training intervention. We developed surgical performance assessment metrics based on discussion with expert trauma surgeons, video review of 10 experts and 10 novice surgeons performing three vascular exposure procedures and lower extremity fasciotomy on cadavers, and validated the metrics with interrater reliability testing by five reviewers blinded to level of expertise and a consensus conference. We tested these performance metrics in 12 surgical residents (Year 3-7) before and 2 weeks after vascular exposure skills training in the Advanced Surgical Skills for Exposure in Trauma (ASSET) course. Performance was assessed in three areas as follows: knowledge (anatomic, management), procedure steps, and technical skills. Time to completion of procedures was recorded, and these metrics were combined into a single performance score, the Trauma Readiness Index (TRI). Wilcoxon matched-pairs signed-ranks test compared pretraining/posttraining effects. Mean time to complete procedures decreased by 4.3 minutes (from 13.4 minutes to 9.1 minutes). The performance component most improved by the 1-day skills training was procedure steps, completion of which increased by 21%. Technical skill scores improved by 12%. Overall knowledge improved by 3%, with 18% improvement in anatomic knowledge. TRI increased significantly from 50% to 64% with ASSET training. Interrater reliability of the surgical performance assessment metrics was validated with single intraclass correlation coefficient of 0.7 to 0.98. A trauma-relevant surgical performance assessment detected improvements in specific procedure steps and anatomic knowledge taught during a 1-day course, quantified by the TRI. ASSET training reduced time to complete vascular control by one third. Future applications include assessing specific skills in a larger surgeon cohort, assessing military surgical readiness, and quantifying skill degradation with time since training.

Implementation and evaluation of a dilation and evacuation simulation training curriculum.

PubMed

York, Sloane L; McGaghie, William C; Kiley, Jessica; Hammond, Cassing

2016-06-01

To evaluate obstetrics and gynecology resident physicians' performance following a simulation curriculum on dilation and evacuation (D&E) procedures. This study included two phases: simulation curriculum development and resident physician performance evaluation following training on a D&E simulator. Trainees participated in two evaluations. Simulation training evaluated participants performing six cases on a D&E simulator, measuring procedural time and a 26-step checklist of D&E steps. The operative training portion evaluated residents' performance after training on the simulator using mastery learning techniques. Intra-operative evaluation was based on a 21-step checklist score, Objective Structured Assessment of Technical Skills (OSATS), and percentage of cases completed. Twenty-two residents participated in simulation training, demonstrating improved performance from cases one and two to cases five and six, as measured by checklist score and procedural time (p<.001 and p=.001, respectively). Of 10 participants in the operative training, all performed at least three D&Es, while seven performed at least six cases. While checklist scores did not change significantly from the first to sixth case (mean for first case: 18.3; for sixth case: 19.6; p=.593), OSATS ratings improved from case one (19.7) to case three (23.5; p=.001) and to case six (26.8; p=.005). Trainees completed approximately 71.6% of their first case (range: 21.4-100%). By case six, the six participants performed 81.2% of the case (range: 14.3-100%). D&E simulation using a newly-developed uterine model and simulation curriculum improves resident technical skills. Simulation training with mastery learning techniques transferred to high level of performance in OR using checklist. The OSATS measured skills and showed improvement in performance with subsequent cases. Implementation of a D&E simulation curriculum offers potential for improved surgical training and abortion provision. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of senior design project for the development of leadership and management skills in construction management

NASA Astrophysics Data System (ADS)

Chowdhury, Tamara

2013-08-01

Senior design courses are a core part of curricula across engineering and technology disciplines. Such courses offer Construction Management (CMG) students the opportunity to bring together, assimilate and apply the knowledge they have acquired over their entire undergraduate academic programme to an applied technical project. Senior or Capstone design course engages students in a real-world project, enhance leadership development, and prepare to manage and lead project teams. The CMG programme's multidisciplinary approach at Alabama A&M University, combines essential components of construction techniques with concepts of business management to develop technically qualified individuals for responsible management roles in the design, construction and operation of major construction projects. This paper analyses the performance of the students and improvement due to the interaction with the faculty advisors and industrial panel during the two semester Capstone project. The results of this Capstone sequence have shown a continuous improvement of student performance.

Linnorm: improved statistical analysis for single cell RNA-seq expression data

PubMed Central

Yip, Shun H.; Wang, Panwen; Kocher, Jean-Pierre A.; Sham, Pak Chung

2017-01-01

Abstract Linnorm is a novel normalization and transformation method for the analysis of single cell RNA sequencing (scRNA-seq) data. Linnorm is developed to remove technical noises and simultaneously preserve biological variations in scRNA-seq data, such that existing statistical methods can be improved. Using real scRNA-seq data, we compared Linnorm with existing normalization methods, including NODES, SAMstrt, SCnorm, scran, DESeq and TMM. Linnorm shows advantages in speed, technical noise removal and preservation of cell heterogeneity, which can improve existing methods in the discovery of novel subtypes, pseudo-temporal ordering of cells, clustering analysis, etc. Linnorm also performs better than existing DEG analysis methods, including BASiCS, NODES, SAMstrt, Seurat and DESeq2, in false positive rate control and accuracy. PMID:28981748

Automatically inserted technical details improve radiology report accuracy.

PubMed

Abujudeh, Hani H; Govindan, Siddharth; Narin, Ozden; Johnson, Jamlik Omari; Thrall, James H; Rosenthal, Daniel I

2011-09-01

To assess the effect of automatically inserted technical details on the concordance of a radiology report header with the actual procedure performed. The study was IRB approved and informed consent was waived. We obtained radiology report audit data from the hospital's compliance office from the period of January 2005 through December 2009 spanning a total of 20 financial quarters. A "discordance percentage" was defined as the percentage of total studies in which a procedure code change was made during auditing. Using Chi-square analysis we compared discordance percentages between reports with manually inserted technical details (MITD) and automatically inserted technical details (AITD). The second quarter data of 2007 was not included in the analysis as the switch from MITD to AITD occurred during this quarter. The hospital's compliance office audited 9,110 studies from 2005-2009. Excluding the 564 studies in the second quarter of 2007, we analyzed a total of 8,546 studies, 3,948 with MITD and 4,598 with AITD. The discordance percentage in the MITD group was 3.95% (156/3,948, range per quarter, 1.5- 6.1%). The AITD discordance percentage was 1.37% (63/4,598, range per quarter, 0.0-2.6%). A Chi-square analysis determined a statistically significant difference between the 2 groups (P < 0.001). There was a statistically significant improvement in the concordance of a radiology report header with the performed procedure using automatically inserted technical details compared to manually inserted details. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2015-01-01

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

Discussion of skill improvement in marine ecosystem dynamic models based on parameter optimization and skill assessment

NASA Astrophysics Data System (ADS)

Shen, Chengcheng; Shi, Honghua; Liu, Yongzhi; Li, Fen; Ding, Dewen

2016-07-01

Marine ecosystem dynamic models (MEDMs) are important tools for the simulation and prediction of marine ecosystems. This article summarizes the methods and strategies used for the improvement and assessment of MEDM skill, and it attempts to establish a technical framework to inspire further ideas concerning MEDM skill improvement. The skill of MEDMs can be improved by parameter optimization (PO), which is an important step in model calibration. An efficient approach to solve the problem of PO constrained by MEDMs is the global treatment of both sensitivity analysis and PO. Model validation is an essential step following PO, which validates the efficiency of model calibration by analyzing and estimating the goodness-of-fit of the optimized model. Additionally, by focusing on the degree of impact of various factors on model skill, model uncertainty analysis can supply model users with a quantitative assessment of model confidence. Research on MEDMs is ongoing; however, improvement in model skill still lacks global treatments and its assessment is not integrated. Thus, the predictive performance of MEDMs is not strong and model uncertainties lack quantitative descriptions, limiting their application. Therefore, a large number of case studies concerning model skill should be performed to promote the development of a scientific and normative technical framework for the improvement of MEDM skill.

PERFORMANCE ASSESSMENT ASSISTANCE ACTIVITIES IN THE DOE COMPLEX

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

Seitz, R.

2012-01-23

The United States Department of Energy Office of Environmental Management (DOE-EM) has established a Performance Assessment Community of Practice (PA CoP) to foster the sharing of information among performance assessment (PA) and risk assessment practitioners, regulators and oversight personnel. The general intent is to contribute to continuous improvement in the consistency, technical adequacy and quality of implementation of PAs and risk assessments around the DOE Complex. The PA CoP activities have involved commercial disposal facilities and international participants to provide a global perspective. The PA CoP has also sponsored annual technical exchanges as a means to foster improved communication andmore » to share lessons learned from on-going modelling activities. The PA CoP encourages activities to provide programmatic and technical assistance in the form of sharing experience and lessons learned with practitioners during the development of PAs and risk assessments. This assistance complements DOE-EM reviews through the Low-Level Waste Disposal Facility Federal Review Group (LFRG) that are conducted after modelling efforts are completed. Such up-front assistance is providing additional value in terms of improving consistency and sharing of information. There has been a substantial increase in the amount of assistance being provided. The assistance has been well received by practitioners and regulators that have been involved. The paper highlights assistance and sharing of information that has been conducted in the last two years to support activities underway in support of proposed disposal facilities at Paducah, Portsmouth, and the Idaho National Laboratory and tank closure at Hanford.« less

Commercial products to preserve specimens for tuberculosis diagnosis: a systematic review.

PubMed

Reeve, B W P; McFall, S M; Song, R; Warren, R; Steingart, K R; Theron, G

2018-07-01

Eliminating tuberculosis in high-burden settings requires improved diagnostic capacity. Important tests such as Xpert® MTB/RIF and culture are often performed at centralised laboratories that are geographically distant from the point of specimen collection. Preserving specimen integrity during transportation, which could affect test performance, is challenging. To conduct a systematic review of commercial products for specimen preservation for a World Health Organization technical consultation. Databases were searched up to January 2018. Methodological quality was assessed using Quality Assessment of Technical Studies, a new technical study quality-appraisal tool, and Quality Assessment of Diagnostic Accuracy Studies-2. Studies were analysed descriptively in terms of the different products, study designs and diagnostic strategies used. Four products were identified from 16 studies: PrimeStore-Molecular-Transport-Medium (PS-MTM), FTA card, GENO•CARD (all for nucleic acid amplification tests [NAATs]) and OMNIgene•SPUTUM (OMS; culture, NAATs). PS-MTM, but not FTA card or GENO•CARD, rendered Mycobacterium tuberculosis non-culturable. OMS reduced Löwenstein-Jensen but not MGIT™ 960™ contamination, led to delayed MGIT time-to-positivity, resulted in Xpert performance similar to cold chain-transported untreated specimens, and obviated the need for N-acetyl-L-cysteine-sodium hydroxide decontamination. Data from paucibacillary specimens were limited. Evidence that a cold chain improves culture was mixed and absent for Xpert. The effect of the product alone could be discerned in only four studies. Limited evidence suggests that transport products result in test performance comparable to that seen in cold chain-transported specimens.

Do previous sports experiences influence the effect of an enrichment programme in basketball skills?

PubMed

Santos, Sara; Mateus, Nuno; Sampaio, Jaime; Leite, Nuno

2017-09-01

The aim of this study was to examine the effect of an enrichment programme in motor, technical and tactical basketball skills, when accounting for the age of youth sport specialisation. Seventy-six college students (age: M = 20.4, SD = 1.9) were allocated according to three different paths: (i) non-structured (n = 14), (ii) early specialisation (n = 34), and (iii) late specialisation (n = 28), according to information previously provided by the participants about the quantity and type of sporting activities performed throughout their sporting careers. Then, the participants of each path were randomly distributed across control and experimental groups. Variables under study included agility, technical skills circuit, as well as tactical actions performed in a 4-on-4 full-court basketball game. The results indicated improvements in the early and late specialisation paths namely in the experimental training groups. However, the late specialisation path revealed larger benefits, in contrast with the non-structured path, which showed less sensitivity to the enrichment programme, mostly sustained in physical literacy and differential learning. Higher improvements were observed in agility, and also in reducing the number of unsuccessful actions performed during the game. Overall, this study provided evidence of how early sports experiences affect basketball skill acquisition and contribute to adapt to new contexts with motor and technical-tactical challenges. In addition, a path supported by late specialisation might present several advantages in sport performance achievement.

An intensive combined training program modulates physical, physiological, biomotoric, and technical parameters in women basketball players.

PubMed

Kilinç, Fatih

2008-11-01

The purpose of this study was the investigation of the effects of an intensive combined training program based on the pretest scores of a university women's basketball team on their physical, physiological, biomotoric, and technical features. Twenty-four university volunteers were equally divided into two groups: an experiment group (intensive combined training group) and a control (technical training) group. The 10-week intensive combined training program was performed on the experiment group according to their pretest outcomes. Before and at the end of each period of training, which was scheduled four times a week, the physical, physiological, biomotoric, and technical performance of each subject were determined. With respect to the pre- and posttest measurements, the basketball group showed significant differences (p < 0.05) in girth measurements (shoulder, waist, hip, arm, thigh, and calf), in skinfold measurements (percent body fat), in physiological measurements (vital capacity and forced vital capacity), in biomotoric tests (right-left hand grip, dynamic and countermovement jump, sit-up, push-up, 1500-m endurance), and in technique tests (free and inside shooting). It can be concluded that a 10-week intensive combined training program performed on university women basketball players had a significant effect on improving their physical, physiological, biomotoric, and technical features. It proved to be highly recommendable for female basketball players who are preparing for short-term tournaments; the basketball group in this study won a championship.

Technical Report - FINAL

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

Barbara Luke, Director, UNLV Engineering Geophysics Laboratory

2007-04-25

Improve understanding of the earthquake hazard in the Las Vegas Valley and to assess the state of preparedness of the area's population and structures for the next big earthquake. 1. Enhance the seismic monitoring network in the Las Vegas Valley 2. Improve understanding of deep basin structure through active-source seismic refraction and reflection testing 3. Improve understanding of dynamic response of shallow sediments through seismic testing and correlations with lithology 4. Develop credible earthquake scenarios by laboratory and field studies, literature review and analyses 5. Refine ground motion expectations around the Las Vegas Valley through simulations 6. Assess current buildingmore » standards in light of improved understanding of hazards 7. Perform risk assessment for structures and infrastructures, with emphasis on lifelines and critical structures 8. Encourage and facilitate broad and open technical interchange regarding earthquake safety in southern Nevada and efforts to inform citizens of earthquake hazards and mitigation opportunities« less

The impact of a bundled policy intervention on improving the performance of rural healthcare in China.

PubMed

Wu, Jian; Li, Xiaofang; Song, Yao; Shao, Hui; Shi, Qian; Qin, Doudou; Xie, Shuangbao; Shi, Lizheng

2016-03-10

The strategy of health policy has been changed for improving the performances to meeting the increasing healthcare demands. However, limited evidences were found to prove that the bundled payment was valid for service delivering in public sector. This study was designed to evaluate the effectiveness of a bundled policy on strengthening the county-village communication and improving the quality of chronic disease management. This is a retrospective cohort study using the data collected in 2011, 2012 and 2014 from the Rural Health Development Project in China. The policy intervention included performance-related contract with health facilities, developing technical guideline for doctors and nurses, routine monitoring of performance, and efforts to increase public awareness about the services. There were two intervention counties in Henan Province, China, while one county with similar characteristics in Henan was selected as control. Funding allocation, work load and salary for health care workers, volume of township-to-village technical assistance were reported before and after the policy was implemented. Our study also examined the policy impacts on improving treatment outcomes of diabetes and hypertension care. There were substantial increases in the provision of the basic package of services including 96.6 % of patients with hypertension, 91.2 % of patients with diabetes under the health management system. After the intervention, there were 34.3 % (hypertension) and 42.0 % (diabetes) increase in regular follow-up visit rates, 24.6 and 17.2 % increase in blood pressure and blood glucose control rates, respectively. The family health records system covered 96 % of the rural families. Technical assistance between township health centres and village clinics were enhanced. Compared with baseline, the monthly training meeting and field supervision & guidance between township health centres and village clinics increased 1.0 meeting, 1.5 field visits, respectively, while the increases in the control county were only 0.3 meeting and 0.3 field visits. At the end of this study, 93.8 % of health workers achieved their performance goals. More patients were referred to appropriate levels of care. This bundled policy intervention effectively improved rural health care delivery. The result of our study can be used for local governments to implement performance-based health system management in developing country.

34 CFR 403.204 - What are the State's responsibilities for program evaluation and improvement?

Code of Federal Regulations, 2011 CFR

2011-07-01

... has not made sufficient progress in meeting the standards and measures developed as required by §§ 403... technical assistance and program activities the State will provide to enhance the performance of the...

Forming a Turbomachinery Seals Working Group: An Overview and Discussion

NASA Technical Reports Server (NTRS)

Proctor, Margaret P.

2007-01-01

Purose: Identify technical challenges to improving turbomachinery seal leakage and wear performance, reliability and cost effectiveness. Develop a coordinated effort to resolve foundational issues for turbomachinery seal technologies. Identify and foster opportunities for collaboration. Advocate for funding.

A Learning Evaluation for an Immersive Virtual Laboratory for Technical Training Applied into a Welding Workshop

ERIC Educational Resources Information Center

Torres, Francisco; Neira Tovar, Leticia A.; del Rio, Marta Sylvia

2017-01-01

This study aims to explore the results of welding virtual training performance, designed using a learning model based on cognitive and usability techniques, applying an immersive concept focused on person attention. Moreover, it also intended to demonstrate that exits a moderating effect of performance improvement when the user experience is taken…

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education

PubMed Central

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J.A.; Dandorf, Stewart J.; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-01-01

Introduction Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. Methods This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Results Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). Conclusion The use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills. PMID:27330672

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education.

PubMed

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J A; Dandorf, Stewart J; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-05-01

Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). The use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills.

Introduction of the non-technical skills for surgeons (NOTSS) system in a Japanese cancer center.

PubMed

Tsuburaya, Akira; Soma, Takahiro; Yoshikawa, Takaki; Cho, Haruhiko; Miki, Tamotsu; Uramatsu, Masashi; Fujisawa, Yoshikazu; Youngson, George; Yule, Steven

2016-12-01

Non-technical skills rating systems, which are designed to support surgical performance, have been introduced worldwide, but not officially in Japan. We performed a pilot study to evaluate the "non-technical skills for surgeons" (NOTSS) rating system in a major Japanese cancer center. Upper gastrointestinal surgeons were selected as trainers or trainees. The trainers attended a master-class on NOTSS, which included simulated demo-videos, to promote consistency across the assessments. The trainers thereafter commenced observing the trainees and whole teams, utilizing the NOTSS and "observational teamwork assessment for surgery" (OTAS) rating systems, before and after their education. Four trainers and six trainees were involved in this study. Test scores for understanding human factors and the NOTSS system were 5.89 ± 1.69 and 8.00 ± 1.32 before and after the e-learning, respectively (mean ± SD, p = 0.010). The OTAS scores for the whole team improved significantly after the trainees' education in five out of nine stages (p < 0.05). There were no differences in the NOTSS scores before and after education, with a small improvement in the total scores for the "teamwork and communication" and "leadership" categories. These findings demonstrate that implementing the NOTSS system is feasible in Japan. Education of both surgical trainers and trainees would contribute to better team performance.

Effects of a Velocity-Vector Based Command Augmentation System and Synthetic Vision System Terrain Portrayal and Guidance Symbology Concepts on Single-Pilot Performance

NASA Technical Reports Server (NTRS)

Liu, Dahai; Goodrich, Kenneth H.; Peak, Bob

2010-01-01

This study investigated the effects of synthetic vision system (SVS) concepts and advanced flight controls on the performance of pilots flying a light, single-engine general aviation airplane. We evaluated the effects and interactions of two levels of terrain portrayal, guidance symbology, and flight control response type on pilot performance during the conduct of a relatively complex instrument approach procedure. The terrain and guidance presentations were evaluated as elements of an integrated primary flight display system. The approach procedure used in the study included a steeply descending, curved segment as might be encountered in emerging, required navigation performance (RNP) based procedures. Pilot performance measures consisted of flight technical performance, perceived workload, perceived situational awareness and subjective preference. The results revealed that an elevation based generic terrain portrayal significantly improved perceived situation awareness without adversely affecting flight technical performance or workload. Other factors (pilot instrument rating, control response type, and guidance symbology) were not found to significantly affect the performance measures.

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

ERIC Educational Resources Information Center

Pietz, Victoria Lynn

2014-01-01

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

Management of Social Incentives in Air Force Technical Training: A Field Experiment. Final Report.

ERIC Educational Resources Information Center

Hakel, Milton D.; And Others

The report is a study of the utility of social reinforcement for improving Air Force training. It was conducted through a field evaluation of social incentive instructional systems which would serve to improve student motivation, classroom performance, and attitudes. The participants included a total of 300 trainees from two Air Force bases; 25…

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

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

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

The learning effect of intraoperative video-enhanced surgical procedure training.

PubMed

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, L J; Koopal, S A; Pierie, J P E N

2011-07-01

The transition from basic skills training in a skills lab to procedure training in the operating theater using the traditional master-apprentice model (MAM) lacks uniformity and efficiency. When the supervising surgeon performs parts of a procedure, training opportunities are lost. To minimize this intervention by the supervisor and maximize the actual operating time for the trainee, we created a new training method called INtraoperative Video-Enhanced Surgical Training (INVEST). Ten surgical residents were trained in laparoscopic cholecystectomy either by the MAM or with INVEST. Each trainee performed six cholecystectomies that were objectively evaluated on an Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Absolute and relative improvements during the training curriculum were compared between the groups. A questionnaire evaluated the trainee's opinion on this new training method. Skill improvement on the OSATS global rating scale was significantly greater for the trainees in the INVEST curriculum compared to the MAM, with mean absolute improvement 32.6 versus 14.0 points and mean relative improvement 59.1 versus 34.6% (P=0.02). INVEST significantly enhances technical and procedural skill development during the early learning curve for laparoscopic cholecystectomy. Trainees were positive about the content and the idea of the curriculum.

Lessons for surgeons in the final moments of Air France Flight 447.

PubMed

Bhangu, Aneel; Bhangu, Sonia; Stevenson, James; Bowley, Douglas M

2013-06-01

All surgeons make mistakes, and learning from critical incidents may help improve performance. The present study aimed to highlight lessons for surgeons from analysis of the final moments of Air France Flight 447. All of the authors work in teams and situations where safety, technical performance, and non-technical skills are critical. This review was born out of discussions regarding the events of Flight 447; specifically, whether the airline disaster was relevant to their work, and whether they could learn anything from it. The study is based on review of the crash reports of Flight 447, which lost flight speed indication after formation of ice prevented air from entering flight speed indicators during a storm. Following a subsequent stall, the aircraft fell at a rate of >10,000 feet/min until it crashed into the Atlantic Ocean, killing 228 passengers and crew. There were errors in decision making, reasoning, communication, and teamwork. Such non-technical skills failures have been recognized previously and can be addressed by existing non-technical skills training. A reliance on autopilot meant that the pilots were unfamiliar with high-altitude flying when the autopilot is disengaged. They were unprepared for and affected by such a sudden and serious problem; an event called "surprise and startle" by the accident investigation. The absence of the senior pilot (who was on a scheduled break) in the critical final minutes slowed error recognition and recovery. Unintended consequences of modern safety strategies may be under-recognized and can lead to adverse events. Both simulation-based and non-simulation-based training should include "surprise and startle" events beyond the scenarios trainees might expect. Likewise, in the face of increasing reliance on modern technology, surgeons should ensure that they would be able to perform procedures in the absence of such technologies. Specific training may improve surgeons' non-technical skills, and recognition of such skills could also be used to help select future surgeons.

The Importance of Postural Control in Relation to Technical Abilities in Small-Sided Soccer Games

PubMed Central

Edis, Çağlar; Vurgun, Hikmet

2016-01-01

Abstract Making assessments regarding postural control and balance is very important for injury prevention in soccer. However, there has been no study that has associated postural control variables with branch-specific technical properties in a game. The aim of the present study was to determine the relationships between variables designating postural control levels and technical performance variables in different (1:1, 2:2 and 3:3) small-sided games (SSGs). Sixteen trained male amateur soccer players volunteered to take part in the study (age 17.2 ± 1.02 years, body height 176.25 ± 0.07 m, body mass 67.67 ± 13.27 kg). Following familiarization sessions, postural control was evaluated using one-leg and both-leg quiet-stance positions by measuring postural sway with a Tekscan HR Mat™ in anterior–posterior and medial–lateral directions. Later, 1:1, 2:2 and 3:3 SSGs were performed at two-day intervals and the technical variables specified for each game were analyzed. A Spearman’s rank-order correlation analysis demonstrated the relationship between postural control and soccer-specific technical variables in 1:1 (r-values ranging from 0.582 to 0.776), 2:2 (rvalues ranging from 0.511 to 0.740) and 3:3 (r-values ranging from 0.502 to 0.834) SSGs. In addition, a Wilcoxon signed rank test revealed differences between SSGs in terms of several variables. The results of the study showed that higher postural control levels are among the important variables that affect success in the performance of technical skills under rival pressure and suddenly changing conditions. Therefore, it is recommended that in addition to its use for injury prevention purposes, balance training should be conducted to improve branch-specific technical skills and to increase the levels of their successful performance in a game. PMID:28149410

The Importance of Postural Control in Relation to Technical Abilities in Small-Sided Soccer Games.

PubMed

Edis, Çağlar; Vural, Faik; Vurgun, Hikmet

2016-12-01

Making assessments regarding postural control and balance is very important for injury prevention in soccer. However, there has been no study that has associated postural control variables with branch-specific technical properties in a game. The aim of the present study was to determine the relationships between variables designating postural control levels and technical performance variables in different (1:1, 2:2 and 3:3) small-sided games (SSGs). Sixteen trained male amateur soccer players volunteered to take part in the study (age 17.2 ± 1.02 years, body height 176.25 ± 0.07 m, body mass 67.67 ± 13.27 kg). Following familiarization sessions, postural control was evaluated using one-leg and both-leg quiet-stance positions by measuring postural sway with a Tekscan HR Mat™ in anterior-posterior and medial-lateral directions. Later, 1:1, 2:2 and 3:3 SSGs were performed at two-day intervals and the technical variables specified for each game were analyzed. A Spearman's rank-order correlation analysis demonstrated the relationship between postural control and soccer-specific technical variables in 1:1 (r-values ranging from 0.582 to 0.776), 2:2 (rvalues ranging from 0.511 to 0.740) and 3:3 (r-values ranging from 0.502 to 0.834) SSGs. In addition, a Wilcoxon signed rank test revealed differences between SSGs in terms of several variables. The results of the study showed that higher postural control levels are among the important variables that affect success in the performance of technical skills under rival pressure and suddenly changing conditions. Therefore, it is recommended that in addition to its use for injury prevention purposes, balance training should be conducted to improve branch-specific technical skills and to increase the levels of their successful performance in a game.

ERCMExpress. Volume 2, Issue 2

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

This issue of the Emergency Response and Crisis Management (ERCM) Technical Assistance Center's "ERCMExpress" introduces the National Clearinghouse for Educational Facilities (NCEF), a free public service that provides information on planning, designing, funding, building, improving and maintaining safe, healthy, high-performance schools. NCEF is…

Highlights of the Transit Bus Technology Workshop - April 29-30, 1982

DOT National Transportation Integrated Search

1982-09-01

The Transit Bus Technology Workshop, held at the Transportation Systems Center on April 29-30, 1982, provided UMTA with current information on research, development, and technical assistance needed to improve the economy and performance of transit bu...

Stabilization of unpaved shoulders on moderate and weak subgrade using geosynthetics : [technical summary].

DOT National Transportation Integrated Search

2016-01-01

Geosynthetics have been used to improve the performance of roadways, especially when : weak subgrade soil exists. In this study, two types of geosynthetic products, geocell and : geogrid, were investigated for their application for stabilization of u...

Evaluation of a novel waste heat recovery system for the cement industry using multi-criteria analysis (MCA) approach

NASA Astrophysics Data System (ADS)

Han, Yue; Guo, Junshan; Zheng, Wei; Ding, Junqi; Zhu, Lingkai; Che, Yongqiang; Zhang, Yanpeng

2017-12-01

Based on a novel waste heat recovery project established in a cement plant, this paper aims to evaluate the performance of the project using multi-criteria analysis (MCA) approach. Economic, environmental, social, and technical perspectives were concerned and analyzed. Different sustainability criteria and indicators related with the project were evaluated through ranking/rating process and pairwise comparison. Results have shown similar outcomes, that ten out of eleven criteria are favorable at a high standard, which reveals the project’s success. Although the project has performed so well in economic, environmental and technical terms, social aspects have some weak points, and measures should be taken to improve social benefit.

First satellite mobile communication trials using BLQS-CDMA

NASA Technical Reports Server (NTRS)

Luzdemateo, Maria; Johns, Simon; Dothey, Michel; Vanhimbeeck, Carl; Deman, Ivan; Wery, Bruno

1993-01-01

In this paper, technical results obtained in the first MSBN Land mobile technical trial are reported. MSBN (Mobile Satellite Business Network) is a new program undertaken by the European Space Agency (ESA) to promote mobile satellite communication in Europe, in particular voice capability. The first phase of the MSBN system implementation plan is an experimental phase. Its purpose is to evaluate through field experiments the performance of the MSBN system prior to finalization of its specifications. Particularly, the objective is to verify in the field and possibly improve the performance of the novel satellite access technique BLQS-CDMA (Band Limited Quasi-Synchronous-Code Division Multiple Access), which is proposed as baseline for the MSBN.

Developing non-technical ward-round skills.

PubMed

Harvey, Rachel; Mellanby, Edward; Dearden, Effie; Medjoub, Karima; Edgar, Simon

2015-10-01

Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform. There is evidence that newly qualified doctors are not adequately prepared by their undergraduate experiences for this task. The aim of this study was to analyse the challenges pertaining to non-technical skills that students would face during ward rounds, and to create a model that facilitates the transition from medical student to doctor. A total of 217 final-year medical students completed a simulated ward round. Free-text responses were analysed using template analysis applying an a priori template developed from the literature by the research team. This drew on the generic categories of non-technical skills suggested by Flin et al. Ninety-seven per cent of students agreed or strongly agreed that the simulated ward round improved their insight into the challenges of ward rounds and their perceived ability to work efficiently as an active member of the ward round. The responding students (206) submitted written feedback describing the learning that they planned to use: 800 learning points were recorded, and all could be categorised into one of seven non-technical skills. Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform We believe that improved task efficiency and insight into the challenges of the ward round gained by medical students will lead to an enhancement in performance during clinical rounds, and will have a positive impact on patient safety. We would suggest that undergraduate medical schools consider this model in the preparation for the clinical practice element of the curriculum. © 2015 John Wiley & Sons Ltd.

Linnorm: improved statistical analysis for single cell RNA-seq expression data.

PubMed

Yip, Shun H; Wang, Panwen; Kocher, Jean-Pierre A; Sham, Pak Chung; Wang, Junwen

2017-12-15

Linnorm is a novel normalization and transformation method for the analysis of single cell RNA sequencing (scRNA-seq) data. Linnorm is developed to remove technical noises and simultaneously preserve biological variations in scRNA-seq data, such that existing statistical methods can be improved. Using real scRNA-seq data, we compared Linnorm with existing normalization methods, including NODES, SAMstrt, SCnorm, scran, DESeq and TMM. Linnorm shows advantages in speed, technical noise removal and preservation of cell heterogeneity, which can improve existing methods in the discovery of novel subtypes, pseudo-temporal ordering of cells, clustering analysis, etc. Linnorm also performs better than existing DEG analysis methods, including BASiCS, NODES, SAMstrt, Seurat and DESeq2, in false positive rate control and accuracy. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

Increasing the technical level of mining haul trucks

NASA Astrophysics Data System (ADS)

Voronov, Yuri; Voronov, Artyom; Grishin, Sergey; Bujankin, Alexey

2017-11-01

Theoretical and methodological fundamentals of mining haul trucks optimal design are articulated. Methods based on the systems approach to integrated assessment of truck technical level and methods for optimization of truck parameters depending on performance standards are provided. The results of using these methods are given. The developed method allows not only assessing the truck technical levels but also choosing the most promising models and providing quantitative evaluations of the decisions to be made at the design stage. These areas are closely connected with the problem of improvement in the industrial output quality, which, being a part of the widely spread in Western world "total quality control" ideology, is one of the major issues for the Russian economy.

Advancing Commercialization of Algal Biofuel through Increased Biomass Productivity and Technical Integration

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

Anton, David

The proposed project built on the foundation of over several years years of intensive and ground-breaking R&D work at Cellana's Kona Demonstration Facility (KDF). Phycological and engineering solutions were provided to tackle key cultivation issues and technical barriers limiting algal biomass productivity identified through work conducted outdoors at industrial (1 acre) scale. The objectives of this project were to significantly improve algal biomass productivity and reduce operational cost in a seawater-based system, using results obtained from two top-performing algal strains as the baseline while technically advancing and more importantly, integrating the various unit operations involved in algal biomass production, processing,more » and refining.« less

16 CFR 1406.5 - Performance and technical data to be furnished to the Commission.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Commission the following performance and technical data related to performance and safety. (a) Written notice... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Performance and technical data to be... TECHNICAL DATA § 1406.5 Performance and technical data to be furnished to the Commission. Manufacturers...

16 CFR 1401.5 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Providing performance and technical data to...: REQUIREMENTS TO PROVIDE THE COMMISSION WITH PERFORMANCE AND TECHNICAL DATA; REQUIREMENTS TO NOTIFY CONSUMERS AT POINT OF PURCHASE OF PERFORMANCE AND TECHNICAL DATA § 1401.5 Providing performance and technical data to...

16 CFR 1401.5 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Providing performance and technical data to...: REQUIREMENTS TO PROVIDE THE COMMISSION WITH PERFORMANCE AND TECHNICAL DATA; REQUIREMENTS TO NOTIFY CONSUMERS AT POINT OF PURCHASE OF PERFORMANCE AND TECHNICAL DATA § 1401.5 Providing performance and technical data to...

16 CFR 1401.5 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Providing performance and technical data to...: REQUIREMENTS TO PROVIDE THE COMMISSION WITH PERFORMANCE AND TECHNICAL DATA; REQUIREMENTS TO NOTIFY CONSUMERS AT POINT OF PURCHASE OF PERFORMANCE AND TECHNICAL DATA § 1401.5 Providing performance and technical data to...

16 CFR 1401.5 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Providing performance and technical data to...: REQUIREMENTS TO PROVIDE THE COMMISSION WITH PERFORMANCE AND TECHNICAL DATA; REQUIREMENTS TO NOTIFY CONSUMERS AT POINT OF PURCHASE OF PERFORMANCE AND TECHNICAL DATA § 1401.5 Providing performance and technical data to...

"Circadian cortical compensation": a longitudinal study of brain function during technical and cognitive skills in acutely sleep-deprived surgical residents.

PubMed

Leff, Daniel Richard; Orihuela-Espina, Felipe; Athanasiou, Thanos; Karimyan, Vahe; Elwell, Clare; Wong, John; Yang, Guang-Zhong; Darzi, Ara W

2010-12-01

To test the hypothesis that fatigue-induced performance decline in surgical residents is associated with changes in brain function as detected by functional near-infrared spectroscopy. Surgical residents (n = 7) participated in a prospective study involving 2-hourly objective measurements of neurocognitive skill (arithmetic calculations using Nintendo "brain training"), technical performance (surgical knot tying on a trainer, and monitoring time taken, path length and number of movements), and introspective fatigue (questionnaire-based) across 10 hours of acute sleep deprivation (10:00 PM to 8:00 PM. Simultaneously, changes in cortical oxyhemoglobin (HbO₂), deoxyhemoglobin (HHb), and total hemoglobin (HbT), inferring prefrontal function, were recorded by using functional near-infrared spectroscopy. Arithmetic performance remained stable despite increasing levels of subject fatigue (time: P = 0.07, errors: P = 0.70, efficiency: P = 0.58). Technical skill improved between the first (10:00 PM and the second (12:00 AM sessions (P < 0.05) and stabilized thereafter (12:00 AM to 8:00 AM. Greater activation was required to complete cognitive versus technical drills. Stimulus type (0: cognitive, 1: technical) was found to be an independent predictor of changes in cortical excitation (HbO₂: P < 0.01, HHb: P < 0.05, HbT: P < 0.01). Cortical responses to the cognitive task increased over the course of the simulated night shift. In addition, "time interval" was observed to be an independent predictor of cortical hemodynamic change (HbO₂: P < 0.01, HbT: P < 0.01). Neurocognitive tasks may tax the sleep-deprived resident more than well-learned technical skills. Performing cognitive skills at night, such as decision making, may depend upon enhanced prefrontal recruitment indicative of a focused attentional strategy and/or compensation to sleep deprivation. Further work should focus on determining whether errors in performance are associated with attentional lapses and failure of cortical compensation.

Quality Improvement in Surgery Combining Lean Improvement Methods with Teamwork Training: A Controlled Before-After Study

PubMed Central

Robertson, Eleanor; Morgan, Lauren; New, Steve; Pickering, Sharon; Hadi, Mohammed; Collins, Gary; Rivero Arias, Oliver; Griffin, Damian; McCulloch, Peter

2015-01-01

Background To investigate the effectiveness of combining teamwork training and lean process improvement, two distinct approaches to improving surgical safety. We conducted a controlled interrupted time series study in a specialist UK Orthopaedic hospital incorporating a plastic surgery team (which received the intervention) and an Orthopaedic theatre team acting as a control. Study Design We used a 3 month intervention with 3 months data collection period before and after it. A combined teamwork training and lean process improvement intervention was delivered by an experienced specialist team. Before and after the intervention we evaluated team non-technical skills using NOTECHS II, technical performance using the glitch rate and WHO checklist compliance using a simple 3 point scale. We recorded complication rate, readmission rate and length of hospital stay data for 6 months before and after the intervention. Results In the active group, but not the control group, full compliance with WHO Time Out (T/O) increased from 14 to 71% (p = 0.032), Sign Out attempt rate (S/O) increased from 0% to 50% (p<0.001) and Oxford NOTECHS II scores increased after the intervention (P = 0.058). Glitch rate decreased in the active group and increased in the control group (p = 0.001). Complications and length of stay appeared to rise in the control group and fall in the active group. Conclusions Combining teamwork training and systems improvement enhanced both technical and non-technical operating team process measures, and were associated with a trend to better safety outcome measures in a controlled study comparison. We suggest that approaches which address both system and culture dimensions of safety may prove valuable in reducing risks to patients. PMID:26381643

Robotic Mitral Valve Repair: The Learning Curve.

PubMed

Goodman, Avi; Koprivanac, Marijan; Kelava, Marta; Mick, Stephanie L; Gillinov, A Marc; Rajeswaran, Jeevanantham; Brzezinski, Anna; Blackstone, Eugene H; Mihaljevic, Tomislav

Adoption of robotic mitral valve surgery has been slow, likely in part because of its perceived technical complexity and a poorly understood learning curve. We sought to correlate changes in technical performance and outcome with surgeon experience in the "learning curve" part of our series. From 2006 to 2011, two surgeons undertook robotically assisted mitral valve repair in 458 patients (intent-to-treat); 404 procedures were completed entirely robotically (as-treated). Learning curves were constructed by modeling surgical sequence number semiparametrically with flexible penalized spline smoothing best-fit curves. Operative efficiency, reflecting technical performance, improved for (1) operating room time for case 1 to cases 200 (early experience) and 400 (later experience), from 414 to 364 to 321 minutes (12% and 22% decrease, respectively), (2) cardiopulmonary bypass time, from 148 to 102 to 91 minutes (31% and 39% decrease), and (3) myocardial ischemic time, from 119 to 75 to 68 minutes (37% and 43% decrease). Composite postoperative complications, reflecting safety, decreased from 17% to 6% to 2% (63% and 85% decrease). Intensive care unit stay decreased from 32 to 28 to 24 hours (13% and 25% decrease). Postoperative stay fell from 5.2 to 4.5 to 3.8 days (13% and 27% decrease). There were no in-hospital deaths. Predischarge mitral regurgitation of less than 2+, reflecting effectiveness, was achieved in 395 (97.8%), without correlation to experience; return-to-work times did not change substantially with experience. Technical efficiency of robotic mitral valve repair improves with experience and permits its safe and effective conduct.

Robotic-Assisted Versus Manual Prostatic Arterial Embolization for Benign Prostatic Hyperplasia: A Comparative Analysis.

PubMed

Bagla, Sandeep; Smirniotopoulos, John; Orlando, Julie C; Piechowiak, Rachel

2017-03-01

Prostatic artery embolization (PAE) is a safe and efficacious procedure for benign prostatic hyperplasia (BPH), though is technically challenging. We present our experience of technical and clinical outcomes of robotic and manual PAE in patients with BPH. IRB-approved retrospective study of 40 consecutive patients 49-81 years old with moderate or severe grade BPH from May 2014 to July 2015: 20 robotic-assisted PAE (group 1), 20 manual PAE (group 2). Robotic-assisted PAE was performed using the Magellan Robotic System. American Urological Association (AUA-SI) score, cost, technical and clinical success, radiation dose, fluoroscopy, and procedure time were reviewed. Statistical analysis was performed within and between each group using paired t test and one-way analysis of variance respectively, at 1 and 3 months. No significant baseline differences in age and AUA-SI between groups. Technical success was 100% (group 1) and 95% (group 2). One unsuccessful subject from group 2 returned for a successful embolization using robotic assistance. Fluoroscopy and procedural times were similar between groups, with a non-significant lower patient radiation dose in group 1 (30,632.8 mGy/cm 2 vs 35,890.9, p = 0.269). Disposable cost was significantly different between groups with the robotic-assisted PAE incurring a higher cost (group 1 $4530.2; group 2 $1588.5, p < 0.0001). Clinical improvement was significant in both arms at 3 months: group 1 mean change in AUA-SI of 8.3 (p = 0.006), group 2: 9.6 (p < 0.0001). No minor or major complications occurred. Robotic-assisted PAE offers technical success comparable to manual PAE, with similar clinical improvement with an increased cost.

Intensive skills week for military medical students increases technical proficiency, confidence, and skills to minimize negative stress.

PubMed

Mueller, Genevieve; Hunt, Bonnie; Wall, Van; Rush, Robert; Molof, Alan; Schoeff, Jonathan; Wedmore, Ian; Schmid, James; Laporta, Anthony

2012-01-01

The effects of stress induced cortisol on learning and memory is well documented in the literature.1-3 Memory and learning are enhanced at low levels while high levels are detrimental. Repetitive training in stressful situations enables management of the stress response4 as demonstrated by the high intensity training military members undergo to prepare for tactical situations. Appropriate management of one?s stress response is critical in the medical field, as the negative effects of stress can potentially hinder life-saving procedures and treatments. This also applies to physicians-in-training as they learn and practice triage, emergency medicine, and surgical skills prior to graduation. Rocky Vista University?s Military Medicine Honor?s Track (MMHT) held a week long high-intensity emergency medicine and surgical Intensive Skills Week (ISW), facilitated by military and university physicians, to advance students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). The short-term goal of the ISW was to overcome negative stress responses to increase confidence, technical and non-technical knowledge, and skill in surgery and emergency medicine in an effort to improve performance as third-year medical students. The long-term goal was to enhance performance and proficiency in residency and future medical practice. The metrics for the short-term goals were the focus of this pilot study. Results show an increase in confidence and decrease in perceived stress as well as statistically significant improvements in technical and non-technical skills and surgical instrumentation knowledge throughout the week. There is a correlative benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or unfeasible. 2012.

Modeling and Quantification of Team Performance in Human Reliability Analysis for Probabilistic Risk Assessment

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

Jeffrey C. JOe; Ronald L. Boring

Probabilistic Risk Assessment (PRA) and Human Reliability Assessment (HRA) are important technical contributors to the United States (U.S.) Nuclear Regulatory Commission’s (NRC) risk-informed and performance based approach to regulating U.S. commercial nuclear activities. Furthermore, all currently operating commercial NPPs in the U.S. are required by federal regulation to be staffed with crews of operators. Yet, aspects of team performance are underspecified in most HRA methods that are widely used in the nuclear industry. There are a variety of "emergent" team cognition and teamwork errors (e.g., communication errors) that are 1) distinct from individual human errors, and 2) important to understandmore » from a PRA perspective. The lack of robust models or quantification of team performance is an issue that affects the accuracy and validity of HRA methods and models, leading to significant uncertainty in estimating HEPs. This paper describes research that has the objective to model and quantify team dynamics and teamwork within NPP control room crews for risk informed applications, thereby improving the technical basis of HRA, which improves the risk-informed approach the NRC uses to regulate the U.S. commercial nuclear industry.« less

Six weeks of β-alanine supplementation did not enhance repeated-sprint ability or technical performances in young elite basketball players.

PubMed

Milioni, Fabio; Redkva, Paulo E; Barbieri, Fabio A; Zagatto, Alessandro M

2017-06-01

Supplementation with β-alanine plays an important role as a precursor of carnosine, the most effective intramuscular buffer, and has been seen as a potential ergogenic aid, especially for high-intensity modalities such as basketball. Thus, the aim of the present study was to investigate the effects of 6 weeks of β-alanine supplementation on repeated sprint ability (RSA) and technical performances in young elite Brazilian basketball players. In total, 27 young basketball players (17±1 years) were randomized into a β-alanine group (Gβ - 6.4 g day -1 of β-alanine) and a placebo group (GP - 6.4 g day -1 of dextrose). Before and after the supplementation period the athletes performed a RSA test composed of ten 30 m sprints with two 180° changes of direction interspaced by 30 s of recovery. During the recovery period (i.e., after the sprints) the athletes performed a countermovement jump (CMJ) and a set of three free throws. After 48 h they performed a Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1). Both groups increased the distance covered in the Yo-Yo IR1 after the supplementation period ( p = 0.001). On the other hand, both groups presented impairment in RSA time-performance (total time, best time, and mean time, p ≤ 0.04), while no significant changes were observed for technical task performances (i.e., CMJ and free throws) ( p ≥ 0.07). No between-group interactions were observed for any variable measured ( p ≥ 0.31). Thus, 6 weeks of β-alanine supplementation did not improve RSA or technical performances in young elite basketball players.

Analysis of Running and Technical Performance in Substitute Players in International Male Rugby Union Competition.

PubMed

Lacome, Mathieu; Piscione, Julien; Hager, Jean-Philippe; Carling, Christopher

2016-09-01

To investigate the patterns and performance of substitutions in 18 international 15-a-side men's rugby union matches. A semiautomatic computerized time-motion system compiled 750 performance observations for 375 players (422 forwards, 328 backs). Running and technical-performance measures included total distance run, high-intensity running (>18.0 km/h), number of individual ball possessions and passes, percentage of passes completed, and number of attempted and percentage of successful tackles. A total of 184 substitutions (85.2%) were attributed to tactical and 32 (14.8%) to injury purposes respectively. The mean period for non-injury-purpose substitutions in backs (17.7%) occurred between 70 and 75 min, while forward substitutions peaked equally between 50-55 and 60-65 min (16.4%). Substitutes generally demonstrated improved running performance compared with both starter players who completed games and players whom they replaced (small differences, ES -0.2 to 0.5) in both forwards and backs over their entire time played. There was also a trend for better running performance in forward and back substitutes over their first 10 min of play compared with the final 10 min for replaced players (small to moderate differences, ES 0.3-0.6). Finally, running performance in both forward and back substitutes was generally lower (ES -0.1 to 0.3, unclear or small differences) over their entire 2nd-half time played compared with their first 10 min of play. The impact of substitutes on technical performance was generally considered unclear. This information provides practitioners with practical data relating to the physical and technical contributions of substitutions that subsequently could enable optimization of their impact on match play.

16 CFR § 1401.5 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Providing performance and technical data to...: REQUIREMENTS TO PROVIDE THE COMMISSION WITH PERFORMANCE AND TECHNICAL DATA; REQUIREMENTS TO NOTIFY CONSUMERS AT POINT OF PURCHASE OF PERFORMANCE AND TECHNICAL DATA § 1401.5 Providing performance and technical data to...

Organization Development: Concept, Process, and Applications in the Department of Defense

DTIC Science & Technology

1989-04-01

collection, the consultant performs an organizational diagnosis in which the focus is on identifying ways to improve the technical, administrative, and...dynamics, and organizational diagnosis . 2. Action/Planning Workshops. This activity consisted of management conferences and management/worker conferences

Improving transportation systems management and operations (TSM&O), capability maturity model workshop white paper : performance measurement.

DOT National Transportation Integrated Search

2015-04-01

Research done through the Second Strategic Highway Research Program (SHRP 2) determined that agencies with the most effective transportation systems management and operations (TSM&O) activities were differentiated not by budgets or technical skills a...

Development of speed models for improving travel forecasting and highway performance evaluation : [technical summary].

DOT National Transportation Integrated Search

2013-12-01

Travel forecasting models predict travel demand based on the present transportation system and its use. Transportation modelers must develop, validate, and calibrate models to ensure that predicted travel demand is as close to reality as possible. Mo...

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

PubMed

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

2016-08-23

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

"Using Data" to Inform Decisions: How Teachers Use Data to Inform Practice and Improve Student Performance in Mathematics. Results from a Randomized Experiment of Program Efficacy

ERIC Educational Resources Information Center

Cavalluzzo, Linda; Geraghty, Thomas M.; Steele, Jennifer L.; Holian, Laura; Jenkins, Frank; Alexander, Jane M.; Yamasaki, Kelsey Y.

2014-01-01

The purpose of this study is to evaluate, using a randomized experimental design, the efficacy of TERC's "Using Data" program to change teacher behavior and improve student learning outcomes. The "Using Data" intervention provides professional development and technical assistance to teachers to help them use data…

Process research of non-CZ silicon material

NASA Technical Reports Server (NTRS)

1983-01-01

High risk, high payoff research areas associated with the Westinghouse process for producing photovoltaic modules using non- CZ sheet material were investigated. All work was performed using dendritic web silicon. The following tasks are discussed and associated technical results are given: (1) determining the technical feasibility of forming front and back junctions in non-CT silicon using dopant techniques; (2) determining the feasibility of forming a liquid applied diffusion mask to replace the more costly chemical vapor deposited SiO2 diffusion mask; (3) determining the feasibility of applying liquid anti-reflective solutions using meniscus coating equipment; (4) studying the production of uniform, high efficiency solar cells using ion implanation junction formation techniques; and (5) quantifying cost improvements associated with process improvements.

Technical errors in planar bone scanning.

PubMed

Naddaf, Sleiman Y; Collier, B David; Elgazzar, Abdelhamid H; Khalil, Magdy M

2004-09-01

Optimal technique for planar bone scanning improves image quality, which in turn improves diagnostic efficacy. Because planar bone scanning is one of the most frequently performed nuclear medicine examinations, maintaining high standards for this examination is a daily concern for most nuclear medicine departments. Although some problems such as patient motion are frequently encountered, the degraded images produced by many other deviations from optimal technique are rarely seen in clinical practice and therefore may be difficult to recognize. The objectives of this article are to list optimal techniques for 3-phase and whole-body bone scanning, to describe and illustrate a selection of deviations from these optimal techniques for planar bone scanning, and to explain how to minimize or avoid such technical errors.

Improving care by understanding the way we work: human factors and behavioural science in the context of intensive care

PubMed Central

Sevdalis, Nick; Brett, Stephen J

2009-01-01

Effectiveness and efficiency of care of the critically ill patient are subject to a number of systemic influences, including skills of individual physicians/nurses (technical and non-technical), team-working in the intensive care unit (ICU), and the ICU environment. We first discuss the paper of Fackler and colleagues as a contribution to the systems approach to clinical performance in the context of intensive care. We then highlight features of care delivery that are unique to intensive care and discuss the need for better understanding of human and non-human elements of the system of care of the critically ill patient as a driver for improvement of care delivery. PMID:19439048

Air traffic management as principled negotiation between intelligent agents

NASA Technical Reports Server (NTRS)

Wangermann, J. P.

1994-01-01

The major challenge facing the world's aircraft/airspace system (AAS) today is the need to provide increased capacity, while reducing delays, increasing the efficiency of flight operations, and improving safety. Technologies are emerging that should improve the performance of the system, but which could also introduce uncertainty, disputes, and inefficiency if not properly implemented. The aim of our research is to apply techniques from intelligent control theory and decision-making theory to define an Intelligent Aircraft/Airspace System (IAAS) for the year 2025. The IAAS would make effective use of the technical capabilities of all parts of the system to meet the demand for increased capacity with improved performance.

Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room: A Randomized Controlled Trial.

PubMed

Bonrath, Esther M; Dedy, Nicolas J; Gordon, Lauren E; Grantcharov, Teodor P

2015-08-01

The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training. Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge; however, it often remains underutilized. Coaching has been successfully used in various industries to enhance performance, but its role in surgery has been insufficiently investigated. This randomized controlled trial was conducted at one surgical training program. Trainees undergoing a minimally invasive surgery rotation were randomized to either conventional training (CT) or comprehensive surgical coaching (CSC). CT included ward and operating room duties, and regular departmental teaching sessions. CSC comprised performance analysis, debriefing, feedback, and behavior modeling. Primary outcome measures were technical performance as measured on global and procedure-specific rating scales, and surgical safety parameters, measured by error count. Operative performance was assessed by blinded video analysis of the first and last cases recorded by the participants during their rotation. Twenty residents were randomized and 18 completed the study. At posttraining the CSC group (n = 9) scored significantly higher on a procedure-specific skill scale compared with the CT group (n = 9) [median, 3.90 (interquartile range, 3.68-4.30) vs 3.60 (2.98-3.70), P = 0.017], and made fewer technical errors [10 (7-13) vs 18 (13-21), P = 0.003]. Significant within-group improvements for all skill metrics were only noted in the CSC group. Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training.

State “Technical Assistance Programs” for nursing home quality improvement: variations and potential implications

PubMed Central

Li, Yue; Spector, Williams D.; Glance, Laurent G.; Mukamel, Dana B.

2013-01-01

Context To improve nursing home quality, many states developed “Technical Assistance Programs” that provide on-site consultation and training for nursing facility staff. Methods We conducted a national survey on these state programs to collect data on program design, operations, financing, and perceived effectiveness. Results As of 2010, 17 states have developed such programs. Compared to existing state nursing home quality regulations, these programs represent a collaborative, rather than enforcement-oriented, approach to quality. However, existing programs vary substantially in key structural features such as staffing patterns, funding levels, and relationship with state survey and certification agencies. Perceived effectiveness by program officials on quality was high, although few states have performed formal evaluations. Perceived barriers to program effectiveness included lack of appropriate staff and funding, among others. Conclusion State “Technical Assistance Programs” for nursing homes varies in program design and perceived effectiveness. Future comparative evaluations are needed to inform evidence-based quality initiatives. PMID:23216345

Technical and Economic Assessment of the Implementation of Measures for Reducing Energy Losses in Distribution Systems

NASA Astrophysics Data System (ADS)

Aguila, Alexander; Wilson, Jorge

2017-07-01

This paper develops a methodology to assess a group of measures of electrical improvements in distribution systems, starting from the complementation of technical and economic criteria. In order to solve the problem of energy losses in distribution systems, technical and economic analysis was performed based on a mathematical model to establish a direct relationship between the energy saved by way of minimized losses and the costs of implementing the proposed measures. This paper aims at analysing the feasibility of reducing energy losses in distribution systems, by changing existing network conductors by larger crosssection conductors and distribution voltage change at higher levels. The impact of this methodology provides a highly efficient mathematical tool for analysing the feasibility of implementing improvement projects based on their costs which is a very useful tool for the distribution companies that will serve as a starting point to the analysis for this type of projects in distribution systems.

Fundamental Aeronautics Program: Overview of Propulsion Work in the Supersonic Cruise Efficiency Technical Challenge

NASA Technical Reports Server (NTRS)

Castner, Ray

2012-01-01

The Supersonics Project, part of NASA's Fundamental Aeronautics Program, contains a number of technical challenge areas which include sonic boom community response, airport noise, high altitude emissions, cruise efficiency, light weight durable engines/airframes, and integrated multi-discipline system design. This presentation provides an overview of the current (2012) activities in the supersonic cruise efficiency technical challenge, and is focused specifically on propulsion technologies. The intent is to develop and validate high-performance supersonic inlet and nozzle technologies. Additional work is planned for design and analysis tools for highly-integrated low-noise, low-boom applications. If successful, the payoffs include improved technologies and tools for optimized propulsion systems, propulsion technologies for a minimized sonic boom signature, and a balanced approach to meeting efficiency and community noise goals. In this propulsion area, the work is divided into advanced supersonic inlet concepts, advanced supersonic nozzle concepts, low fidelity computational tool development, high fidelity computational tools, and improved sensors and measurement capability. The current work in each area is summarized.

Designation of Contracting Officers Representatives and Oversight Framework Could Be Improved for Contracts in Afghanistan

DTIC Science & Technology

2016-08-30

certifying official in the certification of vouchers for payment. 21 U.S. Office of Government Ethics Form 450, “Confidential Financial Disclosure Report...contracting officer to perform specific technical or administrative functions for Government contracts. We performed this audit in response to a...February 2015 U.S. Forces−Afghanistan policy memorandum requesting the DoD Office of Inspector General to review COR performance in the Combined

Replacing fossil based plastic performance products by bio-based plastic products-Technical feasibility.

PubMed

van den Oever, Martien; Molenveld, Karin

2017-07-25

Larger scale market introduction of new bio-based products requires a clear advantage regarding sustainability, as well as an adequate techno-economic positioning relative to fossil based products. In a previous paper [Broeren et al., 2016], LCA results per kg and per functionality equivalent of bio-based plastics were presented, together with economic considerations. The present paper discusses the mechanical and thermal properties of a range of commercially available bio-based plastics based on polylactic acid (PLA), cellulose esters, starch and polyamides, and the feasibility of replacing fossil-based counterparts based on performance. The evaluation is approached from an end user perspective. First, potentially suitable bio-based plastics are selected based on manufacturers' specifications in technical data sheets, then a first experimental evaluation is performed on injection moulded ISO specimens, and finally a further selection of plastics is tested on large 50×70cm panels. This technical feasibility study indicates that so far bio-based plastics do not completely match the properties of high performance materials like flame retardant V-0 PC/ABS blends used in electronic devices. The performance gap is being decreased by the development of stereocomplex PLA and hybrid PLA blends with polycarbonate, which offer clearly improved properties with respect to maximum usage temperature and toughness. In addition, several materials meet the V-0 flammability requirements needed in specific durable applications. On the other hand, improving these properties so far has negative consequences for the bio-based content. This study also shows that replacement of bulk polymers like PS is feasible using PLA compounds with a bio-based content as high as 85%. Copyright © 2016 Elsevier B.V. All rights reserved.

Putting EVM to the Test

NASA Technical Reports Server (NTRS)

Kerby, Jerald; Counts, Stacy

2005-01-01

IN MANY INSTANCES THERE IS NO FOREWARNING; SCHEDULES slip, costs soar, and the project manager is faced with the near impossible task of explaining why each impact occurred. With contractors performing the majority of the work, the management job can become even more obscure. The simple lack of proximity to the contractor can limit effective communication. Add to that a mixture of cultural differences and a desire for the contractor to portray the most optimistic view of their performance, and you create an even more difficult task for the project manager. This was the scenario when the Habitat Holding Rack (HHR) manager at Marshall Space Flight Center (MSFC), Stacy Counts, was introduced to the overall concept of Earned Value Management (EVM). Faced with increased costs (which eventually resulted in decreased scope of the project), continued schedule slides, and several technical anomalies, she was looking for a way to gain a better handle on the project performance. As a component of the Space Station Biological Research Program (SSBRP), the HHR project is an integral piece of the Program content. The HHR is the first rack hardware to be delivered for the Program and has therefore been the first rack to move through the trials of test and verification-documenting anomalies and technical difficulties that will benefit the other SSBRP rack projects. For these reasons, the HHR maintained high visibility throughout the manufacturing and assembly process, continuing through test and verification activities. Needless to say, the higher visibility emphasized the need for improved performance on this project. And to improve project performance, Stacy first had to figure out how to measure the cost, schedule and technical objectives effectively.

Comparison of learning curves and skill transfer between classical and robotic laparoscopy according to the viewing conditions: implications for training.

PubMed

Blavier, Adélaïde; Gaudissart, Quentin; Cadière, Guy-Bernard; Nyssen, Anne-Sophie

2007-07-01

The purpose of this study was to evaluate the perceptual (2-dimensional [2D] vs. 3-dimensional [3D] view) and instrumental (classical vs. robotic) impacts of new robotic system on learning curves. Forty medical students without any surgical experience were randomized into 4 groups (classical laparoscopy with 3D-direct view or with 2D-indirect view, robotic system in 3D or in 2D) and repeated a laparoscopic task 6 times. After these 6 repetitions, they performed 2 trials with the same technique but in the other viewing condition (perceptive switch). Finally, subjects performed the last 3 trials with the technique they never used (technical switch). Subjects evaluated their performance answering a questionnaire (impressions of mastery, familiarity, satisfaction, self-confidence, and difficulty). Our study showed better performance and improvement in 3D view than in 2D view whatever the instrumental aspect. Participants reported less mastery, familiarity, and self-confidence and more difficulty in classical laparoscopy with 2D-indirect view than in the other conditions. Robotic surgery improves surgical performance and learning, particularly by 3D view advantage. However, perceptive and technical switches emphasize the need to adapt and pursue training also with traditional technology to prevent risks in conversion procedure.

Successful technical trading agents using genetic programming.

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

Othling, Andrew S.; Kelly, John A.; Pryor, Richard J.

2004-10-01

Genetic programming (GP) has proved to be a highly versatile and useful tool for identifying relationships in data for which a more precise theoretical construct is unavailable. In this project, we use a GP search to develop trading strategies for agent based economic models. These strategies use stock prices and technical indicators, such as the moving average convergence/divergence and various exponentially weighted moving averages, to generate buy and sell signals. We analyze the effect of complexity constraints on the strategies as well as the relative performance of various indicators. We also present innovations in the classical genetic programming algorithm thatmore » appear to improve convergence for this problem. Technical strategies developed by our GP algorithm can be used to control the behavior of agents in economic simulation packages, such as ASPEN-D, adding variety to the current market fundamentals approach. The exploitation of arbitrage opportunities by technical analysts may help increase the efficiency of the simulated stock market, as it does in the real world. By improving the behavior of simulated stock markets, we can better estimate the effects of shocks to the economy due to terrorism or natural disasters.« less

Systems integration studies for supersonic cruise aircraft

NASA Technical Reports Server (NTRS)

Mascitti, V. R.

1975-01-01

Technical progress in each of the disciplinary research areas affecting the design of supersonic cruise aircraft is discussed. The NASA AST/SCAR Program supported the integration of these technical advances into supersonic cruise aircraft configuration concepts. While the baseline concepts reflect differing design philosophy, all reflect a level of economic performance considerably above the current foreign aircraft as well as the former U.S. SST. Range-payload characteristics of the study configurating show significant improvement, while meeting environmental goals such as takeoff and landing noise and upper atmospheric pollution.

Technological Innovations in Magnetic Resonance for Early Detection of Cardiovascular Diseases.

PubMed

Santarelli, Maria F; Positano, Vincenzo; Martini, Nicola; Valvano, Giuseppe; Landini, Luigi

2016-01-01

Most recent technical innovations in cardiovascular MR imaging (CMRI) are presented in this review. They include hardware and software developments, and novelties in parametric mapping. All these recent improvements lead to high spatial and temporal resolution and quantitative information on the heart structure and function. They make it achievable ambitious goals in the field of magnetic resonance, such as the early detection of cardiovascular pathologies. In this review article, we present recent innovations in CMRI, emphasizing the progresses performed and the solutions proposed to some yet opened technical problems.

An "Intelligent" Optical Design Program

NASA Astrophysics Data System (ADS)

Bohachevsky, I. O.; Viswanathan, V. K.; Woodfin, G.

1984-06-01

Described is a general approach to the development of computer programs capable of designing image-forming optical systems without human intervention and of improving their performance with repeated attempts. The approach utilizes two ideas: 1) interpretation of technical design as a mapping in the configuration space of technical characteristics and 2) development of an "intelligent" routine that recognizes global optima. Examples of lens systems designed and used in the development of the general approach are presented, current status of the project is summarized, and plans for the future efforts are indicated.

Metallic anodes for next generation secondary batteries.

PubMed

Kim, Hansu; Jeong, Goojin; Kim, Young-Ugk; Kim, Jae-Hun; Park, Cheol-Min; Sohn, Hun-Joon

2013-12-07

Li-air(O2) and Li-S batteries have gained much attention recently and most relevant research has aimed to improve the electrochemical performance of air(O2) or sulfur cathode materials. However, many technical problems associated with the Li metal anode have yet to be overcome. This review mainly focuses on the electrochemical behaviors and technical issues related to metallic Li anode materials as well as other metallic anode materials such as alkali (Na) and alkaline earth (Mg) metals, including Zn and Al when these metal anodes were employed for various types of secondary batteries.

Measuring and Reporting Performance Results for the Pollution Prevention Program Need Improvement Report No. 09-P-0088

EPA Pesticide Factsheets

Measuring results is an essential component of any successful P2 program and is one way to determine the success of a technical assistance or training effort. This page introduces the concept of P2 measurement.

Alaska road weather project : technical performance assessment report Fairbanks field demonstration 2013-2014.

DOT National Transportation Integrated Search

2014-02-01

The Alaska Department of Transportation and Public Facilities began implementation of a Maintenance Decision Support System in an : effort to improve snow and ice control in the Fairbanks area. As part of the project the reliability of the weather fo...

40 CFR 51.369 - Improving repair effectiveness.

Code of Federal Regulations, 2010 CFR

2010-07-01

... technical questions that arise in the repair process, and answer questions related to the legal requirements of State and Federal law with regard to emission control device tampering, engine switching, or... vehicles for retest. Performance monitoring shall include statistics on the number of vehicles submitted...

Progress and prospects: gene therapy for performance and appearance enhancement.

PubMed

Kiuru, M; Crystal, R G

2008-03-01

While medical therapies aim at reversing, reducing or eliminating diseases, the goal of enhancements is to improve performance or appearance beyond normal levels. Distinction between the two interventions is not always clear as they often present as a continuum. Gene therapy typically aims at treating or preventing disease, but the technology can theoretically be employed for enhancement. Some of the gene therapy enhancement strategies include improving performance by increasing muscle mass, endurance, memory, and cognition and bettering appearance by controlling weight, height and hair growth. In addition to the technical challenges of making enhancement strategies safe and effective, genetic enhancement presents significant ethical/societal questions that must be addressed.

The new design of final optics assembly on SG-III prototype facility

NASA Astrophysics Data System (ADS)

Li, Ping; Zhao, Runchang; Wang, Wei; Jia, Huaiting; Chen, Liangmin; Su, Jingqin

2014-09-01

To improve the performance of SG-III prototype facility (TIL-Technical Integration Line), final optics assembly (FOA) is re-designed. It contains that stray light and focusing ghosts are optimized, operational performance and environments are improved and the total thickness of optics is reduced. With the re-designed FOA, Some performance advantages are achieved. First, the optics damages are mitigated obviously, especially crystals and Focus lens; Second, stray light and focusing ghosts are controlled better that organic contamination sources inside FOA are eliminated; Third, maintenance and operation are more convenient for the atoms environment; Fourth, the focusable power on target is increased for lower B-integral.

Study on evaluation index system of operational performance of municipal wastewater treatment plants in China

NASA Astrophysics Data System (ADS)

Xiaoxin, Zhang; Jin, Huang; Ling, Lin; Yan, Li

2018-05-01

According to the undeveloped evaluation method for the operational performance of the municipal wastewater treatment plants, this paper analyzes the policies related to sewage treatment industry based on the investigation of the municipal wastewater treatment plants. The applicable evaluation method for the operational performance was proposed from environmental protection performance, resources and energy consumption, technical and economic performance, production management and main equipment, providing a reliable basis for scientific evaluation of the operation as well as improving the operational performance of municipal wastewater treatment plant.

Support of NASA quality requirements by defense contract administration services regions

NASA Technical Reports Server (NTRS)

Farrar, Hiram D.

1966-01-01

Defense Contract Administration Services Regions (DCASR) quality assurance personnel performing under NASA Letters of Delegation must work closely with the assigned technical representative of the NASA centers. It is realized that technical personnel from the NASA Centers cannot make on-site visits as frequently as they would like to. However, DCASR quality assurance personnel would know the assigned NASA technical representative and should contact him when problems arise. The technical representative is the expert on the hardware and should be consulted on any problem area. It is important that the DCASR quality assurance personnel recommend to the delegating NASA Center any new or improved methods of which they may be aware which would assist in achieving the desired quality and reliability in NASA hardware. NASA expects assignment of competent personnel in the Quality Assurance functional area and is not only buying the individual's technical skill, but also his experience. Suggestions by field personnel can many times up-grade the quality or the hardware.

16 CFR § 1407.3 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Providing performance and technical data to... TECHNICAL DATA BY LABELING § 1407.3 Providing performance and technical data to purchasers by labeling. (a... technical data related to performance and safety to prospective purchasers of such products at the time of...

16 CFR 1407.3 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Providing performance and technical data to... TECHNICAL DATA BY LABELING § 1407.3 Providing performance and technical data to purchasers by labeling. (a... technical data related to performance and safety to prospective purchasers of such products at the time of...

16 CFR 1407.3 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Providing performance and technical data to... TECHNICAL DATA BY LABELING § 1407.3 Providing performance and technical data to purchasers by labeling. (a... technical data related to performance and safety to prospective purchasers of such products at the time of...

16 CFR 1407.3 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Providing performance and technical data to... TECHNICAL DATA BY LABELING § 1407.3 Providing performance and technical data to purchasers by labeling. (a... technical data related to performance and safety to prospective purchasers of such products at the time of...

16 CFR 1407.3 - Providing performance and technical data to purchasers by labeling.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Providing performance and technical data to... TECHNICAL DATA BY LABELING § 1407.3 Providing performance and technical data to purchasers by labeling. (a... technical data related to performance and safety to prospective purchasers of such products at the time of...

Improving and monitoring air quality.

PubMed

DuPont, André

2018-05-01

Since the authorization of the Clean Air Act Amendments of 1990, the air quality in the USA has significantly improved because of strong public support. The lessons learned over the last 25 years are being shared with the policy analysts, technical professionals, and scientist who endeavor to improve air quality in their communities. This paper will review how the USA has achieved the "high" standard of air quality that was envisioned in the early 1990s. This document will describe SO 2 gas emission reduction technology and highlight operation of emission monitoring technology. This paper describes the basic process operation of an air pollution control scrubber. A technical review of measures required to operate and maintain a large-scale pollution control system will be described. Also, the author explains how quality assurance procedures in performance of continuous emission monitoring plays a significant role in reducing air pollution.

The Use and Efficacy of Capacity-Building Assistance for Low-Performing Districts: The Case of California's District Assistance and Intervention Teams

ERIC Educational Resources Information Center

Strunk, Katharine O.; McEachin, Andrew; Westover, Theresa N.

2014-01-01

The theory of action upon which high-stakes accountability policies are based calls for systemic reforms in educational systems that will emerge by pairing incentives for improvement with extensive and targeted technical assistance (TA) to build the capacity of low-performing schools and districts. To this end, a little discussed and often…

Final Technical Report: Advanced Measurement and Analysis of PV Derate Factors.

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

King, Bruce Hardison; Burton, Patrick D.; Hansen, Clifford

2015-12-01

The Advanced Measurement and Analysis of PV Derate Factors project focuses on improving the accuracy and reducing the uncertainty of PV performance model predictions by addressing a common element of all PV performance models referred to as “derates”. Widespread use of “rules of thumb”, combined with significant uncertainty regarding appropriate values for these factors contribute to uncertainty in projected energy production.

Joint stars phased array radar antenna

NASA Astrophysics Data System (ADS)

Shnitkin, Harold

1994-10-01

The Joint STARS phased array radar system is capable of performing long range airborne surveillance and was used during the Persian Gulf war on two E8-A aircraft to fly many around-the-clock missions to monitor the Kuwait and Iraq battlefield from a safe distance behind the front lines. This paper is a follow-on to previous publications on the subject of the Joint STARS antenna and deals mainly with mission performance and technical aspects not previously covered. Radar data of troop movements and armament installations will be presented, a brief review of the antenna design is given, followed by technical discussions concerning the three-port interferometry, gain and sidelobe design approach, cost control, range test implementation and future improvements.

The Accreditation Experience of Clinical Laboratories and Blood Banks in Mexico.

PubMed

Quintana, Sandra

2015-11-01

The accreditation of clinical laboratories and blood banks based on ISO 15189 is now being consolidated in Mexico, and is coordinated by the Mexican accreditation entity innovative strategies, A.C. (ema) and supported by the activities of the committee of clinical laboratories and blood banks. The active participation in working groups formed by the technical committee of clinical laboratories and blood banks in specific areas, has contributed to the formulation of technical documents and criteria of evaluation that strengthen the current accreditation scheme. The national registry of evaluation (PNE) consists of technical experts and evaluators from different disciplines of clinical laboratory; the evaluators actively participate in accreditation assessment, with an ultimate goal to receive training and feedback for continuous improvement of its own performance.

The Basic Surgical Skills Course in Sub-Saharan Africa: An Observational Study of Effectiveness.

PubMed

Fergusson, Stuart J; Sedgwick, David M; Ntakiyiruta, Georges; Ntirenganya, Faustin

2018-04-01

The Basic Surgical Skills (BSS) course is a common component of postgraduate surgical training programmes in sub-Saharan Africa, but was originally designed in a UK context, and its efficacy and relevance have not been formally assessed in Africa. An observational study was carried out during a BSS course delivered to early-stage surgical trainees from Rwanda and the Democratic Republic of the Congo. Technical skill in a basic wound closure task was assessed in a formal Objective Structured Assessment of Technical Skills (OSAT) before and after course completion. Participants completed a pre-course questionnaire documenting existing surgical experience and self-perceived confidence levels in surgical skills which were to be taught during the course. Participants repeated confidence ratings and completed course evaluation following course delivery. A cohort of 17 participants had completed a pre-course median of 150 Caesarean sections as primary operator. Performance on the OSAT improved from a mean of 10.5/17 pre-course to 14.2/17 post-course (mean of paired differences 3.7, p < 0.001). Improvements were seen in 15/17 components of wound closure. Pre-course, only 47% of candidates were forming hand-tied knots correctly and 38% were appropriately crossing hands with each throw, improving to 88 and 76%, respectively, following the course (p = 0.01 for both components). Confidence levels improved significantly in all technical skills taught, and the course was assessed as highly relevant by trainees. The Basic Surgical Skills course is effective in improving the basic surgical technique of surgical trainees from sub-Saharan Africa and their confidence in key technical skills.

Development and implementation of a clinical pathway approach to simulation-based training for foregut surgery.

PubMed

Miyasaka, Kiyoyuki W; Buchholz, Joseph; LaMarra, Denise; Karakousis, Giorgos C; Aggarwal, Rajesh

2015-01-01

Contemporary demands on resident education call for integration of simulation. We designed and implemented a simulation-based curriculum for Post Graduate Year 1 surgery residents to teach technical and nontechnical skills within a clinical pathway approach for a foregut surgery patient, from outpatient visit through surgery and postoperative follow-up. The 3-day curriculum for groups of 6 residents comprises a combination of standardized patient encounters, didactic sessions, and hands-on training. The curriculum is underpinned by a summative simulation "pathway" repeated on days 1 and 3. The "pathway" is a series of simulated preoperative, intraoperative, and postoperative encounters in following up a single patient through a disease process. The resident sees a standardized patient in the clinic presenting with distal gastric cancer and then enters an operating room to perform a gastrojejunostomy on a porcine tissue model. Finally, the resident engages in a simulated postoperative visit. All encounters are rated by faculty members and the residents themselves, using standardized assessment forms endorsed by the American Board of Surgery. A total of 18 first-year residents underwent this curriculum. Faculty ratings of overall operative performance significantly improved following the 3-day module. Ratings of preoperative and postoperative performance were not significantly changed in 3 days. Resident self-ratings significantly improved for all encounters assessed, as did reported confidence in meeting the defined learning objectives. Conventional surgical simulation training focuses on technical skills in isolation. Our novel "pathway" curriculum targets an important gap in training methodologies by placing both technical and nontechnical skills in their clinical context as part of managing a surgical patient. Results indicate consistent improvements in assessments of performance as well as confidence and support its continued usage to educate surgery residents in foregut surgery. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Do communication training programs improve students' communication skills?--a follow-up study.

PubMed

Simmenroth-Nayda, Anne; Weiss, Cora; Fischer, Thomas; Himmel, Wolfgang

2012-09-05

Although it is taken for granted that history-taking and communication skills are learnable, this learning process should be confirmed by rigorous studies, such as randomized pre- and post-comparisons. The purpose of this paper is to analyse whether a communication course measurably improves the communicative competence of third-year medical students at a German medical school and whether technical or emotional aspects of communication changed differently. A sample of 32 randomly selected students performed an interview with a simulated patient before the communication course (pre-intervention) and a second interview after the course (post-intervention), using the Calgary-Cambridge Observation Guide (CCOG) to assess history taking ability. On average, the students improved in all of the 28 items of the CCOG. The 6 more technically-orientated communication items improved on average from 3.4 for the first interview to 2.6 in the second interview (p < 0.0001), the 6 emotional items from 2.7 to 2.3 (p = 0.023). The overall score for women improved from 3.2 to 2.5 (p = 0.0019); male students improved from 3.0 to 2.7 (n.s.). The mean interview time significantly increased from the first to the second interview, but the increase in the interview duration and the change of the overall score for the students' communication skills were not correlated (Pearson's r = 0.03; n.s.). Our communication course measurably improved communication skills, especially for female students. These improvements did not depend predominantly on an extension of the interview time. Obviously, "technical" aspects of communication can be taught better than "emotional" communication skills.

Technical quality of root canal treatment performed by undergraduate students using hand instrumentation: a meta-analysis.

PubMed

Ribeiro, D M; Réus, J C; Felippe, W T; Pacheco-Pereira, C; Dutra, K L; Santos, J N; Porporatti, A L; De Luca Canto, G

2018-03-01

The technical quality of root canal treatment (RCT) may impact on the outcome. The quality of education received during undergraduate school may be linked to the quality of treatment provided in general dental practice. In this context, the aim of this systematic review was to answer the following focused questions: (i) What is the frequency of acceptable technical quality of root fillings, assessed radiographically, performed by undergraduate students? (ii) What are the most common errors assessed radiographically and reported in these treatments? For this purpose, articles that evaluated the quality of root fillings performed by undergraduate students were selected. Data were collected based on predetermined criteria. The key features from the included studies were extracted. GRADE-tool assessed the quality of the evidence. MAStARI evaluated the methodological quality, and a meta-analysis on all studies was conducted. At the end of the screening, 24 articles were identified. Overall frequency of acceptable technical quality of root fillings was 48%. From this total, 52% related to anterior teeth, 49% to premolars and 26% to molars. The main procedural errors reported were ledge formation, furcation perforation, apical transportation and apical perforation. The heterogeneity amongst the studies was high (84-99%). Five studies had a high risk of bias, eight had a moderate risk, and 11 had low risk. The overall quality of evidence identified was very low. The conclusion was that technical quality of root fillings performed by undergraduate students is low, which may reveal that endodontic education has limited achievement at undergraduate level. A plan to improve the quality of root fillings, and by extrapolation the overall quality of root canal treatment, should be discussed by the staff responsible for endodontic education and training. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Evaluation of colonoscopy technical skill levels by use of an objective kinematic-based system.

PubMed

Obstein, Keith L; Patil, Vaibhav D; Jayender, Jagadeesan; San José Estépar, Raúl; Spofford, Inbar S; Lengyel, Balazs I; Vosburgh, Kirby G; Thompson, Christopher C

2011-02-01

Colonoscopy requires training and experience to ensure accuracy and safety. Currently, no objective, validated process exists to determine when an endoscopist has attained technical competence. Kinematics data describing movements of laparoscopic instruments have been used in surgical skill assessment to define expert surgical technique. We have developed a novel system to record kinematics data during colonoscopy and quantitatively assess colonoscopist performance. To use kinematic analysis of colonoscopy to quantitatively assess endoscopic technical performance. Prospective cohort study. Tertiary-care academic medical center. This study involved physicians who perform colonoscopy. Application of a kinematics data collection system to colonoscopy evaluation. Kinematics data, validated task load assessment instrument, and technical difficulty visual analog scale. All 13 participants completed the colonoscopy to the terminal ileum on the standard colon model. Attending physicians reached the terminal ileum quicker than fellows (median time, 150.19 seconds vs 299.86 seconds; p<.01) with reduced path lengths for all 4 sensors, decreased flex (1.75 m vs 3.14 m; P=.03), smaller tip angulation, reduced absolute roll, and lower curvature of the endoscope. With performance of attending physicians serving as the expert reference standard, the mean kinematic score increased by 19.89 for each decrease in postgraduate year (P<.01). Overall, fellows experienced greater mental, physical, and temporal demand than did attending physicians. Small cohort size. Kinematic data and score calculation appear useful in the evaluation of colonoscopy technical skill levels. The kinematic score appears to consistently vary by year of training. Because this assessment is nonsubjective, it may be an improvement over current methods for determination of competence. Ongoing studies are establishing benchmarks and characteristic profiles of skill groups based on kinematics data. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

The efficiency and budgeting of public hospitals: case study of iran.

PubMed

Yusefzadeh, Hasan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

2013-05-01

Hospitals are the most costly and important components of any health care system, so it is important to know their economic values, pay attention to their efficiency and consider factors affecting them. The aim of this study was to assess the technical scale and economic efficiency of hospitals in the West Azerbaijan province of Iran, for which Data Envelopment Analysis (DEA) was used to propose a model for operational budgeting. This study was a descriptive-analysis that was conducted in 2009 and had three inputs and two outputs. Deap2, 1 software was used for data analysis. Slack and radial movements and surplus of inputs were calculated for selected hospitals. Finally, a model was proposed for performance-based budgeting of hospitals and health sectors using the DEA technique. The average scores of technical efficiency, pure technical efficiency (managerial efficiency) and scale efficiency of hospitals were 0.584, 0.782 and 0.771, respectively. In other words the capacity of efficiency promotion in hospitals without any increase in costs and with the same amount of inputs was about 41.5%. Only four hospitals among all hospitals had the maximum level of technical efficiency. Moreover, surplus production factors were evident in these hospitals. Reduction of surplus production factors through comprehensive planning based on the results of the Data Envelopment Analysis can play a major role in cost reduction of hospitals and health sectors. In hospitals with a technical efficiency score of less than one, the original and projected values of inputs were different; resulting in a surplus. Hence, these hospitals should reduce their values of inputs to achieve maximum efficiency and optimal performance. The results of this method was applied to hospitals a benchmark for making decisions about resource allocation; linking budgets to performance results; and controlling and improving hospitals performance.

The role of nontechnical skills in simulated trauma resuscitation.

PubMed

Briggs, Alexandra; Raja, Ali S; Joyce, Maurice F; Yule, Steven J; Jiang, Wei; Lipsitz, Stuart R; Havens, Joaquim M

2015-01-01

Trauma team training provides instruction on crisis management through debriefing and discussion of teamwork and leadership skills during simulated trauma scenarios. The effects of team leader's nontechnical skills (NTSs) on technical performance have not been thoroughly studied. We hypothesized that team's and team leader's NTSs correlate with technical performance of clinical tasks. Retrospective cohort study. Brigham and Women's Hospital, STRATUS Center for Surgical Simulation A total of 20 teams composed of surgical residents, emergency medicine residents, emergency department nurses, and emergency services assistants underwent 2 separate, high-fidelity, simulated trauma scenarios. Each trauma scenario was recorded on video for analysis and divided into 4 consecutive sections. For each section, 2 raters used the Non-Technical Skills for Surgeons framework to assess NTSs of the team. To evaluate the entire team's NTS, 2 additional raters used the Modified Non-Technical Skills Scale for Trauma system. Clinical performance measures including adherence to guidelines and time to perform critical tasks were measured independently. NTSs performance by both teams and team leaders in all NTS categories decreased from the beginning to the end of the scenario (all p < 0.05). There was significant correlation between team's and team leader's cognitive skills and critical task performance, with correlation coefficients between 0.351 and 0.478 (p < 0.05). The NTS performance of the team leader highly correlated with that of the entire team, with correlation coefficients between 0.602 and 0.785 (p < 0.001). The NTSs of trauma teams and team leaders deteriorate as clinical scenarios progress, and the performance of team leaders and teams is highly correlated. Cognitive NTS scores correlate with critical task performance. Increased attention to NTSs during trauma team training may lead to sustained performance throughout trauma scenarios. Decision making and situation awareness skills are critical for both team leaders and teams and should be specifically addressed to improve performance. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Energy. Application of solar energy in dwellings: A technical and economical analysis for the European community

NASA Astrophysics Data System (ADS)

1980-03-01

The technical possibilities and economical limitations of solar heating systems for the application in swimming pools, hot water preparation, space heating and air conditioning were investigated. This analysis was performed for dwellings with special consideration of the climatic differences in each community. The computer program, which was used for solar system calculations, and all mathematical models, for technical and economical analysis were elucidated. In the technical and economical analysis, the most suitable solar system sizes for each community was determined. Four types of solar collectors were investigated. The single glass selective collector proved to be the most cost effective collector in all the above applications, provided the the additional cost for the selective coating is not more than 20DM/cu. From the results of the analysis certain recommendations were derived, which can improve the rapid implementation of solar heating systems into the market.

Materials education activities

NASA Technical Reports Server (NTRS)

Ries, Heidi R.; Harris, Jonice; Leake, Woodrow W.; Bunnell, L. Roy; Berrettini, Robert

1993-01-01

Last year, at NEW: Update '91, a panel discussion was held to address the unique difficulties of attracting and retaining minorities and women in technical studies. Unfortunately, retention in technical majors is a problem of varying proportions for the entire student population, and must be improved in order to maintain the strength of the nation's industrial base. To investigate the cause of student attrition in technical majors, in-depth interviews of both current and former (non-graduating) engineering students at four colleges and universities in Colorado were conducted by Hewitt and Seymour. They found that there was no significant difference in the level of high school preparation and undergraduate academic performance in these two groups, despite the prevailing faculty perception that most students who switch from technical to nontechnical majors were underprepared. The majority of engineering students who changed majors reported that they were turned off by science, while one-third complained of poor teaching.

The Role of Emotional Intelligence in Perioperative Nursing and Leadership: Developing Skills for Improved Performance.

PubMed

Beydler, Kathy Williams

2017-10-01

Many responsibilities of perioperative professionals involve concrete tasks that require high technical competence. Emotional intelligence, referred to as EQ, which involves the ability to relate to and influence others, may also be important for perioperative professionals. High EQ has been linked to higher performance in the workplace, higher job satisfaction, lower turnover intentions, and less burnout. Perioperative professionals who demonstrate a combination of technical skills and EQ could be more attuned to the humanity of health care (ie, providing more holistic care for the patient). Perioperative nurses who value providing holistic care for their patients may possess many of the elements of EQ. Leaders who recognize the importance of their own EQ and actively assist staff members to enhance and develop their EQ competency may help to create a competitive advantage by establishing a workforce of nurses who possess strong technical skills and high EQ. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Development and Field Test of the Trial Battery for Project A. Improving the Selection, Classification and Utilization of Army Enlisted Personnel. Project A: Improving the Selection, Classification and Utilization of Army Enlisted Personnel. ARI Technical Report 739.

ERIC Educational Resources Information Center

Peterson, Norman G., Ed.

As part of the United States Army's Project A, research has been conducted to develop and field test a battery of experimental tests to complement the Armed Services Vocational Aptitude Battery in predicting soldiers' job performance. Project A is the United States Army's large-scale manpower effort to improve selection, classification, and…

The Changing Nature of Technical Assistance.

ERIC Educational Resources Information Center

Noggle, Nelson L.

The changing nature of technical assistance activities and evaluation for compensatory education programs was discussed. The emphasis is on the Education Consolidation and Improvement Act (ECIA) Chapter 1 Technical Assistance Centers (TAC) and their clients. Improvement of school practices demands that the technical assistance process be developed…

Technical efficiency of Shiraz school of medicine in research and education domains: a data envelopment analysis.

PubMed

Delavari, Somayeh; Rezaee, Rita; Hatam, Nahid; Delavari, Sajad

2016-01-01

Efficiency evaluation of universities and faculties is one of the tools that help managers to identify the departments' strengths and weakness. The main objective of the present research was to measure and compare the technical efficiency of Shiraz school of medicine departments using Data Envelopment Analysis (DEA) technique. This cross-sectional and retrospective study was performed on clinical and non-clinical departments in research and education domains over the period of 2006 to 2011. Different inputs and outputs were considered for research and educational domain separately. Efficiency was measured based on the observed optimal performance. Findings showed that pathology and anatomy departments achieved the score of 100 in technical efficiency in education during 2006 to 2011. During this period, parasitology, psychiatric and pediatrics department's achieved the score of 100 for technical efficiency in research domain. The lowest mean of relative educational efficiency belonged to orthopedic department; as to relative research efficiency, the lowest mean was shown in orthopedics and genetics departments. The mean technical efficiency of non-medical departments in education and research domain was 91.93 and 76.08, respectively, while the mean technical efficiency of the clinical department in educational and research fields was 91.02 and 82.23, respectively. Using multiple input and output in DEA technique provided a comprehensive evaluation of efficiency in Shiraz school of medicine departments. The DEA could successfully estimate the technical efficiency of the departments in research and educational fields. Moreover, the deficiency in each department was found; this could help them to plan for improvement.

Getting It Right: Designing Principal Preparation Programs That Meet District Needs for Improving Low-Performing Schools. A Technical Report on Innovative Principal Preparation Models

ERIC Educational Resources Information Center

Fry-Ahearn, Betty; Collins, David

2016-01-01

A grant from the School Leadership Program sponsored by the U.S. Department of Education during 2008-14 provided the opportunities and resources for SREB to bring together its cutting-edge knowledge base, field experience, and substantial bank of publications and training materials in the closely related fields of school improvement and school…

Use of innovative concrete mixes for improved constructability and sustainability of bridge decks : [technical summary].

DOT National Transportation Integrated Search

2013-11-01

Bridge deck crack surveys were performed on twelve bridges on US-59 south of Lawrence, Kansas, to determine the effects of mixture proportions, concrete properties, deck type, and girder type on the crack density of reinforced concrete bridge decks.

Assessment of Student Professional Outcomes for Continuous Improvement

ERIC Educational Resources Information Center

Keshavarz, Mohsen; Baghdarnia, Mostafa

2013-01-01

This article describes a method for the assessment of professional student outcomes (performance-type outcomes or soft skills). The method is based upon group activities, research on modern electrical engineering topics by individual students, classroom presentations on chosen research topics, final presentations, and technical report writing.…

An integrated evaluation for the performance of clinical engineering department.

PubMed

Yousry, Ahmed M; Ouda, Bassem K; Eldeib, Ayman M

2014-01-01

Performance benchmarking have become a very important component in all successful organizations nowadays that must be used by Clinical Engineering Department (CED) in hospitals. Many researchers identified essential mainstream performance indicators needed to improve the CED's performance. These studies revealed mainstream performance indicators that use the database of a CED to evaluate its performance. In this work, we believe that those indicators are insufficient for hospitals. Additional important indicators should be included to improve the evaluation accuracy. Therefore, we added new indicators: technical/maintenance indicators, economic indicators, intrinsic criticality indicators, basic hospital indicators, equipment acquisition, and safety indicators. Data is collected from 10 hospitals that cover different types of healthcare organizations. We developed a software tool that analyses collected data to provide a score for each CED under evaluation. Our results indicate that there is an average gap of 67% between the CEDs' performance and the ideal target. The reasons for the noncompliance are discussed in order to improve performance of CEDs under evaluation.

Integrating technical and non-technical skills coaching in an acute trauma surgery team training: Is it too much?

PubMed

Alken, Alexander; Luursema, Jan-Maarten; Weenk, Mariska; Yauw, Simon; Fluit, Cornelia; van Goor, Harry

2017-08-25

Research on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training. Coaching activities of 12 surgical teachers were recorded on audio and video. Six teachers were primed on non-technical skills coaching prior to the training. Six others received no priming and served as controls. Blind observers reviewed the recordings of 2 training scenario's and scored whether the observed behaviors were directed on technical or non-technical skills. We compared the frequency of the non-technical skills coaching between the primed and the non-primed teachers and analyzed for differences according to the trainees' level of experience. Surgical teachers coached trainees during the highly realistic DSATC integrated acute trauma surgery team training. Trainees performed damage control surgery in operating teams on anesthetized porcine models during 6 training scenario's. Twelve experienced surgical teachers participated in this study. Coaching on non-technical skills was limited to about 5%. The primed teachers did not coach more often on non-technical skills than the non-primed teachers. We found no differences in the frequency of non-technical skills coaching based on the trainees' level of experience. Priming experienced surgical teachers does not increase the coaching on non-technical skills. The current DSATC acute trauma surgery team training seems too complex for integrating training on technical and non-technical skills. Patient care, Practice based learning and improvement. Copyright © 2017 Elsevier Inc. All rights reserved.

Using simulation to train orthopaedic trainees in non-technical skills: A pilot study.

PubMed

Heaton, Samuel R; Little, Zoe; Akhtar, Kash; Ramachandran, Manoj; Lee, Joshua

2016-08-18

To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire (strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself. Twenty-six orthopaedic residents participated (24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showed that while the majority of candidates recognised the importance of non-technical (NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course (Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the course achieved its intended aims with realistic simulation scenarios. Participants believed patient care, patient safety and team working would all improve with further human factors training (4.4-4.6). and felt that NT skills learnt through simulation-based training should become an integral component of their training program. Participants demonstrated improved understanding of non-technical performance, recognised its relevance to patient safety and expressed a desire for its integration in training.

Service dogs in the province of Quebec: sociodemographic profile of users and the dogs' impact on functional ability.

PubMed

Vincent, Claude; Gagnon, Dany; Routhier, François; Leblond, Jean; Boucher, Pascale; Blanchet, Marie; Martin-Lemoyne, Valérie

2015-03-01

The objectives of this study were to (1) describe the sociodemographic profile of service dog users, their physical disabilities, main occupations, living environment, and use of technical aids in daily life and (2) evaluate the impact of service dogs on wheelchair travel and picking up objects. Sociodemographic and clinical data were collected and various mobility tests were conducted in the service dog users' home environment (n = 199). The service dog users had injuries to the central or peripheral nervous system (55%), spinal cord (33%), or musculoskeletal or orthopedic system (12%). In the wheelchair travel on flat terrain test (n = 67), users travelled a longer distance in a shorter time, improving their average speed to 1.28 m/s with the service dog compared to 0.75 m/s without (p < 0.001). In a wheelchair propelling up a slope, 42% improved with the service dog (n = 60). Mounting a threshold/curb in a wheelchair, 41% improved with the service dog (n = 39). In a test where walkers and wheelchair users picked up three objects off the ground, 44% improved with the service dog (n = 164). Service dogs significantly improved wheelchair travel speed and distance on flat and ascending terrain, mounting a threshold/curb and picking up objects off the ground. Implications for Rehabilitation For people with motor impairments: Service dogs are most often used as a technical aid to pick up objects (96%), open doors (36%) and pull the wheelchair during travel (34%). Clients' performance in significant travel in a wheelchair (on flat terrain, on an upslope, mounting a threshold) improved with the service dog compared to their own performance without the dog. Clients' grasping performance (picking up three significant objects off the ground) improved with the service dog compared to their own performance without the dog.

[Technical background of data collection for parametric observation of total mesorectal excision (TME) in rectal cancer].

PubMed

Bláha, M; Hoch, J; Ferko, A; Ryška, A; Hovorková, E

Improvement in any human activity is preconditioned by inspection of results and providing feedback used for modification of the processes applied. Comparison of experts experience in the given field is another indispensable part leading to optimisation and improvement of processes, and optimally to implementation of standards. For the purpose of objective comparison and assessment of the processes, it is always necessary to describe the processes in a parametric way, to obtain representative data, to assess the achieved results, and to provide unquestionable and data-driven feedback based on such analysis. This may lead to a consensus on the definition of standards in the given area of health care. Total mesorectal excision (TME) is a standard procedure of rectal cancer (C20) surgical treatment. However, the quality of performed procedures varies in different health care facilities, which is given, among others, by internal processes and surgeons experience. Assessment of surgical treatment results is therefore of key importance. A pathologist who assesses the resected tissue can provide valuable feedback in this respect. An information system for the parametric assessment of TME performance is described in our article, including technical background in the form of a multicentre clinical registry and the structure of observed parameters. We consider the proposed system of TME parametric assessment as significant for improvement of TME performance, aimed at reducing local recurrences and at improving the overall prognosis of patients. rectal cancer total mesorectal excision parametric data clinical registries TME registry.

Progressive learning in endoscopy simulation training improves clinical performance: a blinded randomized trial.

PubMed

Grover, Samir C; Scaffidi, Michael A; Khan, Rishad; Garg, Ankit; Al-Mazroui, Ahmed; Alomani, Tareq; Yu, Jeffrey J; Plener, Ian S; Al-Awamy, Mohamed; Yong, Elaine L; Cino, Maria; Ravindran, Nikila C; Zasowski, Mark; Grantcharov, Teodor P; Walsh, Catharine M

2017-11-01

A structured comprehensive curriculum (SCC) that uses simulation-based training (SBT) can improve clinical colonoscopy performance. This curriculum may be enhanced through the application of progressive learning, a training strategy centered on incrementally challenging learners. We aimed to determine whether a progressive learning-based curriculum (PLC) would lead to superior clinical performance compared with an SCC. This was a single-blinded randomized controlled trial conducted at a single academic center. Thirty-seven novice endoscopists were recruited and randomized to either a PLC (n = 18) or to an SCC (n = 19). The PLC comprised 6 hours of SBT, which progressed in complexity and difficulty. The SCC included 6 hours of SBT, with cases of random order of difficulty. Both groups received expert feedback and 4 hours of didactic teaching. Participants were assessed at baseline, immediately after training, and 4 to 6 weeks after training. The primary outcome was participants' performance during their first 2 clinical colonoscopies, as assessed by using the Joint Advisory Group Direct Observation of Procedural Skills assessment tool (JAG DOPS). Secondary outcomes were differences in endoscopic knowledge, technical and communication skills, and global performance in the simulated setting. The PLC group outperformed the SCC group during first and second clinical colonoscopies, measured by JAG DOPS (P < .001). Additionally, the PLC group had superior technical and communication skills and global performance in the simulated setting (P < .05). There were no differences between groups in endoscopic knowledge (P > .05). Our findings demonstrate the superiority of a PLC for endoscopic simulation, compared with an SCC. Challenging trainees progressively is a simple, theory-based approach to simulation whereby the performance of clinical colonoscopies can be improved. (Clinical trial registration number: NCT02000180.). Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Simulated procedure rehearsal is more effective than a preoperative generic warm-up for endovascular procedures.

PubMed

Willaert, Willem I M; Aggarwal, Rajesh; Daruwalla, Farhad; Van Herzeele, Isabelle; Darzi, Ara W; Vermassen, Frank E; Cheshire, Nicholas J

2012-06-01

Patient-specific simulated rehearsal (PsR) of a carotid artery stenting procedure (CAS) enables the interventionalist to rehearse the case before performing the procedure on the actual patient by incorporating patient-specific computed tomographic data into the simulation software. This study aimed to evaluate whether PsR of a CAS procedure can enhance the operative performance versus a virtual reality (VR) generic CAS warm-up procedure or no preparation at all. During a 10-session cognitive/technical VR course, medical residents were trained in CAS. Thereafter, in a randomized crossover study, each participant performed a patient-specific CAS case 3 times on the simulator, preceded by 3 different tasks: a PsR, a generic case, or no preparation. Technical performances were assessed using simulator-based metrics and expert-based ratings. Twenty medical residents (surgery, cardiology, radiology) were recruited. Training plateaus were observed after 10 sessions for all participants. Performances were significantly better after PsR than after a generic warm-up or no warm-up for total procedure time (16.3 ± 0.6 vs 19.7 ± 1.0 vs 20.9 ± 1.1 minutes, P = 0.001) and fluoroscopy time (9.3 ± 0.1 vs 11.2 ± 0.6 vs 11.2 ± 0.5 minutes, P = 0.022) but did not influence contrast volume or number of roadmaps used during the "real" case. PsR significantly improved the quality of performance as measured by the expert-based ratings (scores 28 vs 25 vs 25, P = 0.020). Patient-specific simulated rehearsal of a CAS procedure significantly improves operative performance, compared to a generic VR warm-up or no warm-up. This technology requires further investigation with respect to improved outcomes on patients in the clinical setting.

Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?

PubMed

Krage, Ralf; Zwaan, Laura; Tjon Soei Len, Lian; Kolenbrander, Mark W; van Groeningen, Dick; Loer, Stephan A; Wagner, Cordula; Schober, Patrick

2017-11-01

Non-technical skills, such as task management, leadership, situational awareness, communication and decision-making refer to cognitive, behavioural and social skills that contribute to safe and efficient team performance. The importance of these skills during cardiopulmonary resuscitation (CPR) is increasingly emphasised. Nonetheless, the relationship between non-technical skills and technical performance is poorly understood. We hypothesise that non-technical skills become increasingly important under stressful conditions when individuals are distracted from their tasks, and investigated the relationship between non-technical and technical skills under control conditions and when external stressors are present. In this simulator-based randomised cross-over study, 30 anaesthesiologists and anaesthesia residents from the VU University Medical Center, Amsterdam, the Netherlands, participated in two different CPR scenarios in random order. In one scenario, external stressors (radio noise and a distractive scripted family member) were added, while the other scenario without stressors served as control condition. Non-technical performance of the team leader and technical performance of the team were measured using the 'Anaesthetists' Non-technical Skill' score and a recently developed technical skills score. Analysis of variance and Pearson correlation coefficients were used for statistical analyses. Non-technical performance declined when external stressors were present (adjusted mean difference 3.9 points, 95% CI 2.4 to 5.5 points). A significant correlation between non-technical and technical performance scores was observed when external stressors were present (r=0.67, 95% CI 0.40 to 0.83, p<0.001), while no evidence for such a relationship was observed under control conditions (r=0.15, 95% CI -0.22 to 0.49, p=0.42). This was equally true for all individual domains of the non-technical performance score (task management, team working, situation awareness, decision-making). During CPR with external stressors, the team's technical performance is related to the non-technical skills of the team leader. This may have important implications for training of CPR teams. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?

PubMed Central

Krage, Ralf; Zwaan, Laura; Tjon Soei Len, Lian; Kolenbrander, Mark W; van Groeningen, Dick; Loer, Stephan A; Wagner, Cordula; Schober, Patrick

2017-01-01

Background Non-technical skills, such as task management, leadership, situational awareness, communication and decision-making refer to cognitive, behavioural and social skills that contribute to safe and efficient team performance. The importance of these skills during cardiopulmonary resuscitation (CPR) is increasingly emphasised. Nonetheless, the relationship between non-technical skills and technical performance is poorly understood. We hypothesise that non-technical skills become increasingly important under stressful conditions when individuals are distracted from their tasks, and investigated the relationship between non-technical and technical skills under control conditions and when external stressors are present. Methods In this simulator-based randomised cross-over study, 30 anaesthesiologists and anaesthesia residents from the VU University Medical Center, Amsterdam, the Netherlands, participated in two different CPR scenarios in random order. In one scenario, external stressors (radio noise and a distractive scripted family member) were added, while the other scenario without stressors served as control condition. Non-technical performance of the team leader and technical performance of the team were measured using the ‘Anaesthetists’ Non-technical Skill’ score and a recently developed technical skills score. Analysis of variance and Pearson correlation coefficients were used for statistical analyses. Results Non-technical performance declined when external stressors were present (adjusted mean difference 3.9 points, 95% CI 2.4 to 5.5 points). A significant correlation between non-technical and technical performance scores was observed when external stressors were present (r=0.67, 95% CI 0.40 to 0.83, p<0.001), while no evidence for such a relationship was observed under control conditions (r=0.15, 95% CI −0.22 to 0.49, p=0.42). This was equally true for all individual domains of the non-technical performance score (task management, team working, situation awareness, decision-making). Conclusions During CPR with external stressors, the team’s technical performance is related to the non-technical skills of the team leader. This may have important implications for training of CPR teams. PMID:28844039

Techno-economic requirements for composite aircraft components

NASA Technical Reports Server (NTRS)

Palmer, Ray

1993-01-01

The primary reason for use of composites is to save structural weight. A well designed composite aircraft structure will usually save 25-30 percent of a well designed metal structure. The weight savings then translates into improved performance of the aircraft in measures of greater payload, increased flying range or improved efficiency - less use of fuel. Composite materials offer technical advantages. Key technical advantages that composites offer are high stiffness, tailored strength capability, fatigue resistance, and corrosion resistance. Low thermal expansion properties produce dimensionally stable structures over a wide range of temperature. Specialty resin 'char' forming characteristics in a fire environment offer potential fire barrier application and safer aircraft. The materials and processes of composite fabrication offer the potential for lower cost structures in the near future. The application of composite materials to aircraft are discussed.

Verification of accurate technical insight: a prerequisite for self-directed surgical training.

PubMed

Hu, Yinin; Kim, Helen; Mahmutovic, Adela; Choi, Joanna; Le, Ivy; Rasmussen, Sara

2015-03-01

Simulation-based surgical skills training during preclinical education is a persistent challenge due to time constraints of trainees and instructors alike. Self-directed practice is resource-efficient and flexible; however, insight into technical proficiency among trainees is often lacking. The purpose of this study is to prospectively assess the accuracy of self-assessments among medical students learning basic surgical suturing. Over seven weekly practice sessions, preclinical medical students performed serial repetitions of a simulation-based suturing task under one-on-one observation by one of four trainers. Following each task repetition, self- and trainer-assessments (SA-TA) were performed using a 36-point weighted checklist of technical standards developed a priori by expert consensus. Upon study completion, agreement between SA and TA was measured using weighted Cohen's kappa coefficients. Twenty-nine medical students each performed a median of 25 suture task repetitions (IQR 21.5-28). Self-assessments tended to overestimate proficiency during the first tertile of practice attempts. Agreement between SA and TA improved with experience, such that the weighted kappa statistics for the two-handed and instrument ties were >0.81 after 18-21 task attempts. Inexperienced trainees frequently overestimate technical proficiency through self-assessments. However, this bias diminishes with repetitive practice. Only after trainees have attained the capacity to accurately self-assess can effective self-directed learning take place.

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

PubMed

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

2016-12-01

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

Can We Predict Technical Aptitude?: A Systematic Review.

PubMed

Louridas, Marisa; Szasz, Peter; de Montbrun, Sandra; Harris, Kenneth A; Grantcharov, Teodor P

2016-04-01

To identify background characteristics and cognitive tests that may predict surgical trainees' future technical performance, and therefore be used to supplement existing surgical residency selection criteria. Assessment of technical skills is not commonly incorporated as part of the selection process for surgical trainees in North America. Emerging evidence, however, suggests that not all trainees are capable of reaching technical competence. Therefore, incorporating technical aptitude into selection processes may prove useful. A systematic search was carried out of the MEDLINE, PsycINFO, and Embase online databases to identify all studies that assessed associations between surrogate markers of innate technical abilities in surgical trainees, and whether these abilities correlate with technical performance. The quality of each study was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation system. A total of 8035 records were identified. After screening by title, abstract, and full text, 52 studies were included. Very few surrogate markers were found to predict technical performance. Significant associations with technical performance were seen for 1 of 23 participant-reported surrogate markers, 2 of 25 visual spatial tests, and 2 of 19 dexterity tests. The assessment of trainee Basic Performance Resources predicted technical performance in 62% and 75% of participants. To date, no single test has been shown to reliably predict the technical performance of surgical trainees. Strategies that rely on assessing multiple innate abilities, their interaction, and their relationship with technical skill may ultimately be more likely to serve as reliable predictors of future surgical performance.

Washington State Student Achievement Initiative Policy Study: Final Report

ERIC Educational Resources Information Center

Jenkins, Davis; Wachen, John; Moore, Colleen; Shulock, Nancy

2012-01-01

In 2007, the Washington State Board for Community and Technical Colleges launched a performance funding policy called the Student Achievement Initiative (SAI) both to improve public accountability by more accurately describing what students achieve from enrolling in community colleges and to provide incentives to colleges through financial rewards…

Synthesis of best practices for the placement of long and short patches for ride quality : technical report.

DOT National Transportation Integrated Search

2013-03-01

Level-up patching is a common corrective maintenance activity in Texas performed by most districts. It involves laying down a thin asphalt mix layer over an existing pavement (rigid or flexible) in areas of sagging or rutting to improve the ride scor...

Services for Children with Deaf-Blindness in Louisiana. Final Performance Report.

ERIC Educational Resources Information Center

Teddlie, Charles

This final report describes activities and accomplishments of the Services for Children with Deaf-Blindness project, a 1-year federally supported project in Louisiana to improve identification and curriculum for these children by providing technical assistance and training to parents, school systems, and agency personnel. Project activities…

Students' Responses to Authentic Assessment Designed to Develop Commitment to Performing at Their Best

ERIC Educational Resources Information Center

Guzzomi, Andrew L.; Male, Sally A.; Miller, Karol

2017-01-01

Engineering educators should motivate and support students in developing not only technical competence but also professional competence including commitment to excellence. We developed an authentic assessment to improve students' understanding of the importance of "perfection" in engineering--whereby 50% good enough will not be…

Setting Meaningful Criterion-Reference Cut Scores as an Effective Professional Development

ERIC Educational Resources Information Center

Munyofu, Paul

2010-01-01

The state of Pennsylvania, like many organizations interested in performance improvement, routinely engages in professional development activities. Educators in this hands-on activity engaged in setting meaningful criterion-referenced cut scores for career and technical education assessments using two methods. The main purposes of this study were…

Evaluation of Aeroservoelastic Effects on Flutter

NASA Technical Reports Server (NTRS)

Nagaraja, K. S.; Felt, Larry R.; Kraft, Raymond

1998-01-01

This report presents work performed by The Boeing Company to satisfy the deliverable "Evaluation of aeroservoelastic Effects on Symmetric Flutter" for Subtask 7 of Reference 1. The objective of this report is to incorporate the improved methods for studying the effects of a closed-loop control system on the aeroservoelastic behavior of the airplane planned under NASA HSR technical Integration Task 20 work. Also, a preliminary evaluation of the existing pitch control laws on symmetric flutter of the TCA configuration was addressed."The goal is to develop an improved modeling methodology and perform design studies that account for the aero-structures-systems interaction effects.

A Comparison of Robotically Assisted Microsurgery versus Manual Microsurgery in Challenging Situations.

PubMed

Willems, Joost I P; Shin, Alexandra M; Shin, Delaney M; Bishop, Allen T; Shin, Alexander Y

2016-04-01

Microsurgery can be challenging secondary to orientation of the vessels, accessibility, or depth of the wound. Robotically assisted microsurgery reduces tremors and improves visualization and may improve the quality of anastomosis compared with traditional microsurgery. The purpose of this study was to compare robotically assisted microsurgery to traditional microsurgery in technically challenging situations with respect to time of anastomosis, quality of anastomosis, and Objective Structured Assessment of Technical Skills. Two investigators with no prior surgery or microsurgery experience performed 160 anastomoses on artificial microvessels after undergoing standardized traditional and robotically assisted microsurgery courses. Five different exposure groups were created with depths of 0, 10, and 20 cm and sidewall angles of 20 and 30 degrees. A comparison of 80 manual with 80 robotically assisted microsurgery anastomoses in different exposure groups was undertaken. The modified Objective Structured Assessment of Technical Skills scoring system, duration per anastomosis, and a subjective comfort scale were evaluated. In the most difficult exposure, Objective Structured Assessment of Technical Skills scores were similar in both groups (p = 0.98), the duration was higher in the manual group (p = 0.004), and the subjective comfort rating was higher in the robotically assisted microsurgery group (p < 0.001). In the easiest (0-cm depth, flat) exposure, Objective Structured Assessment of Technical Skills scores were higher in the manual group (p = 0.018) and the duration was longer in the robotically assisted microsurgery group (p = 0.008). Manual surgery was superior to robotically assisted microsurgery in technically easy exposures. In difficult exposures (greater depth and lower sidewall angles), however, robotically assisted microsurgery had a shorter surgery time and a higher comfort rating, with Objective Structured Assessment of Technical Skills scores similar to those assessing traditional microsurgery. Therapeutic, V.

Improved Ecosystem Predictions of the California Current System via Accurate Light Calculations

DTIC Science & Technology

2011-09-30

System via Accurate Light Calculations Curtis D. Mobley Sequoia Scientific, Inc. 2700 Richards Road, Suite 107 Bellevue, WA 98005 phone: 425...7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Sequoia Scientific, Inc,2700 Richards Road, Suite 107,Bellevue,WA,98005 8. PERFORMING...EcoLight-S 1.0 Users’ Guide and Technical Documentation. Sequoia Scientific, Inc., Bellevue, WA, 38 pages. Mobley, C. D., 2011. Fast light calculations

Lean Participative Process Improvement: Outcomes and Obstacles in Trauma Orthopaedics

PubMed Central

New, Steve; Hadi, Mohammed; Pickering, Sharon; Robertson, Eleanor; Morgan, Lauren; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

2016-01-01

Objectives To examine the effectiveness of a “systems” approach using Lean methodology to improve surgical care, as part of a programme of studies investigating possible synergy between improvement approaches. Setting A controlled before-after study using the orthopaedic trauma theatre of a UK Trust hospital as the active site and an elective orthopaedic theatre in the same Trust as control. Participants All staff involved in surgical procedures in both theatres. Interventions A one-day “lean” training course delivered by an experienced specialist team was followed by support and assistance in developing a 6 month improvement project. Clinical staff selected the subjects for improvement and designed the improvements. Outcome Measures We compared technical and non-technical team performance in theatre using WHO checklist compliance evaluation, “glitch count” and Oxford NOTECHS II in a sample of directly observed operations, and patient outcome (length of stay, complications and readmissions) for all patients. We collected observational data for 3 months and clinical data for 6 months before and after the intervention period. We compared changes in measures using 2-way analysis of variance. Results We studied 576 cases before and 465 after intervention, observing the operation in 38 and 41 cases respectively. We found no significant changes in team performance or patient outcome measures. The intervention theatre staff focused their efforts on improving first patient arrival time, which improved by 20 minutes after intervention. Conclusions This version of “lean” system improvement did not improve measured safety processes or outcomes. The study highlighted an important tension between promoting staff ownership and providing direction, which needs to be managed in “lean” projects. Space and time for staff to conduct improvement activities are important for success. PMID:27124012

Macroergonomic analysis and design for improved safety and quality performance.

PubMed

Kleiner, B M

1999-01-01

Macroergonomics, which emerged historically after sociotechnical systems theory, quality management, and ergonomics, is presented as the basis for a needed integrative methodology. A macroergonomics methodology was presented in some detail to demonstrate how aspects of microergonomics, total quality management (TQM), and sociotechnical systems (STS) can be triangulated in a common approach. In the context of this methodology, quality and safety were presented as 2 of several important performance criteria. To demonstrate aspects of the methodology, 2 case studies were summarized with safety and quality performance results where available. The first case manipulated both personnel and technical factors to achieve a "safety culture" at a nuclear site. The concept of safety culture is defined in INSAG-4 (International Atomic Energy Agency, 1991). as "that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance." The second case described a tire manufacturing intervention to improve quality (as defined by Sink and Tuttle, 1989) through joint consideration of technical and social factors. It was suggested that macroergonomics can yield greater performance than can be achieved through ergonomic intervention alone. Whereas case studies help to make the case, more rigorous formative and summative research is needed to refine and validate the proposed methodology respectively.

The Stanford Microsurgery and Resident Training (SMaRT) Scale: validation of an on-line global rating scale for technical assessment.

PubMed

Satterwhite, Thomas; Son, Ji; Carey, Joseph; Echo, Anthony; Spurling, Terry; Paro, John; Gurtner, Geoffrey; Chang, James; Lee, Gordon K

2014-05-01

We previously reported results of our on-line microsurgery training program, showing that residents who had access to our website significantly improved their cognitive and technical skills. In this study, we report an objective means for expert evaluators to reliably rate trainees' technical skills under the microscope, with the use of our novel global rating scale. "Microsurgery Essentials" (http://smartmicrosurgery.com) is our on-line training curriculum. Residents were randomly divided into 2 groups: 1 group reviewed this online resource and the other did not. Pre- and post-tests consisted of videotaped microsurgical sessions in which the trainee performed "microsurgery" on 3 different models: latex glove, penrose drain, and the dorsal vessel of a chicken foot. The SMaRT (Stanford Microsurgery and Resident Training) scale, consisting of 9 categories graded on a 5-point Likert scale, was used to assess the trainees. Results were analyzed with ANOVA and Student t test, with P less than 0.05 indicating statistical significance. Seventeen residents participated in the study. The SMaRT scale adequately differentiated the performance of more experienced senior residents (PGY-4 to PGY-6, total average score=3.43) from less experienced junior residents (PGY-1 to PGY-3, total average score=2.10, P<0.0001). Residents who viewed themselves as being confident received a higher score on the SMaRT scale (average score 3.5), compared to residents who were not as confident (average score 2.1) (P<0.001). There were no significant differences in scoring among all 3 evaluators (P>0.05). Additionally, junior residents who had access to our website showed a significant increase in their graded technical performance by 0.7 points when compared to residents who did not have access to the website who showed an improvement of only 0.2 points (P=0.01). Our SMaRT scale is valid and reliable in assessing the microsurgical skills of residents and other trainees. Current trainees are more likely to use self-directed on-line education because of its easy accessibility and interactive format. Our global rating scale can help ensure residents are achieving appropriate technical milestones.

Evaluation of Problem- and Simulator-Based Learning in Lumbar Puncture in Adult Neurology Residency Training.

PubMed

Sun, Chenjing; Qi, Xiaokun

2018-01-01

Lumbar puncture (LP) is an essential part of adult neurology residency training. Technologic as well as nontechnologic training is needed. However, current assessment tools mostly focus on the technologic aspects of LP. We propose a training method-problem- and simulator-based learning (PSBL)-in LP residency training to develop overall skills of neurology residents. We enrolled 60 neurology postgraduate-year-1 residents from our standardized residents training center and randomly divided them into 2 groups: traditional teaching group and PSBL group. After training, we assessed the extent that the residents were ready to perform LP and tracked successful LPs performed by the residents. We then asked residents to complete questionnaires about the training models. Performance scores and the results of questionnaires were compared between the 2 groups. Students and faculty concluded that PSBL provided a more effective learning experience than the traditional teaching model. Although no statistical difference was found in the pretest, posttest, and improvement rate scores between the 2 groups, based on questionnaire scores and number of successful LPs after training, the PSBL group showed a statistically significant improvement compared with the traditional group. Findings indicated that nontechnical elements, such as planning before the procedure and controlling uncertainties during the procedure, are more crucial than technical elements. Compared with traditional teaching model, PSBL for LP training can develop overall surgical skills, including technical and nontechnical elements, improving performance. Residents in the PSBL group were more confident and effective in performing LP. Copyright © 2017 Elsevier Inc. All rights reserved.

Advanced Respiratory Motion Compensation for Coronary MR Angiography

PubMed Central

Henningsson, Markus; Botnar, Rene M.

2013-01-01

Despite technical advances, respiratory motion remains a major impediment in a substantial amount of patients undergoing coronary magnetic resonance angiography (CMRA). Traditionally, respiratory motion compensation has been performed with a one-dimensional respiratory navigator positioned on the right hemi-diaphragm, using a motion model to estimate and correct for the bulk respiratory motion of the heart. Recent technical advancements has allowed for direct respiratory motion estimation of the heart, with improved motion compensation performance. Some of these new methods, particularly using image-based navigators or respiratory binning, allow for more advanced motion correction which enables CMRA data acquisition throughout most or all of the respiratory cycle, thereby significantly reducing scan time. This review describes the three components typically involved in most motion compensation strategies for CMRA, including respiratory motion estimation, gating and correction, and how these processes can be utilized to perform advanced respiratory motion compensation. PMID:23708271

Influence of non-preferred foot technical training in reducing lower limbs functional asymmetry among young football players.

PubMed

Guilherme, José; Garganta, Júlio; Graça, Amândio; Seabra, André

2015-01-01

The functional asymmetry of the lower limbs has been regarded as a relevant factor of the performance of football players. We purposed to ascertain whether a specific technical training programme for the non-preferred foot has implications in the increasing utilisation rate of the respective member during the game. Young football players (n = 71) were randomly divided into experimental group (N = 35; 14.37 ± 1.94 years) and control group (N = 36; 14.50 ± 1.81 years). The study was developed into three stages: first, assessment of the index utilisation of both limbs during the game; second, application of a technical training programme that includes the drilling of specific motor skills exclusively directed to the non-preferred foot; and third, assessment of the new rate of both limbs' utilisation after the predefined six months. The main findings were: (1) the use of the non-preferred foot increased significantly with the technical training programme in the experimental group and remained constant in the control group; (2) the use of the preferred foot decreased significantly in the experimental group and remained similar in control group. We concluded that a systematic and specific technical training for the non-preferred foot increases its use and reduces functional asymmetry in game situation, consequently improving the player's performance.

Annual Report, Fall 2016: Identifying Cost Effective Tank Waste Characterization Approaches

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

Reboul, S. H.; DiPrete, D. P.

2016-12-12

This report documents the activities that were performed during the second year of a project undertaken to improve the cost effectiveness and timeliness of SRNL’s tank closure characterization practices. The activities performed during the first year of the project were previously reported in SRNL-STI-2015-00144. The scope of the second year activities was divided into the following three primary tasks: 1) develop a technical basis and strategy for improving the cost effectiveness and schedule of SRNL’s tank closure characterization program; 2) initiate the design and assembly of a new waste removal system for improving the throughput and reducing the personnel dosemore » associated with extraction chromatography radiochemical separations; and 3) develop and perform feasibility testing of three alternative radiochemical separation protocols holding promise for improving high resource demand/time consuming tank closure sample analysis methods.« less

Prospects for the development of coal-steam plants in Russia

NASA Astrophysics Data System (ADS)

Tumanovskii, A. G.

2017-06-01

Evaluation of the technical state of the modern coal-fired power plants and quality of coal consumed by Russian thermal power plants (TPP) is provided. Measures aimed at improving the economic and environmental performance of operating 150-800 MW coal power units are considered. Ways of efficient use of technical methods of NO x control and electrostatic precipitators' upgrade for improving the efficiency of ash trapping are summarized. Examples of turbine and boiler equipment efficiency upgrading through its deep modernization are presented. The necessity of the development and introduction of new technologies in the coal-fired power industry is shown. Basic technical requirements for a 660-800 MW power unit with the steam conditions of 28 MPa, 600/600°C are listed. Design solutions taking into account features of Russian coal combustion are considered. A field of application of circulating fluidized bed (CFB) boilers and their effectiveness are indicated. The results of development of a new generation coal-fired TPP, including a steam turbine with an increased efficiency of the compartments and disengaging clutch, an elevated steam conditions boiler, and a highly efficient NO x /SO2 and ash particles emission control system are provided. In this case, the resulting ash and slag are not to be sent to the ash dumps and are to be used to a maximum advantage. Technical solutions to improve the efficiency of coal gasification combined cycle plants (CCP) are considered. A trial plant based on a 16 MW gas turbine plant (GTP) and an air-blown gasifier is designed as a prototype of a high-power CCP. The necessity of a state-supported technical reequipment and development program of operating coal-fired power units, as well as putting into production of new generation coal-fired power plants, is noted.

Robotic pancreaticoduodenectomy in a case of duodenal gastrointestinal stromal tumor.

PubMed

Parisi, Amilcare; Desiderio, Jacopo; Trastulli, Stefano; Grassi, Veronica; Ricci, Francesco; Farinacci, Federico; Cacurri, Alban; Castellani, Elisa; Corsi, Alessia; Renzi, Claudio; Barberini, Francesco; D'Andrea, Vito; Santoro, Alberto; Cirocchi, Roberto

2014-12-04

Laparoscopic pancreaticoduodenectomy is rarely performed, and it has not been particularly successful due to its technical complexity. The objective of this study is to highlight how robotic surgery could improve a minimally invasive approach and to expose the usefulness of robotic surgery even in complex surgical procedures. The surgical technique employed in our center to perform a pancreaticoduodenectomy, which was by means of the da Vinci™ robotic system in order to remove a duodenal gastrointestinal stromal tumor, is reported. Robotic technology has improved significantly over the traditional laparoscopic approach, representing an evolution of minimally invasive techniques, allowing procedures to be safely performed that are still considered to be scarcely feasible or reproducible.

Matching Community and Technical College Professional/Technical Education Capacity to Employer Demand. Final Report.

ERIC Educational Resources Information Center

Sommers, Paul; Heg, Deena

A project was conducted to improve the state of Washington's community and technical college system by developing and using an improved occupational forecasting system to assess and respond to education and training needs. First, long-term occupational forecast data from Washington's Employment Security Department were matched with technical and…

Effect of obstetric team training on team performance and medical technical skills: a randomised controlled trial.

PubMed

Fransen, A F; van de Ven, J; Merién, A E R; de Wit-Zuurendonk, L D; Houterman, S; Mol, B W; Oei, S G

2012-10-01

To determine whether obstetric team training in a medical simulation centre improves the team performance and utilisation of appropriate medical technical skills of healthcare professionals. Cluster randomised controlled trial. The Netherlands. The obstetric departments of 24 Dutch hospitals. The obstetric departments were randomly assigned to a 1-day session of multiprofessional team training in a medical simulation centre or to no such training. Team training was given with high-fidelity mannequins by an obstetrician and a communication expert. More than 6 months following training, two unannounced simulated scenarios were carried out in the delivery rooms of all 24 obstetric departments. The scenarios, comprising a case of shoulder dystocia and a case of amniotic fluid embolism, were videotaped. The team performance and utilisation of appropriate medical skills were evaluated by two independent experts. Team performance evaluated with the validated Clinical Teamwork Scale (CTS) and the employment of two specific obstetric procedures for the two clinical scenarios in the simulation (delivery of the baby with shoulder dystocia in the maternal all-fours position and conducting a perimortem caesarean section within 5 minutes for the scenario of amniotic fluid embolism). Seventy-four obstetric teams from 12 hospitals in the intervention group underwent teamwork training between November 2009 and July 2010. The teamwork performance in the training group was significantly better in comparison to the nontraining group (median CTS score: 7.5 versus 6.0, respectively; P = 0.014). The use of the predefined obstetric procedures for the two clinical scenarios was also significantly more frequent in the training group compared with the nontraining group (83 versus 46%, respectively; P = 0.009). Team performance and medical technical skills may be significantly improved after multiprofessional obstetric team training in a medical simulation centre. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Assessing the use of psychological skills by sports category and the relation with sports performance satisfaction.

PubMed

Tomé-Lourido, David; Arce, Constantino; Vales-Vázquez, Ángel; Ponte, Dolores

2018-05-02

The evaluation of psychological skills by athletes and their relationship with sports performance and satisfaction has been of great interest in recent decades. Likewise, there has been an emergent tendency to focus on developing specific psychological skills for each sport. The principal aim of this study was to determine the frequency with which athletes deploy psychological skills whilst competing and whether their frequency varies in accordance with the technical, tactical and physical characteristics of the sport in question. A further objective was to establish the connection between the frequency of use of psychological skills and athletes' degree of satisfaction with their performance. The study comprised 1003 athletes practising 43 different sports, grouped into 7 categories based on the similarities between them. Frequency of use of the psychological skills was measured with the Test of Performance Strategies 3. The data analyses allowed the following conclusions to be drawn: the degree to which psychological skills are used is dependent on the technical, tactical and physical characteristics of each sport; and the higher the frequency of the use of psychological skills, the greater the athletes' degree of satisfaction with their performance. These results allow athletes and coaches to increase levels of sports performance by working on the use of psychological skills, adapted to the technical, tactical or physical requirements of the category in which their sport is included. In addition, working on different psychological skills will improve their satisfaction with sports performance.

Objective Structured Assessment of Technical Skills (OSATS) evaluation of hysteroscopy training: a prospective study.

PubMed

Alici, Ferizan; Buerkle, Bernd; Tempfer, Clemens B

2014-07-01

To describe the performance curve of hysteroscopy-naïve probands repeatedly working through a surgery algorithm on a hysteroscopy trainer. We prospectively recruited medical students to a 30min demonstration session teaching a standardized surgery algorithm. Subjects subsequently performed three training courses immediately after training (T1) and after 24h (T2) and 48h (T3). Skills were recorded with a 20-item Objective Structured Assessment of Technical Skills (OSATS) at T1, T2, and T3. The presence of a sustained OSATS score improvement from T1 to T3 was the primary outcome. Performance time (PT) and self assessment (SA) were secondary outcomes. Statistics were performed using paired T-test and multiple linear regression analysis. 92 subjects were included. OSATS scores significantly improved over time from T1 to T2 (15.21±1.95 vs. 16.02±2.06, respectively; p<0.0001) and from T2 to T3 (16.02±2.06 vs. 16.95±1.61, respectively; p<0.0001). The secondary outcomes PT (414±119s vs. 357±88s vs. 304±91s; p<0.0001) and SA (3.02±0.85 vs. 3.80±0.76 vs. 4.41±0.67; p<0.0001) also showed an improvement over time with quicker performance and higher confidence. SA, but not PT demonstrated construct validity. In a multiple linear regression analysis, gender (odds ratio (OR) 0.96; 95% confidence interval (CI) 0.35-2.71; p=0.9) did not independently influence the likelihood of OSATS score improvement. In a hysteroscopy-naïve population, there is a continuous and sustained improvement of surgical proficiency and confidence after multiple training courses on a hysteroscopy trainer. Serial hysteroscopy trainings may be helpful for teaching hysteroscopy skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Relationship between intraoperative non-technical performance and technical events in bariatric surgery.

PubMed

Fecso, A B; Kuzulugil, S S; Babaoglu, C; Bener, A B; Grantcharov, T P

2018-03-30

The operating theatre is a unique environment with complex team interactions, where technical and non-technical performance affect patient outcomes. The correlation between technical and non-technical performance, however, remains underinvestigated. The purpose of this study was to explore these interactions in the operating theatre. A prospective single-centre observational study was conducted at a tertiary academic medical centre. One surgeon and three fellows participated as main operators. All patients who underwent a laparoscopic Roux-en-Y gastric bypass and had the procedures captured using the Operating Room Black Box ® platform were included. Technical assessment was performed using the Objective Structured Assessment of Technical Skills and Generic Error Rating Tool instruments. For non-technical assessment, the Non-Technical Skills for Surgeons (NOTSS) and Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) tools were used. Spearman rank-order correlation and N-gram statistics were conducted. Fifty-six patients were included in the study and 90 procedural steps (gastrojejunostomy and jejunojejunostomy) were analysed. There was a moderate to strong correlation between technical adverse events (r s  = 0·417-0·687), rectifications (r s  = 0·380-0·768) and non-technical performance of the surgical and nursing teams (NOTSS and SPLINTS). N-gram statistics showed that after technical errors, events and prior rectifications, the staff surgeon and the scrub nurse exhibited the most positive non-technical behaviours, irrespective of operator (staff surgeon or fellow). This study demonstrated that technical and non-technical performances are related, on both an individual and a team level. Valuable data can be obtained around intraoperative errors, events and rectifications. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

How to Improve the Design and Delivery of High-Quality Technical Assistance. Newsletter

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2005

2005-01-01

Educators often use the term technical assistance to define services delivered or received in the pursuit of school- and district-improvement initiatives. More specifically, technical assistance can be defined as any assistance that identifies, selects, or designs research-based solutions and practices to support school improvement (Mattson &…

Comparison of the Booster Interface Temperature in Stainless Steel (SS) V-Channel Versus the Aluminum (Al) Y-Channel Primer Chamber Assemblies (PCAs). Volume 2; Appendices

NASA Technical Reports Server (NTRS)

Garcia, Roberto; Saulsberry, Regor L.

2011-01-01

NASA's Technical Fellow for Propulsion, requested a technical assessment of the performance improvement achieved by the introduction of the stainless steel (SS) V-channel compared to the aluminum (Al) Y-channel Primer Chamber Assembly (PCA) design. The SS V-channel PCA was developed for NASA's Mars Science Laboratory (MSL) Project. The principle focus of the assessment was to measure the transient temperature at the booster interface with both designs. This document contains the Appendices to the Volume I main report.

Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

PubMed Central

Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F.

2015-01-01

Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients’ decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. Purpose To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. Methods This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman’s rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Results Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001). Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities. Conclusion There is the need to intensify client education and balanced commitment to technical and perceived quality improvement efforts. This will help enhance client confidence in Ghana’s healthcare system, stimulate active participation in the national health insurance, increase healthcare utilization and ultimately improve public health outcomes. PMID:26465935

Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

PubMed

Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F

2015-01-01

Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001). Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities. There is the need to intensify client education and balanced commitment to technical and perceived quality improvement efforts. This will help enhance client confidence in Ghana's healthcare system, stimulate active participation in the national health insurance, increase healthcare utilization and ultimately improve public health outcomes.

The Accreditation Experience of Clinical Laboratories and Blood Banks in Mexico

PubMed Central

2015-01-01

The accreditation of clinical laboratories and blood banks based on ISO 15189 is now being consolidated in Mexico, and is coordinated by the Mexican accreditation entity innovative strategies, A.C. (ema) and supported by the activities of the committee of clinical laboratories and blood banks. The active participation in working groups formed by the technical committee of clinical laboratories and blood banks in specific areas, has contributed to the formulation of technical documents and criteria of evaluation that strengthen the current accreditation scheme. The national registry of evaluation (PNE) consists of technical experts and evaluators from different disciplines of clinical laboratory; the evaluators actively participate in accreditation assessment, with an ultimate goal to receive training and feedback for continuous improvement of its own performance. PMID:27683498

Socio-technical issues and challenges in implementing safe patient handovers: insights from ethnographic case studies.

PubMed

Balka, Ellen; Tolar, Marianne; Coates, Shannon; Whitehouse, Sandra

2013-12-01

Ineffective handovers in patient care, including those where information loss occurs between care providers, have been identified as a risk to patient safety. Computerization of health information is often offered as a solution to improve the quality of care handovers and decrease adverse events related to patient safety. The purpose of this paper is to broaden our understanding of clinical handover as a patient safety issue, and to identify socio-technical issues which may come to bear on the success of computer based handover tools. Three in depth ethnographic case studies were undertaken. Field notes were transcribed and analyzed with the aid of qualitative data analysis software. Within case analysis was performed on each case, and subsequently, cross case analyses were performed. We identified five types of socio-technical issues which must be addressed if electronic handover tools are to succeed. The inter-dependencies of these issues are addressed in relation to arenas in which health care work takes place. We suggest that the contextual nature of information, ethical and medico-legal issues arising in relation to information handover, and issues related to data standards and system interoperability must be addressed if computerized health information systems are to achieve improvements in patient safety related to handovers in care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of Virtual Reality Training in Orthopaedic Surgery.

PubMed

Aïm, Florence; Lonjon, Guillaume; Hannouche, Didier; Nizard, Rémy

2016-01-01

The purpose of this study was to conduct a systematic review to determine the effectiveness of virtual reality (VR) training in orthopaedic surgery. A comprehensive systematic review was performed of articles of VR training in orthopaedic surgery published up to November 2014 from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases. We included 10 relevant trials of 91 identified articles, which all reported on training in arthroscopic surgery (shoulder, n = 5; knee, n = 4; undefined, n = 1). A total of 303 participants were involved. Assessment after training was made on a simulator in 9 of the 10 studies, and in one study it took place in the operating room (OR) on a real patient. A total of 32 different outcomes were extracted; 29 of them were about skills assessment. None involved a patient-related outcome. One study focused on anatomic learning, and the other evaluated technical task performance before and after training on a VR simulator. Five studies established construct validity. Three studies reported a statistically significant improvement in technical skills after training on a VR simulator. VR training leads to an improvement of technical skills in orthopaedic surgery. Before its widespread use, additional trials are needed to clarify the transfer of VR training to the OR. Systematic review of Level I through Level IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Advanced Exploration Systems Atmosphere Resource Recovery and Environmental Monitoring

NASA Technical Reports Server (NTRS)

Perry, J.; Abney, M.; Conrad, R.; Garber, A.; Howard, D.; Kayatin, M.; Knox, J.; Newton, R.; Parrish, K.; Roman, M.;

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

Rhinefrank, Kenneth; Lamb, Bradford; Prudell, Joseph

This Project aims to satisfy objectives of the DOE’s Water Power Program by completing a system detailed design (SDD) and other important activities in the first phase of a utility-scale grid-connected ocean wave energy demonstration. In early 2012, Columbia Power (CPwr) had determined that further cost and performance optimization was necessary in order to commercialize its StingRAY wave energy converter (WEC). CPwr’s progress toward commercialization, and the requisite technology development path, were focused on transitioning toward a commercial-scale demonstration. This path required significant investment to be successful, and the justification for this investment required improved annual energy production (AEP) andmore » lower capital costs. Engineering solutions were developed to address these technical and cost challenges, incorporated into a proposal to the US Department of Energy (DOE), and then adapted to form the technical content and statement of project objectives of the resulting Project (DE-EE0005930). Through Project cost-sharing and technical collaboration between DOE and CPwr, and technical collaboration with Oregon State University (OSU), National Renewable Energy Lab (NREL) and other Project partners, we have demonstrated experimentally that these conceptual improvements have merit and made significant progress towards a certified WEC system design at a selected and contracted deployment site at the Wave Energy Test Site (WETS) at the Marine Corps Base in Oahu, HI (MCBH).« less

The application of DEA (Data Envelopment Analysis) window analysis in the assessment of influence on operational efficiencies after the establishment of branched hospitals.

PubMed

Jia, Tongying; Yuan, Huiyun

2017-04-12

Many large-scaled public hospitals have established branched hospitals in China. This study is to provide evidence for strategy making on the management and development of multi-branched hospitals by evaluating and comparing the operational efficiencies of different hospitals before and after their establishment of branched hospitals. DEA (Data Envelopment Analysis) window analysis was performed on a 7-year data pool from five public hospitals provided by health authorities and institutional surveys. The operational efficiencies of sample hospitals measured in this study (including technical efficiency, pure technical efficiency and scale efficiency) had overall trends towards increase during this 7-year period of time, however, a temporary downturn occurred shortly after the establishment of branched hospitals; pure technical efficiency contributed more to the improvement of technical efficiency compared to scale efficiency. The establishment of branched-hospitals did not lead to a long-term negative effect on hospital operational efficiencies. Our data indicated the importance of improving scale efficiency via the optimization of organizational management, as well as the advantage of a different form of branch-establishment, merging and reorganization. This study brought an insight into the practical application of DEA window analysis on the assessment of hospital operational efficiencies.

Improving performance by anchoring movement and "nerves".

PubMed

Iso-Ahola, Seppo E; Dotson, Charles O; Jagodinsky, Adam E; Clark, Lily C; Smallwood, Lorraine L; Wilburn, Christopher; Weimar, Wendi H; Miller, Matthew W

2016-10-01

Golf's governing bodies' recent decision to ban all putting styles "anchoring one end of the club against the body" bridges an important practical problem with psychological theory. We report the first experiment testing whether anchoring provides technical and/or psychological advantage in competitive performance. Many "greats" of professional golf from Arnold Palmer and Jack Nicklaus to Tiger Woods have argued against anchoring, believing that it takes "nerves" out of competitive performance and therefore artificially levels the playing field. To shed more light on the issue, we tested participants' performance with anchored and unanchored putters under low and high pressure when controlling for the putter length. We found no statistically significant evidence for a technical advantage due to anchoring but a clear psychological advantage: participants who anchored their putters significantly outperformed unanchored counterparts under high, but not low, pressure. Results provide tentative evidence for the ban's justification from a competitive standpoint. However, before any definite conclusions can be made, more research is needed when using high-level golfers. Copyright © 2016 Elsevier B.V. All rights reserved.

Compiling the space shuttle wind tunnel data base: An exercise in technical and managerial innovators

NASA Technical Reports Server (NTRS)

Kemp, N. D.

1983-01-01

Engineers evaluating Space Shuttle flight data and performance results are using a massive data base of wind tunnel test data. A wind tunnel test data base of the magnitude attained is a major accomplishment. The Apollo program spawned an automated wind tunnel data analysis system called SADSAC developed by the Chrysler Space Division. An improved version of this system renamed DATAMAN was used by Chrysler to document analyzed wind tunnel data and data bank the test data in standardized formats. These analysis documents, associated computer graphics and standard formatted data were disseminated nationwide to the Shuttle technical community. These outputs became the basis for substantiating and certifying the flight worthiness of the Space Shuttle and for improving future designs. As an aid to future programs this paper documents the lessons learned in compiling the massive wind tunnel test data base for developing the Space Shuttle. In particular, innovative managerial and technical concepts evolved in the course of conceiving and developing this successful DATAMAN system and the methods and organization for applying the system are presented.

Final priority; technical assistance to improve state data capacity--National Technical Assistance Center to improve state capacity to accurately collect and report IDEA data. Final priority.

PubMed

2013-05-20

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Technical Assistance to Improve State Data Capacity program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to focus attention on an identified national need to provide technical assistance (TA) to States to improve their capacity to meet the data collection and reporting requirements of the Individuals with Disabilities Education Act (IDEA). We intend this priority to establish a TA center to improve State capacity to accurately collect and report IDEA data (Data Center).

Technical indicators of economic performance in dairy sheep farming.

PubMed

Theodoridis, A; Ragkos, A; Roustemis, D; Arsenos, G; Abas, Z; Sinapis, E

2014-01-01

In this study, the level of technical efficiency of 58 sheep farms rearing the Chios breed in Greece was measured through the application of the stochastic frontier analysis method. A Translog stochastic frontier production function was estimated using farm accounting data of Chios sheep farms and the impact of various socio-demographic and biophysical factors on the estimated efficiency of the farms was evaluated. The farms were classified into efficiency groups on the basis of the estimated level of efficiency and a technical and economic descriptive analysis was applied in order to illustrate an indicative picture of their structure and productivity. The results of the stochastic frontier model indicate that there are substantial production inefficiencies among the Chios sheep farms and that these farms could increase their production through the improvement of technical efficiency, whereas the results of the inefficiency effects model reveal that the farm-specific explanatory factors can partly explain the observed efficiency differentials. The measurement of technical inefficiency and the detection of its determinants can be used to form the basis of policy recommendations that could contribute to the development of the sector.

Is High Fidelity Simulation the Most Effective Method for the Development of Non-Technical Skills in Nursing? A Review of the Current Evidence

PubMed Central

Lewis, Robin; Strachan, Alasdair; Smith, Michelle McKenzie

2012-01-01

Aim: To review the literature on the use of simulation in the development of non-technical skills in nursing Background: The potential risks to patients associated with learning 'at the bedside' are becoming increasingly unacceptable, and the search for innovative education and training methods that do not expose the patient to preventable errors continues. All the evidence shows that a significant proportion of adverse events in health care is caused by problems relating to the application of the 'non-technical' skills of communication, teamwork, leadership and decision-making. Results: Simulation is positively associated with significantly improved interpersonal communication skills at patient handover, and it has also been clearly shown to improve team behaviours in a wide variety of clinical contexts and clinical personnel, associated with improved team performance in the management of crisis situations. It also enables the effective development of transferable, transformational leadership skills, and has also been demonstrated to improve students' critical thinking and clinical reasoning in complex care situations, and to aid in the development of students' self-efficacy and confidence in their own clinical abilities. Conclusion: High fidelity simulation is able to provide participants with a learning environment in which to develop non-technical skills, that is safe and controlled so that the participants are able to make mistakes, correct those mistakes in real time and learn from them, without fear of compromising patient safety. Participants in simulation are also able to rehearse the clinical management of rare, complex or crisis situations in a valid representation of clinical practice, before practising on patients. PMID:22893783

Effectiveness of PowerPoint Presentation on Students' Cognitive Achievement in Technical Drawing

ERIC Educational Resources Information Center

Gambari, Amosa Isiaka; Yusuf, Hamdalat Taiwo; Balogun, Sherifat Adepeju

2015-01-01

This paper discusses importance of technology education and evidence of declining performance of junior secondary school students in basic technology subject. Benefits of PowerPoint presentation in classroom instruction as a means to improve classroom teaching in the developing countries are also discussed. The effectiveness of PowerPoint…

Reclassification of English Learner Students in California. Technical Appendices

ERIC Educational Resources Information Center

Hill, Laura E.; Weston, Margaret; Hayes, Joseph M.

2014-01-01

Former English Learner students who have improved their facility with English to such a degree that they have been reclassified by their school districts as fluent in the English language are among the best performing students in the state. Because these Reclassified Fluent English Proficient (RFEP) students have much better academic outcomes than…

Technical Report: Guide Details Best Practices in Photovoltaic System

Science.gov Websites

Operations and Maintenance | Solar Research | NREL Guide Details Best Practices in Photovoltaic A best-practices report on photovoltaic (PV) operations and maintenance (O&M) released by NREL and the PV O&M Working Group provides valuable insights on improving the performance of PV systems

The Oregon Applied Academics Project: Final Report

ERIC Educational Resources Information Center

Pearson, Donna; Richardson, George B.; Sawyer, Jennifer M.

2013-01-01

This report contains the findings of the Oregon Applied Academics research and development project which spanned three academic years from 2010 through 2013. The overall purpose of the project was to develop and implement a technical math course that would meet graduation requirements and improve student performance. The State of Oregon has been…

Career and Technical Education in High School: Does It Improve Student Outcomes?

ERIC Educational Resources Information Center

Dougherty, Shaun M.

2016-01-01

Until the late 1990s, "vocational education" in traditional trades such as carpentry, cosmetology, and auto mechanics was often the presumptive high school placement for low-performing students considered ill-suited for college. However, in the past two decades, policymakers and educators have reconsidered what is now referred to as…

77 FR 52318 - Notice of Submission for OMB Review; Office of Planning, Evaluation and Policy Development; Study...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review; Office of Planning, Evaluation and..., including technical assistance to improve the quality of evaluations and performance reporting; and how to.... Department of Education, 400 Maryland Avenue SW., LBJ, Washington, DC 20202-4537. Copies of the proposed...

77 FR 52707 - Notice of Submission for OMB Review; Office of Planning, Evaluation and Policy Development; Study...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review; Office of Planning, Evaluation and..., including technical assistance to improve the quality of evaluations and performance reporting; and how to.... Department of Education, 400 Maryland Avenue SW, LBJ, Washington, DC 20202-4537. Copies of the proposed...

The MDE Diploma: First International Postgraduate Specialization in Model-Driven Engineering

ERIC Educational Resources Information Center

Cabot, Jordi; Tisi, Massimo

2011-01-01

Model-Driven Engineering (MDE) is changing the way we build, operate, and maintain our software-intensive systems. Several projects using MDE practices are reporting significant improvements in quality and performance but, to be able to handle these projects, software engineers need a set of technical and interpersonal skills that are currently…

OR2020: The Operating Room of the Future

DTIC Science & Technology

2004-05-01

25 3.3 Technical Requirements: Standards and Tools for Improved Operating R oom Process Integration...Image processing and visualization tools must be made available to the operating room. 5. Communications issues must be addressed and aim toward...protocols for effectively performing advanced surgeries and using telecommunications-ready tools as needed. The following recommendations were made

78 FR 29338 - Applications for New Award; Technical Assistance To Improve State Data Capacity-National...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

... formative and summative evaluations of the project; Note: The following Web site provides more information... plan, linked to the project's logic model, for a formative evaluation of the project's activities. The plan must describe how the formative evaluation will use clear performance objectives to ensure...

Total Quality: An Understanding and Application For Community, Junior, and Technical Colleges.

ERIC Educational Resources Information Center

Burgdorf, Augustus

1992-01-01

Total Quality (TQ), is a customer-oriented philosophy of management that utilizes total employee involvement in the relentless, daily search for improvement of product and service quality, through the use of statistical methods, employee teams, and performance management. In the TQ framework, "internal" customers are individuals within the…

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2013 CFR

2013-01-01

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

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

History and Development of Instructional Technology and Media in Social Work Education

ERIC Educational Resources Information Center

Shorkey, Clayton T.; Uebel, Michael

2014-01-01

Since the mid-20th century, instructional technologies and educational media in social work education have undergone significant development with the goals of improving learning and performance and enhancing access. This growth has been marked by technical advances in hardware and by innovations in media, or so-called soft formats. Current…

Turning State Data and Research into Information: An Example from Washington State's Student Achievement Initiative

ERIC Educational Resources Information Center

Prince, David; Seppanen, Loretta; Stephens, Deborah; Stewart, Carmen

2010-01-01

This chapter discusses Washington State's Student Achievement Initiative, a new performance funding system for community and technical colleges. Its purposes are to improve public accountability by more accurately describing what students achieve from enrolling in state colleges each year and provide incentives through financial rewards to…

Energy efficiency in light-frame wood construction

Treesearch

Gerald E. Sherwood; Gunard Hans

1979-01-01

This report presents information needed for design and construction of energy-efficient light-frame wood structures. The opening section discusses improving the thermal performance of a house by careful planning and design. A second section of the report provides technical information on the thermal properties of construction materials, and on the basic engineering...

77 FR 2280 - Request for Information To Gather Technical Expertise Pertaining to Testing Integrity

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... may help SEAs and LEAs ensure the integrity of the data used to measure student achievement and to... this RFI, a testing irregularity includes any occurrence that may inappropriately influence a student's..., reliable, and timely information on student academic performance to improve instruction and help all...

Speaker-Machine Interaction in Automatic Speech Recognition. Technical Report.

ERIC Educational Resources Information Center

Makhoul, John I.

The feasibility and limitations of speaker adaptation in improving the performance of a "fixed" (speaker-independent) automatic speech recognition system were examined. A fixed vocabulary of 55 syllables is used in the recognition system which contains 11 stops and fricatives and five tense vowels. The results of an experiment on speaker…

A Formal Construction of Term Classes. Technical Report No. TR73-18.

ERIC Educational Resources Information Center

Yu, Clement T.

The computational complexity of a formal process for the construction of term classes for information retrieval is examined. While the process is proven to be difficult computationally, heuristic methods are applied. Experimental results are obtained to illustrate the maximum possible improvement in system performance of retrieval using the formal…

[Creation of a medical work station for use in community-based care].

PubMed

Mercier, Samuel; Desauty, Fabrice; Lamache, Christophe; Lefort, Hugues

2017-03-01

In community-based care, the teams must adapt to the environment and perform a number of technical procedures. Foldable medical equipment has been developed and patented, enabling the care provision to approach hospital standards and improving working conditions in this context. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Tools for Schools: Filtration for Improved Air Quality. Technical Services Bulletin.

ERIC Educational Resources Information Center

2001

This product bulletin addresses air pollution control in educational facilities to enhance educational performance, provides air quality recommendations for schools, and examines the filtration needs of various school areas. The types of air particles typically present are highlighted, and the use of proper filtration to control gases and vapors…

Department of Education Revives Civil Rights Office

ERIC Educational Resources Information Center

Finkel, Ed

2010-01-01

This article reports on the mission of the Office for Civil Rights in the U.S. Department of Education to ensure equal access to education through compliance reviews. The Office hopes to use these reviews to provide technical assistance to help districts improve their performance. In late March, the Los Angeles Unified School District became the…

Environmentally Responsible Aviation (ERA) Project - N+2 Advanced Vehicle Concepts Study and Conceptual Design of Subscale Test Vehicle (STV) Final Report

NASA Technical Reports Server (NTRS)

Bonet, John T.; Schellenger, Harvey G.; Rawdon, Blaine K.; Elmer, Kevin R.; Wakayama, Sean R.; Brown, Derrell L.; Guo, Yueping

2011-01-01

NASA has set demanding goals for technology developments to meet national needs to improve fuel efficiency concurrent with improving the environment to enable air transportation growth. A figure shows NASA's subsonic transport system metrics. The results of Boeing ERA N+2 Advanced Vehicle Concept Study show that the Blended Wing Body (BWB) vehicle, with ultra high bypass propulsion systems have the potential to meet the combined NASA ERA N+2 goals. This study had 3 main activities. 1) The development of an advanced vehicle concepts that can meet the NASA system level metrics. 2) Identification of key enabling technologies and the development of technology roadmaps and maturation plans. 3) The development of a subscale test vehicle that can demonstrate and mature the key enabling technologies needed to meet the NASA system level metrics. Technology maturation plans are presented and include key performance parameters and technical performance measures. The plans describe the risks that will be reduced with technology development and the expected progression of technical maturity.

FY2016 Propulsion Materials Annual Progress Report

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

None, None

The Propulsion Materials Program actively supports the energy security and reduction of greenhouse emissions goals of VTO by investigating and identifying the materials properties that are most essential for continued development of cost-effective, highly efficient, and environmentally friendly next-generation heavy and light-duty powertrains. The technical approaches available to enhance propulsion systems focus on improvements in both vehicle efficiency and fuel substitution, both of which must overcome the performance limitations of the materials currently in use. Propulsion Materials Program activities work with national laboratories, industry experts, and VTO powertrain systems (e.g., Advanced Combustion Engines and Fuels) teams to develop strategies thatmore » overcome materials limitations in future powertrain performance. The technical maturity of the portfolio of funded projects ranges from basic science to subsystem prototype validation. Projects within a Propulsion Materials Program activity address materials concerns that directly impact critical technology barriers within each of the above programs, including barriers that impact fuel efficiency, thermal management, emissions reduction, improved reliability, and reduced manufacturing costs. The program engages only the barriers that result from material property limitations and represent fundamental, high-risk materials issues.« less

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya

PubMed Central

Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

2017-01-01

Abstract The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client–provider consultation sessions. The cross-sectional study observed 366 client–provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63–0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07–14.21), adequate infrastructure (5.29; 95% CI: 2.89–7.69) and reagents (1.48; 95% CI: 1.02–1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92–4.36), job satisfaction (2.02; 95% CI: 1.21–2.83) and supervision (1.01; 95% CI: 0.35–1.68), while workload (−0.88; 95% CI: −1.75 to − 0.01) was negatively associated. Technical quality of the client–provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client–provider consultation sessions as measured by both health facility structural and provider factors. PMID:29194543

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

PubMed

Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

2017-11-01

The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility structural and provider factors. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Flexible Fabrics with High Thermal Conductivity for Advanced Spacesuits

NASA Technical Reports Server (NTRS)

Trevino, Luis A.; Bue, Grant; Orndoff, Evelyne; Kesterson, Matt; Connel, John W.; Smith, Joseph G., Jr.; Southward, Robin E.; Working, Dennis; Watson, Kent A.; Delozier, Donovan M.

2006-01-01

This paper describes the effort and accomplishments for developing flexible fabrics with high thermal conductivity (FFHTC) for spacesuits to improve thermal performance, lower weight and reduce complexity. Commercial and additional space exploration applications that require substantial performance enhancements in removal and transport of heat away from equipment as well as from the human body can benefit from this technology. Improvements in thermal conductivity were achieved through the use of modified polymers containing thermally conductive additives. The objective of the FFHTC effort is to significantly improve the thermal conductivity of the liquid cooled ventilation garment by improving the thermal conductivity of the subcomponents (i.e., fabric and plastic tubes). This paper presents the initial system modeling studies, including a detailed liquid cooling garment model incorporated into the Wissler human thermal regulatory model, to quantify the necessary improvements in thermal conductivity and garment geometries needed to affect system performance. In addition, preliminary results of thermal conductivity improvements of the polymer components of the liquid cooled ventilation garment are presented. By improving thermal garment performance, major technology drivers will be addressed for lightweight, high thermal conductivity, flexible materials for spacesuits that are strategic technical challenges of the Exploration

Structure of energy consumption and improving open-pit dump truck efficiency

NASA Astrophysics Data System (ADS)

Koptev, V. Yu; Kopteva, A. V.

2017-10-01

This paper studies the dynamics of the improvement of wheel type transport vehicles environmental and energy performance in open-pit mines. The paper discloses characteristics of the gas turbine engine with capacity of 1250 hp, mounted on tanks, and technical-economic calculations, confirming reasonability of their use in open-pit dump trucks with the 120 …130-ton loading capacity. The general layout scheme of mechanical transmission with the gas turbine engine is shown.

Virtual Reality Simulation for the Operating Room

PubMed Central

Gallagher, Anthony G.; Ritter, E Matt; Champion, Howard; Higgins, Gerald; Fried, Marvin P.; Moses, Gerald; Smith, C Daniel; Satava, Richard M.

2005-01-01

Summary Background Data: To inform surgeons about the practical issues to be considered for successful integration of virtual reality simulation into a surgical training program. The learning and practice of minimally invasive surgery (MIS) makes unique demands on surgical training programs. A decade ago Satava proposed virtual reality (VR) surgical simulation as a solution for this problem. Only recently have robust scientific studies supported that vision Methods: A review of the surgical education, human-factor, and psychology literature to identify important factors which will impinge on the successful integration of VR training into a surgical training program. Results: VR is more likely to be successful if it is systematically integrated into a well-thought-out education and training program which objectively assesses technical skills improvement proximate to the learning experience. Validated performance metrics should be relevant to the surgical task being trained but in general will require trainees to reach an objectively determined proficiency criterion, based on tightly defined metrics and perform at this level consistently. VR training is more likely to be successful if the training schedule takes place on an interval basis rather than massed into a short period of extensive practice. High-fidelity VR simulations will confer the greatest skills transfer to the in vivo surgical situation, but less expensive VR trainers will also lead to considerably improved skills generalizations. Conclusions: VR for improved performance of MIS is now a reality. However, VR is only a training tool that must be thoughtfully introduced into a surgical training curriculum for it to successfully improve surgical technical skills. PMID:15650649

Assessing overall, technical, and scale efficiency among home health care agencies.

PubMed

Valdmanis, Vivian G; Rosko, Michael D; Leleu, Hervé; Mukamel, Dana B

2017-06-01

While home health care agencies (HHAs) play a vital role in the production of health, little research has been performed gauging their efficiency. Employing a robust approach to data envelopment analysis (DEA) we assessed overall, technical, and scale efficiency on a nationwide sample of HHAs. After deriving the three efficiency measures, we regressed these scores on a variety of environmental factors. We found that HHAs, on average, could proportionally reduce inputs by 28 % (overall efficiency), 23 % (technical efficiency) and 6 % (scale efficiency). For-profit ownership was positively associated with improvements in overall efficiency and technical efficiency and chain ownership was positively associated with global efficiency. There were also state-by-state variations on all the efficiency measures. As home health becomes an increasingly important player in the health care system, and its share of national health expenditures increases, it has become important to understand the cost structure of the industry and the potential for efficiencies. Therefore, further research is recommended as this sector continues to grow.

Technical performance and match-to-match variation in elite football teams.

PubMed

Liu, Hongyou; Gómez, Miguel-Angel; Gonçalves, Bruno; Sampaio, Jaime

2016-01-01

Recent research suggests that match-to-match variation adds important information to performance descriptors in team sports, as it helps measure how players fine-tune their tactical behaviours and technical actions to the extreme dynamical environments. The current study aims to identify the differences in technical performance of players from strong and weak teams and to explore match-to-match variation of players' technical match performance. Performance data of all the 380 matches of season 2012-2013 in the Spanish First Division Professional Football League were analysed. Twenty-one performance-related match actions and events were chosen as variables in the analyses. Players' technical performance profiles were established by unifying count values of each action or event of each player per match into the same scale. Means of these count values of players from Top3 and Bottom3 teams were compared and plotted into radar charts. Coefficient of variation of each match action or event within a player was calculated to represent his match-to-match variation of technical performance. Differences in the variation of technical performances of players across different match contexts (team and opposition strength, match outcome and match location) were compared. All the comparisons were achieved by the magnitude-based inferences. Results showed that technical performances differed between players of strong and weak teams from different perspectives across different field positions. Furthermore, the variation of the players' technical performance is affected by the match context, with effects from team and opposition strength greater than effects from match location and match outcome.

Advanced and innovative wind energy concept development: Dynamic inducer system, executive summary

NASA Astrophysics Data System (ADS)

Lissaman, P. B. S.; Zalay, A. D.; Hibbs, B. H.

1981-05-01

Concepts to improve the technical and economic performance of wind energy conversion systems (WECS) were examined. One technique for improving the cost-effectiveness of WECS is the use of tip vanes. Tip vanes are small airfoils attached approximately at right angles to the rotor tips with their span oriented approximately parallel to the local freestream. The performance benefits of the dynamic inducer tip vane system were demonstrated Tow-tests conducted on a three-bladed, 3.6-meter diameter rotor show that a dynamic inducer can achieve a power coefficient of 0.5, which exceeds that of a plain rotor by about 35%.

Spacecraft Multiple Array Communication System Performance Analysis

NASA Technical Reports Server (NTRS)

Hwu, Shian U.; Desilva, Kanishka; Sham, Catherine C.

2010-01-01

The Communication Systems Simulation Laboratory (CSSL) at the NASA Johnson Space Center is tasked to perform spacecraft and ground network communication system simulations, design validation, and performance verification. The CSSL has developed simulation tools that model spacecraft communication systems and the space and ground environment in which the tools operate. In this paper, a spacecraft communication system with multiple arrays is simulated. Multiple array combined technique is used to increase the radio frequency coverage and data rate performance. The technique is to achieve phase coherence among the phased arrays to combine the signals at the targeting receiver constructively. There are many technical challenges in spacecraft integration with a high transmit power communication system. The array combining technique can improve the communication system data rate and coverage performances without increasing the system transmit power requirements. Example simulation results indicate significant performance improvement can be achieved with phase coherence implementation.

The Relationship Between Technical Errors and Decision Making Skills in the Junior Resident

PubMed Central

Nathwani, J. N.; Fiers, R.M.; Ray, R.D.; Witt, A.K.; Law, K. E.; DiMarco, S.M.; Pugh, C.M.

2017-01-01

Objective The purpose of this study is to co-evaluate resident technical errors and decision-making capabilities during placement of a subclavian central venous catheter (CVC). We hypothesize that there will be significant correlations between scenario based decision making skills, and technical proficiency in central line insertion. We also predict residents will have problems in anticipating common difficulties and generating solutions associated with line placement. Design Participants were asked to insert a subclavian central line on a simulator. After completion, residents were presented with a real life patient photograph depicting CVC placement and asked to anticipate difficulties and generate solutions. Error rates were analyzed using chi-square tests and a 5% expected error rate. Correlations were sought by comparing technical errors and scenario based decision making. Setting This study was carried out at seven tertiary care centers. Participants Study participants (N=46) consisted of largely first year research residents that could be followed longitudinally. Second year research and clinical residents were not excluded. Results Six checklist errors were committed more often than anticipated. Residents performed an average of 1.9 errors, significantly more than the 1 error, at most, per person expected (t(44)=3.82, p<.001). The most common error was performance of the procedure steps in the wrong order (28.5%, P<.001). Some of the residents (24%) had no errors, 30% committed one error, and 46 % committed more than one error. The number of technical errors committed negatively correlated with the total number of commonly identified difficulties and generated solutions (r(33)= −.429, p=.021, r(33)= −.383, p=.044 respectively). Conclusions Almost half of the surgical residents committed multiple errors while performing subclavian CVC placement. The correlation between technical errors and decision making skills suggests a critical need to train residents in both technique and error management. ACGME Competencies Medical Knowledge, Practice Based Learning and Improvement, Systems Based Practice PMID:27671618

Patterns of technical error among surgical malpractice claims: an analysis of strategies to prevent injury to surgical patients.

PubMed

Regenbogen, Scott E; Greenberg, Caprice C; Studdert, David M; Lipsitz, Stuart R; Zinner, Michael J; Gawande, Atul A

2007-11-01

To identify the most prevalent patterns of technical errors in surgery, and evaluate commonly recommended interventions in light of these patterns. The majority of surgical adverse events involve technical errors, but little is known about the nature and causes of these events. We examined characteristics of technical errors and common contributing factors among closed surgical malpractice claims. Surgeon reviewers analyzed 444 randomly sampled surgical malpractice claims from four liability insurers. Among 258 claims in which injuries due to error were detected, 52% (n = 133) involved technical errors. These technical errors were further analyzed with a structured review instrument designed by qualitative content analysis. Forty-nine percent of the technical errors caused permanent disability; an additional 16% resulted in death. Two-thirds (65%) of the technical errors were linked to manual error, 9% to errors in judgment, and 26% to both manual and judgment error. A minority of technical errors involved advanced procedures requiring special training ("index operations"; 16%), surgeons inexperienced with the task (14%), or poorly supervised residents (9%). The majority involved experienced surgeons (73%), and occurred in routine, rather than index, operations (84%). Patient-related complexities-including emergencies, difficult or unexpected anatomy, and previous surgery-contributed to 61% of technical errors, and technology or systems failures contributed to 21%. Most technical errors occur in routine operations with experienced surgeons, under conditions of increased patient complexity or systems failure. Commonly recommended interventions, including restricting high-complexity operations to experienced surgeons, additional training for inexperienced surgeons, and stricter supervision of trainees, are likely to address only a minority of technical errors. Surgical safety research should instead focus on improving decision-making and performance in routine operations for complex patients and circumstances.

Virtual reality robotic surgery warm-up improves task performance in a dry laboratory environment: a prospective randomized controlled study.

PubMed

Lendvay, Thomas S; Brand, Timothy C; White, Lee; Kowalewski, Timothy; Jonnadula, Saikiran; Mercer, Laina D; Khorsand, Derek; Andros, Justin; Hannaford, Blake; Satava, Richard M

2013-06-01

Preoperative simulation warm-up has been shown to improve performance and reduce errors in novice and experienced surgeons, yet existing studies have only investigated conventional laparoscopy. We hypothesized that a brief virtual reality (VR) robotic warm-up would enhance robotic task performance and reduce errors. In a 2-center randomized trial, 51 residents and experienced minimally invasive surgery faculty in General Surgery, Urology, and Gynecology underwent a validated robotic surgery proficiency curriculum on a VR robotic simulator and on the da Vinci surgical robot (Intuitive Surgical Inc). Once they successfully achieved performance benchmarks, surgeons were randomized to either receive a 3- to 5-minute VR simulator warm-up or read a leisure book for 10 minutes before performing similar and dissimilar (intracorporeal suturing) robotic surgery tasks. The primary outcomes compared were task time, tool path length, economy of motion, technical, and cognitive errors. Task time (-29.29 seconds, p = 0.001; 95% CI, -47.03 to -11.56), path length (-79.87 mm; p = 0.014; 95% CI, -144.48 to -15.25), and cognitive errors were reduced in the warm-up group compared with the control group for similar tasks. Global technical errors in intracorporeal suturing (0.32; p = 0.020; 95% CI, 0.06-0.59) were reduced after the dissimilar VR task. When surgeons were stratified by earlier robotic and laparoscopic clinical experience, the more experienced surgeons (n = 17) demonstrated significant improvements from warm-up in task time (-53.5 seconds; p = 0.001; 95% CI, -83.9 to -23.0) and economy of motion (0.63 mm/s; p = 0.007; 95% CI, 0.18-1.09), and improvement in these metrics was not statistically significantly appreciated in the less-experienced cohort (n = 34). We observed significant performance improvement and error reduction rates among surgeons of varying experience after VR warm-up for basic robotic surgery tasks. In addition, the VR warm-up reduced errors on a more complex task (robotic suturing), suggesting the generalizability of the warm-up. Copyright © 2013 American College of Surgeons. All rights reserved.

Virtual Reality Robotic Surgery Warm-Up Improves Task Performance in a Dry Lab Environment: A Prospective Randomized Controlled Study

PubMed Central

Lendvay, Thomas S.; Brand, Timothy C.; White, Lee; Kowalewski, Timothy; Jonnadula, Saikiran; Mercer, Laina; Khorsand, Derek; Andros, Justin; Hannaford, Blake; Satava, Richard M.

2014-01-01

Background Pre-operative simulation “warm-up” has been shown to improve performance and reduce errors in novice and experienced surgeons, yet existing studies have only investigated conventional laparoscopy. We hypothesized a brief virtual reality (VR) robotic warm-up would enhance robotic task performance and reduce errors. Study Design In a two-center randomized trial, fifty-one residents and experienced minimally invasive surgery faculty in General Surgery, Urology, and Gynecology underwent a validated robotic surgery proficiency curriculum on a VR robotic simulator and on the da Vinci surgical robot. Once successfully achieving performance benchmarks, surgeons were randomized to either receive a 3-5 minute VR simulator warm-up or read a leisure book for 10 minutes prior to performing similar and dissimilar (intracorporeal suturing) robotic surgery tasks. The primary outcomes compared were task time, tool path length, economy of motion, technical and cognitive errors. Results Task time (-29.29sec, p=0.001, 95%CI-47.03,-11.56), path length (-79.87mm, p=0.014, 95%CI -144.48,-15.25), and cognitive errors were reduced in the warm-up group compared to the control group for similar tasks. Global technical errors in intracorporeal suturing (0.32, p=0.020, 95%CI 0.06,0.59) were reduced after the dissimilar VR task. When surgeons were stratified by prior robotic and laparoscopic clinical experience, the more experienced surgeons(n=17) demonstrated significant improvements from warm-up in task time (-53.5sec, p=0.001, 95%CI -83.9,-23.0) and economy of motion (0.63mm/sec, p=0.007, 95%CI 0.18,1.09), whereas improvement in these metrics was not statistically significantly appreciated in the less experienced cohort(n=34). Conclusions We observed a significant performance improvement and error reduction rate among surgeons of varying experience after VR warm-up for basic robotic surgery tasks. In addition, the VR warm-up reduced errors on a more complex task (robotic suturing) suggesting the generalizability of the warm-up. PMID:23583618

Technical Review of the Domestic Nuclear Detection Office Transformational and Applied Research Directorate’s Research and Development Program

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

Lavietes, Anthony; Trebes, James; Borchers, Robert

2013-01-01

At the request of the Domestic Nuclear Detection Office (DNDO), a Review Committee comprised of representatives from the American Physical Society (APS) Panel on Public Affairs (POPA) and the Institute of Electrical and Electronics Engineers (IEEE) Nuclear and Plasma Sciences Society (NPSS) performed a technical review of the DNDO Transformational and Applied Research Directorate (TARD) research and development program. TARD’s principal objective is to address gaps in the Global Nuclear Detection Architecture (GNDA) through improvements in the performance, cost, and operational burden of detectors and systems. The charge to the Review Committee was to investigate the existing TARD research andmore » development plan and portfolio, recommend changes to the existing plan, and recommend possible new R&D areas and opportunities. The Review Committee has several recommendations.« less

75 FR 27341 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... Market and Planning Efficiency Through Improved Software; Notice of Technical Conference To Discuss Increasing Market and Planning Efficiency Through Improved Software May 7, 2010. Take notice that Commission... planning efficiency through improved software. [[Page 27342

Improving the engineering-and-economical performance of ore-thermal electric furnaces in the smelting of silicomanganese

NASA Astrophysics Data System (ADS)

Kondrashov, V. P.; Pogrebisskiy, M. Ya; Lykov, A. G.; Rabinovich, V. L.; Bulgakov, A. S.

2018-02-01

Ways of increase of ore-heating electric furnaces, used for production of silicomanganese, engineering-and-economical performance are analyzed. Questions of data of the electric, thermal and technological modes of the furnace functioning collecting and processing for use in operation of an advanced control system of the furnace providing increase in technical and economic efficiency of technological process and an adaptability to quality of burden stock are considered.

The Efficiency and Budgeting of Public Hospitals: Case Study of Iran

PubMed Central

Yusefzadeh, Hasan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

2013-01-01

Background Hospitals are the most costly and important components of any health care system, so it is important to know their economic values, pay attention to their efficiency and consider factors affecting them. Objective The aim of this study was to assess the technical scale and economic efficiency of hospitals in the West Azerbaijan province of Iran, for which Data Envelopment Analysis (DEA) was used to propose a model for operational budgeting. Materials and Methods This study was a descriptive-analysis that was conducted in 2009 and had three inputs and two outputs. Deap2, 1 software was used for data analysis. Slack and radial movements and surplus of inputs were calculated for selected hospitals. Finally, a model was proposed for performance-based budgeting of hospitals and health sectors using the DEA technique. Results The average scores of technical efficiency, pure technical efficiency (managerial efficiency) and scale efficiency of hospitals were 0.584, 0.782 and 0.771, respectively. In other words the capacity of efficiency promotion in hospitals without any increase in costs and with the same amount of inputs was about 41.5%. Only four hospitals among all hospitals had the maximum level of technical efficiency. Moreover, surplus production factors were evident in these hospitals. Conclusions Reduction of surplus production factors through comprehensive planning based on the results of the Data Envelopment Analysis can play a major role in cost reduction of hospitals and health sectors. In hospitals with a technical efficiency score of less than one, the original and projected values of inputs were different; resulting in a surplus. Hence, these hospitals should reduce their values of inputs to achieve maximum efficiency and optimal performance. The results of this method was applied to hospitals a benchmark for making decisions about resource allocation; linking budgets to performance results; and controlling and improving hospitals performance. PMID:24349726

Sustainable hydropower in Lower Mekong Countries: Technical assessment and training travel report

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

Hadjerioua, Boualem; Witt, Adam M.

The U.S. Agency for International Development (USAID), through their partnership with the U.S. Department of the Interior (DOI), requested the support of Oak Ridge National Laboratory (ORNL) to provide specialized technical assistance as part of the Smart Infrastructure for the Mekong (SIM) Program in Thailand. Introduced in July 2013 by U.S. Secretary of State John Kerry, SIM is a U.S. Government Inter-Agency program that provides Lower Mekong partner countries with targeted, demand-driven technical and scientific assistance to support environmentally sound, climate conscious and socially equitable infrastructure, clean energy development, and water resources optimization. The U.S. Government is committed to supportingmore » sustainable economic development within the region by providing tools, best practices, technical assistance, and lessons learned for the benefit of partner countries. In response to a request from the Electricity Generating Authority of Thailand (EGAT), a SIM project was developed with two main activities: 1) to promote hydropower sustainability and efficiency through technical assessment training at two existing hydropower assets in Thailand, and 2) the design and implementation of one national and two or three regional science and policy workshops, to be co-hosted with EGAT, to build common understanding of and commitment to environmental and social safeguards for Mekong Basin hydropower projects. The U.S. Department of Energy (DOE) is leading the technical assessment (Activity 1), and has contracted ORNL to provide expert technical assistance focused on increasing efficiency at existing projects, with the goal of increasing renewable energy generation at little to no capital cost. ORNL is the leading national laboratory in hydropower analysis, with a nationally recognized and highly qualified team of scientists addressing small to large-scale systems (basin-, regional-, and national-scale) energy generation optimization analysis for DOE. The mission of the ORNL Water Power Program is to develop technologies, decision-support tools, and methods of analysis that enable holistic management of water-dependent energy infrastructure and natural resources in support of the DOE Energy Efficiency and Renewable Energy Office (DOE-EERE), Federal hydropower agencies, Federal Energy Regulatory Commission (FERC), Nuclear Regulatory Commission (NRC), energy producers, and other entities. In support of SIM, ORNL completed technical assessments of two hydropower plants owned and operated by the Electricity Generating Authority of Thailand (EGAT): Vajiralongkorn (VRK), with an installed capacity of 300 MW, and Rajjaprabha (RPB), with an installed capacity of 240MW. Technical assessment is defined as the assessment of hydropower operation and performance, and the identification of potential opportunities for performance improvement through plant optimization. At each plant, the assessment included an initial analysis of hydropower operating and performance metrics, provided by dam owners. After this analysis, ORNL engaged with the plant management team in a skills exchange, where best practices, operational methods, and technical challenges were discussed. The technical assessment process was outlined to plant management followed by a presentation of preliminary results and analysis based on 50 days of operational data. EGAT has agreed to provide a full year of operational data so a complete and detailed assessment that captures seasonal variability can be completed. The results of these assessments and discussions will be used to develop a set of best practices, training, and procedure recommendations to improve the efficiency of the two assessed plants« less

Performance Management and Optimization of Semiconductor Design Projects

NASA Astrophysics Data System (ADS)

Hinrichs, Neele; Olbrich, Markus; Barke, Erich

2010-06-01

The semiconductor industry is characterized by fast technological changes and small time-to-market windows. Improving productivity is the key factor to stand up to the competitors and thus successfully persist in the market. In this paper a Performance Management System for analyzing, optimizing and evaluating chip design projects is presented. A task graph representation is used to optimize the design process regarding time, cost and workload of resources. Key Performance Indicators are defined in the main areas cost, profit, resources, process and technical output to appraise the project.

The Collegiate Learning Assessment: Setting Standards for Performance at a College or University. Technical Report

ERIC Educational Resources Information Center

Hardison, Chaitra M.; Vilamovska, Anna-Marie

2009-01-01

The Collegiate Learning Assessment (CLA) is a measure of how much students' critical thinking improves after attending college or university. This report illustrates how institutions can set their own standards on the CLA using a method that is appropriate for the CLA's unique characteristics. The authors examined evidence of reliability and…

Isolating Attention Systems: A Cognitive-Anatomical Analysis. Cognitive Science Program, Technical Report No. 86-3.

ERIC Educational Resources Information Center

Posner, Michael I.; And Others

Recently, knowledge of the mechanisms of visual-spatial attention has improved due to studies employing single cell recording with alert monkeys and studies using performance analysis of neurological patients. These studies suggest that a complex neural network including parts of the posterior parietal lobe and midbrain are involved in covert…

The Captive Helicopter as a Training Device: Experimental Evaluation of a Concept. Technical Report 68-9.

ERIC Educational Resources Information Center

Caro, Paul W., Jr.; And Others

As part of the Army's effort to use synthetic devices to improve training, researchers evaluated a captive helicopter attached to a ground effects machine. Experimental groups received varying amounts of pre-flight practice tasks designed to develop flight skills, while control groups received no device training. Student flight performance during…

Performance Objectives, Task Analysis, Learning Content, Content Limits, and Domain Referenced Tests for the Agricultural Chemicals Catalog. Final Report.

ERIC Educational Resources Information Center

Hamilton, William; And Others

This document contains Indiana agricultural chemicals curriculum materials based on the Vocational-Technical Education Consortium of States (VTECS) Agricultural Chemicals Catalog. It is intended to improve preparation of high school and adult students for handling and using agricultural chemicals and for jobs as chemical salespersons or chemical…

Optimising boiler performance.

PubMed

Mayoh, Paul

2009-01-01

Soaring fuel costs continue to put the squeeze on already tight health service budgets. Yet it is estimated that combining established good practice with improved technologies could save between 10% and 30% of fuel costs for boilers. Paul Mayoh, UK technical manager at Spirax Sarco, examines some of the practical measures that healthcare organisations can take to gain their share of these potential savings.

Familiarity with Latin and Greek Anatomical Terms and Course Performance in Undergraduates

ERIC Educational Resources Information Center

Pampush, James D.; Petto, Andrew J.

2011-01-01

Commonly used technical anatomy and physiology (A&P) terms are predominantly rooted in Latin and Greek vocabulary, so it is commonly inferred that a solid grounding in Latin and Greek roots of medical terminology will improve student learning in anatomy and related disciplines. This study examines the association of etymological knowledge of…

Instance-Based Question Answering

DTIC Science & Technology

2006-12-01

answer clustering, composition, and scoring. Moreover, with the effort dedicated to improving monolingual system performance, system parameters are...text collections: document type, manual or automatic annotations (if any), and stylistic and notational differences in technical terms. Monolingual ...forum in which cross language retrieval systems and question answering systems are tested for various Eu- ropean languages. The CLEF QA monolingual task

Surgical videos for accident analysis, performance improvement, and complication prevention: time for a surgical black box?

PubMed

Gambadauro, Pietro; Magos, Adam

2012-03-01

Conventional audit of surgical records through review of surgical results provides useful knowledge but hardly helps identify the technical reasons lying behind specific outcomes or complications. Surgical teams not only need to know that a complication might happen but also how and when it is most likely to happen. Functional awareness is therefore needed to prevent complications, know how to deal with them, and improve overall surgical performance. The authors wish to argue that the systematic recording and reviewing of surgical videos, a "surgical black box," might improve surgical care, help prevent complications, and allow accident analysis. A possible strategy to test this hypothesis is presented and discussed. Recording and reviewing surgical interventions, apart from helping us achieve functional awareness and increasing the safety profile of our performance, allows us also to effectively share our experience with colleagues. The authors believe that those potential implications make this hypothesis worth testing.

Simulation experience enhances physical therapist student confidence in managing a patient in the critical care environment.

PubMed

Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael

2013-02-01

Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high student satisfaction. Using simulation, students were introduced to the critical care environment, which may increase interest in working in this practice area.

The evolution of the Italian EPR system for the management of household Waste Electrical and Electronic Equipment (WEEE). Technical and economic performance in the spotlight.

PubMed

Favot, Marinella; Veit, Raphael; Massarutto, Antonio

2016-10-01

In this paper we analyse the Italian collective system for the management of household Waste Electrical and Electronic Equipment (WEEE), and its evolution over time, following the European Directives on WEEE, which include the Extended Producer Responsibility (EPR). The analysis focuses on the technical and economic performance of WEEE compliance organisations (consortia), as they are the key players in the Italian EPR regime. Economic results have not usually been provided in previous studies, due to the lack of available data. This study overcomes this problem by accessing the financial statements for the years 2009-2014 of all consortia. The main conclusions of the study are: The Italian EPR system barely exceeded the technical target of the first WEEE Directive (4kg per capita). Improvements are necessary to achieve the target set for 2019 by the Recast Directive. The economic performance of the Italian EPR regime improved significantly over time. The fees charged per tonne of WEEE collected decreased by almost 43% from 652 Euro per tonne in 2009 to 374 Euro per tonne in 2014, while the fees per tonne put on the market (POM) were 134 Euro in 2009 and 104 Euro in 2014. The results prove the theory which states that, competing consortia use the learning effects to reduce the contribution fees for producers rather than to increase the quantity collected. Municipalities remain the most important actor in WEEE collection operations. Consortia compensate municipalities with a reimbursement that ranges between 28 and 38 Euros per tonne collected. These repayments cover only partially their costs. Additional studies should investigate their role. Copyright © 2016 Elsevier Ltd. All rights reserved.

A decade of imaging surgeons' brain function (part II): A systematic review of applications for technical and nontechnical skills assessment.

PubMed

Modi, Hemel Narendra; Singh, Harsimrat; Yang, Guang-Zhong; Darzi, Ara; Leff, Daniel Richard

2017-11-01

Functional neuroimaging technologies enable assessment of operator brain function and can deepen our understanding of skills learning, ergonomic optima, and cognitive processes in surgeons. Although there has been a critical mass of data detailing surgeons' brain function, this literature has not been reviewed systematically. A systematic search of original neuroimaging studies assessing surgeons' brain function and published up until November 2016 was conducted using Medline, Embase, and PsycINFO databases. Twenty-seven studies fulfilled the inclusion criteria, including 3 feasibility studies, 14 studies exploring the neural correlates of technical skill acquisition, and the remainder investigating brain function in the context of intraoperative decision-making (n = 1), neurofeedback training (n = 1), robot-assisted technology (n = 5), and surgical teaching (n = 3). Early stages of learning open surgical tasks (knot-tying) are characterized by prefrontal cortical activation, which subsequently attenuates with deliberate practice. However, with complex laparoscopic skills (intracorporeal suturing), prefrontal cortical engagement requires substantial training, and attenuation occurs over a longer time course, after years of refinement. Neurofeedback and interventions that improve neural efficiency may enhance technical performance and skills learning. Imaging surgeons' brain function has identified neural signatures of expertise that might help inform objective assessment and selection processes. Interventions that improve neural efficiency may target skill-specific brain regions and augment surgical performance. Copyright © 2017 Elsevier Inc. All rights reserved.

Hemodiafiltration: Technical and Clinical Issues.

PubMed

Ronco, Claudio

2015-01-01

Hemodiafiltration (HDF) seems to represent the gold standard in the field of replacement of renal function by dialysis. High convective fluxes have been correlated with better clinical outcomes. Sometimes, however, there are technical barriers to the achievement of high blood flows adequate to perform effective convective therapies. In spite of optimized procedures, the progressive increase in transmembrane pressure (TMP), the blood viscosity due to hemoconcentration and blood path resistance sometimes becomes inevitable. We propose two possible solutions that can be operated automatically via specific software in the dialysis machine: predilution on demand and backflush on demand. Predilution on demand consists in an automatic feedback of the machine, diverting part of the filtered dialysate into a predilution mode with an infusion of 200 ml in 30 s while the ultrafiltration pump stops. This produces a sudden hemodilution with a return of the parameters to acceptable values. The performance of the filter improves, and the pressure alterations are mitigated. Backflush on demand consists in an automatic feedback of the machine triggered by the TMP control, producing a positive pressure in the dialysate compartment due to a stop of filtration and rapid infusion of at least 100 ml of ultrapure dialysate into the hollow fiber. This not only produces a significant hemodilution, but also backflushes the membrane pores detaching protein layers and improving membrane permeability. These are two examples of how technology will permit to overcome technical barriers to a widespread diffusion of HDF and adequate convective dose delivery. © 2015 S. Karger AG, Basel.

Procurement engineering - the productivity factor

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

Bargerstock, S.B.

1993-01-01

The industry is several years on the road to implementation of the Nuclear Management and Resources Council (NUMARC) initiatives on commercial-grade item dedication and procurement. Utilities have taken several approaches to involve engineering in the procurement process. A common result for the approaches is the additional operations and maintenance (O M) cost imposed by the added resource requirements. Procurement engineering productivity is a key element in controlling this business area. Experience shows that 400 to 500% improvements in productivity are possible with a 2-yr period. Improving the productivity of the procurement engineering function is important in today's competitive utility environment.more » Procurement engineering typically involves four distinct technical evaluation responsibilities along with several administrative areas. Technical evaluations include the functionally based safety classification of replacement components and parts (lacking a master parts list), the determination of dedication requirements for safety-related commercial-grade items, the preparation of a procurement specification to maintain the licensed design bases, and the equivalency evaluation of alternate items not requiring the design-change process. Administrative duties include obtaining technical review of vendor-supplied documentation, identifying obsolete parts and components, resolving material nonconformances, initiating the design-change process for replacement items (as needed), and providing technical support to O M. Although most utilities may not perform or require all the noted activities, a large percentage will apply to each utility station.« less

The role of simulation training in anesthesiology resident education.

PubMed

Yunoki, Kazuma; Sakai, Tetsuro

2018-06-01

An increasing number of reports indicate the efficacy of simulation training in anesthesiology resident education. Simulation education helps learners to acquire clinical skills in a safe learning environment without putting real patients at risk. This useful tool allows anesthesiology residents to obtain medical knowledge and both technical and non-technical skills. For faculty members, simulation-based settings provide the valuable opportunity to evaluate residents' performance in scenarios including airway management and regional, cardiac, and obstetric anesthesiology. However, it is still unclear what types of simulators should be used or how to incorporate simulation education effectively into education curriculums. Whether simulation training improves patient outcomes has not been fully determined. The goal of this review is to provide an overview of the status of simulation in anesthesiology resident education, encourage more anesthesiologists to get involved in simulation education to propagate its influence, and stimulate future research directed toward improving resident education and patient outcomes.

The Candela and Photometric and Radiometric Measurements

PubMed Central

Parr, Albert C.

2001-01-01

The national measurement system for photometric and radiometric quantities is presently based upon techniques that make these quantities traceable to a high-accuracy cryogenic radiometer. The redefinition of the candela in 1979 provided the opportunity for national measurement laboratories to base their photometric measurements on optical detector technology rather than on the emission from high-temperature blackbody optical sources. The ensuing technical developments of the past 20 years, including the significant improvements in cryogenic radiometer performance, have provided the opportunity to place the fundamental maintenance of photometric quantities upon absolute detector based technology as was allowed by the 1979 redefinition. Additionally, the development of improved photodetectors has had a significant impact on the methodology in most of the radiometric measurement areas. This paper will review the status of the NIST implementation of the technical changes mandated by the 1979 redefinition of the candela and its effect upon the maintenance and dissemination of optical radiation measurements. PMID:27500020

The MAMMOTH project

NASA Technical Reports Server (NTRS)

Gerchar, Tim

1994-01-01

On the surface MAMMOTH is a high performance 5.25-inch half-high 8mm helical scan tape drive that records a native 20 Gigabytes of data on Advanced Metal Evaporated media at a sustained throughput of 3 Megabyte per second over a high speed SCSI interface, that is scheduled for production in the second half of 1995. But it's much more than that. Inside its custom designed sheet metal enclosure lies one of the greatest technical achievements of its kind. Exabyte's strategic direction is to increase throughput and capacity while continuing to improve drive, data and media reliability to its products. MAMMOTH adheres to that direction and the description of its technical advances is described in this paper. MAMMOTH can be broken down into four main functional assemblies: high-performance integrated digital electronics, high-reliability tape transport mechanism, high-performance scanner, and advanced metal evaporated media. All this technology is packaged into a standard 5.25-inch half-high form factor that dissipates only 15 watts.

A Technical Analysis Information Fusion Approach for Stock Price Analysis and Modeling

NASA Astrophysics Data System (ADS)

Lahmiri, Salim

In this paper, we address the problem of technical analysis information fusion in improving stock market index-level prediction. We present an approach for analyzing stock market price behavior based on different categories of technical analysis metrics and a multiple predictive system. Each category of technical analysis measures is used to characterize stock market price movements. The presented predictive system is based on an ensemble of neural networks (NN) coupled with particle swarm intelligence for parameter optimization where each single neural network is trained with a specific category of technical analysis measures. The experimental evaluation on three international stock market indices and three individual stocks show that the presented ensemble-based technical indicators fusion system significantly improves forecasting accuracy in comparison with single NN. Also, it outperforms the classical neural network trained with index-level lagged values and NN trained with stationary wavelet transform details and approximation coefficients. As a result, technical information fusion in NN ensemble architecture helps improving prediction accuracy.

Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

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

Hewes, Tom; Peeks, Brady

2013-11-01

The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in themore » manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50 percent over typical manufactured homes produced in the northwest.« less

Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

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

Hewes, Tom; Peeks, Brady

2013-11-01

The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in themore » manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50% over typical manufactured homes produced in the northwest.« less

The fractured landscape of RNA-seq alignment: the default in our STARs.

PubMed

Ballouz, Sara; Dobin, Alexander; Gingeras, Thomas R; Gillis, Jesse

2018-06-01

Many tools are available for RNA-seq alignment and expression quantification, with comparative value being hard to establish. Benchmarking assessments often highlight methods' good performance, but are focused on either model data or fail to explain variation in performance. This leaves us to ask, what is the most meaningful way to assess different alignment choices? And importantly, where is there room for progress? In this work, we explore the answers to these two questions by performing an exhaustive assessment of the STAR aligner. We assess STAR's performance across a range of alignment parameters using common metrics, and then on biologically focused tasks. We find technical metrics such as fraction mapping or expression profile correlation to be uninformative, capturing properties unlikely to have any role in biological discovery. Surprisingly, we find that changes in alignment parameters within a wide range have little impact on both technical and biological performance. Yet, when performance finally does break, it happens in difficult regions, such as X-Y paralogs and MHC genes. We believe improved reporting by developers will help establish where results are likely to be robust or fragile, providing a better baseline to establish where methodological progress can still occur.

Software Engineering Improvement Activities/Plan

NASA Technical Reports Server (NTRS)

2003-01-01

bd Systems personnel accomplished the technical responsibilities for this reporting period, as planned. A close working relationship was maintained with personnel of the MSFC Avionics Department Software Group (ED14). Work accomplishments included development, evaluation, and enhancement of a software cost model, performing literature search and evaluation of software tools available for code analysis and requirements analysis, and participating in other relevant software engineering activities. Monthly reports were submitted. This support was provided to the Flight Software Group/ED 1 4 in accomplishing the software engineering improvement engineering activities of the Marshall Space Flight Center (MSFC) Software Engineering Improvement Plan.

A conceptual model to empower software requirements conflict detection and resolution with rule-based reasoning

NASA Astrophysics Data System (ADS)

Ahmad, Sabrina; Jalil, Intan Ermahani A.; Ahmad, Sharifah Sakinah Syed

2016-08-01

It is seldom technical issues which impede the process of eliciting software requirements. The involvement of multiple stakeholders usually leads to conflicts and therefore the need of conflict detection and resolution effort is crucial. This paper presents a conceptual model to further improve current efforts. Hence, this paper forwards an improved conceptual model to assist the conflict detection and resolution effort which extends the model ability and improves overall performance. The significant of the new model is to empower the automation of conflicts detection and its severity level with rule-based reasoning.

Percutaneous Coronary Revascularization for Chronic Total Occlusions: A Novel Predictive Score of Technical Failure Using Advanced Technologies.

PubMed

Galassi, Alfredo R; Boukhris, Marouane; Azzarelli, Salvatore; Castaing, Marine; Marzà, Francesco; Tomasello, Salvatore D

2016-05-09

The aims of this study were to describe the 10-year experience of a single operator dedicated to chronic total occlusion (CTO) and to establish a model for predicting technical failure. During the last decade, the interest in percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) has increased, allowing the improvement of success rate. One thousand nineteen patients with CTO underwent 1,073 CTO procedures performed by a single CTO-dedicated operator. The study population was subdivided into 2 groups by time period: period 1 (January 2005 to December 2009, n = 378) and period 2 (January 2010 to December 2014, n = 641). Observations were randomly assigned to a derivation set and a validation set (in a 2:1 ratio). A prediction score was established by assigning points for each independent predictor of technical failure in the derivation set according to the beta coefficient and summing all points accrued. Lesions attempted in period 2 were more complex in comparison with those in period 1. Compared with period 1, both technical and clinical success rates significantly improved (from 87.8% to 94.4% [p = 0.001] and from 77.6% to 89.9% [p < 0.001], respectively). A prediction score for technical failure including age ≥75 years (1 point), ostial location (1 point), and collateral filling Rentrop grade <2 (2 points) was established, stratifying procedures into 4 difficulty groups: easy (0), intermediate (1), difficult (2), and very difficult (3 or 4), with decreasing technical success rates. In derivation and validation sets, areas under the curve were comparable (0.728 and 0.772, respectively). With growing expertise, the success rate has increased despite increasing complexity of attempted lesions. The established model predicted the probability of technical failure and thus might be applied to grading the difficulty of CTO procedures. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians.

PubMed

Myers, J A; Powell, D M C; Aldington, S; Sim, D; Psirides, A; Hathaway, K; Haney, M F

2017-11-01

The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design). Trained assessors blinded to participants' fatigue status performed detailed structured assessments based on expected behaviours in four non-technical skills domains: teamwork, situational awareness, task management, and decision making. Participants also provided self-ratings of their performance. The primary endpoint was the sum score of overall non-technical performance. The main finding, the overall non-technical skills performance rating of the clinicians, was better in rested than fatigued states (mean difference with 95% CI, 2.8 [2.2-3.4]). The findings remained consistent across individual non-technical skills domains; also when controlling for an order effect and examining the impact of a number of possible covariates. There was no difference in self-ratings of clinical performance between rested and fatigued states. Non-technical performance of critical care air transfer clinicians is degraded when they are fatigued. Fatigued clinicians may fail to recognise the degree to which their performance is compromised. These findings represent risk to clinical care quality and patient safety in the dynamic and isolated environment of air ambulance transfer. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

42 CFR 493.1413 - Standard; Technical consultant responsibilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... consultant responsibilities. The technical consultant is responsible for the technical and scientific... of performance of instrument maintenance and function checks; (v) Assessment of test performance...

42 CFR 493.1413 - Standard; Technical consultant responsibilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... consultant responsibilities. The technical consultant is responsible for the technical and scientific... of performance of instrument maintenance and function checks; (v) Assessment of test performance...

Current state and future direction of computer systems at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Rogers, James L. (Editor); Tucker, Jerry H. (Editor)

1992-01-01

Computer systems have advanced at a rate unmatched by any other area of technology. As performance has dramatically increased there has been an equally dramatic reduction in cost. This constant cost performance improvement has precipitated the pervasiveness of computer systems into virtually all areas of technology. This improvement is due primarily to advances in microelectronics. Most people are now convinced that the new generation of supercomputers will be built using a large number (possibly thousands) of high performance microprocessors. Although the spectacular improvements in computer systems have come about because of these hardware advances, there has also been a steady improvement in software techniques. In an effort to understand how these hardware and software advances will effect research at NASA LaRC, the Computer Systems Technical Committee drafted this white paper to examine the current state and possible future directions of computer systems at the Center. This paper discusses selected important areas of computer systems including real-time systems, embedded systems, high performance computing, distributed computing networks, data acquisition systems, artificial intelligence, and visualization.

Defense Information Systems Agency Technical Integration Support (DISA- TIS). MUMPS Study.

DTIC Science & Technology

1993-01-01

usable in DoD, MUMPS must continue to improve in its support of DoD and OSE standards such as SQL , X-Windows, POSIX, PHIGS, etc. MUMPS and large AlSs...Language ( SQL ), X-Windows, and Graphical Kernel Services (GKS)) 2.2.2.3 FIPS Adoption by NIST The National Institute of Standards and Technology (NIST...many of the performance tuning mechanisms that must be performed explicitly with other systems. The VA looks forward to the SQL binding (1993 ANS) that

A feedback intervention to increase digital and paper checklist performance in technically advanced aircraft simulation.

PubMed

Rantz, William G; Van Houten, Ron

2011-01-01

This study examined whether pilots operating a flight simulator completed digital or paper flight checklists more accurately after receiving postflight graphic and verbal feedback. The dependent variable was the number of checklist items completed correctly per flight. Following treatment, checklist completion with paper and digital checklists increased from 38% and 39%, respectively, to nearly 100% and remained close to 100% after feedback and praise for improvement were withdrawn. Performance was maintained at or near 100% during follow-up probes.

Performance indicators for the efficiency analysis of urban drainage systems.

PubMed

Artina, S; Becciu, G; Maglionico, M; Paoletti, A; Sanfilippo, U

2005-01-01

Performance indicators implemented in a decision support system (DSS) for the technical, managerial and economic evaluation of urban drainage systems (UDS), called MOMA FD, are presented. Several kinds of information are collected and processed by MOMA FD to evaluate both present situation and future scenarios of development and enhancement. Particular interest is focused on the evaluation of the environmental impact, which is considered a very relevant factor in the decision making process to identify the priorities for UDS improvements.

Systematic review and meta-analysis of the role of mental training in the acquisition of technical skills in surgery.

PubMed

Rao, Ahsan; Tait, Ian; Alijani, Afshin

2015-09-01

Mental training is rehearsal of mental imagery without physically performing the task. The aim of the study was to perform systematic review and meta-analysis on all the available data to evaluate the role of mental training in the acquisition of surgical technical skills. The following search databases were used: EMBASE, MEDLINE, Web of Science, Clinicaltrials.gov.uk, SIGN guidelines, NICE guidelines, and Cochrane review register. Meta-analysis was performed using Revman 5.2 statistical software. There were a total of 9 randomized controlled trials with 474 participants, of which 189 participants received mental training. Five randomized controlled trials concluded positive impact of mental training. Mental training group did not show any significant improvement in overall performance of the task carried in each study (P = .06). Mental training can be used as an important supplementary tool in learning surgical skills when run in parallel with physical training and applied to trainees with some experience of the skill. Copyright © 2015 Elsevier Inc. All rights reserved.

Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

PubMed

Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

2015-03-01

The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence doing procedures and 29 of 37 (78%) reported knowing when the procedure should be applied. Oxford Non-Technical Skills evaluation demonstrated significant improvement in PGY 2 resident performance assessed during the 2 study periods: communication score increased from 3 to 3.71 (P=.01), leadership score increased from 2.77 to 3.86 (P<.001), teamwork score increased from 3.15 to 3.86 (P=.007), and procedural ability score increased from 2.23 to 3.43 (P=.03). There were no statistically significant improved scores in PGY 2 decision making or situation awareness. No improvements in skills were seen among PGY 1 participants. The PGY 2 residents improved their skills, but the PGY 1 residents did not. Participants found interprofessional simulations to be realistic and a valuable educational tool. Interprofessional simulation provides a valuable means of educating surgical residents and evaluating their skills in real-life clinical scenarios.

Bioethics for Technical Experts

NASA Astrophysics Data System (ADS)

Asano, Shigetaka

Along with rapidly expanding applications of life science and technology, technical experts have been implicated more and more often with ethical, social, and legal problems than before. It should be noted that in this background there are scientific and social uncertainty elements which are inevitable during the progress of life science in addition to the historically-established social unreliability to scientists and engineers. In order to solve these problems, therefore, we should establish the social governance with ‘relief’ and ‘reliance’ which enables for both citizens and engineers to share the awareness of the issues, to design social orders and criterions based on hypothetical sense of values for bioethics, to carry out practical use management of each subject carefully, and to improve the sense of values from hypothetical to universal. Concerning these measures, the technical experts can learn many things from the present performance in the medical field.

The technical consideration of multi-beam mask writer for production

NASA Astrophysics Data System (ADS)

Lee, Sang Hee; Ahn, Byung-Sup; Choi, Jin; Shin, In Kyun; Tamamushi, Shuichi; Jeon, Chan-Uk

2016-10-01

Multi-beam mask writer is under development to solve the throughput and patterning resolution problems in VSB mask writer. Theoretically, the writing time is appropriate for future design node and the resolution is improved with multi-beam mask writer. Many previous studies show the feasible results of resolution, CD control and registration. Although such technical results of development tool seem to be enough for mass production, there are still many unexpected problems for real mass production. In this report, the technical challenges of multi-beam mask writer are discussed in terms of production and application. The problems and issues are defined based on the performance of current development tool compared with the requirements of mask quality. Using the simulation and experiment, we analyze the specific characteristics of electron beam in multi-beam mask writer scheme. Consequently, we suggest necessary specifications for mass production with multi-beam mask writer in the future.

Laparoscopic Ultrasound-Guided Radiofrequency Ablation of Uterine Fibroids

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

Milic, Andrea; Asch, Murray R.; Hawrylyshyn, Peter A.

Four patients with symptomatic uterine fibroids measuring less than 6 cm underwent laparoscopic ultrasound-guided radiofrequency ablation (RFA) using multiprobe-array electrodes. Follow-up of the treated fibroids was performed with gadolinium-enhanced magnetic resonance imaging (MRI) and patients' symptoms were assessed by telephone interviews. The procedure was initially technically successful in 3 of the 4 patients and MRI studies at 1 month demonstrated complete fibroid ablation. Symptom improvement, including a decrease in menstrual bleeding and pain, was achieved in 2 patients at 3 months. At 7 months, 1 of these 2 patients experienced symptom worsening which correlated with recurrent fibroid on MRI. Themore » third, initially technically successfully treated patient did not experience any symptom relief after the procedure and was ultimately diagnosed with adenomyosis. Our preliminary results suggest that RFA is a technically feasible treatment for symptomatic uterine fibroids in appropriately selected patients.« less

Robotic virtual reality simulation plus standard robotic orientation versus standard robotic orientation alone: a randomized controlled trial.

PubMed

Vaccaro, Christine M; Crisp, Catrina C; Fellner, Angela N; Jackson, Christopher; Kleeman, Steven D; Pavelka, James

2013-01-01

The objective of this study was to compare the effect of virtual reality simulation training plus robotic orientation versus robotic orientation alone on performance of surgical tasks using an inanimate model. Surgical resident physicians were enrolled in this assessor-blinded randomized controlled trial. Residents were randomized to receive either (1) robotic virtual reality simulation training plus standard robotic orientation or (2) standard robotic orientation alone. Performance of surgical tasks was assessed at baseline and after the intervention. Nine of 33 modules from the da Vinci Skills Simulator were chosen. Experts in robotic surgery evaluated each resident's videotaped performance of the inanimate model using the Global Rating Scale (GRS) and Objective Structured Assessment of Technical Skills-modified for robotic-assisted surgery (rOSATS). Nine resident physicians were enrolled in the simulation group and 9 in the control group. As a whole, participants improved their total time, time to incision, and suture time from baseline to repeat testing on the inanimate model (P = 0.001, 0.003, <0.001, respectively). Both groups improved their GRS and rOSATS scores significantly (both P < 0.001); however, the GRS overall pass rate was higher in the simulation group compared with the control group (89% vs 44%, P = 0.066). Standard robotic orientation and/or robotic virtual reality simulation improve surgical skills on an inanimate model, although this may be a function of the initial "practice" on the inanimate model and repeat testing of a known task. However, robotic virtual reality simulation training increases GRS pass rates consistent with improved robotic technical skills learned in a virtual reality environment.

77 FR 19280 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... Market and Planning Efficiency Through Improved Software; Notice of Technical Conference: Increasing Real-Time and Day- Ahead Market Efficiency Through Improved Software Take notice that Commission staff will...-time and day-ahead market efficiency through improved software. A detailed agenda with the list of and...

76 FR 28022 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-13

... Market and Planning Efficiency Through Improved Software; Notice of Technical Conference: Increasing Real-Time and Day- Ahead Market Efficiency Through Improved Software Take notice that Commission staff will... for increasing real-time and day-ahead market efficiency through improved software. This conference...

Do PICU patients meet technical criteria for performing indirect calorimetry?

PubMed

Beggs, Megan R; Garcia Guerra, Gonzalo; Larsen, Bodil M K

2016-10-01

Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown. In the current study, we aimed to quantify the daily proportion of consecutive PICU patients who met technical criteria to perform indirect calorimetry and describe the technical contraindications when criteria were not met. Prospective, observational, single-centre study conducted in a cardiac and general PICU. All consecutive patients admitted for at least 96 h were included in the study. Variables collected for each patient included age at admission, admission diagnosis, and if technical criteria for indirect calorimetry were met. Technical criteria variables were collected within the same 2 h each morning and include: provision of supplemental oxygen, ventilator settings, endotracheal tube (ETT) leak, diagnosis of chest tube air leak, provision of external gas support (i.e. nitric oxide), and provision of extracorporeal membrane oxygenation (ECMO). 288 patients were included for a total of 3590 patient days between June 2014 and February 2015. The main reasons for admission were: surgery (cardiac and non-cardiac), respiratory distress, trauma, oncology and medicine/other. The median (interquartile range) patient age was 0.7 (0.3-4.6) years. The median length of PICU stay was 7 (5-14) days. Only 34% (95% CI, 32.4-35.5%) of patient days met technical criteria for IC. For patients less than 6 months of age, technical criteria were met on significantly fewer patient days (29%, p < 0.01). Moreover, 27% of patients did not meet technical criteria for IC on any day during their PICU stay. Most frequent reasons for why IC could not be performed included supplemental oxygen, ECMO, and ETT leak. In the current study, technical criteria to perform IC in the PICU were not met for 27% of patients and were not met on 66% of patient days. Moreover, criteria were met on only 29% of days for infants 6 months and younger where children 24 months of age and older still only met criteria on 40% of patient days. This data represents a major gap in the feasibility of current recommendations for assessing energy requirements of this population. Future studies are needed to improve methods of predicting and measuring energy requirements in critically ill children who do not meet current criteria for indirect calorimetry. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Is the technical performance of young soccer players influenced by hormonal status, sexual maturity, anthropometric profile, and physical performance?

PubMed

Moreira, Alexandre; Massa, Marcelo; Thiengo, Carlos R; Rodrigues Lopes, Rafael Alan; Lima, Marcelo R; Vaeyens, Roel; Barbosa, Wesley P; Aoki, Marcelo S

2017-12-01

The aim of this study was to examine the influence of hormonal status, anthropometric profile, sexual maturity level, and physical performance on the technical abilities of 40 young male soccer players during small-sided games (SSGs). Anthropometric profiling, saliva sampling, sexual maturity assessment (Tanner scale), and physical performance tests (Yo-Yo and vertical jumps) were conducted two weeks prior to the SSGs. Salivary testosterone was determined by the enzyme-linked immunosorbent assay method. Technical performance was determined by the frequency of actions during SSGs. Principal component analyses identified four technical actions of importance: total number of passes, effectiveness, goal attempts, and total tackles. A multivariate canonical correlation analysis was then employed to verify the prediction of a multiple dependent variables set (composed of four technical actions) from an independent set of variables, composed of testosterone concentration, stage of pubic hair and genitalia development, vertical jumps and Yo-Yo performance. A moderate-to-large relationship between the technical performance set and the independent set was observed. The canonical correlation was 0.75 with a canonical R 2 of 0.45. The highest structure coefficient in the technical performance set was observed for tackles (0.77), while testosterone presented the highest structure coefficient (0.75) for the variables of the independent set. The current data suggest that the selected independent set of variables might be useful in predicting SSG performance in young soccer players. Coaches should be aware that physical development plays a key role in technical performance to avoid decision-making mistakes during the selection of young players.

IGF-I and GH: potential use in gene doping.

PubMed

Harridge, Stephen D R; Velloso, Cristiana P

2009-08-01

Gene doping is the term given to the potential misuse of gene therapy for the purposes of enhancing athletic performance. Insulin like growth factor-I (IGF-I), the prime target of growth hormone action, is one candidate gene for improving performance. In recent years a number of transgenic and somatic gene transfer studies on animals have shown that upregulation of IGF-I stimulates muscle growth and improves function. This increase in muscle IGF-I is not reflected in measurable increases in circulating IGF-I. Whilst the responses obtained in the animal studies would appear to give clear benefits for performance, the transfer of such techniques to humans still presents many technical challenges. Further challenges will also be faced by the anti doping authorities in detecting the endogenously produced products of enhanced gene expression.

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

Nichols, T.

The Nuclear Forensics Analysis Center (NFAC) is part of Savannah River National Laboratory (SRNL) and is one of only two USG National Laboratories accredited to perform nuclear forensic analyses to the requirements of ISO 17025. SRNL NFAC is capable of analyzing nuclear and radiological samples from bulk material to ultra-trace samples. NFAC provides analytical support to the FBI's Radiological Evidence Examination Facility (REEF), which is located within SRNL. REEF gives the FBI the capability to perform traditional forensics on material that is radiological and/or is contaminated. SRNL is engaged in research and development efforts to improve the USG technical nuclearmore » forensics capabilities. Research includes improving predictive signatures and developing a database containing comparative samples.« less

Video-assisted palatopharyngeal surgery: a model for improved education and training.

PubMed

Allori, Alexander C; Marcus, Jeffrey R; Daluvoy, Sanjay; Bond, Jennifer

2014-09-01

Objective : The learning process for intraoral procedures is arguably more difficult than for other surgical procedures because of the assistant's severely limited visibility. Consequently, trainees may not be able to adequately see and follow all steps of the procedure, and attending surgeons may be less willing to entrust trainees with critical portions of the procedure. In this report, we propose a video-assisted approach to intraoral procedures that improves lighting, visibility, and potential for effective education and training. Design : Technical report (idea/innovation). Setting : Tertiary referral hospital. Patients : Children with cleft palate and velopharyngeal insufficiency requiring surgery. Interventions : Video-assisted palatoplasty, sphincteroplasty, and pharyngoplasty. Main Outcome Measures : Qualitative and semiquantitative educational outcomes, including learner perception regarding "real-time" (video-assisted surgery) and "non-real-time" (video-library-based) surgical education. Results : Trainees were strongly in favor of the video-assisted modality in "real-time" surgical training. Senior trainees identified more opportunities in which they had been safely entrusted to perform critical portions of the procedure, corresponding with satisfaction with the learning process scores, and they showed greater comfort/confidence scores related to performing the procedure under supervision and alone. Conclusions : Adoption of the video-assisted approach can be expected to markedly improve the learning curve for surgeons in training. This is now standard practice at our institution. We are presently conducting a full educational technology assessment to better characterize the effect on knowledge acquisition and technical improvement.

48 CFR 1852.242-70 - Technical direction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Direction (SEP 1993) (a) Performance of the work under this contract is subject to the written technical... the Contracting Officer in writing in accordance with NASA FAR Supplement 1842.270. “Technical... in writing by the COTR. (d) The Contractor shall proceed promptly with the performance of technical...

Orthology prediction methods: A quality assessment using curated protein families

PubMed Central

Trachana, Kalliopi; Larsson, Tomas A; Powell, Sean; Chen, Wei-Hua; Doerks, Tobias; Muller, Jean; Bork, Peer

2011-01-01

The increasing number of sequenced genomes has prompted the development of several automated orthology prediction methods. Tests to evaluate the accuracy of predictions and to explore biases caused by biological and technical factors are therefore required. We used 70 manually curated families to analyze the performance of five public methods in Metazoa. We analyzed the strengths and weaknesses of the methods and quantified the impact of biological and technical challenges. From the latter part of the analysis, genome annotation emerged as the largest single influencer, affecting up to 30% of the performance. Generally, most methods did well in assigning orthologous group but they failed to assign the exact number of genes for half of the groups. The publicly available benchmark set (http://eggnog.embl.de/orthobench/) should facilitate the improvement of current orthology assignment protocols, which is of utmost importance for many fields of biology and should be tackled by a broad scientific community. PMID:21853451

Sustaining global progress in E and P health, safety, and environment

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

Arscott, R.L.; Edwardes, R.J.; Ognedal, M.

1996-12-01

The third International Conference on Health, Safety and Environment (HSE) was held in New Orleans in June 1996. During this meeting, the technical committee members were asked to complete a questionnaire with two questions: (1) What are the three biggest improvements in the industry`s performance in the HSE function over the past 5 years? and (2) What are the three biggest challenges for the next 5 years? The results from 30 replies from industry experts were compared with a similar survey conducted at the 1991 meeting, where the question was, What are the key action items the industry should takemore » to enhance performance over the next decade? This article gives the most frequently occurring comments cited by the 1996 technical committee relating to the 1991 recommendations. This may be considered a mid-decade review of worldwide E and P progress.« less

48 CFR 216.402-2 - Technical performance incentives.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Technical performance incentives. 216.402-2 Section 216.402-2 Federal Acquisition Regulations System DEFENSE ACQUISITION... Contracts 216.402-2 Technical performance incentives. See PGI 216.402-2 for guidance on establishing...

Integration of role-playing into technical skills training: a randomized controlled trial.

PubMed

Nikendei, C; Kraus, B; Schrauth, M; Weyrich, P; Zipfel, S; Herzog, W; Jünger, J

2007-11-01

Recently, efforts have been undertaken to enhance the face validity of technical skills training by introducing role-plays and standardised patients. Since little is known about the effects of role-playing with respect to the realism of a training situation and students' objective performance, we performed a randomized controlled trial. 36 medical students participated in videotaped small group skills-lab sessions on the topics of Doppler sonography and gastric tube insertion. One half of the students participated in role-plays and the other half practised without role-playing. Realism of the training situation was analysed by means of post-intervention self-selected student survey evaluations. Technical performance and patient-physician communication were assessed by independent ratings of the videotaped sessions. The physician's role was regarded to be significantly more realistic when performing role-plays. Assessment of videotaped sessions showed that practising technical skills by performing role-plays resulted in significantly better patient-physician communication whereas students' technical performance did not differ between groups. Introducing role-plays enhances the realism of technical skills training and leads to better patient-physician communication. Students do not seem to be overstrained by practising clinical technical skills using role-plays. We conclude that role-playing is a valuable method in practising technical skills.

Integration of Hands-On Team Training into Existing Curriculum Improves Both Technical and Nontechnical Skills in Laparoscopic Cholecystectomy.

PubMed

Caskey, Robert C; Owei, Lily; Rao, Raghavendra; Riddle, Elijah W; Brooks, Ari D; Dempsey, Daniel T; Morris, Jon B; Neylan, Christopher J; Williams, Noel N; Dumon, Kristoffel R

Nontechnical skills are an essential component of surgical education and a major competency assessed by the ACGME milestones project. However, the optimal way to integrate nontechnical skills training into existing curricula and then objectively evaluate the outcome is still unknown. The aim of this study was to determine the effect laparoscopic team-based task training would have on the nontechnical skills needed for laparoscopic surgery. 9 PGY-1 residents underwent an established training curriculum for teaching the knowledge and technical skills involved in laparoscopic cholecystectomy. Initial training involved a didactic session, expert-led practice on a porcine model in a simulated operating room and laparoscopic skills practice on a virtual reality trainer. Residents then performed a laparoscopic cholecystectomy on the same porcine model as a preintervention test. Three to four months following this, residents were subjected to specific nontechnical skills training involving 2 simple team-based laparoscopic tasks. They then practiced a further 4 to 6 hours on the virtual reality trainer. A repeat postintervention laparoscopic cholecystectomy was then performed 3 to 4 months after nontechnical skills training. Both the preintervention and postintervention laparoscopic cholecystectomies were audiovisually recorded and then evaluated by 2 independent surgeons in a blinded fashion. Technical skills were assessed using objective structured assessment of technical skills (OSATS) and a technique specific rating scale (TRS) that we developed for laparoscopic cholecystectomy. Nontechnical skills were assessed using nontechnical skills for surgeons (NOTSS). Residents also completed a survey at the beginning and end of the training. Tertiary care, university based teaching institution. A total of 9 general surgery residents at the intern level. The mean OSATS score improved from 13.7 ± 1.24 to 26.7 ± 0.31 (p < 0.001), the mean TRS score improved from 6 ± 0.46 to 13.1 ± 0.36 (p < 0.001) and the mean NOTSS score improved from 21.7 ± 1.83 to 36.3 ± 0.87 (p < 0.001) following the training. There was a strong correlation between OSATS and NOTSS scores (Pearson's R = 0.98) and TRS and NOTSS (R = 0.94). The inter-rater agreement was 0.79 for NOTSS, 0.9 for OSATS, and 0.82 for TRS. Following completion of the training, residents self-reported improvements in exchanging information (p < 0.01), coordinating activities (p < 0.01) and coping with pressure in the operating room (p < 0.001). Simple, team-based nontechnical skills training for laparoscopic cholecystectomy that was separate from technical skills training led to a sustained increase in residents' nontechnical skills 3 to 4 months after training. This was associated with a self-reported improvement in many nontechnical skills based on resident survey. Based on these results, we recommend that such designated nontechnical skills training is a valid alternative to other methods such as coaching and debriefing. We, therefore, plan to continue our efforts to develop team-based simulation tasks aimed at improving nontechnical skills for multiple surgical modalities. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Using the Internet as a Tool for Public Service: Creating a Community History Web Site

ERIC Educational Resources Information Center

Henson, Darold Leigh

2005-01-01

Creating a community history Web site is a way for technical communication practitioners, students, and teachers to improve their expertise while performing a valuable public service. Developers of this kind of Web site combine personal interest in the history and culture of their chosen communities with professional interest in a wide range of…

The Determination of the Conflict Resolution Strategies of University Students that They Use when They Have Conflicts with People

ERIC Educational Resources Information Center

Dincyurek, Sibel; Civelek, Ali H.

2008-01-01

This study is performed aiming to find out the resolution strategies our youth develop for the conflicts they live through along the way to being a mature individual, "grown teenager-young-teen-adolescent", who can keep abreast of the rapid progress and improvement in technical and social areas today. (Contains 11 tables.)

Improving Cybersecurity Incident Response Team (CSIRT) Skills, Dynamics and Effectiveness

DTIC Science & Technology

2017-03-01

recommendations for optimal CSIRT performance. 15. SUBJECT TERMS Cyber Incident Response, Response Teams, Cognitive Task Analysis 16. SECURITY...conducted a study of the cognitive , social, personality, and motivational requirements involved in cybersecurity incident response and then validated...corporate CSIRTs, and academic institution CSIRTs. • Survey of Non-Technical KSAOs. Previous known studies of CSIRTs did not examine cognitive , social, and

Progeny testing: proceedings of servicewide genetics workshop

Treesearch

Dick Miller

1984-01-01

The primary objective of this workshop was to discuss in detail the state- of-the-art of progeny testing. All aspects, from setting objectives through data collection and analysis, was be covered. We all know progeny testing is a highly technical phase of our tree improvement programs. Each task is critical and must be performed accurately and within a prescribed time...

Technical note: Evaluation of a crucible furnace retort for laboratory torrefactions of wood chips

Treesearch

Thomas L. Eberhardt; Karen G. Reed

2014-01-01

Torrefaction is a thermal process that improves biomass performance as a fuel by property enhancements such as decreased moisture uptake and increased carbon density. Most studies to date have used very small amounts of finely ground biomass. This study reports the testing of a crucible furnace retort that was fabricated to produce intermediate quantities of torrefied...

Permissible Inferences from the Outcome of Training Studies in Cognitive Development Research. Technical Report No. 127.

ERIC Educational Resources Information Center

Brown, Ann L.; Campione, Joseph C.

In modal training studies, the comparative groups differ in the use of a particular cognitive process; training to overcome the deficiency is provided for the deficient group only, and their performance is then compared to the standard set by the untrained group. Improvements are necessary in the design of training studies, as are a…

Improvements in the re-flight of spaceflight experiments on plant tropisms

NASA Astrophysics Data System (ADS)

Kiss, John Z.; Millar, Katherine D. L.; Kumar, Prem; Edelmann, Richard E.; Correll, Melanie J.

2011-02-01

In order to effectively study phototropism, the directed growth in response to light, we performed a series of experiments in microgravity to better understand light response without the “complications” of a 1-g stimulus. These experiments were named TROPI (for tropisms) and were performed on the European Modular Cultivation System (EMCS), a laboratory facility on the International Space Station (ISS). TROPI-1 was performed in 2006, and while it was a successful experiment, there were a number of technical difficulties. We had the opportunity to perform TROPI-2 in 2010 and were able to optimize experimental conditions as well as to extend the studies of phototropism to fractional gravity created by the EMCS centrifuge. This paper focuses on how the technical improvements in TROPI-2 allowed for a better experiment with increased scientific return. Major modifications in TROPI-2 compared to TROPI-1 included the use of spaceflight hardware that was off-gassed for a longer period and reduced seed storage (less than 2 months) in hardware. These changes resulted in increased seed germination and more vigorous growth of seedlings. While phototropism in response to red illumination was observed in hypocotyls of seedlings grown in microgravity during TROPI-1, there was a greater magnitude of red-light-based phototropic curvature in TROPI-2. Direct downlinking of digital images from the ISS in TROPI-2, rather than the use of analog tapes in TROPI-1, resulted in better quality images and simplified data analyses. In TROPI-2, improved cryo-procedures and the use of the GLACIER freezer during transport of samples back to Earth maintained the low temperature necessary to obtain good-quality RNA required for use in gene profiling studies.

FY2014 Propulsion Materials R&D Annual Progress Report

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

None

The Propulsion Materials Program actively supports the energy security and reduction of greenhouse emissions goals of VTO by investigating and identifying the materials properties that are most essential for continued development of cost-effective, highly efficient, and environmentally friendly next-generation heavy and light-duty powertrains. The technical approaches available to enhance propulsion systems focus on improvements in both vehicle efficiency and fuel substitution, both of which must overcome the performance limitations of the materials currently in use. Propulsion Materials Program activities work with national laboratories, industry experts, and VTO powertrain systems (e.g., Advanced Combustion Engines [ACE], Advanced Power Electronics and Electrical Machinesmore » [APEEM], and fuels) teams to develop strategies that overcome materials limitations in future powertrain performance. The technical maturity of the portfolio of funded projects ranges from basic science to subsystem prototype validation. Projects within a Propulsion Materials Program activity address materials concerns that directly impact critical technology barriers within each of the above programs, including barriers that impact fuel efficiency, thermal management, emissions reduction, improved reliability, and reduced manufacturing costs. The program engages only the barriers that result from material property limitations and represent fundamental, high-risk materials issues.« less

FY2015 Propulsion Materials Annual Report

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

None, None

The Propulsion Materials Program actively supports the energy security and reduction of greenhouse emissions goals of VTO by investigating and identifying the materials properties that are most essential for continued development of cost-effective, highly efficient, and environmentally friendly next-generation heavy and light-duty powertrains. The technical approaches available to enhance propulsion systems focus on improvements in both vehicle efficiency and fuel substitution, both of which must overcome the performance limitations of the materials currently in use. Propulsion Materials Program activities work with national laboratories, industry experts, and VTO powertrain systems (e.g., Advanced Combustion Engines [ACE], Advanced Power Electronics and Electrical Machinesmore » [APEEM], and fuels) teams to develop strategies that overcome materials limitations in future powertrain performance. The technical maturity of the portfolio of funded projects ranges from basic science to subsystem prototype validation. Projects within a Propulsion Materials Program activity address materials concerns that directly impact critical technology barriers within each of the above programs, including barriers that impact fuel efficiency, thermal management, emissions reduction, improved reliability, and reduced manufacturing costs. The program engages only the barriers that result from material property limitations and represent fundamental, high-risk materials issues.« less

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

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

Systematic review of coaching to enhance surgeons' operative performance.

PubMed

Min, Hyeyoun; Morales, Dianali Rivera; Orgill, Dennis; Smink, Douglas S; Yule, Steven

2015-11-01

There is increasing attention on the coaching of surgeons and trainees to improve performance but no comprehensive review on this topic. The purpose of this review is to summarize the quantity and the quality of studies involving surgical coaching methods and their effectiveness. We performed a systematic literature search through PubMed and PsychINFO by using predefined inclusion criteria. Evidence for main outcome categories was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and the Medical Education Research Study Quality Instrument (MERSQI). Of a total 3,063 articles, 23 met our inclusion criteria; 4 randomized controlled trials and 19 observational studies. We categorized the articles into 4 groups on the basis of the outcome studied: perception, attitude and opinion; technical skills; nontechnical skills; and performance measures. Overall strength of evidence for each outcome groups was as follows: Perception, attitude, and opinion (Grading of Recommendations Assessment, Development, and Evaluation: Very Low, Medical Education Research Study Quality Instrument [MERSQI]: 10); technical skills (randomized controlled trials: High, 13.1; Observation studies: Very Low, 11.5); nontechnical skills (Very Low, 12.4) and performance measures (Very Low, 13.6). Simulation was the most used setting for coaching; more than half of the studies deployed an experienced surgeon as a coach and showed that coaching was effective. Surgical coaching interventions have a positive impact on learners' perception and attitudes, their technical and nontechnical skills, and performance measures. Evidence of impact on patient outcomes was limited, and the quality of research studies was variable. Despite this, our systematic review of different coaching interventions will benefit future coaching strategies and implementation to enhance operative performance. Copyright © 2015 Elsevier Inc. All rights reserved.

Spatial Visualization ability improves with and without studying Technical Drawing.

PubMed

Contreras, María José; Escrig, Rebeca; Prieto, Gerardo; Elosúa, M Rosa

2018-03-27

The results of several studies suggest that spatial ability can be improved through direct training with tasks similar to those integrated in the tests used to measure the ability. However, there is a greater interest in analyzing the effectiveness of indirect training such as games or of learning subjects that involve spatial processes to a certain extent. Thus, the objective of the present study was to analyze whether the indirect training in Technical Drawing improved the Spatial Visualization ability of Architecture students. For this purpose, a group of students enrolled in Fundamentals of Architecture were administered two tests, a Spatial Visualization task and an Abstract Reasoning task, at the beginning and the end of a semester, after having received training through the subjects "Technical Drawing I: Geometry and Perception" and "Projects I." The results of this group were compared with those of a control group of students enrolled in a Mathematics degree, who were also pre-post evaluated but had not received the training in Technical Drawing. The study showed a significant pre-post improvement in both, Visualization and reasoning. However, this improvement occurred in both groups, thereby concluding that this improvement was not due to indirect training. Furthermore, no significant differences were found between men and women in any of the groups or conditions. These results clarify those of an earlier study where improvement in Visualization after training in Technical Drawing was found but did not include a comparison with a control condition. The control condition has proved to be important in order to consider the limitations of the effect of Technical Drawing on said improvement.

Aligning Theme and Information Structure to Improve the Readability of Technical Writing

ERIC Educational Resources Information Center

Moore, N. A. J.

2006-01-01

The readability of technical writing, and technical manuals in particular, especially for second language readers, can be noticeably improved by pairing Theme with Given and Rheme with New. This allows for faster processing of text and easier access to the "method of development" of the text. Typical Theme-Rheme patterns are described, and the…

The impact of nontechnical skills on technical performance in surgery: a systematic review.

PubMed

Hull, Louise; Arora, Sonal; Aggarwal, Rajesh; Darzi, Ara; Vincent, Charles; Sevdalis, Nick

2012-02-01

Failures in nontechnical and teamwork skills frequently lie at the heart of harm and near-misses in the operating room (OR). The purpose of this systematic review was to assess the impact of nontechnical skills on technical performance in surgery. MEDLINE, EMBASE, PsycINFO databases were searched, and 2,041 articles were identified. After limits were applied, 341 articles were retrieved for evaluation. Of these, 28 articles were accepted for this review. Data were extracted from the articles regarding sample population, study design and setting, measures of nontechnical skills and technical performance, study findings, and limitations. Of the 28 articles that met inclusion criteria, 21 articles assessed the impact of surgeons' nontechnical skills on their technical performance. The evidence suggests that receiving feedback and effectively coping with stressful events in the OR has a beneficial impact on certain aspects of technical performance. Conversely, increased levels of fatigue are associated with detriments to surgical skill. One article assessed the impact of anesthesiologists' nontechnical skills on anesthetic technical performance, finding a strong positive correlation between the 2 skill sets. Finally, 6 articles assessed the impact of multiple nontechnical skills of the entire OR team on surgical performance. A strong relationship between teamwork failure and technical error was empirically demonstrated in these studies. Evidence suggests that certain nontechnical aspects of performance can enhance or, if lacking, contribute to deterioration of surgeons' technical performance. The precise extent of this effect remains to be elucidated. Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Simulation of pipeline in the area of the underwater crossing

NASA Astrophysics Data System (ADS)

Burkov, P.; Chernyavskiy, D.; Burkova, S.; Konan, E. C.

2014-08-01

The article studies stress-strain behavior of the main oil-pipeline section Alexandrovskoye-Anzhero-Sudzhensk using software system Ansys. This method of examination and assessment of technical conditions of objects of pipeline transport studies the objects and the processes that affect the technical condition of these facilities, including the research on the basis of computer simulation. Such approach allows to develop the theory, methods of calculations and designing of objects of pipeline transport, units and parts of machines, regardless of their industry and destination with a view to improve the existing constructions and create new structures, machines of high performance, durability and reliability, maintainability, low material capacity and cost, which have competitiveness on the world market.

Instrumentation and control of harmonic oscillators via a single-board microprocessor-FPGA device.

PubMed

Picone, Rico A R; Davis, Solomon; Devine, Cameron; Garbini, Joseph L; Sidles, John A

2017-04-01

We report the development of an instrumentation and control system instantiated on a microprocessor-field programmable gate array (FPGA) device for a harmonic oscillator comprising a portion of a magnetic resonance force microscope. The specific advantages of the system are that it minimizes computation, increases maintainability, and reduces the technical barrier required to enter the experimental field of magnetic resonance force microscopy. Heterodyne digital control and measurement yields computational advantages. A single microprocessor-FPGA device improves system maintainability by using a single programming language. The system presented requires significantly less technical expertise to instantiate than the instrumentation of previous systems, yet integrity of performance is retained and demonstrated with experimental data.

Instrumentation and control of harmonic oscillators via a single-board microprocessor-FPGA device

NASA Astrophysics Data System (ADS)

Picone, Rico A. R.; Davis, Solomon; Devine, Cameron; Garbini, Joseph L.; Sidles, John A.

2017-04-01

We report the development of an instrumentation and control system instantiated on a microprocessor-field programmable gate array (FPGA) device for a harmonic oscillator comprising a portion of a magnetic resonance force microscope. The specific advantages of the system are that it minimizes computation, increases maintainability, and reduces the technical barrier required to enter the experimental field of magnetic resonance force microscopy. Heterodyne digital control and measurement yields computational advantages. A single microprocessor-FPGA device improves system maintainability by using a single programming language. The system presented requires significantly less technical expertise to instantiate than the instrumentation of previous systems, yet integrity of performance is retained and demonstrated with experimental data.

Effects and effectiveness of dynamic arm supports: a technical review.

PubMed

van der Heide, Loek A; Gelderblom, Gert Jan; de Witte, Luc P

2015-01-01

Numerous dynamic arm supports have been developed in recent decades to increase independence in the performance of activities of daily living. Much effort and money have been spent on their development and prescription, yet insight into their effects and effectiveness is lacking. This article is a systematic review of evaluations of dynamic arm supports. The 8 technical evaluations, 12 usability evaluations, and 27 outcome studies together make 47 evaluations. Technical evaluations were often used as input for new developments and directed at balancing quality, forces and torques, and range of motion of prototypes. Usability studies were mostly single-measure designs that had varying results as to whether devices were usable for potential users. An increased ability to perform activities of daily living and user satisfaction were reported in outcome studies. However, the use of dynamic arm supports in the home situation was reported to be low. Gaining insight into why devices are not used when their developers believe them to be effective seems crucial for every new dynamic arm support developed. The methodological quality of the outcome studies was often low, so it is important that this is improved in the future.

Does warm-up using mental practice improve crisis resource management performance? A simulation study.

PubMed

Hayter, M A; Bould, M D; Afsari, M; Riem, N; Chiu, M; Boet, S

2013-02-01

Mental practice (MP) is defined as the 'symbolic rehearsal of a physical activity in the absence of any gross-muscular movements' and has been used in sport and music to enhance performance. In healthcare, MP has been demonstrated to improve technical skill performance of surgical residents. However, its effect on crisis resource management (CRM) skills has yet to be determined. We aimed to investigate the effect of warm-up with MP on CRM skill performance during a simulated crisis scenario. Following ethics board approval, 40 anaesthesia residents were randomized. The intervention group performed 20 min of MP of a script based on CRM principles. The control group received a 20 min didactic teaching session on an unrelated topic. Each subject then managed a simulated cardiac arrest. Two CRM experts rated the video recordings of each performance using the previously validated Ottawa GRS. The time to start chest compressions, administer epinephrine, and give blood was recorded. There was no significant difference between the intervention and control groups: total Ottawa GRS score was 24.50 (18.63-28.88 [6.50-34.50]) (median (inter-quartile range [range]) vs 20.50 (13.00-29.13 [6.50-34.50]) (P=0.53); the time to start chest compressions 146.0 s (138.0-231.0 [115.0-323.0]) vs 162.5 s (138.0-231.0 [100.0-460.0]) (P=0.27), the time to epinephrine administration 163.0 s (151.0-187.0 [111.0-337.0]) vs 187.0 s (164.0-244.0 [115.0-310.0]) (P=0.09), and the time to blood administration 220.5 s (130.8-309.0 [92.0-485.0]) vs 252.5 (174.5-398.8 [65.0-527.0]) (P=0.48). Unlike technical skills, warm-up with MP does not seem to improve CRM skills in simulated crisis scenarios.

From pre-registration to publication: a non-technical primer for conducting a meta-analysis to synthesize correlational data

PubMed Central

Quintana, Daniel S.

2015-01-01

Meta-analysis synthesizes a body of research investigating a common research question. Outcomes from meta-analyses provide a more objective and transparent summary of a research area than traditional narrative reviews. Moreover, they are often used to support research grant applications, guide clinical practice, and direct health policy. The aim of this article is to provide a practical and non-technical guide for psychological scientists that outlines the steps involved in planning and performing a meta-analysis of correlational datasets. I provide a supplementary R script to demonstrate each analytical step described in the paper, which is readily adaptable for researchers to use for their analyses. While the worked example is the analysis of a correlational dataset, the general meta-analytic process described in this paper is applicable for all types of effect sizes. I also emphasize the importance of meta-analysis protocols and pre-registration to improve transparency and help avoid unintended duplication. An improved understanding this tool will not only help scientists to conduct their own meta-analyses but also improve their evaluation of published meta-analyses. PMID:26500598

From pre-registration to publication: a non-technical primer for conducting a meta-analysis to synthesize correlational data.

PubMed

Quintana, Daniel S

2015-01-01

Meta-analysis synthesizes a body of research investigating a common research question. Outcomes from meta-analyses provide a more objective and transparent summary of a research area than traditional narrative reviews. Moreover, they are often used to support research grant applications, guide clinical practice, and direct health policy. The aim of this article is to provide a practical and non-technical guide for psychological scientists that outlines the steps involved in planning and performing a meta-analysis of correlational datasets. I provide a supplementary R script to demonstrate each analytical step described in the paper, which is readily adaptable for researchers to use for their analyses. While the worked example is the analysis of a correlational dataset, the general meta-analytic process described in this paper is applicable for all types of effect sizes. I also emphasize the importance of meta-analysis protocols and pre-registration to improve transparency and help avoid unintended duplication. An improved understanding this tool will not only help scientists to conduct their own meta-analyses but also improve their evaluation of published meta-analyses.

Concentrating solar power (CSP) power cycle improvements through application of advanced materials

NASA Astrophysics Data System (ADS)

Siefert, John A.; Libby, Cara; Shingledecker, John

2016-05-01

Concentrating solar power (CSP) systems with thermal energy storage (TES) capability offer unique advantages to other renewable energy technologies in that solar radiation can be captured and stored for utilization when the sun is not shining. This makes the technology attractive as a dispatchable resource, and as such the Electric Power Research Institute (EPRI) has been engaged in research and development activities to understand and track the technology, identify key technical challenges, and enable improvements to meet future cost and performance targets to enable greater adoption of this carbon-free energy resource. EPRI is also involved with technically leading a consortium of manufacturers, government labs, and research organizations to enable the next generation of fossil fired power plants with advanced ultrasupercritical (A-USC) steam temperatures up to 760°C (1400°F). Materials are a key enabling technology for both of these seemingly opposed systems. This paper discusses how major strides in structural materials for A-USC fossil fired power plants may be translated into improved CSP systems which meet target requirements.

Application of dexterous space robotics technology to myoelectric prostheses

NASA Astrophysics Data System (ADS)

Hess, Clifford; Li, Larry C. H.; Farry, Kristin A.; Walker, Ian D.

1994-02-01

Future space missions will require robots equipped with highly dexterous robotic hands to perform a variety of tasks. A major technical challenge in making this possible is an improvement in the way these dexterous robotic hands are remotely controlled or teleoperated. NASA is currently investigating the feasibility of using myoelectric signals to teleoperate a dexterous robotic hand. In theory, myoelectric control of robotic hands will require little or no mechanical parts and will greatly reduce the bulk and weight usually found in dexterous robotic hand control devices. An improvement in myoelectric control of multifinger hands will also benefit prosthetics users. Therefore, as an effort to transfer dexterous space robotics technology to prosthetics applications and to benefit from existing myoelectric technology, NASA is collaborating with the Limbs of Love Foundation, the Institute for Rehabilitation and Research, and Rice University in developing improved myoelectric control multifinger hands and prostheses. In this paper, we will address the objectives and approaches of this collaborative effort and discuss the technical issues associated with myoelectric control of multifinger hands. We will also report our current progress and discuss plans for future work.

Application of dexterous space robotics technology to myoelectric prostheses

NASA Technical Reports Server (NTRS)

Hess, Clifford; Li, Larry C. H.; Farry, Kristin A.; Walker, Ian D.

1994-01-01

Future space missions will require robots equipped with highly dexterous robotic hands to perform a variety of tasks. A major technical challenge in making this possible is an improvement in the way these dexterous robotic hands are remotely controlled or teleoperated. NASA is currently investigating the feasibility of using myoelectric signals to teleoperate a dexterous robotic hand. In theory, myoelectric control of robotic hands will require little or no mechanical parts and will greatly reduce the bulk and weight usually found in dexterous robotic hand control devices. An improvement in myoelectric control of multifinger hands will also benefit prosthetics users. Therefore, as an effort to transfer dexterous space robotics technology to prosthetics applications and to benefit from existing myoelectric technology, NASA is collaborating with the Limbs of Love Foundation, the Institute for Rehabilitation and Research, and Rice University in developing improved myoelectric control multifinger hands and prostheses. In this paper, we will address the objectives and approaches of this collaborative effort and discuss the technical issues associated with myoelectric control of multifinger hands. We will also report our current progress and discuss plans for future work.

A technical innovation for improving identification of the trackers by the LED cameras in navigation-assisted total knee arthroplasty.

PubMed

Darmanis, Spyridon; Toms, Andrew; Durman, Robert; Moore, Donna; Eyres, Keith

2007-07-01

To reduce the operating time in computer-assisted navigated total knee replacement (TKR), by improving communication between the infrared camera and the trackers placed on the patient. The innovation involves placing a routinely used laser pointer on top of the camera, so that the infrared cameras focus precisely on the trackers located on the knee to be operated on. A prospective randomized study was performed involving 40 patients divided into two groups, A and B. Both groups underwent navigated TKR, but for group B patients a laser pointer was used to improve the targeting capabilities of the cameras. Without the laser pointer, the camera had to move a mean 9.2 times in order to identify the trackers. With the introduction of the laser pointer, this was reduced to 0.9 times. Accordingly, the additional mean time required without the laser pointer was 11.6 minutes. Time delays are a major problem in computer-assisted surgery, and our technical suggestion can contribute towards reducing the delays associated with this particular application.

48 CFR 1816.402-270 - NASA technical performance incentives.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false NASA technical performance incentives. 1816.402-270 Section 1816.402-270 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND....402-270 NASA technical performance incentives. (a) Pursuant to the guidelines in 1816.402, NASA has...

48 CFR 1816.402-270 - NASA technical performance incentives.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true NASA technical performance incentives. 1816.402-270 Section 1816.402-270 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND....402-270 NASA technical performance incentives. (a) Pursuant to the guidelines in 1816.402, NASA has...

48 CFR 1816.402-270 - NASA technical performance incentives.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false NASA technical performance incentives. 1816.402-270 Section 1816.402-270 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND....402-270 NASA technical performance incentives. (a) Pursuant to the guidelines in 1816.402, NASA has...

48 CFR 1816.402-270 - NASA technical performance incentives.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false NASA technical performance incentives. 1816.402-270 Section 1816.402-270 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND....402-270 NASA technical performance incentives. (a) Pursuant to the guidelines in 1816.402, NASA has...

48 CFR 1816.402-270 - NASA technical performance incentives.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false NASA technical performance incentives. 1816.402-270 Section 1816.402-270 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND....402-270 NASA technical performance incentives. (a) Pursuant to the guidelines in 1816.402, NASA has...

Feasibility of remote real-time guidance of a cardiac examination performed by novices using a pocket-sized ultrasound device.

PubMed

Mai, Tuan V; Ahn, David T; Phillips, Colin T; Agan, Donna L; Kimura, Bruce J

2013-01-01

Background. The potential of pocket-sized ultrasound devices (PUDs) to improve global healthcare delivery is limited by the lack of a suitable imaging protocol and trained users. Therefore, we investigated the feasibility of performing a brief, evidence-based cardiac limited ultrasound exam (CLUE) through wireless guidance of novice users. Methods. Three trainees applied PUDs on 27 subjects while directed by an off-site cardiologist to obtain a CLUE to screen for LV systolic dysfunction (LVSD), LA enlargement (LAE), ultrasound lung comets (ULC+), and elevated CVP (eCVP). Real-time remote audiovisual guidance and interpretation by the cardiologist were performed using the iPhone 4/iPod (FaceTime, Apple, Inc.) attached to the PUD and transmitted data wirelessly. Accuracy and technical quality of transmitted images were compared to on-site, gold-standard echo thresholds. Results. Novice versus sonographer imaging yielded technically adequate views in 122/135 (90%) versus 130/135 (96%) (P < 0.05). CLUE's combined SN, SP, and ACC were 0.67, 0.96, and 0.90. Technical adequacy (%) and accuracy for each abnormality (n) were LVSD (85%, 0.93, n = 5), LAE (89%, 0.74, n = 16), ULC+ (100%, 0.94, n = 5), and eCVP (78%, 0.91, n = 1). Conclusion. A novice can perform the CLUE using PUD when wirelessly guided by an expert. This method could facilitate PUD use for off-site bedside medical decision making and triaging of patients.

Simulation-based training delivered directly to the pediatric cardiac intensive care unit engenders preparedness, comfort, and decreased anxiety among multidisciplinary resuscitation teams.

PubMed

Allan, Catherine K; Thiagarajan, Ravi R; Beke, Dorothy; Imprescia, Annette; Kappus, Liana J; Garden, Alexander; Hayes, Gavin; Laussen, Peter C; Bacha, Emile; Weinstock, Peter H

2010-09-01

Resuscitation of pediatric cardiac patients involves unique and complex physiology, requiring multidisciplinary collaboration and teamwork. To optimize team performance, we created a multidisciplinary Crisis Resource Management training course that addressed both teamwork and technical skill needs for the pediatric cardiac intensive care unit. We sought to determine whether participation improved caregiver comfort and confidence levels regarding future resuscitation events. We developed a simulation-based, in situ Crisis Resource Management curriculum using pediatric cardiac intensive care unit scenarios and unit-specific resuscitation equipment, including an extracorporeal membrane oxygenation circuit. Participants replicated the composition of a clinical team. Extensive video-based debriefing followed each scenario, focusing on teamwork principles and technical resuscitation skills. Pre- and postparticipation questionnaires were used to determine the effects on participants' comfort and confidence regarding participation in future resuscitations. A total of 182 providers (127 nurses, 50 physicians, 2 respiratory therapists, 3 nurse practitioners) participated in the course. All participants scored the usefulness of the program and scenarios as 4 of 5 or higher (5 = most useful). There was significant improvement in participants' perceived ability to function as a code team member and confidence in a code (P < .001). Participants reported they were significantly more likely to raise concerns about inappropriate management to the code leader (P < .001). We developed a Crisis Resource Management training program in a pediatric cardiac intensive care unit to teach technical resuscitation skills and improve team function. Participants found the experience useful and reported improved ability to function in a code. Further work is needed to determine whether participation in the Crisis Resource Management program objectively improves team function during real resuscitations. 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

SHARP's systems engineering challenge: rectifying integrated product team requirements with performance issues in an evolutionary spiral development acquisition

NASA Astrophysics Data System (ADS)

Kuehl, C. Stephen

2003-08-01

Completing its final development and early deployment on the Navy's multi-role aircraft, the F/A-18 E/F Super Hornet, the SHAred Reconnaissance Pod (SHARP) provides the war fighter with the latest digital tactical reconnaissance (TAC Recce) Electro-Optical/Infrared (EO/IR) sensor system. The SHARP program is an evolutionary acquisition that used a spiral development process across a prototype development phase tightly coupled into overlapping Engineering and Manufacturing Development (EMD) and Low Rate Initial Production (LRIP) phases. Under a tight budget environment with a highly compressed schedule, SHARP challenged traditional acquisition strategies and systems engineering (SE) processes. Adopting tailored state-of-the-art systems engineering process models allowd the SHARP program to overcome the technical knowledge transition challenges imposed by a compressed program schedule. The program's original goal was the deployment of digital TAC Recce mission capabilities to the fleet customer by summer of 2003. Hardware and software integration technical challenges resulted from requirements definition and analysis activities performed across a government-industry led Integrated Product Team (IPT) involving Navy engineering and test sites, Boeing, and RTSC-EPS (with its subcontracted hardware and government furnished equipment vendors). Requirements development from a bottoms-up approach was adopted using an electronic requirements capture environment to clarify and establish the SHARP EMD product baseline specifications as relevant technical data became available. Applying Earned-Value Management (EVM) against an Integrated Master Schedule (IMS) resulted in efficiently managing SE task assignments and product deliveries in a dynamically evolving customer requirements environment. Application of Six Sigma improvement methodologies resulted in the uncovering of root causes of errors in wiring interconnectivity drawings, pod manufacturing processes, and avionics requirements specifications. Utilizing the draft NAVAIR SE guideline handbook and the ANSI/EIA-632 standard: Processes for Engineering a System, a systems engineering tailored process approach was adopted for the accelerated SHARP EMD prgram. Tailoring SE processes in this accelerated product delivery environment provided unique opportunities to be technically creative in the establishment of a product performance baseline. This paper provides an historical overview of the systems engineering activities spanning the prototype phase through the EMD SHARP program phase, the performance requirement capture activities and refinement process challenges, and what SE process improvements can be applied to future SHARP-like programs adopting a compressed, evolutionary spiral development acquisition paradigm.

Reducing Vehicle Weight and Improving U.S. Energy Efficiency Using Integrated Computational Materials Engineering

NASA Astrophysics Data System (ADS)

Joost, William J.

2012-09-01

Transportation accounts for approximately 28% of U.S. energy consumption with the majority of transportation energy derived from petroleum sources. Many technologies such as vehicle electrification, advanced combustion, and advanced fuels can reduce transportation energy consumption by improving the efficiency of cars and trucks. Lightweight materials are another important technology that can improve passenger vehicle fuel efficiency by 6-8% for each 10% reduction in weight while also making electric and alternative vehicles more competitive. Despite the opportunities for improved efficiency, widespread deployment of lightweight materials for automotive structures is hampered by technology gaps most often associated with performance, manufacturability, and cost. In this report, the impact of reduced vehicle weight on energy efficiency is discussed with a particular emphasis on quantitative relationships determined by several researchers. The most promising lightweight materials systems are described along with a brief review of the most significant technical barriers to their implementation. For each material system, the development of accurate material models is critical to support simulation-intensive processing and structural design for vehicles; improved models also contribute to an integrated computational materials engineering (ICME) approach for addressing technical barriers and accelerating deployment. The value of computational techniques is described by considering recent ICME and computational materials science success stories with an emphasis on applying problem-specific methods.

Bridging Human Reliability Analysis and Psychology, Part 1: The Psychological Literature Review for the IDHEAS Method

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

April M. Whaley; Stacey M. L. Hendrickson; Ronald L. Boring

In response to Staff Requirements Memorandum (SRM) SRM-M061020, the U.S. Nuclear Regulatory Commission (NRC) is sponsoring work to update the technical basis underlying human reliability analysis (HRA) in an effort to improve the robustness of HRA. The ultimate goal of this work is to develop a hybrid of existing methods addressing limitations of current HRA models and in particular issues related to intra- and inter-method variabilities and results. This hybrid method is now known as the Integrated Decision-tree Human Event Analysis System (IDHEAS). Existing HRA methods have looked at elements of the psychological literature, but there has not previously beenmore » a systematic attempt to translate the complete span of cognition from perception to action into mechanisms that can inform HRA. Therefore, a first step of this effort was to perform a literature search of psychology, cognition, behavioral science, teamwork, and operating performance to incorporate current understanding of human performance in operating environments, thus affording an improved technical foundation for HRA. However, this literature review went one step further by mining the literature findings to establish causal relationships and explicit links between the different types of human failures, performance drivers and associated performance measures ultimately used for quantification. This is the first of two papers that detail the literature review (paper 1) and its product (paper 2). This paper describes the literature review and the high-level architecture used to organize the literature review, and the second paper (Whaley, Hendrickson, Boring, & Xing, these proceedings) describes the resultant cognitive framework.« less

Simulation as a set-up for technical proficiency: can a virtual warm-up improve live fibre-optic intubation?

PubMed

Samuelson, S T; Burnett, G; Sim, A J; Hofer, I; Weinberg, A D; Goldberg, A; Chang, T S; DeMaria, S

2016-03-01

Fibre-optic intubation (FOI) is an advanced technical skill, which anaesthesia residents must frequently perform under pressure. In surgical subspecialties, a virtual 'warm-up' has been used to prime a practitioner's skill set immediately before performance of challenging procedures. This study examined whether a virtual warm-up improved the performance of elective live patient FOI by anaesthesia residents. Clinical anaesthesia yr 1 and 2 (CA1 and CA2) residents were recruited to perform elective asleep oral FOI. Residents either underwent a 5 min, guided warm-up (using a bronchoscopy simulator) immediately before live FOI on patients with predicted normal airways or performed live FOI on similar patients without the warm-up. Subjects were timed performing FOI (from scope passing teeth to viewing the carina) and were graded on a 45-point skill scale by attending anaesthetists. After a washout period, all subjects were resampled as members of the opposite cohort. Multivariate analysis was performed to control for variations in previous FOI experience of the residents. Thirty-three anaesthesia residents were recruited, of whom 22 were CA1 and 11 were CA2. Virtual warm-up conferred a 37% reduction in time for CA1s (mean 35.8 (SD 3.2) s vs. 57 (SD 3.2) s, P<0.0002) and a 26% decrease for CA2s (mean 23 (SD 1.7) s vs. 31 (SD 1.7) s, P=0.0118). Global skill score increased with warm-up by 4.8 points for CA1s (mean 32.8 (SD 1.2) vs. 37.6 (SD 1.2), P=0.0079) and 5.1 points for CA2s (37.7 (SD 1.1) vs. 42.8 (SD 1.1), P=0.0125). Crossover period and sequence did not show a statistically significant association with performance. Virtual warm-up significantly improved performance by residents of FOI in live patients with normal airway anatomy, as measured both by speed and by a scaled evaluation of skills. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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.

Surgical simulators in cataract surgery training.

PubMed

Sikder, Shameema; Tuwairqi, Khaled; Al-Kahtani, Eman; Myers, William G; Banerjee, Pat

2014-02-01

Virtual simulators have been widely implemented in medical and surgical training, including ophthalmology. The increasing number of published articles in this field mandates a review of the available results to assess current technology and explore future opportunities. A PubMed search was conducted and a total of 10 articles were reviewed. Virtual simulators have shown construct validity in many modules, successfully differentiating user experience levels during simulated phacoemulsification surgery. Simulators have also shown improvements in wet-lab performance. The implementation of simulators in the residency training has been associated with a decrease in cataract surgery complication rates. Virtual reality simulators are an effective tool in measuring performance and differentiating trainee skill level. Additionally, they may be useful in improving surgical skill and patient outcomes in cataract surgery. Future opportunities rely on taking advantage of technical improvements in simulators for education and research.

A Survey of Vocational Administrators and Teachers in Career and Technical Education Centers regarding Their Perception of Vocational Program Improvements

ERIC Educational Resources Information Center

Hummel, Richard Lynn, Jr.

2012-01-01

The purpose of this statewide study is to assess the perceived improvements made to programs that are offered at Career and Technical Education Centers from the perspective of vocational administrators and teachers following the Bureau of Career and Technical Education conduction of an Approved Program Evaluation. The Pennsylvania Bureau of Career…

NASA Technical Management Report (533Q)

NASA Technical Reports Server (NTRS)

Klosko, S. M.; Sanchez, B. (Technical Monitor)

2001-01-01

The objective of this task is analytical support of the NASA Satellite Laser Ranging (SLR) program in the areas of SLR data analysis, software development, assessment of SLR station performance, development of improved models for atmospheric propagation and interpretation of station calibration techniques, and science coordination and analysis functions for the NASA led Central Bureau of the International Laser Ranging Service (ILRS). The contractor shall in each year of the five year contract: (1) Provide software development and analysis support to the NASA SLR program and the ILRS. Attend and make analysis reports at the monthly meetings of the Central Bureau of the ILRS covering data received during the previous period. Provide support to the Analysis Working Group of the ILRS including special tiger teams that are established to handle unique analysis problems. Support the updating of the SLR Bibliography contained on the ILRS web site; (2) Perform special assessments of SLR station performance from available data to determine unique biases and technical problems at the station; (3) Develop improvements to models of atmospheric propagation and for handling pre- and post-pass calibration data provided by global network stations; (4) Provide review presentation of overall ILRS network data results at one major scientific meeting per year; (5) Contribute to and support the publication of NASA SLR and ILRS reports highlighting the results of SLR analysis activity.

Performance Demonstration of Mcmb-LiNiCoO2 Cells Containing Electrolytes Designed for Wide Operating Temperature Range

NASA Technical Reports Server (NTRS)

Smart, M. C.; Ratnakumar, B. V.; Whicanack, L. D.; Smith, K. A.; Santee, S.; Puglia, F. J.; Gitzendanner, R.

2009-01-01

With the intent of improving the performance of Li-ion cells over a wide operating temperature range, we have investigated the use of co-solvents to improve the properties of electrolyte formulations. In the current study, we have focused upon evaluating promising electrolytes which have been incorporated into large capacity (7 Ah) prototype Li-ion cells, fabricated by Yardney Technical Products, Inc. The electrolytes selected for performance evaluation include the use of a number of esters as co-solvents, including methyl propionate (MP), ethyl propionate (EP), ethyl butyrate (EB), propyl butyrate (PB), and 2,2,2-trifluoroethyl butyrate (TFEB). The performance of the prototype cells containing the ester-based electrolytes was compared with an extensive data base generated on cells containing previously developed all carbonate-based electrolytes. A number of performance tests were performed, including determining (i) the discharge rate capacity over a wide range of temperatures, (ii) the charge characteristics, (iii) the cycle life characteristics under various conditions, and (iv) the impedance characteristics.

Emergency Locator Transmitter Survivability and Reliability Study

NASA Technical Reports Server (NTRS)

Stimson, Chad M.; Littell, Justin D.; Mazzuca, Lisa M.; Foster, Anthony W.; Theodorakos, George J.

2017-01-01

A comprehensive study of Emergency Locator Transmitter (ELT) performance was conducted over a three year period concluding in 2016 in support of the Search and Rescue (SAR) Mission Office at National Aeronautics and Space Administration (NASA) Goddard Space Flight Center (GSFC). The study began with a review of reported performance cited in a collection of works published as early as 1980 as well as analysis of a focused set of contemporary aviation crash reports. Based on initial research findings, a series of subscale and fullscale system tests were performed at NASA Langley Research Center (LaRC) with the goals of investigating ELT system failure modes and developing recommended improvements to the Radio Technical Commission for Aeronautics (RTCA) Minimum Operational Performance Specification (MOPS) that will result in improved system performance. Enhanced performance of ELT systems in aviation accidents will reduce unnecessary loss of human life and make SAR operations safer and less costly by reducing the amount of time required to locate accident sites.

Multidisciplinary team simulation for the operating theatre: a review of the literature.

PubMed

Tan, Shaw Boon; Pena, Guilherme; Altree, Meryl; Maddern, Guy J

2014-01-01

Analyses of adverse events inside the operating theatre has demonstrated that many errors are caused by failure in non-technical skills and teamwork. While simulation has been used successfully for teaching and improving technical skills, more recently, multidisciplinary simulation has been used for training team skills. We hypothesized that this type of training is feasible and improves team skills in the operating theatre. A systematic search of the literature for studies describing true multidisciplinary operating theatre team simulation was conducted in November and December 2012. We looked at the characteristics and outcomes of the team simulation programmes. 1636 articles were initially retrieved. Utilizing a stepwise evaluation process, 26 articles were included in the review. The studies reveal that multidisciplinary operating theatre simulation has been used to provide training in technical and non-technical skills, to help implement new techniques and technologies, and to identify latent weaknesses within a health system. Most of the studies included are descriptions of training programmes with a low level of evidence. No randomized control trial was identified. Participants' reactions to the training programme were positive in all studies; however, none of them could objectively demonstrate that skills acquired from simulation are transferred to the operating theatre or show a demonstrable benefit in patient outcomes. Multidisciplinary operating room team simulation is feasible and widely accepted by participants. More studies are required to assess the impact of this type of training on operative performance and patient safety. © 2013 Royal Australasian College of Surgeons.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

PubMed Central

Bilge Gülsüm, NUR; Evren, OK; ALTUNSOY, Mustafa; AĞLARCI, Osman Sami; ÇOLAK, Mehmet; GÜNGÖR, Enes

2014-01-01

Objective This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. Material and Methods The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. Results The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. Conclusions The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics. PMID:25591019

Patient-specific simulation in carotid artery stenting.

PubMed

Willaert, Willem; Aggarwal, Rajesh; Bicknell, Colin; Hamady, Mo; Darzi, Ara; Vermassen, Frank; Cheshire, Nicholas

2010-12-01

Patient-specific virtual reality (VR) simulation is a technologic advancement that allows planning and practice of the carotid artery stenting (CAS) procedure before it is performed on the patient. The initial findings are reported, using this novel VR technique as a tool to optimize technical and nontechnical aspects of this complex endovascular procedure. In the angiography suite, the same interventional team performed the VR rehearsal and the actual CAS on the patient. All proceedings were recorded to allow for video analysis of team, technical, and nontechnical skills. Analysis of both procedures showed identical use of endovascular tools, similar access strategy, and a high degree of similarity between the angiography images. The total procedure time (24.04 vs 60.44 minutes), fluoroscopy time (11.19 vs 21.04 minutes), and cannulation of the common carotid artery (1.35 vs 9.34) took considerably longer in reality. An extensive questionnaire revealed that all team members found that the rehearsal increased the subjective sense of teamwork (4/5), communication (4/5), and patient safety (4/5). A VR procedure rehearsal is a practical and feasible preparatory tool for CAS and shows a high correlation with the real procedure. It has the potential to enhance the technical, nontechnical, and team performance. Further research is needed to evaluate if this technology can lead to improved outcomes for patients. Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

48 CFR 215.404-71-2 - Performance risk.

Code of Federal Regulations, 2010 CFR

2010-10-01

...—the technical uncertainties of performance. (2) Management/cost control—the degree of management... Technical (1) (2) N/A N/A 22 Management/Cost Control (1) (2) N/A N/A 23 Performance Risk (Composite) N/A (3...(percent) Assignedvalue (percent) Weightedvalue (percent) Technical 60 5.0 3.0 Management/Cost Control 40 4...

Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.

PubMed

Buerkle, Bernd; Pueth, Julia; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

2012-10-01

To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; P<.001). The secondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; P<.001), self-assessment (3.15±0.94 compared with 2.72±1.01; P=.002), and confidence (3.72±0.98 compared with 3.34±0.90, respectively; P=.005), but not performance time (3:19±0:48 minutes compared with 3:31±1:05 minutes; P=.1), were also significantly different, favoring group 1. After 72 hours, Objective Structured Assessment of Technical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; P<.001) as were GRS (10.80±2.62 compared with 8.15±2.59; P<.001) and self assessment (SA; 3.44±0.87 compared with 2.95±0.94; P=.003). In a multiple linear regression analysis, group assignment (group 1 compared with 2; P<.001) and sex (P=.002) independently influenced Objective Structured Assessment of Technical Skills scores. Hands-on training helps to achieve a significant improvement of shoulder dystocia management on a pelvic training model. www.ClinicalTrials.gov, NCT01618565. I.

A technical framework to describe occupant behavior for building energy simulations

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

Turner, William; Hong, Tianzhen

2013-12-20

Green buildings that fail to meet expected design performance criteria indicate that technology alone does not guarantee high performance. Human influences are quite often simplified and ignored in the design, construction, and operation of buildings. Energy-conscious human behavior has been demonstrated to be a significant positive factor for improving the indoor environment while reducing the energy use of buildings. In our study we developed a new technical framework to describe energy-related human behavior in buildings. The energy-related behavior includes accounting for individuals and groups of occupants and their interactions with building energy services systems, appliances and facilities. The technical frameworkmore » consists of four key components: i. the drivers behind energy-related occupant behavior, which are biological, societal, environmental, physical, and economical in nature ii. the needs of the occupants are based on satisfying criteria that are either physical (e.g. thermal, visual and acoustic comfort) or non-physical (e.g. entertainment, privacy, and social reward) iii. the actions that building occupants perform when their needs are not fulfilled iv. the systems with which an occupant can interact to satisfy their needs The technical framework aims to provide a standardized description of a complete set of human energy-related behaviors in the form of an XML schema. For each type of behavior (e.g., occupants opening/closing windows, switching on/off lights etc.) we identify a set of common behaviors based on a literature review, survey data, and our own field study and analysis. Stochastic models are adopted or developed for each type of behavior to enable the evaluation of the impact of human behavior on energy use in buildings, during either the design or operation phase. We will also demonstrate the use of the technical framework in assessing the impact of occupancy behavior on energy saving technologies. The technical framework presented is part of our human behavior research, a 5-year program under the U.S. - China Clean Energy Research Center for Building Energy Efficiency.« less

Kinetics of Supercritical Water Oxidation

DTIC Science & Technology

1995-12-31

milestone and Sandia Technical Report. A much-needed report describing in detail the operation of the Supercritical Fluids Reactor (SFR) was also...years. In addition, the literature research required to arrive at this optimal design will be used to improve the performance of the Supercritical Fluids ...the Supercritical Fluids Reactor (SFR)" (Sandia National Laboratories Report SAND-8203, Livermore, CA, 1995). R. R. Steeper, "Methane and Methanol

Lubrication free centrifugal compressor. Technical report

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

Gottschlich, J.M.; Scaringe, R.P.; Gui, F.

1994-04-22

This paper describes an effort to demonstrate the benefits of an innovative, lightweight, lubrication free centrifugal compressor that allows the use of environmentally sale alternate refrigerants with improved system efficiencies over current state-of-the-art technology. This effort couples the recently developed 3-D high efficiency centrifugal compressor and fabrication technologies with magnetic bearing technology and will then prove the performance, life and reliability of the compressor.

Summary of Technical Operations, 1991

DTIC Science & Technology

1992-01-01

exploit commonality. The project is using the Feature-Oriented Domain Analysis ( FODA ) method, developed by the project in 1990, to perform this...the development of new movement control software. The analysis will also serve as a means of improving the FODA method. The results of this analysis ...STARS environment. The NASA Program Office has officially decided to expand the use of Rate Monotonic Analysis (RMA), which was originally isolated to

Introducing the CERT (Trademark) Resiliency Engineering Framework: Improving the Security and Sustainability Processes

DTIC Science & Technology

2007-05-01

business processes and services. 4. Security operations management addresses the day-to-day activities that the organization performs to protect the...Management TM – Technology Management Security Operations Management SOM – Security Operations Management 5.7.2 Important Operations Competency...deals with the provision of access rights to informa- tion and technical assets SOM – Security Operations Management , which addresses the fundamental

Integrated United States Air Surveillance Governance Report

DTIC Science & Technology

2010-07-07

with examining whether and how IS departments and agencies might establish a governance mechanism to manage IS services in a manner that improves...Task Force recommends that an enduring interagency organization be established for collaborative management of IS services. It should be based on a...Committee (ISSAC)--would provide overall IS management and policy direction. IS technical work would be performed by a robust network of ISSAC

Adaptive Acquisitions: Maintaining Military Dominance By Managing Innovation

DTIC Science & Technology

2014-04-01

for the relatively unknown disruptive technologies , even for the technical experts. For example, in the early years of rocket research Jerome Hunsaker...improve along existing performance metrics.19 Since disruptive technologies generally underperform along these old value metrics, customers tend to...since the actual value of the innovation is difficult, if not impossible, to determine a priori. In fact, most of the claimed potential disruptive

Exploration on the Experiences Obtained by the Student in Sports

NASA Astrophysics Data System (ADS)

Jun, Chen

Through using the method of literature, logical speculation, this paper studied the sports experience. The result shows that the sports itself is a type of experience. The characteristics in the sports experience are innovational, emotional, personal, generating and individual. Through the sports experience, the student could improve their technical performance, cultivate the abundant emotion, form the independent character and produce the moral integrity.

A randomized controlled study to evaluate the role of video-based coaching in training laparoscopic skills.

PubMed

Singh, Pritam; Aggarwal, Rajesh; Tahir, Muaaz; Pucher, Philip H; Darzi, Ara

2015-05-01

This study evaluates whether video-based coaching can enhance laparoscopic surgical skills performance. Many professions utilize coaching to improve performance. The sports industry employs video analysis to maximize improvement from every performance. Laparoscopic novices were baseline tested and then trained on a validated virtual reality (VR) laparoscopic cholecystectomy (LC) curriculum. After competence, subjects were randomized on a 1:1 ratio and each performed 5 VRLCs. After each LC, intervention group subjects received video-based coaching by a surgeon, utilizing an adaptation of the GROW (Goals, Reality, Options, Wrap-up) coaching model. Control subjects viewed online surgical lectures. All subjects then performed 2 porcine LCs. Performance was assessed by blinded video review using validated global rating scales. Twenty subjects were recruited. No significant differences were observed between groups in baseline performance and in VRLC1. For each subsequent repetition, intervention subjects significantly outperformed controls on all global rating scales. Interventions outperformed controls in porcine LC1 [Global Operative Assessment of Laparoscopic Skills: (20.5 vs 15.5; P = 0.011), Objective Structured Assessment of Technical Skills: (21.5vs 14.5; P = 0.001), and Operative Performance Rating System: (26 vs 19.5; P = 0.001)] and porcine LC2 [Global Operative Assessment of Laparoscopic Skills: (28 vs 17.5; P = 0.005), Objective Structured Assessment of Technical Skills: (30 vs 16.5; P < 0.001), and Operative Performance Rating System: (36 vs 21; P = 0.004)]. Intervention subjects took significantly longer than controls in porcine LC1 (2920 vs 2004 seconds; P = 0.009) and LC2 (2297 vs 1683; P = 0.003). Despite equivalent exposure to practical laparoscopic skills training, video-based coaching enhanced the quality of laparoscopic surgical performance on both VR and porcine LCs, although at the expense of increased time. Video-based coaching is a feasible method of maximizing performance enhancement from every clinical exposure.

The effect of teamwork training on team performance and clinical outcome in elective orthopaedic surgery: a controlled interrupted time series study.

PubMed

Morgan, Lauren; Hadi, Mohammed; Pickering, Sharon; Robertson, Eleanor; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter; New, Steve

2015-04-20

To evaluate the effectiveness of aviation-style teamwork training in improving operating theatre team performance and clinical outcomes. 3 operating theatres in a UK district general hospital, 1 acting as a control group and the other 2 as the intervention group. 72 operations (37 intervention, 35 control) were observed in full by 2 trained observers during two 3-month observation periods, before and after the intervention period. A 1-day teamwork training course for all staff, followed by 6 weeks of weekly in-service coaching to embed learning. We measured team non-technical skills using Oxford NOTECHS II, (evaluating the whole team and the surgical, anaesthetic and nursing subteams, and evaluated technical performance using the Glitch count. We evaluated compliance with the WHO checklist by recording whether time-out (T/O) and sign-out (S/O) were attempted, and whether T/O was fully complied with. We recorded complications, re-admissions and duration of hospital stay using hospital administrative data. We compared the before-after change in the intervention and control groups using 2-way analysis of variance (ANOVA) and regression modelling. Mean NOTECHS II score increased significantly from 71.6 to 75.4 in the active group but remained static in the control group (p=0.047). Among staff subgroups, the nursing score increased significantly (p=0.006), but the anaesthetic and surgical scores did not. The attempt rate for WHO T/O procedures increased significantly in both active and control groups, but full compliance with T/O improved only in the active group (p=0.003). Mean glitch rate was unchanged in the control group but increased significantly (7.2-10.2/h, p=0.002) in the active group. Teamwork training was associated with improved non-technical skills in theatre teams but also with a rise in operative glitches. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Technology Solutions for New Manufactured Homes: Idaho, Oregon, and Washington Manufactured Home Builders (Fact Sheet)

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

None, None

2013-11-01

The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in themore » manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50 percent over typical manufactured homes produced in the northwest.« less

Improving Technical Instruction Using Personality Styles.

ERIC Educational Resources Information Center

Tomal, Daniel R.

2003-01-01

Incorporating personality styles into technical instruction can enhance student learning. Four personality styles based on Jung--intuitor, feeler, thinker, and doer--have implications for individualizing technical instruction. (JOW)

The Successful Teacher in Technical Education: The Preparation of the Successful Teacher.

ERIC Educational Resources Information Center

Storm, George

The purposes of this study were to identify success factors in technical education teaching and to obtain subject matter recommendations for the improvement of technical teacher education. A national population of technical education directors offering post-secondary technical education programs in 1963 under Title III of the National Defense…

Improvement of research report distribution and access and promotion of more effective use of Technical Report Documentation Page, USDOT Form 1700.7.

DOT National Transportation Integrated Search

2014-09-30

This report covers two studies: (Part A) Improvement of research report distribution and access process improvement of State Planning and Research (SPR) funded reports; and (Part B) Promotion of more effective use of the Technical Report Documentatio...

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Technical Reports Server (NTRS)

Raiman, Laura B.

1992-01-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Astrophysics Data System (ADS)

Raiman, Laura B.

1992-12-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Morphometric assessment of hip dysplasia in a cat treated by juvenile pubic symphysiodesis.

PubMed

Lai, Alen; Culvenor, John; Bailey, Craig

2016-09-20

To quantitatively evaluate the change of the coxofemoral joints using computed tomography and distraction index in a cat with hip dysplasia treated by juvenile pubic symphysiodesis. Case report. Eighteen-week-old female entire Maine Coon cat. Juvenile pubic symphysiodesis resulted in changes in the distraction index, acetabular angle, dorsal acetabular rim angle, dorsal acetabular sector angle, and clinical improvement at the six month follow-up. No intra-operative or postoperative complications were recorded. Juvenile pubic symphysiodesis performed at 18 weeks of age resulted in improvement in hip joint conformation and hip laxity in a dysplastic cat. Juvenile pubic symphysiodesis may be a promising treatment for feline hip dysplasia and is a safe and technically simple procedure to perform. Further investigations are warranted.

Glucose Biosensors: An Overview of Use in Clinical Practice

PubMed Central

Yoo, Eun-Hyung; Lee, Soo-Youn

2010-01-01

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

Application of Game Theory Approaches in Routing Protocols for Wireless Networks

NASA Astrophysics Data System (ADS)

Javidi, Mohammad M.; Aliahmadipour, Laya

2011-09-01

An important and essential issue for wireless networks is routing protocol design that is a major technical challenge due to the function of the network. Game theory is a powerful mathematical tool that analyzes the strategic interactions among multiple decision makers and the results of researches show that applied game theory in routing protocol lead to improvement the network performance through reduce overhead and motivates selfish nodes to collaborate in the network. This paper presents a review and comparison for typical representatives of routing protocols designed that applied game theory approaches for various wireless networks such as ad hoc networks, mobile ad hoc networks and sensor networks that all of them lead to improve the network performance.

Inertial Sensor Technology for Elite Swimming Performance Analysis: A Systematic Review

PubMed Central

Mooney, Robert; Corley, Gavin; Godfrey, Alan; Quinlan, Leo R; ÓLaighin, Gearóid

2015-01-01

Technical evaluation of swimming performance is an essential factor of elite athletic preparation. Novel methods of analysis, incorporating body worn inertial sensors (i.e., Microelectromechanical systems, or MEMS, accelerometers and gyroscopes), have received much attention recently from both research and commercial communities as an alternative to video-based approaches. This technology may allow for improved analysis of stroke mechanics, race performance and energy expenditure, as well as real-time feedback to the coach, potentially enabling more efficient, competitive and quantitative coaching. The aim of this paper is to provide a systematic review of the literature related to the use of inertial sensors for the technical analysis of swimming performance. This paper focuses on providing an evaluation of the accuracy of different feature detection algorithms described in the literature for the analysis of different phases of swimming, specifically starts, turns and free-swimming. The consequences associated with different sensor attachment locations are also considered for both single and multiple sensor configurations. Additional information such as this should help practitioners to select the most appropriate systems and methods for extracting the key performance related parameters that are important to them for analysing their swimmers’ performance and may serve to inform both applied and research practices. PMID:26712760

A procedural skills OSCE: assessing technical and non-technical skills of internal medicine residents.

PubMed

Pugh, Debra; Hamstra, Stanley J; Wood, Timothy J; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges

2015-03-01

Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal medicine (IM) residents to assess their technical and non-technical skills when performing procedures. Thirty-five first to third-year IM residents participated in a 5-station PS-OSCE, which combined partial task models, standardized patients, and allied health professionals. Formal blueprinting was performed and content experts were used to develop the cases and rating instruments. Examiners underwent a frame-of-reference training session to prepare them for their rater role. Scores were compared by levels of training, experience, and to evaluation data from a non-procedural OSCE (IM-OSCE). Reliability was calculated using Generalizability analyses. Reliabilities for the technical and non-technical scores were 0.68 and 0.76, respectively. Third-year residents scored significantly higher than first-year residents on the technical (73.5 vs. 62.2%) and non-technical (83.2 vs. 75.1%) components of the PS-OSCE (p < 0.05). Residents who had performed the procedures more frequently scored higher on three of the five stations (p < 0.05). There was a moderate disattenuated correlation (r = 0.77) between the IM-OSCE and the technical component of the PS-OSCE scores. The PS-OSCE is a feasible method for assessing multiple competencies related to performing procedures and this study provides validity evidence to support its use as an in-training examination.

Technical Assistance and Changes in Nutrition and Physical Activity Practices in the National Early Care and Education Learning Collaboratives Project, 2015-2016.

PubMed

Chiappone, Alethea; Smith, Teresa M; Estabrooks, Paul A; Rasmussen, Cristy Geno; Blaser, Casey; Yaroch, Amy L

2018-04-26

The National Early Care and Education Learning Collaboratives Project (ECELC) aims to improve best practices in early care and education (ECE) programs in topic areas of the Nutrition and Physical Activity Self-Assessment in Child Care (NAP SACC). Technical assistance is a component of the ECELC, yet its effect on outcomes is unclear. Beyond dose and duration of technical assistance, limited research exists on characteristics of technical assistance that contribute to outcomes. The objective of this study was to identify and describe technical assistance characteristics and explore associations with NAP SACC outcomes. We collected data from 10 collaboratives comprising 84 ECE programs in 2 states in 2015-2016. The objective of technical assistance was to support programs in improving best practices. Technical assistance was provided to programs via on-site, telephone, or email and was tailored to program needs. We used a mixed-methods design to examine associations between technical assistance and NAP SACC outcomes. We used multiple regression analysis to assess quantitative data and qualitative comparative analysis to determine necessary and sufficient technical assistance conditions supporting NAP SACC outcomes. We also conducted a document review to describe technical assistance that referred conditions identified by the qualitative comparative analysis. Regression analyses detected an inverse relationship between changes in NAP SACC scores and hours of technical assistance. No clear pattern emerged in the qualitative comparative analysis, leaving no necessary and sufficient conditions. However, the qualitative comparative analysis identified feedback as a potentially important component of technical assistance, whereas resource sharing and frequent email were characteristics that seemed to reduce the likelihood of improved outcomes. Email and resource sharing were considered primarily general information rather than tailored technical assistance. Technical assistance may be used in programs and made adaptable to program needs. The inclusion and evaluation of technical assistance, especially tailored approaches, is warranted for environmental interventions, including ECE settings.

Temporal Changes in Technical and Physical Performances During a Small-Sided Game in Elite Youth Soccer Players

PubMed Central

Moreira, Alexandre; Saldanha Aoki, Marcelo; Carling, Chris; Alan Rodrigues Lopes, Rafael; Felipe Schultz de Arruda, Ademir; Lima, Marcelo; Cesar Correa, Umberto; Bradley, Paul S

2016-01-01

Background There have been claims that small-sided games (SSG) may generate an appropriate environment to develop youth players’ technical performance associated to game-related problem solving. However, the temporal change in technical performance parameters of youth players during SSG is still unknown. Objectives The aim of this study was to examine temporal changes in technical and physical performances during a small-sided game (SSG) in elite soccer players. Methods Sixty elite youth players (age 14.8 ± 0.2 yr; stature 177 ± 5 cm; body mass 66.2 ± 4.7 kg) completed a 5 v 5 SSG using two repetitions of 8 minutes interspersed by 3 minutes of passive recovery. To evaluate temporal changes in performance, the data were analysed across 4 minutes quarters. Physical performance parameters included the total distance covered (TDC), the frequency of sprints (>18 km•h-1), accelerations and decelerations (> 2.0 m•s-2 and - 2.0 m•s-2), metabolic power (W•kg-1), training impulse (TRIMP), TDC: TRIMP, number of impacts, and body load. Technical performance parameters included goal attempts, total number of tackles, tackles and interceptions, total number of passes, and passes effectiveness. Results All physical performance parameters decreased from the first to the last quarter with notable declines in TDC, metabolic power and the frequency of sprints, accelerations and decelerations (P < 0.05; moderate to very large ES: 1.08 - 3.30). However, technical performance parameters did not vary across quarters (P > 0.05; trivial ES for 1st v 4th quarters: 0.15 - 0.33). Conclusions The data demonstrate that technical performance is maintained despite substantial declines in physical performance during a SSG in elite youth players. This finding may have implications for designing SSG’s for elite youth players to ensure physical, technical and tactical capabilities are optimized. Modifications in player number, pitch dimensions, rules, coach encouragement, for instance, should be included taking into account the main aim of a given session and then focused on overloading physical or technical elements. PMID:28144411

Temporal Changes in Technical and Physical Performances During a Small-Sided Game in Elite Youth Soccer Players.

PubMed

Moreira, Alexandre; Saldanha Aoki, Marcelo; Carling, Chris; Alan Rodrigues Lopes, Rafael; Felipe Schultz de Arruda, Ademir; Lima, Marcelo; Cesar Correa, Umberto; Bradley, Paul S

2016-12-01

There have been claims that small-sided games (SSG) may generate an appropriate environment to develop youth players' technical performance associated to game-related problem solving. However, the temporal change in technical performance parameters of youth players during SSG is still unknown. The aim of this study was to examine temporal changes in technical and physical performances during a small-sided game (SSG) in elite soccer players. Sixty elite youth players (age 14.8 ± 0.2 yr; stature 177 ± 5 cm; body mass 66.2 ± 4.7 kg) completed a 5 v 5 SSG using two repetitions of 8 minutes interspersed by 3 minutes of passive recovery. To evaluate temporal changes in performance, the data were analysed across 4 minutes quarters. Physical performance parameters included the total distance covered (TDC), the frequency of sprints (>18 km•h -1 ), accelerations and decelerations (> 2.0 m•s -2 and - 2.0 m•s -2 ), metabolic power (W•kg -1 ), training impulse (TRIMP), TDC: TRIMP, number of impacts, and body load. Technical performance parameters included goal attempts, total number of tackles, tackles and interceptions, total number of passes, and passes effectiveness. All physical performance parameters decreased from the first to the last quarter with notable declines in TDC, metabolic power and the frequency of sprints, accelerations and decelerations (P < 0.05; moderate to very large ES: 1.08 - 3.30). However, technical performance parameters did not vary across quarters (P > 0.05; trivial ES for 1st v 4th quarters: 0.15 - 0.33). The data demonstrate that technical performance is maintained despite substantial declines in physical performance during a SSG in elite youth players. This finding may have implications for designing SSG's for elite youth players to ensure physical, technical and tactical capabilities are optimized. Modifications in player number, pitch dimensions, rules, coach encouragement, for instance, should be included taking into account the main aim of a given session and then focused on overloading physical or technical elements.

An application of data mining in district heating substations for improving energy performance

NASA Astrophysics Data System (ADS)

Xue, Puning; Zhou, Zhigang; Chen, Xin; Liu, Jing

2017-11-01

Automatic meter reading system is capable of collecting and storing a huge number of district heating (DH) data. However, the data obtained are rarely fully utilized. Data mining is a promising technology to discover potential interesting knowledge from vast data. This paper applies data mining methods to analyse the massive data for improving energy performance of DH substation. The technical approach contains three steps: data selection, cluster analysis and association rule mining (ARM). Two-heating-season data of a substation are used for case study. Cluster analysis identifies six distinct heating patterns based on the primary heat of the substation. ARM reveals that secondary pressure difference and secondary flow rate have a strong correlation. Using the discovered rules, a fault occurring in remote flow meter installed at secondary network is detected accurately. The application demonstrates that data mining techniques can effectively extrapolate potential useful knowledge to better understand substation operation strategies and improve substation energy performance.

The Relationship of Aptitudes to the Performance of Skilled Technical Jobs in Engine Manufacturing. Technical Report 1982-5 [and Supplement].

ERIC Educational Resources Information Center

Daniel, Mark; And Others

A study examined the relationship of aptitudes to the performance of skilled technical jobs in engine manufacturing. During the study, several approaches were utilized, including criterion-referenced validation, taxonomic validation, construct validation, and detailed anlaysis of the behaviors involved in performing the jobs. The study sample…

A FEEDBACK INTERVENTION TO INCREASE DIGITAL AND PAPER CHECKLIST PERFORMANCE IN TECHNICALLY ADVANCED AIRCRAFT SIMULATION

PubMed Central

Rantz, William G; Van Houten, Ron

2011-01-01

This study examined whether pilots operating a flight simulator completed digital or paper flight checklists more accurately after receiving postflight graphic and verbal feedback. The dependent variable was the number of checklist items completed correctly per flight. Following treatment, checklist completion with paper and digital checklists increased from 38% and 39%, respectively, to nearly 100% and remained close to 100% after feedback and praise for improvement were withdrawn. Performance was maintained at or near 100% during follow-up probes. PMID:21541133

Computer program to perform cost and weight analysis of transport aircraft. Volume 2: Technical volume

NASA Technical Reports Server (NTRS)

1973-01-01

An improved method for estimating aircraft weight and cost using a unique and fundamental approach was developed. The results of this study were integrated into a comprehensive digital computer program, which is intended for use at the preliminary design stage of aircraft development. The program provides a means of computing absolute values for weight and cost, and enables the user to perform trade studies with a sensitivity to detail design and overall structural arrangement. Both batch and interactive graphics modes of program operation are available.

Removing inter-subject technical variability in magnetic resonance imaging studies.

PubMed

Fortin, Jean-Philippe; Sweeney, Elizabeth M; Muschelli, John; Crainiceanu, Ciprian M; Shinohara, Russell T

2016-05-15

Magnetic resonance imaging (MRI) intensities are acquired in arbitrary units, making scans non-comparable across sites and between subjects. Intensity normalization is a first step for the improvement of comparability of the images across subjects. However, we show that unwanted inter-scan variability associated with imaging site, scanner effect, and other technical artifacts is still present after standard intensity normalization in large multi-site neuroimaging studies. We propose RAVEL (Removal of Artificial Voxel Effect by Linear regression), a tool to remove residual technical variability after intensity normalization. As proposed by SVA and RUV [Leek and Storey, 2007, 2008, Gagnon-Bartsch and Speed, 2012], two batch effect correction tools largely used in genomics, we decompose the voxel intensities of images registered to a template into a biological component and an unwanted variation component. The unwanted variation component is estimated from a control region obtained from the cerebrospinal fluid (CSF), where intensities are known to be unassociated with disease status and other clinical covariates. We perform a singular value decomposition (SVD) of the control voxels to estimate factors of unwanted variation. We then estimate the unwanted factors using linear regression for every voxel of the brain and take the residuals as the RAVEL-corrected intensities. We assess the performance of RAVEL using T1-weighted (T1-w) images from more than 900 subjects with Alzheimer's disease (AD) and mild cognitive impairment (MCI), as well as healthy controls from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. We compare RAVEL to two intensity-normalization-only methods: histogram matching and White Stripe. We show that RAVEL performs best at improving the replicability of the brain regions that are empirically found to be most associated with AD, and that these regions are significantly more present in structures impacted by AD (hippocampus, amygdala, parahippocampal gyrus, enthorinal area, and fornix stria terminals). In addition, we show that the RAVEL-corrected intensities have the best performance in distinguishing between MCI subjects and healthy subjects using the mean hippocampal intensity (AUC=67%), a marked improvement compared to results from intensity normalization alone (AUC=63% and 59% for histogram matching and White Stripe, respectively). RAVEL is promising for many other imaging modalities. Published by Elsevier Inc.

An analysis of information design and packaging for an inelastic market

NASA Technical Reports Server (NTRS)

Pinelli, T. E.; Mccullough, R.; Cordle, V. M.

1982-01-01

Producers of technical reports can increase the potential use of the technical report, as an information product, by making certain changes to the sequential, language, and presentation components. These improvements, which effect the overall design and packaging of the product, are discussed. These improvements are likely to have their greatest impact on the marginal technical report user. However, these improvements are not without economic consideration. For this reason, cost factors should be calculated to ensure that benefits to the user and/or increased utility will outweight the cost to the producer.

Technical report writing

NASA Technical Reports Server (NTRS)

Vidoli, Carol A.

1992-01-01

This manual covers the fundamentals of organizing, writing, and reviewing NASA technical reports. It was written to improve the writing skills of LeRC technical authors and the overall quality of their reports.

29 CFR 95.44 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., record of past performance, financial and technical resources or accessibility to other necessary..., whenever practicable, of technical requirements in terms of functions to be performed or performance...

15 CFR 14.44 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., record of past performance, financial and technical resources or accessibility to other necessary... practicable, of technical requirements in terms of functions to be performed or performance required...

Setting Performance Standards for Technical and Nontechnical Competence in General Surgery.

PubMed

Szasz, Peter; Bonrath, Esther M; Louridas, Marisa; Fecso, Andras B; Howe, Brett; Fehr, Adam; Ott, Michael; Mack, Lloyd A; Harris, Kenneth A; Grantcharov, Teodor P

2017-07-01

The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. Scores on performance assessments are difficult to interpret in the absence of established standards. Trained raters observed General Surgery residents performing laparoscopic cholecystectomies using the Objective Structured Assessment of Technical Skill (OSATS) and the Objective Structured Assessment of Non-Technical Skills (OSANTS) instruments, while as also providing a global competent/noncompetent decision for each performance. The global decision was used to divide the trainees into 2 contrasting groups and the OSATS or OSANTS scores were graphed per group to determine the performance standard. Parametric statistics were used to determine classification accuracy and concurrent standard acquisition, receiver operator characteristic (ROC) curves were used to delineate predictive factors. Thirty-six trainees were observed 101 times. The technical standard was an OSATS of 21.04/35.00 and the nontechnical standard an OSANTS of 22.49/35.00. Applying these standards, competent/noncompetent trainees could be discriminated in 94% of technical and 95% of nontechnical performances (P < 0.001). A 21% discordance between technically and nontechnically competent trainees was identified (P < 0.001). ROC analysis demonstrated case experience and trainee level were both able to predict achieving the standards with an area under the curve (AUC) between 0.83 and 0.96 (P < 0.001). The present study presents defensible standards for technical and nontechnical performance. Such standards are imperative to implementing summative assessments into surgical training.

An update on technical and methodological aspects for cardiac PET applications.

PubMed

Presotto, Luca; Busnardo, Elena; Gianolli, Luigi; Bettinardi, Valentino

2016-12-01

Positron emission tomography (PET) is indicated for a large number of cardiac diseases: perfusion and viability studies are commonly used to evaluate coronary artery disease; PET can also be used to assess sarcoidosis and endocarditis, as well as to investigate amyloidosis. Furthermore, a hot topic for research is plaque characterization. Most of these studies are technically very challenging. High count rates and short acquisition times characterize perfusion scans while very small targets have to be imaged in inflammation/infection and plaques examinations. Furthermore, cardiac PET suffers from respiratory and cardiac motion blur. Each type of studies has specific requirements from the technical and methodological point of view, thus PET systems with overall high performances are required. Furthermore, in the era of hybrid PET/computed tomography (CT) and PET/Magnetic Resonance Imaging (MRI) systems, the combination of complementary functional and anatomical information can be used to improve diagnosis and prognosis. Moreover, PET images can be qualitatively and quantitatively improved exploiting information from the other modality, using advanced algorithms. In this review we will report the latest technological and methodological innovations for PET cardiac applications, with particular reference to the state of the art of the hybrid PET/CT and PET/MRI. We will also report the most recent advancements in software, from reconstruction algorithms to image processing and analysis programs.

Feasibility of Computer-Based Videogame Therapy for Children with Cerebral Palsy

PubMed Central

Radtka, Sandra; Hone, Robert; Brown, Charles; Mastick, Judy; Melnick, Marsha E.

2013-01-01

Abstract Objectives Standing and gait balance problems are common in children with cerebral palsy (CP), resulting in falls and injuries. Task-oriented exercises to strengthen and stretch muscles that shift the center of mass and change the base of support are effective in improving balance. Gaming environments can be challenging and fun, encouraging children to engage in exercises at home. The aims of this project were to demonstrate the technical feasibility, ease of use, appeal, and safety of a computer-based videogame program designed to improve balance in children with CP. Materials and Methods This study represents a close collaboration between computer design and clinical team members. The first two phases were performed in the laboratory, and the final phase was done in subjects' homes. The prototype balance game was developed using computer-based real-time three-dimensional programming that enabled the team to capture engineering data necessary to tune the system. Videogame modifications, including identifying compensatory movements, were made in an iterative fashion based on feedback from subjects and observations of clinical and software team members. Results Subjects (n=14) scored the game 21.5 out of 30 for ease of use and appeal, 4.0 out of 5 for enjoyment, and 3.5 on comprehension. There were no safety issues, and the games performed without technical flaws in final testing. Conclusions A computer-based videogame incorporating therapeutic movements to improve gait and balance in children with CP was appealing and feasible for home use. A follow-up study examining its effectiveness in improving balance in children with CP is recommended. PMID:24761324

Feasibility of Computer-Based Videogame Therapy for Children with Cerebral Palsy.

PubMed

Radtka, Sandra; Hone, Robert; Brown, Charles; Mastick, Judy; Melnick, Marsha E; Dowling, Glenna A

2013-08-01

Standing and gait balance problems are common in children with cerebral palsy (CP), resulting in falls and injuries. Task-oriented exercises to strengthen and stretch muscles that shift the center of mass and change the base of support are effective in improving balance. Gaming environments can be challenging and fun, encouraging children to engage in exercises at home. The aims of this project were to demonstrate the technical feasibility, ease of use, appeal, and safety of a computer-based videogame program designed to improve balance in children with CP. This study represents a close collaboration between computer design and clinical team members. The first two phases were performed in the laboratory, and the final phase was done in subjects' homes. The prototype balance game was developed using computer-based real-time three-dimensional programming that enabled the team to capture engineering data necessary to tune the system. Videogame modifications, including identifying compensatory movements, were made in an iterative fashion based on feedback from subjects and observations of clinical and software team members. Subjects ( n =14) scored the game 21.5 out of 30 for ease of use and appeal, 4.0 out of 5 for enjoyment, and 3.5 on comprehension. There were no safety issues, and the games performed without technical flaws in final testing. A computer-based videogame incorporating therapeutic movements to improve gait and balance in children with CP was appealing and feasible for home use. A follow-up study examining its effectiveness in improving balance in children with CP is recommended.

The Medicare Health Outcomes Survey program: overview, context, and near-term prospects.

PubMed

Jones, Nathaniel; Jones, Stephanie L; Miller, Nancy A

2004-07-12

In 1996, the Centers for Medicare & Medicaid Services (CMS) initiated the Medicare Health Outcomes Survey (HOS). It is the first national survey to measure the quality of life and functional health status of Medicare beneficiaries enrolled in managed care. The program seeks to gather valid and reliable health status data in Medicare managed care for use in quality improvement activities, public reporting, plan accountability and improving health outcomes based on competition. The context that led to the development of the HOS was formed by the convergence of the following factors: 1) a recognized need to monitor the performance of managed care plans, 2) technical expertise and advancement in the areas of quality measurement and health outcomes assessment, 3) the existence of a tested functional health status assessment tool (SF-36)1, which was valid for an elderly population, 4) CMS leadership, and 5) political interest in quality improvement. Since 1998, there have been six baseline surveys and four follow up surveys. CMS, working with its partners, performs the following tasks as part of the HOS program: 1) Supports the technical/scientific development of the HOS measure, 2) Certifies survey vendors, 3) Collects Health Plan Employer Data and Information Set(HEDIS)2 HOS data, 4) Cleans, scores, and disseminates annual rounds of HOS data, public use files and reports to CMS, Quality Improvement Organizations (QIOs), Medicare+Choice Organizations (M+COs), and other stakeholders, 5) Trains M+COs and QIOs in the use of functional status measures and best practices for improving care, 6) Provides technical assistance to CMS, QIOs, M+COs and other data users, and 7) Conducts analyses using HOS data to support CMS and HHS priorities.CMS has recently sponsored an evaluation of the HOS program, which will provide the information necessary to enhance the future administration of the program. Information collected to date reveals that the HOS program is a valuable tool that provides a rich set of data that is useful for quality monitoring and improvement efforts. To enhance the future of the HOS program, many stakeholders recommend the implementation of incentives to encourage the use of the data, while others identify the need to monitor the health status of plan disenrollees.Overall, the HOS program represents an important vehicle for collecting outcomes data from Medicare beneficiaries. The new Medicare Prescription Drug, Improvement, and Modernization Act (2003) mandates the collection and use of data for outcomes measurement. Consequently, it is important to improve HOS to most effectively meet the mandate.

The quality assurance liaison: Combined technical and quality assurance support

NASA Astrophysics Data System (ADS)

Bolivar, S. L.; Day, J. L.

1993-03-01

The role of the quality assurance liaison, the responsibilities of this position, and the evolutionary changes in duties over the last six years are described. The role of the quality assurance liaison has had a very positive impact on the Los Alamos Yucca Mountain Site Characterization (YW) quality assurance program. Having both technical and quality assurance expertise, the quality assurance liaisons are able to facilitate communications with scientists on quality assurance issues and requirements, thereby generating greater productivity in scientific investigations. The quality assurance liaisons help ensure that the scientific community knows and implements existing requirements, is aware of new or changing regulations, and is able to conduct scientific work within Project requirements. The influence of the role of the quality assurance liaison can be measured by an overall improvement in attitude of the staff regarding quality assurance requirements and improved job performance, as well as a decrease in deficiencies identified during both internal and external audits and surveillances. This has resulted in a more effective implementation of quality assurance requirements.

Fundamental Aeronautics Program: Overview of Project Work in Supersonic Cruise Efficiency

NASA Technical Reports Server (NTRS)

Castner, Raymond

2011-01-01

The Supersonics Project, part of NASA?s Fundamental Aeronautics Program, contains a number of technical challenge areas which include sonic boom community response, airport noise, high altitude emissions, cruise efficiency, light weight durable engines/airframes, and integrated multi-discipline system design. This presentation provides an overview of the current (2011) activities in the supersonic cruise efficiency technical challenge, and is focused specifically on propulsion technologies. The intent is to develop and validate high-performance supersonic inlet and nozzle technologies. Additional work is planned for design and analysis tools for highly-integrated low-noise, low-boom applications. If successful, the payoffs include improved technologies and tools for optimized propulsion systems, propulsion technologies for a minimized sonic boom signature, and a balanced approach to meeting efficiency and community noise goals. In this propulsion area, the work is divided into advanced supersonic inlet concepts, advanced supersonic nozzle concepts, low fidelity computational tool development, high fidelity computational tools, and improved sensors and measurement capability. The current work in each area is summarized.

Coronagraph observations and analyses of the ultraviolet solar corona

NASA Technical Reports Server (NTRS)

Kohl, John L.

1989-01-01

The major activities on the Spartan Ultraviolet Coronal Spectrometer project include both scientific and experimental/technical efforts. In the scientific area, a detailed analysis of the previously reported Doppler dimming of HI Ly-alpha from the July 1982 rocket flight has determined an outflow velocity at 2 solar radii from sun center to be between 153 and 251 km/s at 67 percent confidence. The technical activities include, several improvements made to the instrument that will result in enhanced scientific performance or in regaining a capability that had deteriorated during the delay time in the launch date. These include testing and characterizing the detector for OVI radiation, characterizing a serrated occulter at UV and visible wavelengths, fabricating and testing telescope mirrors with improved edges, testing and evaluating a new array detector system, modifying the slit mask mechanism and installing a mask in the instrument to block the Ly-alpha resonance line when the electron scattered component is being observed.

77 FR 27490 - Plant-Specific Adoption, Revision 4 of the Improved Standard Technical Specifications

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-10

...,'' NUREG-1432, ``Standard Technical Specifications, Combustion Engineering Plants,'' NUREG-1433, ``Standard..., ``Standard Technical Specifications, Combustion Engineering Plants'' Revision 4, ADAMS Accession No..., Westinghouse Plants''.. NUREG-1432, ``Standard Technical ML12102A165 ML12102A169 Specifications, Combustion...

Toward development of a comprehensive external quality assurance program for polyfunctional intracellular cytokine staining assays

PubMed Central

Staats, Janet S.; Enzor, Jennifer H.; Sanchez, Ana M.; Rountree, Wes; Chan, Cliburn; Jaimes, Maria; Chan, Ray Chun-Fai; Gaur, Amitabh; Denny, Thomas N.; Weinhold, Kent J.

2014-01-01

The External Quality Assurance Program Oversight Laboratory (EQAPOL) Flow Cytometry Program assesses the proficiency of NIH/NIAID/DAIDS-supported and potentially other interested research laboratories in performing Intracellular Cytokine Staining (ICS) assays. The goal of the EQAPOL Flow Cytometry External Quality Assurance Program (EQAP) is to provide proficiency testing and remediation for participating sites. The program is not punitive; rather, EQAPOL aims to help sites identify areas for improvement. EQAPOL utilizes a highly standardized ICS assay to minimize variability and readily identify those sites experiencing technical difficulties with their assays. Here, we report the results of External Proficiency 3 (EP3) where participating sites performed a 7-color ICS assay. On average, sites perform well in the Flow Cytometry EQAP (median score is “Good”). The most common technical issues identified by the program involve protocol adherence and data analysis; these areas have been the focus of site remediation. The EQAPOL Flow Cytometry team is now in the process of expanding the program to 8-color ICS assays. Evaluating polyfunctional ICS responses would align the program with assays currently being performed in support of HIV immune monitoring assays. PMID:24968072

THE EFFECT OF FEEDBACK ON THE ACCURACY OF CHECKLIST COMPLETION DURING INSTRUMENT FLIGHT TRAINING

PubMed Central

Rantz, William G; Dickinson, Alyce M; Sinclair, Gilbert A; Van Houten, Ron

2009-01-01

This study examined whether pilots completed airplane checklists more accurately when they receive postflight graphic and verbal feedback. Participants were 8 college students who are pilots with an instrument rating. The task consisted of flying a designated flight pattern using a personal computer aviation training device (PCATD). The dependent variables were the number of checklist items completed correctly. A multiple baseline design across pairs of participants with withdrawal of treatment was employed in this study. During baseline, participants were given postflight technical feedback. During intervention, participants were given postflight graphic feedback on checklist use and praise for improvements along with technical feedback. The intervention produced near perfect checklist performance, which was maintained following a return to the baseline conditions. PMID:20190914

75 FR 34734 - Improving Market and Planning Efficiency Through Improved Software; Notice of Agenda and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... Market and Planning Efficiency Through Improved Software; Notice of Agenda and Procedures for Staff Technical Conference June 10, 2010. This notice establishes the agenda and procedures for the staff[email protected] . Kimberly D. Bose, Secretary. Agenda for AD10-12 Staff Technical Conference on Enhanced Power...

Experience measuring performance improvement in multiphase picture archiving and communications systems implementations.

PubMed

Reed, G; Reed, D H

1999-05-01

When planning a picture archiving and communications system (PACS) implementation and determining which equipment will be implemented in earlier and later phases, collection and analysis of selected data will aid in setting implementation priorities. If baseline data are acquired relative to performance objectives, the same information used for implementation planning can be used to measure performance improvement and outcomes. The main categories of data to choose from are: (1) financial data; (2) productivity data; (3) operational parameters; (4) clinical data; and (5) information about customer satisfaction. In the authors' experience, detailed workflow data have not proved valuable in measuring PACS performance and outcomes. Reviewing only one category of data in planning will not provide adequate basis for targeting operational improvements that will lead to the most significant gains. Quality improvement takes into account all factors in production: human capacity, materials, operating capital and assets. Once we have identified key areas of focus for quality improvement in each phase, we can translate objectives into implementation requirements and finally into detailed functional and performance requirements. Here, Integration Resources reports its experience measuring PACS performance relative to phased implementation strategies for three large medical centers. Each medical center had its own objectives for overcoming image management, physical/geographical, and functional/technical barriers. The report outlines (1) principal financial and nonfinancial measures used as performance indicators; (2) implementation strategies chosen by each of the three medical centers; and (3) the results of those strategies as compared with baseline data.

45 CFR 2543.44 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., record of past performance, financial and technical resources or accessibility to other necessary... technical requirements in terms of functions to be performed or performance required, including the range of...

36 CFR 1210.44 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., record of past performance, financial and technical resources or accessibility to other necessary... technical requirements in terms of functions to be performed or performance required, including the range of...

14 CFR 1260.144 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., record of past performance, financial and technical resources or accessibility to other necessary... technical requirements in terms of functions to be performed or performance required, including the range of...

The Development of Technical and Vocational Education in Malaysia--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Hee, Tieng Fok

The economic profile of Malaysia has changed from an economy mainly based on agriculture and the production of tin ore to a more balanced economy with continuing growth in the manufacturing and industrial sectors. Educational programs need to be upgraded and improved, particularly the direction and development of technical and vocational education…

Vocational and Technical Education Performance Standards and Competencies.

ERIC Educational Resources Information Center

Connecticut State Board of Education, Hartford.

These Connecticut vocational and technical performance standards and competencies are a guide for overall quality attainment in these seven vocational and technical program areas: agricultural science technology education; business and finance technology education; cooperative work education; family and consumer sciences education; marketing…

32 CFR 37.895 - How is the final performance report to be sent to the Defense Technical Information Center?

Code of Federal Regulations, 2014 CFR

2014-07-01

... How is the final performance report to be sent to the Defense Technical Information Center? (a... 32 National Defense 1 2014-07-01 2014-07-01 false How is the final performance report to be sent to the Defense Technical Information Center? 37.895 Section 37.895 National Defense Department of...

32 CFR 37.895 - How is the final performance report to be sent to the Defense Technical Information Center?

Code of Federal Regulations, 2011 CFR

2011-07-01

... How is the final performance report to be sent to the Defense Technical Information Center? (a... 32 National Defense 1 2011-07-01 2011-07-01 false How is the final performance report to be sent to the Defense Technical Information Center? 37.895 Section 37.895 National Defense Department of...

32 CFR 37.895 - How is the final performance report to be sent to the Defense Technical Information Center?

Code of Federal Regulations, 2013 CFR

2013-07-01

... How is the final performance report to be sent to the Defense Technical Information Center? (a... 32 National Defense 1 2013-07-01 2013-07-01 false How is the final performance report to be sent to the Defense Technical Information Center? 37.895 Section 37.895 National Defense Department of...

32 CFR 37.895 - How is the final performance report to be sent to the Defense Technical Information Center?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false How is the final performance report to be sent to the Defense Technical Information Center? 37.895 Section 37.895 National Defense Department of... How is the final performance report to be sent to the Defense Technical Information Center? (a...

7 CFR 1469.9 - Technical assistance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Technical assistance. 1469.9 Section 1469.9... Provisions § 1469.9 Technical assistance. (a) NRCS may use the services of NRCS-approved or certified Technical Service Providers in performing its responsibilities for technical assistance. (b) Technical...

Spatial abilities and technical skills performance in health care: a systematic review.

PubMed

Langlois, Jean; Bellemare, Christian; Toulouse, Josée; Wells, George A

2015-11-01

The aim of this study was to conduct a systematic review and meta-analysis of the relationship between spatial abilities and technical skills performance in health care in beginners and to compare this relationship with those in intermediate and autonomous learners. Search criteria included 'spatial abilities' and 'technical skills'. Keywords related to these criteria were defined. A literature search was conducted to 20 December, 2013 in Scopus (including MEDLINE) and in several databases on EBSCOhost platforms (CINAHL Plus with Full Text, ERIC, Education Source and PsycINFO). Citations were obtained and reviewed by two independent reviewers. Articles related to retained citations were reviewed and a final list of eligible articles was determined. Articles were assessed for quality using the Scottish Intercollegiate Guidelines Network-50 assessment instrument. Data were extracted from articles in a systematic way. Correlations between spatial abilities test scores and technical skills performance were identified. A series of 8289 citations was obtained. Eighty articles were retained and fully reviewed, yielding 36 eligible articles. The systematic review found a tendency for spatial abilities to be negatively correlated with the duration of technical skills and positively correlated with the quality of technical skills performance in beginners and intermediate learners. Pooled correlations of studies were -0.46 (p = 0.03) and -0.38 (95% confidence interval [CI] -0.53 to -0.21) for duration and 0.33 (95% CI 0.20-0.44) and 0.41 (95% CI 0.26-0.54) for quality of technical skills performance in beginners and intermediate learners, respectively. However, correlations between spatial abilities test scores and technical skills performance were not statistically significant in autonomous learners. Spatial abilities are an important factor to consider in selecting and training individuals in technical skills in health care. © 2015 John Wiley & Sons Ltd.

Simulation-Based Laparoscopic Surgery Crisis Resource Management Training-Predicting Technical and Nontechnical Skills.

PubMed

Goldenberg, Mitchell G; Fok, Kai H; Ordon, Michael; Pace, Kenneth T; Lee, Jason Y

2017-12-19

To develop a unique simulation-based assessment using a laparoscopic inferior vena cava (IVC) injury scenario that allows for the safe assessment of urology resident's technical and nontechnical skills, and investigate the effect of personality traits performance in a surgical crisis. Urology residents from our institution were recruited to participate in a simulation-based training laparoscopic nephrectomy exercise. Residents completed demographic and multidimensional personality questionnaires and were instructed to play the role of staff urologist. A vasovagal response to pneumoperitoneum and an IVC injury event were scripted into the scenario. Technical and nontechnical skills were assessed by expert laparoscopic surgeons using validated tools (task checklist, GOALS, and NOTSS). Ten junior and five senior urology residents participated. Five residents were unable to complete the exercise safely. Senior residents outperformed juniors on technical (checklist score 15.1 vs 9.9, p < 0.01, GOALS score 18.0 vs 13.3, p < 0.01) and nontechnical performance (NOTSS score 13.8 vs 10.1, p = 0.03). Technical performance scores correlated with NOTSS scores (p < 0.01) and pass/fail rating correlated with technical performance (p < 0.01 for both checklist and GOALS), NOTSS score (p = 0.02), and blood loss (p < 0.01). Only the conscientiousness dimension of the big five inventory correlated with technical score (p = 0.03) and pass/fail rating (p = 0.04). Resident level of training and laparoscopic experience correlated with technical performance during a simulation-based laparoscopic IVC injury crisis management scenario, as well as multiple domains of nontechnical performance. Personality traits of our surgical residents are similar and did not predict technical skill. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Technical and physical determinants of soccer match-play performance in elite youth soccer players.

PubMed

Rowat, Owain; Fenner, Jonathan; Unnithan, Viswanath

2017-04-01

The aim of this study was to evaluate whether physical performance characteristics could be a better predictor than technical skills in determining the technical level of county soccer players in a match situation. With institutional ethics approval, 25 male youth soccer players aged 16-18.5 years from a professional soccer academy in South East Asia were selected and height and body mass were recorded. Players were tested for sexual maturity (pubertal development scale [PDS] self-assessment), aerobic capacity (yo-yo intermittent recovery test level 1 [YYIR1]), repeated sprint ability (7 x 35 m sprints) acceleration (15 m sprint) and four soccer skills tests (dribble with pass, dribbling speed, passing and shooting accuracy). Players' technical ability during match play was assessed in small-sided games of soccer (5 v 5) using a novel game technical scoring chart (scoring chart completed by coaches to assess technical performance in a match situation) developed from criteria (e.g., first touch, dribbling and two footedness) used by youth soccer coaches for talent identification. A Spearman's rank correlation showed the YYIR1 test and 15 m sprint test were limited in predicting technical match performance (r=0.03, P=0.88, r=-0.23, P=0.32 respectively). A Pearson product moment correlation showed that the repeated sprint test was also limited in predicting technical match performance (r=-0.34, P=0.14). A dribbling skill with a pass was found to be the best determinant of a player's technical ability in a match (r=-0.57, P=0.00). Talent identification and selection programs in Asian youth soccer should include a dribbling skill performed with a pass.

INDOT Technical Training Plan : [Technical Summary

DOT National Transportation Integrated Search

2012-01-01

A wide range of job classifications, increasing technical : performance expectations, licensing and certification requirements, : budget restrictions and frequent department : reorganization has made technical training of employees : more difficult, ...

[The study of establishment of the " Chinese provincial Blindness prevention technical guidance group performance evaluation system"].

PubMed

Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D

2016-11-11

Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems. Conclusion: This system established is appropriate at current time, and it can effectively evaluate the performance of the Chinese provincial Blindness prevention technical guidance group. (Chin J Ophthalmol, 2016, 52:814-824) .

United States Supports Distributed Wind Technology Improvements; NREL (National Renewable Energy Laboratory)

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

Sinclair, Karin

2015-06-15

This presentation provides information on the activities conducted through the Competitiveness Improvement Project (CIP), initiated in 2012 by the U.S. Department of Energy (DOE) and executed through the National Renewable Energy Laboratory (NREL) to support the distributed wind industry. The CIP provides research and development funding and technical support to improve distributed wind turbine technology and increase the competitiveness of U.S. small and midsize wind turbine manufacturers. Through this project, DOE/NREL assists U.S. manufacturers to lower the levelized cost of energy of wind turbines through component improvements, manufacturing process upgrades, and turbine testing. Ultimately, this support is expected to leadmore » to turbine certification through testing to industry-recognized wind turbine performance and safety standards.« less

Numerical modeling of cold room's hinged door opening and closing processes

NASA Astrophysics Data System (ADS)

Carneiro, R.; Gaspar, P. D.; Silva, P. D.; Domingues, L. C.

2016-06-01

The need of rationalize energy consumption in agrifood industry has fasten the development of methodologies to improve the thermal and energy performances of cold rooms. This paper presents a three-dimensional (3D) transient Computational Fluid Dynamics (CFD) modelling of a cold room to evaluate the air infiltration rate through hinged doors. A species transport model is used for modelling the tracer gas concentration decay technique. Numerical predictions indicate that air temperature difference between spaces affects the air infiltration. For this case study, the infiltration rate increases 0.016 m3 s-1 per K of air temperature difference. The knowledge about the evolution of air infiltration during door opening/closing times allows to draw some conclusions about its influence on the air conditions inside the cold room, as well as to suggest best practices and simple technical improvements that can minimize air infiltration, and consequently improve thermal performance and energy consumption rationalization.

Measuring Efficiency of Health Systems of the Middle East and North Africa (MENA) Region Using Stochastic Frontier Analysis.

PubMed

Hamidi, Samer; Akinci, Fevzi

2016-06-01

The main purpose of this study is to measure the technical efficiency of twenty health systems in the Middle East and North Africa (MENA) region to inform evidence-based health policy decisions. In addition, the effects of alternative stochastic frontier model specification on the empirical results are examined. We conducted a stochastic frontier analysis to estimate the country-level technical efficiencies using secondary panel data for 20 MENA countries for the period of 1995-2012 from the World Bank database. We also tested the effect of alternative frontier model specification using three random-effects approaches: a time-invariant model where efficiency effects are assumed to be static with regard to time, and a time-varying efficiency model where efficiency effects have temporal variation, and one model to account for heterogeneity. The average estimated technical inefficiency of health systems in the MENA region was 6.9 % with a range of 5.7-7.9 % across the three models. Among the top performers, Lebanon, Qatar, and Morocco are ranked consistently high according to the three different inefficiency model specifications. On the opposite side, Sudan, Yemen and Djibouti ranked among the worst performers. On average, the two most technically efficient countries were Qatar and Lebanon. We found that the estimated technical efficiency scores vary substantially across alternative parametric models. Based on the findings reported in this study, most MENA countries appear to be operating, on average, with a reasonably high degree of technical efficiency compared with other countries in the region. However, there is evidence to suggest that there are considerable efficiency gains yet to be made by some MENA countries. Additional empirical research is needed to inform future health policies aimed at improving both the efficiency and sustainability of the health systems in the MENA region.

Users perspectives on interactive distance technology enabling home-based motor training for stroke patients.

PubMed

Ehn, Maria; Hansson, Pär; Sjölinder, Marie; Boman, Inga-Lill; Folke, Mia; Sommerfeld, Disa; Borg, Jörgen; Palmcrantz, Susanne

2015-01-01

The aim of this work has been to develop a technical support enabling home-based motor training after stroke. The basis for the work plan has been to develop an interactive technical solution supporting three different groups of stroke patients: (1) patients with stroke discharged from hospital with support from neuro team; (2) patients with stroke whose support from neuro team will be phased out and (3) patients living with impaired motor functions long-term. The technology has been developed in close collaboration with end-users using a method earlier evaluated and described [12]. This paper describes the main functions of the developed technology. Further, results from early user-tests with end-users, performed to identify needs for improvements to be carried out during further technical development. The developed technology will be tested further in a pilot study of the safety and, usefulness of the technology when applied as a support for motor training in three different phases of the post-stroke rehabilitation process.

ISU Team Project: An Integral View on Space Debris Mitigation and Removal

NASA Astrophysics Data System (ADS)

Maier, Philipp; Ricote Navarro, Carmon; Jehn, Rudiger; Gini, Andrea; Faure, Pauline; Adriaensen, Maarten; Datta, Iman; Hilbich, Daniel; Jacimovic, Aleksandar; Jacques, Lionel; Penent, Guilhem; Sinn, Thomas; Shioi, Hiroaki

2013-08-01

The issue of space debris poses challenges not only in technical, but also legal, political and economic dimensions. A sustainable solution needs to take into account all of them. This paper investigates such a potential solution in a multidisciplinary approach. To this end, it addresses the effectiveness of the existing debris mitigation guidelines, and identifies technical improvements for mitigation. It continues examining technical concepts for debris removal and performing proper cost-benefit trade-offs. The results of new simulations to assess the damage cost caused by space debris are presented. Based on these findings, an organizational framework and political recommendations are developed which will enable a sustainable use of space starting in 2020. The findings are compiled into a roadmap, which outlines 1) a path to the full adherence to debris mitigation guidelines and 2) the removal of ten large pieces of debris per year by a dedicated international organization, including expected expenditures necessary for its implementation.

Non-technical skills evaluation in the critical care air ambulance environment: introduction of an adapted rating instrument--an observational study.

PubMed

Myers, Julia A; Powell, David M C; Psirides, Alex; Hathaway, Karyn; Aldington, Sarah; Haney, Michael F

2016-03-08

In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment. In the first phase of the project the anaesthetists' non-technical skills (ANTS) framework was adapted to the air ambulance setting, using data collected directly from clinician groups, published literature, and field observation. In the second phase experienced and inexperienced inter-hospital transport clinicians completed a simulated critical care air transport scenario, and their non-technical skills performance was independently rated by two blinded assessors. Observed and self-rated general clinical performance ratings were also collected. Rank-based statistical tests were used to examine differences in the performance of experienced and inexperienced clinicians, and relationships between different assessment approaches and assessors. The framework developed during phase one was referred to as an aeromedical non-technical skills framework, or AeroNOTS. During phase two 16 physicians from speciality training programmes in intensive care, emergency medicine and anaesthesia took part in the clinical simulation study. Clinicians with inter-hospital transport experience performed more highly than those without experience, according to both AeroNOTS non-technical skills ratings (p = 0.001) and general performance ratings (p = 0.003). Self-ratings did not distinguish experienced from inexperienced transport clinicians (p = 0.32) and were not strongly associated with either observed general performance (r(s) = 0.4, p = 0.11) or observed non-technical skills performance (r(s) = 0.4, p = 0.1). This study describes a framework which characterises the non-technical skills required by critical care air ambulance clinicians, and distinguishes higher and lower levels of performance. The AeroNOTS framework could be used to facilitate education and training in non-technical skills for air ambulance clinicians, and further evaluation of this rating system is merited.

New stapling devices in robotic surgery

PubMed Central

Casiraghi, Monica; Pardolesi, Alessandro; Borri, Alessandro; Spaggiari, Lorenzo

2017-01-01

Minimally invasive thoracic surgery is rapidly diffusing worldwide. Robotic anatomic pulmonary resection is gaining popularity and acceptance in the thoracic community for the reported feasibility, safety, and good outcomes. The last available robotic system, da Vinci Xi System, added new technical improvements on robotic device allowing best performances in robotic lung resection. We report our initial experience in the use of EndoWrist Stapler during robotic anatomic surgery for lung cancer. PMID:29078608

Shoulder arthroscopy: the basics.

PubMed

Farmer, Kevin W; Wright, Thomas W

2015-04-01

Shoulder arthroscopy is a commonly performed and accepted procedure for a wide variety of pathologies. Surgeon experience, patient positioning, knowledge of surgical anatomy, proper portal placement, and proper use of instrumentation can improve technical success and minimize complication risks. This article details the surgical anatomy, indications, patient positioning, portal placement, instrumentation, and complications for basic shoulder arthroscopy. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Achieving world class performance step by step.

PubMed

Kerr, L J

1992-02-01

Bridgestone of Japan acquired Firestone, a United States corporation, in early 1988. This article describes the integration process of the two organizations' cultures. There are many lessons in the approach that should apply to a variety of organizations. The Strategic Improvement Process, a rather highly structured approach, harnesses the strengths of both the Japanese and American organizations and starts the manufacturing and technical departments on the road to excellence.

Alloy undercooling experiments

NASA Technical Reports Server (NTRS)

Flemings, Merton C.; Matson, Douglas M.

1995-01-01

The research accomplished during 1995 can be organized into three parts. The first task involves analyzing the results of microgravity experiments carried out using TEMPUS hardware during the IML-2 mission on STS-65. The second part was to finalize ground-based experimentation which supported the above flight sample analysis. The final part was to provide technical support for post-flight mission activities specifically aimed at improving TEMPUS performance for potential future missions.

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

Vajda, Zsolt, E-mail: Z.Vajda@klinikum-stuttgart.de; Guethe, Thomas, E-mail: T.Guethe@klinikum-stuttgart.de; Perez, Marta Aguilar, E-mail: M.Aguilar@klinikum-stuttgart.de

Stenting in intracranial atherosclerotic disease (ICAD) is increasingly debated, due to issues of procedural safety, technical efficacy, and in-stent recurrent stenoses (ISR). In the present study, feasibility, safety, and efficacy of angioplasty using a drug-eluting balloon (DEB) followed by the implantation of a self-expanding stent (Enterprise) were evaluated for the treatment of ICAD lesions. Fifty-two patients (median age: 71 years; range: 54-86 years; male/female ratio 37:15) underwent stenting of high-grade ICAD lesions between February 2010 and November 2011 in a single center. Angioplasty using a paclitaxel coated SeQuent Please (B. Braun, Germany) or DIOR (Eurocor, Germany) coronary PTCA balloon, followedmore » by the implantation of a self-expanding stent (Enterprise, Codman, USA) was performed in 54 lesions. Angiographic and clinical follow-up was performed at 6 and 12 weeks, 6 and 12 months, and yearly thereafter. Technical success rate, periprocedural complications, occurrence of recurrent ischemic symptoms, and the development of an ISR were analyzed. Angioplasty using a DEB followed by stent implantation was successfully performed in 44 (81 %) cases. DEB insertion failed in 19 % of the cases and angioplasty was finally performed using a conventional PTCA balloon. The combined procedure related permanent neurologic morbidity and mortality rate (stroke, ICH, and subarachnoid hemorrhage) at 30 days and beyond was 5 %. Angiographic and clinical follow-up were obtained in 33 (61 %) lesions in 32 patients. Recurrent stenosis was seen in one (3 %) lesion. Angioplasty and stenting using a DEB is safe and yields encouragingly low ISR rates. Further technical developments to improve lesion accessibility are, nevertheless, mandatory.« less

Initial experience of using high field strength intraoperative MRI for neurosurgical procedures.

PubMed

Raheja, Amol; Tandon, Vivek; Suri, Ashish; Sarat Chandra, P; Kale, Shashank S; Garg, Ajay; Pandey, Ravindra M; Kalaivani, Mani; Mahapatra, Ashok K; Sharma, Bhawani S

2015-08-01

We report our initial experience to optimize neurosurgical procedures using high field strength intraoperative magnetic resonance imaging (IOMRI) in 300 consecutive patients as high field strength IOMRI rapidly becomes the standard of care for neurosurgical procedures. Three sequential groups (groups A, B, C; n=100 each) were compared with respect to time management, complications and technical difficulties to assess improvement in these parameters with experience. We observed a reduction in the number of technical difficulties (p<0.001), time to induction (p<0.001) and total anesthesia time (p=0.007) in sequential groups. IOMRI was performed for neuronavigation guidance (n=252) and intraoperative validation of extent of resection (EOR; n=67). Performing IOMRI increased the EOR over and beyond the primary surgical attempt in 20.5% (29/141) and 18% (11/61) of patients undergoing glioma and pituitary surgery, respectively. Overall, EOR improved in 59.7% of patients undergoing IOMRI (40/67). Intraoperative tractography and real time navigation using re-uploaded IOMRI images (accounting for brain shift) helps in intraoperative planning to reduce complications. IOMRI is an asset to neurosurgeons, helping to augment the EOR, especially in glioma and pituitary surgery, with no significant increase in morbidity to the patient. Copyright © 2015 Elsevier Ltd. All rights reserved.

A survey of nurses' perceived competence and educational needs in performing resuscitation.

PubMed

Roh, Young Sook; Issenberg, S Barry; Chung, Hyun Soo; Kim, So Sun; Lim, Tae Ho

2013-05-01

Effective training is needed for high-quality performance of staff nurses, who are often the first responders in initiating resuscitation. There is insufficient evidence to identify specific educational strategies that improve outcomes, including early recognition and rescue of the critical patient. This study was conducted to identify perceived competence and educational needs as well as to examine factors influencing perceived competence in resuscitation among staff nurses to build a resuscitation training curriculum. A convenience sample of 502 staff nurses was recruited from 11 hospitals in a single city. Staff nurses were asked to complete a self-administered questionnaire. On a five-point scale, chest compression was the lowest-rated technical skill (M = 3.33, SD = 0.80), whereas staying calm and focusing on required tasks was the lowest-rated non-technical skill (M = 3.30, SD = 0.80). Work duration, the usefulness of simulation, recent code experience, and recent simulation-based training were significant factors in perceived competence, F(4, 496) = 45.94, p < .001. Simulation-based resuscitation training was the most preferred training modality, and cardiac arrest was the most preferred training topic. Based on this needs assessment, a simulation-based resuscitation training curriculum with cardiac arrest scenarios is suggested to improve the resuscitation skills of staff nurses. Copyright 2013, SLACK Incorporated.

Selection and collection of multi parameter physiological data for cardiac rhythm diagnostic algorithm development

NASA Astrophysics Data System (ADS)

Bostock, J.; Weller, P.; Cooklin, M.

2010-07-01

Automated diagnostic algorithms are used in implantable cardioverter-defibrillators (ICD's) to detect abnormal heart rhythms. Algorithms misdiagnose and improved specificity is needed to prevent inappropriate therapy. Knowledge engineering (KE) and artificial intelligence (AI) could improve this. A pilot study of KE was performed with artificial neural network (ANN) as AI system. A case note review analysed arrhythmic events stored in patients ICD memory. 13.2% patients received inappropriate therapy. The best ICD algorithm had sensitivity 1.00, specificity 0.69 (p<0.001 different to gold standard). A subset of data was used to train and test an ANN. A feed-forward, back-propagation network with 7 inputs, a 4 node hidden layer and 1 output had sensitivity 1.00, specificity 0.71 (p<0.001). A prospective study was performed using KE to list arrhythmias, factors and indicators for which measurable parameters were evaluated and results reviewed by a domain expert. Waveforms from electrodes in the heart and thoracic bio-impedance; temperature and motion data were collected from 65 patients during cardiac electrophysiological studies. 5 incomplete datasets were due to technical failures. We concluded that KE successfully guided selection of parameters and ANN produced a usable system and that complex data collection carries greater risk of technical failure, leading to data loss.

Cognitive training for technical and non-technical skills in robotic surgery: a randomised controlled trial.

PubMed

Raison, Nicholas; Ahmed, Kamran; Abe, Takashige; Brunckhorst, Oliver; Novara, Giacomo; Buffi, Nicolò; McIlhenny, Craig; van der Poel, Henk; van Hemelrijck, Mieke; Gavazzi, Andrea; Dasgupta, Prokar

2018-05-07

To investigate the effectiveness of motor imagery (MI) for technical skill and non-technical skill (NTS) training in minimally invasive surgery (MIS). A single-blind, parallel-group randomised controlled trial was conducted at the Vattikuti Institute of Robotic Surgery, King's College London. Novice surgeons were recruited by open invitation in 2015. After basic robotic skills training, participants underwent simple randomisation to either MI training or standard training. All participants completed a robotic urethrovesical anastomosis task within a simulated operating room. In addition to the technical task, participants were required to manage three scripted NTS scenarios. Assessment was performed by five blinded expert surgeons and a NTS expert using validated tools for evaluating technical skills [Global Evaluative Assessment of Robotic Skills (GEARS)] and NTS [Non-Technical Skills for Surgeons (NOTSS)]. Quality of MI was assessed using a revised Movement Imagery Questionnaire (MIQ). In all, 33 participants underwent MI training and 29 underwent standard training. Interrater reliability was high, Krippendorff's α = 0.85. After MI training, the mean (sd) GEARS score was significantly higher than after standard training, at 13.1 (3.25) vs 11.4 (2.97) (P = 0.03). There was no difference in mean NOTSS scores, at 25.8 vs 26.4 (P = 0.77). MI training was successful with significantly higher imagery scores than standard training (mean MIQ score 5.1 vs 4.5, P = 0.04). Motor imagery is an effective training tool for improving technical skill in MIS even in novice participants. No beneficial effect for NTS was found. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.