Deer Velvet

MedlinePlus

... activity (as an aphrodisiac), and treat male sexual performance problems (erectile dysfunction, ED). Women use deer velvet to reduce the dose of ... combinations, deer velvet is used to improve athletic performance; to improve ... reproductive disorders including premenstrual syndrome (PMS), ED, and ...

The Effectiveness of Public Simulated Oral Examinations in Preparation for the American Board of Surgery Certifying Examination: A Systematic Review.

PubMed

Pennell, Christopher; McCulloch, Peter

2015-01-01

The purpose of this study was to determine whether American Board of Surgery Certifying Examination (CE) performance is improved among residents who prepare using simulated oral examinations (SOEs). EMBASE and MEDLINE were searched using predefined search terms. No language restrictions were imposed and the latest search date was in November 2014. Included studies must have reported on residents training in a general surgery residency in the United States who used SOEs to prepare for the CE and have measured their performance against those without exposure to SOEs. Studies meeting inclusion criteria were qualitatively and quantitatively analyzed and a fixed effects meta-analysis was performed to determine the net effect of SOEs on CE performance. Overall, 4 of 25 abstracts reviewed met inclusion criteria and are included in this review. The most common simulation format included public examinations in front of resident peers during scheduled education sessions. All 4 included studies trended toward improved performance with SOEs and in 2 of these studies the improvement was statistically significant. Overall, 3 studies were of adequate quality to perform a meta-analysis and demonstrated a relative risk for first-attempt CE success of 1.22 (95% CI: 1.07-1.39, p = 0.003) for residents preparing with SOEs compared to those without SOEs. The published literature evaluating SOEs is limited and generally of fair quality. A modest improvement in CE performance was identified when public SOEs were used as an educational tool aimed to improve professionalism and communication skills, encourage reading at home, and provide a regular review of clinically relevant topics. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Improving Driver Performance. A Curriculum for Licensed Drivers.

ERIC Educational Resources Information Center

Highway Users Federation for Safety and Mobility, Washington, DC.

Curriculum material presented in this manual is for use in the development of an instructional program for drivers who either want or need to improve their driving performance. Three principal units are included: man and highway transportation, driver performance, and factors influencing driver behavior. Each unit is further divided into episodes…

Tough high performance composite matrix

NASA Technical Reports Server (NTRS)

Pater, Ruth H. (Inventor); Johnston, Norman J. (Inventor)

1994-01-01

This invention is a semi-interpentrating polymer network which includes a high performance thermosetting polyimide having a nadic end group acting as a crosslinking site and a high performance linear thermoplastic polyimide. Provided is an improved high temperature matrix resin which is capable of performing in the 200 to 300 C range. This resin has significantly improved toughness and microcracking resistance, excellent processability, mechanical performance, and moisture and solvent resistances.

The relationships between pesticide metabolites and neurobehavioral test performance in the third National Health and Nutrition Examination Survey.

PubMed

Krieg, Edward F

2013-01-01

Regression analysis was used to estimate and test for relationships between urinary pesticide metabolites and neurobehavioral test performance in adults, 20 to 59 years old, participating in the third National Health and Nutrition Examination Survey. The 12 pesticide metabolites included 2 naphthols, 8 phenols, a phenoxyacetic acid, and a pyridinol. The 3 neurobehavioral tests included in the survey were simple reaction time, symbol-digit substitution, and serial digit learning. As the 2,4-dichlorophenol, 2,5-dichlorophenol, and the pentachlorophenol concentrations increased, performance on the serial digit learning test improved. As the 2,5-dichlorophenol concentration increased, performance on the symbol-digit substitution test improved. At low concentrations, the parent compounds of these metabolites may act at acetylcholine and γ-aminobutyric acid synapses in the central nervous system to improve neurobehavioral test performance.

Improving Student Outcomes with mCLASS: Math, a Technology-Enhanced CBM and Diagnostic Interview Assessment

ERIC Educational Resources Information Center

Wang, Ye; Gushta, Matthew

2013-01-01

The No Child Left Behind Act resulted in increased school-level implementation of assessment-based school interventions that aim to improve student performance. Diagnostic assessments are included among these interventions, designed to help teachers use evidence about student performance to modify and differentiate instruction and improve student…

Feedback Providing Improvement Strategies and Reflection on Feedback Use: Effects on Students' Writing Motivation, Process, and Performance

ERIC Educational Resources Information Center

Duijnhouwer, Hendrien; Prins, Frans J.; Stokking, Karel M.

2012-01-01

This study investigated the effects of feedback providing improvement strategies and a reflection assignment on students' writing motivation, process, and performance. Students in the experimental feedback condition (n = 41) received feedback including improvement strategies, whereas students in the control feedback condition (n = 41) received…

1L Mark-IV Target Design Review

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

Koehler, Paul E.

This presentation includes General Design Considerations; Current (Mark-III) Lower Tier; Mark-III Upper Tier; Performance Metrics; General Improvements for Material Science; General Improvements for Nuclear Science; Improving FOM for Nuclear Science; General Design Considerations Summary; Design Optimization Studies; Expected Mark-IV Performance: Material Science; Expected Mark-IV Performance: Nuclear Science (Disk); Mark IV Enables Much Wider Range of Nuclear-Science FOM Gains than Mark III; Mark-IV Performance Summary; Rod or Disk? Center or Real FOV?; and Project Cost and Schedule.

Alterations in Aerobic Exercise Performance and Gait Economy Following High-Intensity Dynamic Stepping Training in Persons With Subacute Stroke.

PubMed

Leddy, Abigail L; Connolly, Mark; Holleran, Carey L; Hennessy, Patrick W; Woodward, Jane; Arena, Ross A; Roth, Elliot J; Hornby, T George

2016-10-01

Impairments in metabolic capacity and economy (O2cost) are hallmark characteristics of locomotor dysfunction following stroke. High-intensity (aerobic) training has been shown to improve peak oxygen consumption in this population, with fewer reports of changes in O2cost. However, particularly in persons with subacute stroke, inconsistent gains in walking function are observed with minimal associations with gains in metabolic parameters. The purpose of this study was to evaluate changes in aerobic exercise performance in participants with subacute stroke following high-intensity variable stepping training as compared with conventional therapy. A secondary analysis was performed on data from a randomized controlled trial comparing high-intensity training with conventional interventions, and from the pilot study that formed the basis for the randomized controlled trial. Participants 1 to 6 months poststroke received 40 or fewer sessions of high-intensity variable stepping training (n = 21) or conventional interventions (n = 12). Assessments were performed at baseline (BSL), posttraining, and 2- to 3-month follow-up and included changes in submaximal (Equation is included in full-text article.)O2 ((Equation is included in full-text article.)O2submax) and O2cost at fastest possible treadmill speeds and peak speeds at BSL testing. Significant improvements were observed in (Equation is included in full-text article.)O2submax with less consistent improvements in O2cost, although individual responses varied substantially. Combined changes in both (Equation is included in full-text article.)O2submax and (Equation is included in full-text article.)O2 at matched peak BSL speeds revealed stronger correlations to improvements in walking function as compared with either measure alone. High-intensity stepping training may elicit significant improvements in (Equation is included in full-text article.)O2submax, whereas changes in both peak capacity and economy better reflect gains in walking function. Providing high-intensity training to improve locomotor and aerobic exercise performance may increase the efficiency of rehabilitation sessions.Video Abstract available for more insights from the authors (see Supplemental Digital Content, http://links.lww.com/JNPT/A142).

A tough high performance composite matrix

NASA Technical Reports Server (NTRS)

Pater, Ruth H. (Inventor); Johnston, Norman J. (Inventor)

1992-01-01

This invention is a semi-interpenetrating polymer network which includes a high performance thermosetting polyimide having a nadic end group acting as a crosslinking site and a high performance linear thermoplastic polyimide. An improved high temperature matrix resin is provided which is capable of performing in the 200 to 300 C range. This resin has significantly improved toughness and microcracking resistance, excellent processability, mechanical performance and moisture and solvent resistances.

One hundred ampere-hour nickel-cadmium battery cells of improved design

NASA Technical Reports Server (NTRS)

Kantner, E.

1972-01-01

Nickel cadmium battery cells with 100 ampere hour capacity were developed. The design features, notably extension of the current collector tab to the full width of the battery plate, and the location of the cell terminals on the opposite ends, resulted in a reduction of internal impedance, and improved electrical performance with expected improvement in thermal performance. Tables of data and performance curves are included to support the theoretical considerations.

The People Side of Performance Improvement.

ERIC Educational Resources Information Center

Gerson, Richard F.

1999-01-01

Discusses 11 keys to the personal side of performance improvement, including positive attitude, high self esteem and positive self-image, communication skills, lifelong learning, caring about other people, health and well-being, motivation, goal setting, relaxation, visualization, and personal value system. (LRW)

Are university rankings useful to improve research? A systematic review.

PubMed

Vernon, Marlo M; Balas, E Andrew; Momani, Shaher

2018-01-01

Concerns about reproducibility and impact of research urge improvement initiatives. Current university ranking systems evaluate and compare universities on measures of academic and research performance. Although often useful for marketing purposes, the value of ranking systems when examining quality and outcomes is unclear. The purpose of this study was to evaluate usefulness of ranking systems and identify opportunities to support research quality and performance improvement. A systematic review of university ranking systems was conducted to investigate research performance and academic quality measures. Eligibility requirements included: inclusion of at least 100 doctoral granting institutions, be currently produced on an ongoing basis and include both global and US universities, publish rank calculation methodology in English and independently calculate ranks. Ranking systems must also include some measures of research outcomes. Indicators were abstracted and contrasted with basic quality improvement requirements. Exploration of aggregation methods, validity of research and academic quality indicators, and suitability for quality improvement within ranking systems were also conducted. A total of 24 ranking systems were identified and 13 eligible ranking systems were evaluated. Six of the 13 rankings are 100% focused on research performance. For those reporting weighting, 76% of the total ranks are attributed to research indicators, with 24% attributed to academic or teaching quality. Seven systems rely on reputation surveys and/or faculty and alumni awards. Rankings influence academic choice yet research performance measures are the most weighted indicators. There are no generally accepted academic quality indicators in ranking systems. No single ranking system provides a comprehensive evaluation of research and academic quality. Utilizing a combined approach of the Leiden, Thomson Reuters Most Innovative Universities, and the SCImago ranking systems may provide institutions with a more effective feedback for research improvement. Rankings which extensively rely on subjective reputation and "luxury" indicators, such as award winning faculty or alumni who are high ranking executives, are not well suited for academic or research performance improvement initiatives. Future efforts should better explore measurement of the university research performance through comprehensive and standardized indicators. This paper could serve as a general literature citation when one or more of university ranking systems are used in efforts to improve academic prominence and research performance.

IMPROVING THE ENVIRONMENTAL PERFORMANCE OF CHEMICAL PROCESSES THROUGH THE USE OF INFORMATION TECHNOLOGY

EPA Science Inventory

Efforts are currently underway at the USEPA to develop information technology applications to improve the environmental performance of the chemical process industry. These efforts include the use of genetic algorithms to optimize different process options for minimal environmenta...

Culturally Based Math Education as a Way to Improve Alaska Native Students' Math Performance.

ERIC Educational Resources Information Center

Lipka, Jerry; Adams, Barbara

2004-01-01

Culturally based instruction has long been touted as a preferred approach to improving the performance of American Indian and Alaska Native (AI/AN) students? academic performance. However, there has been scant research to support this conjecture, particularly when quantitative data and quasi-experimental designs are included. The results of this…

The reliability of in-training assessment when performance improvement is taken into account.

PubMed

van Lohuizen, Mirjam T; Kuks, Jan B M; van Hell, Elisabeth A; Raat, A N; Stewart, Roy E; Cohen-Schotanus, Janke

2010-12-01

During in-training assessment students are frequently assessed over a longer period of time and therefore it can be expected that their performance will improve. We studied whether there really is a measurable performance improvement when students are assessed over an extended period of time and how this improvement affects the reliability of the overall judgement. In-training assessment results were obtained from 104 students on rotation at our university hospital or at one of the six affiliated hospitals. Generalisability theory was used in combination with multilevel analysis to obtain reliability coefficients and to estimate the number of assessments needed for reliable overall judgement, both including and excluding performance improvement. Students' clinical performance ratings improved significantly from a mean of 7.6 at the start to a mean of 7.8 at the end of their clerkship. When taking performance improvement into account, reliability coefficients were higher. The number of assessments needed to achieve a reliability of 0.80 or higher decreased from 17 to 11. Therefore, when studying reliability of in-training assessment, performance improvement should be considered.

Factors Influencing Competence and Performance of Reference Librarians in Academic Libraries in Nigeria.

ERIC Educational Resources Information Center

Omoniyi, Joseph O.

2002-01-01

Reports on research that focused on competence and performance of reference libraries in academic libraries in Nigeria. Includes recommendations for improving competence and performance, including the reference process; staffing and other resources; education for reference librarians; knowledge of modern technology; and emotional stability and…

Improving Process Heating System Performance v3

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

None

2016-04-11

Improving Process Heating System Performance: A Sourcebook for Industry is a development of the U.S. Department of Energy (DOE) Advanced Manufacturing Office (AMO) and the Industrial Heating Equipment Association (IHEA). The AMO and IHEA undertook this project as part of an series of sourcebook publications developed by AMO on energy-consuming industrial systems, and opportunities to improve performance. Other topics in this series include compressed air systems, pumping systems, fan systems, steam systems, and motors and drives

OAO battery data analysis

NASA Technical Reports Server (NTRS)

Gaston, S.; Wertheim, M.; Orourke, J. A.

1973-01-01

Summary, consolidation and analysis of specifications, manufacturing process and test controls, and performance results for OAO-2 and OAO-3 lot 20 Amp-Hr sealed nickel cadmium cells and batteries are reported. Correlation of improvements in control requirements with performance is a key feature. Updates for a cell/battery computer model to improve performance prediction capability are included. Applicability of regression analysis computer techniques to relate process controls to performance is checked.

The effects of Crew Resource Mangement (CRM) training in airline maintenance: Results following three years' experience

NASA Technical Reports Server (NTRS)

Taylor, J. C.; Robertson, M. M.

1995-01-01

This report describes three years' evaluation of the effects of one airline's Crew Resources Management (CRM) training operation for maintenance. This evaluation focuses on the post-training attitudes of maintenance managers' and technical support professionals, their reported behaviors, and the safety, efficiency and dependable maintenance performance of their units. The results reveal a strong positive effect of the training. The overall program represents the use of CRM training as a long-term commitment to improving performance through effective communication at all levels in airline maintenance operations. The initial findings described in our previous progress reports are reinforced and elaborated here. The current results benefit from the entire pre-post training survey, which now represents total attendance of all managers and staff professionals. Additionally there are now full results from the two-month, six-month, and 12-month follow-up questionnaires, together with as many as 33 months of post-training performance data, using several indicators. In this present report, we examine participants' attitudes, their reported behaviors following the training, the performance of their work units, and the relationships among these variables. Attitudes include those measured immediately before and after the training as well as participants' attitudes months after their training. Performance includes measures, by work units, of on-time flight departures, on-schedule maintenance releases, occupational and aircraft safety, and efficient labor costs. We report changes in these performance measures following training, as well their relationships with the training participants' attitudes. Highlights of results from this training program include increased safety and improved costs associated with positive attitudes about the use of more assertive communication, and the improved management of stress. Improved on-time performance is also related to those improved attitudes, as well as favorable attitudes about participative management.

Defining the performance gap: Conducting a self-assessment

NASA Technical Reports Server (NTRS)

Braymer, Susan A.; Stoner, David L.; Powell, William C.

1992-01-01

This paper presents two different approaches to performing self-assessments of continuous improvement activities. Case Study 1 describes the activities performed by JSC to assess the implementation of continuous improvement efforts at the NASA Center. The JSC approach included surveys administered to randomly selected NASA personnel and personal interviews with NASA and contractor management personnel. Case Study 2 describes the continuous improvement survey performed by the JSC Safety, Reliability, and Quality Assurance (SR&QA) organization. This survey consisted of a short questionnaire (50 questions) administered to all NASA and contractor SR&QA personnel. The questionnaire is based on the eight categories of the President's Award for Quality and Productivity Improvement. It is designed to objectively determine placement on the TQ benchmark and identify a roadmap for improvement.

The effects of respiratory-muscle training on exercise in older women.

PubMed

Watsford, Mark; Murphy, Arona

2008-07-01

This research examined the effects of respiratory-muscle (RM) training on RM function and exercise performance in older women. Twenty-six women (60-69 yr of age) were assessed for spirometry, RM strength (maximal inspiratory and expiratory pressure), inspiratory-muscle endurance, and walking performance to a perceived exertion rating of "hard." They were randomly allocated to a threshold RM training group (RMT) or a nonexercising control group (CON) for 8 wk.After training, the 22% (inspiratory) and 30% (expiratory) improvements in RM strength in the RMT group were significantly higher than in the CON group (p < .05). The RMT group also displayed several significant performance improvements, including improved within-group treadmill performance time (12%) and reductions in submaximal heart rate (5%), percentage of maximum voluntary ventilation (16%), and perceived exertion for breathing (8%). RM training appears to improve RM function in older women. Furthermore, these improvements appear to be related to improved submaximal exercise performance.

Balance training with multi-task exercises improves fall-related self-efficacy, gait, balance performance and physical function in older adults with osteoporosis: a randomized controlled trial.

PubMed

Halvarsson, Alexandra; Franzén, Erika; Ståhle, Agneta

2015-04-01

To evaluate the effects of a balance training program including dual- and multi-task exercises on fall-related self-efficacy, fear of falling, gait and balance performance, and physical function in older adults with osteoporosis with an increased risk of falling and to evaluate whether additional physical activity would further improve the effects. Randomized controlled trial, including three groups: two intervention groups (Training, or Training+Physical activity) and one Control group, with a 12-week follow-up. Stockholm County, Sweden. Ninety-six older adults, aged 66-87, with verified osteoporosis. A specific and progressive balance training program including dual- and multi-task three times/week for 12 weeks, and physical activity for 30 minutes, three times/week. Fall-related self-efficacy (Falls Efficacy Scale-International), fear of falling (single-item question - 'In general, are you afraid of falling?'), gait speed with and without a cognitive dual-task at preferred pace and fast walking (GAITRite®), balance performance tests (one-leg stance, and modified figure of eight), and physical function (Late-Life Function and Disability Instrument). Both intervention groups significantly improved their fall-related self-efficacy as compared to the controls (p ≤ 0.034, 4 points) and improved their balance performance. Significant differences over time and between groups in favour of the intervention groups were found for walking speed with a dual-task (p=0.003), at fast walking speed (p=0.008), and for advanced lower extremity physical function (p=0.034). This balance training program, including dual- and multi-task, improves fall-related self-efficacy, gait speed, balance performance, and physical function in older adults with osteoporosis. © The Author(s) 2014.

Augmenting an observation network to facilitate flow and transport model discrimination.

USDA-ARS?s Scientific Manuscript database

Improving understanding of subsurface conditions includes performance comparison for competing models, independently developed or obtained via model abstraction. The model comparison and discrimination can be improved if additional observations will be included. The objective of this work was to i...

Motivational Factors of Pay-for-Performance Plans in Educational Institutions: A Study of Select Private, Faith-Based Schools

ERIC Educational Resources Information Center

Wrobbel, Paul H.

2009-01-01

In the United States there is considerable focus on the need for continuous improvement in the quality of schools, including student achievement and teacher performance. Performance-based pay has been repeatedly suggested as a way to improve teaching in school systems. Therefore, a more thorough understanding of the differences in the perceptions…

Contract management techniques for improving construction quality

DOT National Transportation Integrated Search

1997-07-01

Efforts to improve quality in highway construction embrace many aspects of the construction process. Quality goals include enhanced efficiency and productivity, optimal cost and delivery time, improved performance, and changes in attitude-promoting a...

Improving performance on core processes of care.

PubMed

Austin, John Matthew; Pronovost, Peter J

2016-06-01

This article describes the recent literature on using extrinsic and intrinsic motivators to improve performance on core processes of care, highlighting literature that describes general frameworks for quality improvement work. The literature supporting the effectiveness of extrinsic motivators to improve quality is generally positive for public reporting of performance, with mixed results for pay-for-performance. A four-element quality improvement framework developed by The Armstrong Institute at Johns Hopkins Medicine was developed with intrinsic motivation in mind. The clear definition and communication of goals are important for quality improvement work. Training clinicians in improvement science, such as lean sigma, teamwork, or culture change provides clinicians with the skills they need to drive the improvement work. Peer learning communities offer the opportunity for clinicians to engage with each other and offer support in their work. The transparent reporting of performance helps ensure accountability of performance ranging from individual clinicians to governance. Quality improvement work that is led by and engages clinicians offers the opportunity for the work to be both meaningful and sustainable. The literature supports approaching quality improvement work in a systematic way, including the key elements of communication, infrastructure building, training, transparency, and accountability.

Electrolysis Performance Improvement and Validation Experiment

NASA Technical Reports Server (NTRS)

Schubert, Franz H.

1992-01-01

Viewgraphs on electrolysis performance improvement and validation experiment are presented. Topics covered include: water electrolysis: an ever increasing need/role for space missions; static feed electrolysis (SFE) technology: a concept developed for space applications; experiment objectives: why test in microgravity environment; and experiment description: approach, hardware description, test sequence and schedule.

Interdistrict Magnet High School Students' Perceived Social Support: An Exploratory Investigation

ERIC Educational Resources Information Center

LaRocco, Diana J.; Fitzgerald, Jessica

2010-01-01

Magnet high school attendance seems to lead to improved academic performance (Cobb, Bifulco, & Bell, 2009; U.S. Department of Education, 2008; Yu & Taylor, 1997). Likewise, perceived social support has been linked with positive outcomes for adolescents, including improved academic performance (Rosenfeld, Richman, & Bowen, 2000; Demaray & Malecki,…

How to Improve the Supply of High-Quality Teachers

ERIC Educational Resources Information Center

Hanushek, Eric Alan; Rivkin, Steven G.

2004-01-01

Virtually everybody interested in improving the performance of schools concentrates on the importance of teacher quality. Yet policy recommendations related to teacher quality frequently do not incorporate existing evidence about performance. This paper reviews the various strands of research related to teacher quality, including the role of…

Performance of a logging truck with a central tire inflation system.

Treesearch

John A. Sturos; Douglas B. Brumm; Andrew Lehto

1995-01-01

Describes the performance of an 11-axle logging truck with a central tire inflation system. Results included reduced damages to roads, improved ride of the truck, improved drawbar pull, and reduced rolling resistance. Road construction costs were reduced 62%, primarily due to using 33% less gravel.

Maturing Weapon Systems for Improved Availability at Lower Costs

DTIC Science & Technology

1994-01-01

development of new measures of R&M performance and improved data collection and analysis capabilities . Innovations in automated data collection, including the...45 Capabilities Required to Implement Maturation Development ...... 45 Assess R&M Performance Accurately ....................... 46 Identify...Requirements Determination ...................................... 49 Capabilities of the Best Existing Databases ..................... 49 Data Elements Needed

The effectiveness of external sensory cues in improving functional performance in individuals with Parkinson's disease: a systematic review with meta-analysis.

PubMed

Cassimatis, Constantine; Liu, Karen P Y; Fahey, Paul; Bissett, Michelle

2016-09-01

A systematic review with meta-analysis was performed to investigate the effect external sensory cued therapy on activities of daily living (ADL) performance that include walking and daily tasks such as dressing for individuals with Parkinson's disease (PD). A detailed computer-aided search of the literature was applied to MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EMBASE and PubMed. Studies investigating the effects of external sensory cued therapy on ADL performance for individuals with PD in all stages of disease progression were collected. Relevant articles were critically reviewed and study results were synthesized by two independent researchers. A data-analysis method was used to extract data from selected articles. A meta-analysis was carried out for all randomized-controlled trials. Six studies with 243 individuals with PD were included in this review. All six studies yielded positive findings in favour of external sensory cues. The meta-analysis showed that external sensory cued therapy improved statistically after treatment (P=0.011) and at follow-up (P<0.001) for ADL performance. The results of this review provided evidence of an improvement in ADL performance in general in individuals with PD. It is recommended that clinicians incorporate external sensory into a training programme focused on improving daily task performance.

Multi-scale theory-assisted nano-engineering of plasmonic-organic hybrid electro-optic device performance

NASA Astrophysics Data System (ADS)

Elder, Delwin L.; Johnson, Lewis E.; Tillack, Andreas F.; Robinson, Bruce H.; Haffner, Christian; Heni, Wolfgang; Hoessbacher, Claudia; Fedoryshyn, Yuriy; Salamin, Yannick; Baeuerle, Benedikt; Josten, Arne; Ayata, Masafumi; Koch, Ueli; Leuthold, Juerg; Dalton, Larry R.

2018-02-01

Multi-scale (correlated quantum and statistical mechanics) modeling methods have been advanced and employed to guide the improvement of organic electro-optic (OEO) materials, including by analyzing electric field poling induced electro-optic activity in nanoscopic plasmonic-organic hybrid (POH) waveguide devices. The analysis of in-device electro-optic activity emphasizes the importance of considering both the details of intermolecular interactions within organic electro-optic materials and interactions at interfaces between OEO materials and device architectures. Dramatic improvement in electro-optic device performance-including voltage-length performance, bandwidth, energy efficiency, and lower optical losses have been realized. These improvements are critical to applications in telecommunications, computing, sensor technology, and metrology. Multi-scale modeling methods illustrate the complexity of improving the electro-optic activity of organic materials, including the necessity of considering the trade-off between improving poling-induced acentric order through chromophore modification and the reduction of chromophore number density associated with such modification. Computational simulations also emphasize the importance of developing chromophore modifications that serve multiple purposes including matrix hardening for enhanced thermal and photochemical stability, control of matrix dimensionality, influence on material viscoelasticity, improvement of chromophore molecular hyperpolarizability, control of material dielectric permittivity and index of refraction properties, and control of material conductance. Consideration of new device architectures is critical to the implementation of chipscale integration of electronics and photonics and achieving the high bandwidths for applications such as next generation (e.g., 5G) telecommunications.

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.

RTSJ Memory Areas and Their Affects on the Performance of a Flight-Like Attitude Control System

NASA Technical Reports Server (NTRS)

Niessner, Albert F.; Benowitz, Edward G.

2003-01-01

The two most important factors in improving performance in any software system, but especially a real-time, embedded system, are knowing which components are the low performers and knowing what can be done to improve their performance. The word performance with respect to a real-time, embedded system does not necessarily mean fast execution, which is the common definition when discussing non real-time systems. It also includes meeting all of the specified execution dead-lines and executing at the correct time without sacrificing non real-time performance. Using a Java prototype of an existing control system used on Deep Space 1[1], the effects from adding memory areas are measured and evaluated with respect to improving performance.

EGU2013 SM1.4/GI1.6 session: "Improving seismic networks performances: from site selection to data integration"

NASA Astrophysics Data System (ADS)

Pesaresi, D.; Busby, R.

2013-08-01

The number and quality of seismic stations and networks in Europe continually improves, nevertheless there is always scope to optimize their performance. In this session we welcomed contributions from all aspects of seismic network installation, operation and management. This includes site selection; equipment testing and installation; planning and implementing communication paths; policies for redundancy in data acquisition, processing and archiving; and integration of different datasets including GPS and OBS.

Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review

PubMed Central

Boaz, Annette; Hanney, Stephen; Jones, Teresa; Soper, Bryony

2015-01-01

Objective There is a widely held assumption that engagement by clinicians and healthcare organisations in research improves healthcare performance at various levels, but little direct empirical evidence has previously been collated. The objective of this study was to address the question: Does research engagement (by clinicians and organisations) improve healthcare performance? Methods An hourglass-shaped review was developed, consisting of three stages: (1) a planning and mapping stage; (2) a focused review concentrating on the core question of whether or not research engagement improves healthcare performance; and (3) a wider (but less systematic) review of papers identified during the two earlier stages, focusing on mechanisms. Results Of the 33 papers included in the focused review, 28 identified improvements in health services performance. Seven out of these papers reported some improvement in health outcomes, with others reporting improved processes of care. The wider review demonstrated that mechanisms such as collaborative and action research can encourage some progress along the pathway from research engagement towards improved healthcare performance. Organisations that have deliberately integrated the research function into organisational structures demonstrate how research engagement can, among other factors, contribute to improved healthcare performance. Conclusions Current evidence suggests that there is an association between the engagement of individuals and healthcare organisations in research and improvements in healthcare performance. The mechanisms through which research engagement might improve healthcare performance overlap and rarely act in isolation, and their effectiveness often depends on the context in which they operate. PMID:26656023

Improvement of Ice Hockey Players' On-Ice Sprint With Combined Plyometric and Strength Training.

PubMed

Dæhlin, Torstein E; Haugen, Ole C; Haugerud, Simen; Hollan, Ivana; Raastad, Truls; Rønnestad, Bent R

2017-08-01

Combined plyometric and strength training has previously been suggested as a strategy to improve skating performance in ice hockey players. However, the effects of combined plyometric and strength training have not previously been compared with the effects of strength training only. To compare the effects of combined plyometric and strength training on ice hockey players' skating sprint performance with those of strength training only. Eighteen participants were randomly assigned to 2 groups that completed 5 strength-training sessions/wk for 8 wk. One group included plyometric exercises at the start of 3 sessions/wk (PLY+ST), and the other group included core exercises in the same sessions (ST). Tests of 10- and 35-m skating sprints, horizontal jumping, 1-repetition-maximum (1 RM) squat, skating multistage aerobic test (SMAT), maximal oxygen consumption, repeated cycle sprints, and body composition were performed before and after the intervention. The participants increased their 1RM squat, lean mass, and body mass (P < .05), with no difference between the groups. Furthermore, they improved their 3×broad jump, repeated cycle sprint, and SMAT performance (P < .05), with no difference between the groups. PLY+ST gained a larger improvement in 10-m on-ice sprint performance than ST (P < .025). Combining plyometric and strength training for 8 wk was superior to strength training alone at improving 10-m on-ice sprint performance in high-level ice hockey players.

Are university rankings useful to improve research? A systematic review

PubMed Central

Momani, Shaher

2018-01-01

Introduction Concerns about reproducibility and impact of research urge improvement initiatives. Current university ranking systems evaluate and compare universities on measures of academic and research performance. Although often useful for marketing purposes, the value of ranking systems when examining quality and outcomes is unclear. The purpose of this study was to evaluate usefulness of ranking systems and identify opportunities to support research quality and performance improvement. Methods A systematic review of university ranking systems was conducted to investigate research performance and academic quality measures. Eligibility requirements included: inclusion of at least 100 doctoral granting institutions, be currently produced on an ongoing basis and include both global and US universities, publish rank calculation methodology in English and independently calculate ranks. Ranking systems must also include some measures of research outcomes. Indicators were abstracted and contrasted with basic quality improvement requirements. Exploration of aggregation methods, validity of research and academic quality indicators, and suitability for quality improvement within ranking systems were also conducted. Results A total of 24 ranking systems were identified and 13 eligible ranking systems were evaluated. Six of the 13 rankings are 100% focused on research performance. For those reporting weighting, 76% of the total ranks are attributed to research indicators, with 24% attributed to academic or teaching quality. Seven systems rely on reputation surveys and/or faculty and alumni awards. Rankings influence academic choice yet research performance measures are the most weighted indicators. There are no generally accepted academic quality indicators in ranking systems. Discussion No single ranking system provides a comprehensive evaluation of research and academic quality. Utilizing a combined approach of the Leiden, Thomson Reuters Most Innovative Universities, and the SCImago ranking systems may provide institutions with a more effective feedback for research improvement. Rankings which extensively rely on subjective reputation and “luxury” indicators, such as award winning faculty or alumni who are high ranking executives, are not well suited for academic or research performance improvement initiatives. Future efforts should better explore measurement of the university research performance through comprehensive and standardized indicators. This paper could serve as a general literature citation when one or more of university ranking systems are used in efforts to improve academic prominence and research performance. PMID:29513762

Performance Pay and Teacher Motivation: Separating Myth from Reality

ERIC Educational Resources Information Center

Hulleman, Chris S.; Barron, Kenneth E.

2010-01-01

This article draws on research from outside of education to evaluate some common myths about performance pay and to consider future directions for designing and evaluating performance pay systems in K-12 education. The five common myths surrounding performance pay include: (1) Performance pay systems improve performance; (2) Performance pay…

AQUATOX Fact Sheet

EPA Pesticide Factsheets

AQUATOX Release 3.1 includes numerous enhancements designed to improve model performance, more closely match data requirements with generally available data, improve data manipulation and analysis, and increase user friendliness.

What Is Improvement Science? Do We Need It in Education?

ERIC Educational Resources Information Center

Lewis, Catherine

2015-01-01

The theory and tools of "improvement science" have produced performance improvements in many organizational sectors. This essay describes improvement science and explores its potential and challenges within education. Potential contributions include attention to the knowledge-building and motivational systems within schools, strategies…

A framework for assessing the performance of health systems.

PubMed Central

Murray, C. J.; Frenk, J.

2000-01-01

Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. Improving health means both increasing the average health status and reducing health inequalities. Responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). Fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). This implies that everyone is protected from financial risks due to health care. The measurement of performance relates goal attainment to the resources available. Variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). By investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance, but also to contemplate major policy challenges. PMID:10916909

A framework for assessing the performance of health systems.

PubMed

Murray, C J; Frenk, J

2000-01-01

Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. Improving health means both increasing the average health status and reducing health inequalities. Responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). Fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). This implies that everyone is protected from financial risks due to health care. The measurement of performance relates goal attainment to the resources available. Variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). By investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance, but also to contemplate major policy challenges.

Performance Based Logistics: A Readiness Strategy Tailor Made for Austere Times

DTIC Science & Technology

2015-06-01

reducing cost and improving support performance to conclude that if it is effectively implemented and managed, PBL yields significant benefits. Key...These include outcomes that facilitate both product and process improvements to drive out cost and drive up readiness as well as outcomes that... improvements , and proactive obsolescence and the mitigation of Diminishing Manufacturing Sources and Material Shortages (DMSMS). In short, we are looking for

Implementing a Nurse Manager Profile to Improve Unit Performance.

PubMed

Krugman, Mary E; Sanders, Carolyn L

2016-06-01

Nurse managers face significant pressures in the rapidly changing healthcare environment. Staying current with multiple sources of data, including reports that detail institutional and unit performance outcomes, is particularly challenging. A Nurse Manager Customized Profile was developed at a western academic hospital to provide a 1-page visual of pertinent data to help managers and director supervisors focus coaching to improve unit performance. Use of the Decisional Involvement Scale provided new insights into measuring manager performance.

Semi-interpenetrating polymer network for tougher and more microcracking resistant high temperature polymers

NASA Technical Reports Server (NTRS)

Pater, Ruth H. (Inventor)

1992-01-01

This invention is a semi-interpenetrating polymer network which includes a high performance thermosetting polyimide having a nadic end group acting as a crosslinking site and a high performance linear thermoplastic polyimide. An improved high temperature matrix resin is provided which is capable of performing at 316 C in air for several hundreds of hours. This resin has significantly improved toughness and microcracking resistance, excellent processability and mechanical performance, and cost effectiveness.

CF6 jet engine performance improvement program. Short core exhaust nozzle performance improvement concept. [specific fuel consumption reduction

NASA Technical Reports Server (NTRS)

Fasching, W. A.

1979-01-01

The short core exhaust nozzle was evaluated in CF6-50 engine ground tests including performance, acoustic, and endurance tests. The test results verified the performance predictions from scale model tests. The short core exhaust nozzle provides an internal cruise sfc reduction of 0.9 percent without an increase in engine noise. The nozzle hardware successfully completed 1000 flight cycles of endurance testing without any signs of distress.

Corporatization as a means of improving water quality: the experience in Victoria, Australia.

PubMed

Martin, Narelle

Factors including fragmentation, a lack of direction, poor accountability, poor water quality, and a sizable state government subsidy contributed to the rural water industry in Victoria, Australia, in 1993. In 1993 the state government set out parameters for reform to change the size, structure, performance, and culture of the water industry. The path taken was not privatization, but corporatization. Tools used included amalgamation of organizations; separating water provisions from local government; changing the composition and reporting mechanisms of the boards; establishing clear benchmarks and performance criteria; making information publicly available; and providing a commercial orientation. The outcomes of the reforms were to be a focus on water quality and effluent management. In 2001, 15 water authorities were in place. There were significant improvements in accountability, finances, and performance. The authorities provided information on performance to both the state and the public. Reductions of operating costs have been in the range of 20-35%, with savings put back into new infrastructure. Water quality has significantly improved in a number of parameters and effluent management has also improved. This paper describes the challenges faced before the reform process, the reforms initiated, and the outcomes. It argues that privatization is not the only path to improvement: Developing a corporate structure and accountability can also deliver substantial improvements.

Evaluating mepindolol in a test model of examination anxiety in students.

PubMed

Krope, P; Kohrs, A; Ott, H; Wagner, W; Fichte, K

1982-03-01

The effect of a single dose of beta-blocker (5 or 10 mg mepindolol) during a written examination was investigated in two double-blind studies (N : 49 and 55 students, respectively). The question was whether the beta-blocker would in comparison to placebo diminish examination anxiety and improve the performance of highly complex tasks, while leaving the performance of less complex tasks unchanged. A reduction in examination anxiety after beta-blocker intake could not be demonstrated with a multi-level test model (which included the parameters self-rated anxiety, motor behaviour, task performance and physiology), although pulse rates were lowered significantly. An improvement in performance could not be observed, while - by the same token - the performance was not impaired by the beta-blocker. A hypothesis according to which a beta-blocker has an anxiolytic effect and improves performance, dependent on the level of habitual examination anxiety, was tested post hoc, but could not be confirmed. Ten of the subjects treated with 10 mg mepindolol, complained of different side effects, including dizziness, fatigue and headache.

Active-Learning Methods To Improve Student Performance and Scientific Interest in a Large Introductory Oceanography Course.

ERIC Educational Resources Information Center

Yuretich, Richard F.; Khan, Samia A.; Leckie, R. Mark; Clement, John J.

2001-01-01

Transfers the environment of a large enrollment oceanography course by modifying lectures to include cooperative learning via interactive in-class exercises and directed discussion. Results of student surveys, course evaluations, and exam performance demonstrate that learning of the subject under these conditions has improved. (Author/SAH)

LED Lighting in a Performing Arts Building

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

Miller, N. J.; Kaye, S. M.; Coleman, P. M.

At the University of Florida in Gainesville, the DOE Solid-State Lighting GATEWAY program evaluated LED architectural and theatrical lighting in four academic/performance-related spaces within the Nadine McGuire Theatre + Dance Pavilion. Due to a wise choice of products and luminaire light distributions, the change brought significant quality improvements including improved controllability and color.

Patients' satisfaction: customer relationship management as a new opportunity for quality improvement in thoracic surgery.

PubMed

Rocco, Gaetano; Brunelli, Alessandro

2012-11-01

Clinical and nonclinical indicators of performance are meant to provide the surgeon with tools to identify weaknesses to be improved. The World Health Organization's Performance Evaluation Systems represent a multidimensional approach to quality measurement based on several categories made of different indicators. Indicators for patient satisfaction may include overall perceived quality, accessibility, humanization and patient involvement, communication, and trust in health care providers. Patient satisfaction is included among nonclinical indicators of performance in thoracic surgery and is increasingly recognized as one of the outcome measures for delivered quality of care. Copyright © 2012 Elsevier Inc. All rights reserved.

Performance of an improved thermal neutron activation detector for buried bulk explosives

NASA Astrophysics Data System (ADS)

McFee, J. E.; Faust, A. A.; Andrews, H. R.; Clifford, E. T. H.; Mosquera, C. M.

2013-06-01

First generation thermal neutron activation (TNA) sensors, employing an isotopic source and NaI(Tl) gamma ray detectors, were deployed by Canadian Forces in 2002 as confirmation sensors on multi-sensor landmine detection systems. The second generation TNA detector is being developed with a number of improvements aimed at increasing sensitivity and facilitating ease of operation. Among these are an electronic neutron generator to increase sensitivity for deeper and horizontally displaced explosives; LaBr3(Ce) scintillators, to improve time response and energy resolution; improved thermal and electronic stability; improved sensor head geometry to minimize spatial response nonuniformity; and more robust data processing. The sensor is described, with emphasis on the improvements. Experiments to characterize the performance of the second generation TNA in detecting buried landmines and improvised explosive devices (IEDs) hidden in culverts are described. Performance results, including comparisons between the performance of the first and second generation systems are presented.

The design and operating characteristics of an advanced 30-kW ammonia arcjet engine

NASA Technical Reports Server (NTRS)

Deininger, William D.; Pivirotto, Thomas J.; Brophy, John R.

1987-01-01

Experimental investigations were conducted to evaluate the effects of a contoured nozzle and modified cathode shape on ammonia arcjet engine performance. The contoured nozzle performance data were compared to the performance data of an arcjet which had a 38-deg included-angle, conical nozzle. Thrust improvements of up to 10 percent were demonstrated which corresponded to 3 percent improvements in specific impulse and 10 percent improvements in thrust efficiency. Performance characterizations for the modified cathode tip were conducted with the contoured nozzle arcjet. A uniform 15 percent decrease in arc voltage was demonstrated over a mass flow range of 0.175 to 0.350 g/s. A 4 percent improvement in thrust efficiency was noted at 22.0 kW.

[Using Interdisciplinary Cooperation to Improve the Rate of Proper Performance of a Hand Exercise Among Hemodialysis Patients With Arteriovenous Fistula Construction].

PubMed

Hsiao, Ya-Hsin; Shin, Miao-Ling; Huang, Cyong-Pei; Chen, Siang-Jyun; Huang, Tsuey-Yuan

2017-06-01

Patients who undergo new arteriovenous fistula (AVF) construction as part of their hemodialysis treatment program are required to perform hand exercises properly in order to maintain AVF function. However, poor performance of these hand exercises currently results in the failure of many patients to preserve AVF function. To increase the rate of performing this hand exercise properly from 55% to 80%. A comprehensive investigation identified the following five main problems: (a) Insufficient muscular endurance; (b) Resistance was not labeled on the ball; (c) Difficulties with maintaining a grip on the ball during the exercise; (d) Lack of standardized education procedures; and (e) Nurses lack latest knowledge on the hand exercise. The strategies used to improve the situation included: (a) Interdisciplinary team cooperation with physiotherapists to design individualized resistance training regimens; (b) Exercise tool improvement; (c) Standardized AVF care; (d) Continuous education for nursing staffs; and (e) Seed teacher program for hand exercise. The rate of proper hand exercise performance increased from 55% to 93%. This nursing project involved an interdisciplinary team that included physiotherapists in order to successfully improve the rate at which the hand exercise was performed properly. This positive experience may be applied to other hemodialysis departments in the treatment of patients with AVF.

Seven Performance Drivers.

ERIC Educational Resources Information Center

Ross, Linda

2003-01-01

Recent work with automotive e-commerce clients led to the development of a performance analysis methodology called the Seven Performance Drivers, including: standards, incentives, capacity, knowledge and skill, measurement, feedback, and analysis. This methodology has been highly effective in introducing and implementing performance improvement.…

Practical Approaches to Quality Improvement for Radiologists.

PubMed

Kelly, Aine Marie; Cronin, Paul

2015-10-01

Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. © RSNA, 2015.

Improving Performance on Preventive Health Quality Measures Using Clinical Decision Support to Capture Care Done Elsewhere and Patient Exceptions.

PubMed

Bowen, Michael E; Bhat, Deepa; Fish, Jason; Moran, Brett; Howell-Stampley, Temple; Kirk, Lynne; Persell, Stephen D; Halm, Ethan A

Preventive services required for performance measurement often are completed in outside health systems and not captured in electronic medical records (EMRs). A before-after study was conducted to examine the ability of clinical decision support (CDS) to improve performance on preventive quality measures, capture clinician-reported services completed elsewhere, and patient/medical exceptions and to describe their impact on quality measurement. CDS improved performance on colorectal cancer screening, osteoporosis screening, and pneumococcal vaccination measures ( P < .05) but not breast or cervical cancer screening. CDS captured clinician-reported services completed elsewhere (2% to 10%) and patient/medical exceptions (<3%). Compared to measures using only within-system data, including services completed elsewhere in the numerator improved performance: pneumococcal vaccine (73% vs 82%); breast (69% vs 75%), colorectal (58% vs 70%), and cervical cancer (53% vs 62%); and osteoporosis (72% vs 75%) screening ( P < .05). Visit-based CDS can capture clinician-reported preventive services, and accounting for services completed elsewhere improves performance on quality measures.

Test-Enhanced Learning in an Immunology and Infectious Disease Medicinal Chemistry/Pharmacology Course.

PubMed

Hernick, Marcy

2015-09-25

Objective. To develop a series of active-learning modules that would improve pharmacy students' performance on summative assessments. Design. A series of optional online active-learning modules containing questions with multiple formats for topics in a first-year (P1) course was created using a test-enhanced learning approach. A subset of module questions was modified and included on summative assessments. Assessment. Student performance on module questions improved with repeated attempts and was predictive of student performance on summative assessments. Performance on examination questions was higher for students with access to modules than for those without access to modules. Module use appeared to have the most impact on low performing students. Conclusion. Test-enhanced learning modules with immediate feedback provide pharmacy students with a learning tool that improves student performance on summative assessments and also may improve metacognitive and test-taking skills.

Test-Enhanced Learning in an Immunology and Infectious Disease Medicinal Chemistry/Pharmacology Course

PubMed Central

2015-01-01

Objective. To develop a series of active-learning modules that would improve pharmacy students’ performance on summative assessments. Design. A series of optional online active-learning modules containing questions with multiple formats for topics in a first-year (P1) course was created using a test-enhanced learning approach. A subset of module questions was modified and included on summative assessments. Assessment. Student performance on module questions improved with repeated attempts and was predictive of student performance on summative assessments. Performance on examination questions was higher for students with access to modules than for those without access to modules. Module use appeared to have the most impact on low performing students. Conclusion. Test-enhanced learning modules with immediate feedback provide pharmacy students with a learning tool that improves student performance on summative assessments and also may improve metacognitive and test-taking skills. PMID:27168610

Performance improvement with patient service partners.

PubMed

Burns, J P

1998-01-01

Once the decision is made to use a patient-focused care delivery system, a variety of methods can be used to successfully design the model. The author describes the process used by a multilevel, multidisciplinary team at a community hospital to design and implement a Service Partner role that would meet and exceed customer expectations. Demonstrated performance improvements included increased patient satisfaction, productive labor dollar savings, and improvements in the work environment for staff members.

Substantial Progress Yet Significant Opportunity for Improvement in Stroke Care in China.

PubMed

Li, Zixiao; Wang, Chunjuan; Zhao, Xingquan; Liu, Liping; Wang, Chunxue; Li, Hao; Shen, Haipeng; Liang, Li; Bettger, Janet; Yang, Qing; Wang, David; Wang, Anxin; Pan, Yuesong; Jiang, Yong; Yang, Xiaomeng; Zhang, Changqing; Fonarow, Gregg C; Schwamm, Lee H; Hu, Bo; Peterson, Eric D; Xian, Ying; Wang, Yilong; Wang, Yongjun

2016-11-01

Stroke is a leading cause of death in China. Yet the adherence to guideline-recommended ischemic stroke performance metrics in the past decade has been previously shown to be suboptimal. Since then, several nationwide stroke quality management initiatives have been conducted in China. We sought to determine whether adherence had improved since then. Data were obtained from the 2 phases of China National Stroke Registries, which included 131 hospitals (12 173 patients with acute ischemic stroke) in China National Stroke Registries phase 1 from 2007 to 2008 versus 219 hospitals (19 604 patients) in China National Stroke Registries phase 2 from 2012 to 2013. Multiple regression models were developed to evaluate the difference in adherence to performance measure between the 2 study periods. The overall quality of care has improved over time, as reflected by the higher composite score of 0.76 in 2012 to 2013 versus 0.63 in 2007 to 2008. Nine of 13 individual performance metrics improved. However, there were no significant improvements in the rates of intravenous thrombolytic therapy and anticoagulation for atrial fibrillation. After multivariate analysis, there remained a significant 1.17-fold (95% confidence interval, 1.14-1.21) increase in the odds of delivering evidence-based performance metrics in the more recent time periods versus older data. The performance metrics with the most significantly increased odds included stroke education, dysphagia screening, smoking cessation, and antithrombotics at discharge. Adherence to stroke performance metrics has increased over time, but significant opportunities remain for further improvement. Continuous stroke quality improvement program should be developed as a national priority in China. © 2016 American Heart Association, Inc.

Projecting technology change to improve space technology planning and systems management

NASA Astrophysics Data System (ADS)

Walk, Steven Robert

2011-04-01

Projecting technology performance evolution has been improving over the years. Reliable quantitative forecasting methods have been developed that project the growth, diffusion, and performance of technology in time, including projecting technology substitutions, saturation levels, and performance improvements. These forecasts can be applied at the early stages of space technology planning to better predict available future technology performance, assure the successful selection of technology, and improve technology systems management strategy. Often what is published as a technology forecast is simply scenario planning, usually made by extrapolating current trends into the future, with perhaps some subjective insight added. Typically, the accuracy of such predictions falls rapidly with distance in time. Quantitative technology forecasting (QTF), on the other hand, includes the study of historic data to identify one of or a combination of several recognized universal technology diffusion or substitution patterns. In the same manner that quantitative models of physical phenomena provide excellent predictions of system behavior, so do QTF models provide reliable technological performance trajectories. In practice, a quantitative technology forecast is completed to ascertain with confidence when the projected performance of a technology or system of technologies will occur. Such projections provide reliable time-referenced information when considering cost and performance trade-offs in maintaining, replacing, or migrating a technology, component, or system. This paper introduces various quantitative technology forecasting techniques and illustrates their practical application in space technology and technology systems management.

Impact of lean six sigma process improvement methodology on cardiac catheterization laboratory efficiency.

PubMed

Agarwal, Shikhar; Gallo, Justin J; Parashar, Akhil; Agarwal, Kanika K; Ellis, Stephen G; Khot, Umesh N; Spooner, Robin; Murat Tuzcu, Emin; Kapadia, Samir R

2016-03-01

Operational inefficiencies are ubiquitous in several healthcare processes. To improve the operational efficiency of our catheterization laboratory (Cath Lab), we implemented a lean six sigma process improvement initiative, starting in June 2010. We aimed to study the impact of lean six sigma implementation on improving the efficiency and the patient throughput in our Cath Lab. All elective and urgent cardiac catheterization procedures including diagnostic coronary angiography, percutaneous coronary interventions, structural interventions and peripheral interventions performed between June 2009 and December 2012 were included in the study. Performance metrics utilized for analysis included turn-time, physician downtime, on-time patient arrival, on-time physician arrival, on-time start and manual sheath-pulls inside the Cath Lab. After implementation of lean six sigma in the Cath Lab, we observed a significant improvement in turn-time, physician downtime, on-time patient arrival, on-time physician arrival, on-time start as well as sheath-pulls inside the Cath Lab. The percentage of cases with optimal turn-time increased from 43.6% in 2009 to 56.6% in 2012 (p-trend<0.001). Similarly, the percentage of cases with an aggregate on-time start increased from 41.7% in 2009 to 62.8% in 2012 (p-trend<0.001). In addition, the percentage of manual sheath-pulls performed in the Cath Lab decreased from 60.7% in 2009 to 22.7% in 2012 (p-trend<0.001). The current longitudinal study illustrates the impact of successful implementation of a well-known process improvement initiative, lean six sigma, on improving and sustaining efficiency of our Cath Lab operation. After the successful implementation of this continuous quality improvement initiative, there was a significant improvement in the selected performance metrics namely turn-time, physician downtime, on-time patient arrival, on-time physician arrival, on-time start as well as sheath-pulls inside the Cath Lab. Copyright © 2016 Elsevier Inc. All rights reserved.

Performance Improvement Assuming Complexity

ERIC Educational Resources Information Center

Rowland, Gordon

2007-01-01

Individual performers, work teams, and organizations may be considered complex adaptive systems, while most current human performance technologies appear to assume simple determinism. This article explores the apparent mismatch and speculates on future efforts to enhance performance if complexity rather than simplicity is assumed. Included are…

The Effects of Preexercise Caffeinated Coffee Ingestion on Endurance Performance: An Evidence-Based Review.

PubMed

Higgins, Simon; Straight, Chad R; Lewis, Richard D

2016-06-01

Endurance athletes commonly ingest caffeine as a means to enhance training intensity and competitive performance. A widely-used source of caffeine is coffee, however conflicting evidence exists regarding the efficacy of coffee in improving endurance performance. In this context, the aims of this evidence-based review were threefold: 1) to evaluate the effects of preexercise coffee on endurance performance, 2) to evaluate the effects of coffee on perceived exertion during endurance performance, and 3) to translate the research into usable information for athletes to make an informed decision regarding the intake of caffeine via coffee as a potential ergogenic aid. Searches of three major databases were performed using terms caffeine and coffee, or coffee-caffeine, and endurance, or aerobic. Included studies (n = 9) evaluated the effects of caffeinated coffee on human subjects, provided the caffeine dose administered, administered caffeine ≥ 45 min before testing, and included a measure of endurance performance (e.g., time trial). Significant improvements in endurance performance were observed in five of nine studies, which were on average 24.2% over controls for time to exhaustion trials, and 3.1% for time to completion trials. Three of six studies found that coffee reduced perceived exertion during performance measures significantly more than control conditions (p < .05). Based on the reviewed studies there is moderate evidence supporting the use of coffee as an ergogenic aid to improve performance in endurance cycling and running. Coffee providing 3-8.1 mg/kg (1.36-3.68 mg/lb) of caffeine may be used as a safe alternative to anhydrous caffeine to improve endurance performance.

Cancer Care Ontario and integrated cancer programs: portrait of a performance management system and lessons learned.

PubMed

Cheng, Siu Mee; Thompson, Leslee J

2006-01-01

A performance management system has been implemented by Cancer Care Ontario (CCO). This system allows for the monitoring and management of 11 integrated cancer programs (ICPs) across the Province of Ontario. The system comprises of four elements: reporting frequency, reporting requirements, review meetings and accountability and continuous improvement activities. CCO and the ICPs have recently completed quarterly performance review exercises for the last two quarters of the fiscal year 2004-2005. The purpose of this paper is to address some of the key lessons learned. The paper provides an outline of the CCO performance management system. These lessons included: data must be valid and reliable; performance management requires commitments from both parties in the performance review exercises; streamlining performance reporting is beneficial; technology infrastructure which allows for cohesive management of data is vital for a sustainable performance management system; performance indicators need to stand up to scrutiny by both parties; and providing comparative data across the province is valuable. Critical success factors which would help to ensure a successful performance management system include: corporate engagement from various parts of an organization in the review exercises; desire to focus on performance improvement and avoidance of blaming; and strong data management systems. The performance management system is a practical and sustainable system that allows for performance improvement of cancer care services. It can be a vital tool to enhance accountability within the health care system. The paper demonstrates that the performance management system supports accountability in the cancer care system for Ontario, and reflects the principles of the provincial governments commitment to continuous improvement of healthcare.

Conflict and Gaming in Instruction and Performance.

ERIC Educational Resources Information Center

Kowitz, Gerald T.; Smith, Jay C.

1989-01-01

Discussion of instruction and training to introduce new ideas and to improve performance focuses on the presence of conflict and the theory of games. Topics discussed include learner participation; Theory X; Theory Y; and Theory Z; and game rules, including control, scoring, changing rules, and ending the game. (25 references) (LRW)

Improvements in magnetic bearing performance for flywheel energy storage

NASA Technical Reports Server (NTRS)

Plant, David P.; Anand, Davinder K.; Kirk, James A.; Calomeris, Anthony J.; Romero, Robert L.

1988-01-01

The paper considers the development of a 500-Watt-hour magnetically suspended flywheel stack energy storage system. The work includes hardware testing results from a stack flywheel energy storage system, improvements in the area of noncontacting displacement transducers, and performance enhancements of magnetic bearings. Experimental results show that a stack flywheel energy storage system is feasible technology.

The CF6 jet engine performance improvement: New front mount

NASA Technical Reports Server (NTRS)

Fasching, W. A.

1979-01-01

The New Front Mount was evaluated in component tests including stress, deflection/distortion and fatigue tests. The test results demonstrated a performance improvement of 0.1% in cruise sfc, 16% in compressor stall margin and 10% in compressor stator angle margin. The New Front Mount hardware successfully completed 35,000 simulated flight cycles endurance testing.

A Human Resource Development Performance Improvement Model for Workers with Mental Retardation in Supported Employment

ERIC Educational Resources Information Center

Fornes, Sandra; Rosenberg, Howard; Rocco, Tonette S.; Gallagher, Jo

2006-01-01

This literature review discusses the factors for successful job retention of adult workers with mental retardation (MR) including external factors related to work environments and internal issues of the individual worker. Through the synthesis of the literature, a performance improvement model for supported employment (SE) is discussed based on…

A Problem-Solving Intervention Using iPads to Improve Transition-Related Task Performance of Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Yakubova, Gulnoza; Zeleke, Waganesh A.

2016-01-01

In this study, the effectiveness of teaching problem-solving to improve transition-related task performance of three students with autism spectrum disorder (ASD) was examined using a multiple probe across students design. Target behaviors included various transition-related tasks individualized for each student based on their individual…

Sharing Antarctic Research in the Classroom: Authentic Outreach as a Means of Improving Student Performance

ERIC Educational Resources Information Center

Betteley, Pat; Harr, Natalie; Lee, Richard E., Jr.

2013-01-01

For six seasons, Richard Lee has included a K-12 teacher on his Antarctic research team to coordinate outreach to U.S. classrooms. These teachers have communicated with thousands of students and their teachers and planned authentic outreach activities to improve student performance. Program success depends on funding by the National Science…

Improved components for engine fuel savings

NASA Technical Reports Server (NTRS)

Antl, R. J.; Mcaulay, J. E.

1980-01-01

NASA programs for developing fuel saving technology include the Engine Component Improvement Project for short term improvements in existing air engines. The Performance Improvement section is to define component technologies for improving fuel efficiency for CF6, JT9D and JT8D turbofan engines. Sixteen concepts were developed and nine were tested while four are already in use by airlines. If all sixteen concepts are successfully introduced the gain will be fuel savings of more than 6 billion gallons over the lifetime of the engines. The improvements include modifications in fans, mounts, exhaust nozzles, turbine clearance and turbine blades.

Fiber-Reinforced Reactive Nano-Epoxy Composites

NASA Technical Reports Server (NTRS)

Zhong, Wei-Hong

2011-01-01

An ultra-high-molecular-weight polyethylene/ matrix interface based on the fabrication of a reactive nano-epoxy matrix with lower surface energy has been improved. Enhanced mechanical properties versus pure epoxy on a three-point bend test include: strength (25 percent), modulus (20 percent), and toughness (30 percent). Increased thermal properties include higher Tg (glass transition temperature) and stable CTE (coefficient of thermal expansion). Improved processability for manufacturing composites includes faster wetting rates on macro-fiber surfaces, lower viscosity, better resin infusion rates, and improved rheological properties. Improved interfacial adhesion properties with Spectra fibers by pullout tests include initial debonding force of 35 percent, a maximum pullout force of 25 percent, and energy to debond at 65 percent. Improved mechanical properties of Spectra fiber composites (tensile) aging resistance properties include hygrothermal effects. With this innovation, high-performance composites have been created, including carbon fibers/nano-epoxy, glass fibers/nano-epoxy, aramid fibers/ nano-epoxy, and ultra-high-molecularweight polyethylene fiber (UHMWPE).

Prior experience in micro-surgery may improve the surgeon's performance in robotic surgical training.

PubMed

Perez, Manuela; Perrenot, Cyril; Tran, Nguyen; Hossu, Gabriela; Felblinger, Jacques; Hubert, Jacques

2013-09-01

Robotic surgery has witnessed a huge expansion. Robotic simulators have proved to be of major interest in training. Some authors have suggested that prior experience in micro-surgery could improve robotic surgery training. To test micro-surgery as a new approach in training, we proposed a prospective study comparing the surgical performance of micro-surgeons with that of general surgeons on a robotic simulator. 49 surgeons were enrolled; 11 in the micro-surgery group (MSG); 38 n the control group (CG). Performance was evaluated based on five dV-Trainer® exercises. MSG achieved better results for all exercises including exercises requiring visual evaluation of force feed-back, economy of motion, instrument force and position. These results show that experience in micro-surgery could significantly improve surgeons' abilities and their performance in robotic training. So, as micro-surgery practice is relatively cheap, it could be easily included in basic robotic surgery training. Copyright © 2013 John Wiley & Sons, Ltd.

Infrastructure for Large-Scale Quality-Improvement Projects: Early Lessons from North Carolina Improving Performance in Practice

ERIC Educational Resources Information Center

Newton, Warren P.; Lefebvre, Ann; Donahue, Katrina E.; Bacon, Thomas; Dobson, Allen

2010-01-01

Introduction: Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods: Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3)…

Development of a Tool for Documenting, Tracking, Recording, and Analyzing Improvements to Intersection Sites and Roadway Departures in Curve Locations : Research Project Capsule

DOT National Transportation Integrated Search

2012-09-01

Intermodal transportation : system planning, design, : improvement, performance : evaluation, or economic : assessments include safety : improvements because they : lower the overall cost of : transportation. State Departments of Transportation (DOTs...

Dissemination of performance information and continuous improvement: A narrative systematic review.

PubMed

Lemire, Marc; Demers-Payette, Olivier; Jefferson-Falardeau, Justin

2013-01-01

Developing a performance measure and reporting the results to support decision making at an individual level has yielded poor results in many health systems. The purpose of this paper is to highlight the factors associated with the dissemination of performance information that generate and support continuous improvement in health organizations. A systematic data collection strategy that includes empirical and theoretical research published from 1980 to 2010, both qualitative and quantitative, was performed on Web of Science, Current Contents, EMBASE and MEDLINE. A narrative synthesis method was used to iteratively detail explicative processes that underlie the intervention. A classification and synthesis framework was developed, drawing on knowledge transfer and exchange (KTE) literature. The sample consisted of 114 articles, including seven systematic or exhaustive reviews. Results showed that dissemination in itself is not enough to produce improvement initiatives. Successful dissemination depends on various factors, which influence the way collective actors react to performance information such as the clarity of objectives, the relationships between stakeholders, the system's governance and the available incentives. This review was limited to the process of knowledge dissemination in health systems and its utilization by users at the health organization level. Issues related to improvement initiatives deserve more attention. Knowledge dissemination goes beyond better communication and should be considered as carefully as the measurement of performance. Choices pertaining to intervention should be continuously prompted by the concern to support organizational action. While considerable attention was paid to the public reporting of performance information, this review sheds some light on a more promising avenue for changes and improvements, notably in public health systems.

Evaluation of Knowledge Development in a Healthcare Setting

NASA Astrophysics Data System (ADS)

Schaffer, Scott P.

Healthcare organizations worldwide have recently increased efforts to improve performance, quality, and knowledge transfer using information and communication technologies. Evaluation of the effectiveness and quality of such efforts is challenging. A macro and micro-level system evaluation conducted with a 14000 member US hospital administrative services organization examined the appropriateness of a blended face-to-face and technology-enabled performance improvement and knowledge development system. Furthermore, a successful team or microsystem in a high performing hospital was studied in-depth. Several types of data methods including interview, observation, and questionnaire were used to address evaluation questions within a knowledge development framework created for the study. Results of this preliminary study focus on how this organization attempted to organize clinical improvement efforts around quality and performance improvement processes supported by networked technologies.

Aiding planning in air traffic control: an experimental investigation of the effects of perceptual information integration.

PubMed

Moertl, Peter M; Canning, John M; Gronlund, Scott D; Dougherty, Michael R P; Johansson, Joakim; Mills, Scott H

2002-01-01

Prior research examined how controllers plan in their traditional environment and identified various information uncertainties as detriments to planning. A planning aid was designed to reduce this uncertainty by perceptually representing important constraints. This included integrating spatial information on the radar screen with discrete information (planned sequences of air traffic). Previous research reported improved planning performance and decreased workload in the planning aid condition. The purpose of this paper was to determine the source of these performance improvements. Analysis of computer interactions using log-linear modeling showed that the planning interface led to less repetitive--but more integrated--information retrieval compared with the traditional planning environment. Ecological interface design principles helped explain how the integrated information retrieval gave rise to the performance improvements. Actual or potential applications of this research include the design and evaluation of interface automation that keeps users in active control by modification of perceptual task characteristics.

Well-being improvement in a midsize employer: changes in well-being, productivity, health risk, and perceived employer support after implementation of a well-being improvement strategy.

PubMed

Hamar, Brent; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

2015-04-01

To evaluate employee well-being change and associated change in productivity, health risk including biometrics, and workplace support over 2 years after implementation of a well-being improvement strategy. This was an employer case study evaluation of well-being, productivity (presenteeism, absenteeism, and job performance), health risk, and employer support across three employee assessment spanning 2 years. Employee well-being was compared with an independent sample of workers in the community. Well-being and job performance increased and presenteeism and health risk decreased significantly over the 2 years. Employee well-being started lower and increased to exceed community worker averages, approaching significance. Well-being improvement was associated with higher productivity across all measures. Increases in employer support for well-being were associated with improved well-being and productivity. This employer's well-being strategy, including a culture supporting well-being, was associated with improved health and productivity.

A Continuous Quality Improvement Airway Program Results in Sustained Increases in Intubation Success.

PubMed

Olvera, David J; Stuhlmiller, David F E; Wolfe, Allen; Swearingen, Charles F; Pennington, Troy; Davis, Daniel P

2018-02-21

Airway management is a critical skill for air medical providers, including the use of rapid sequence intubation (RSI) medications. Mediocre success rates and a high incidence of complications has challenged air medical providers to improve training and performance improvement efforts to improve clinical performance. The aim of this research was to describe the experience with a novel, integrated advanced airway management program across a large air medical company and explore the impact of the program on improvement in RSI success. The Helicopter Advanced Resuscitation Training (HeART) program was implemented across 160 bases in 2015. The HeART program includes a novel conceptual framework based on thorough understanding of physiology, critical thinking using a novel algorithm, difficult airway predictive tools, training in the optimal use of specific airway techniques and devices, and integrated performance improvement efforts to address opportunities for improvement. The C-MAC video/direct laryngoscope and high-fidelity human patient simulation laboratories were implemented during the study period. Chi-square test for trend was used to evaluate for improvements in airway management and RSI success (overall intubation success, first-attempt success, first-attempt success without desaturation) over the 25-month study period following HeART implementation. A total of 5,132 patients underwent RSI during the study period. Improvements in first-attempt intubation success (85% to 95%, p < 0.01) and first-attempt success without desaturation (84% to 94%, p < 0.01) were observed. Overall intubation success increased from 95% to 99% over the study period, but the trend was not statistically significant (p = 0.311). An integrated advanced airway management program was successful in improving RSI intubation performance in a large air medical company.

Instability resistance training across the exercise continuum.

PubMed

Behm, David G; Colado, Juan C; Colado, Juan C

2013-11-01

Instability resistance training (IRT; unstable surfaces and devices to strengthen the core or trunk muscles) is popular in fitness training facilities. To examine contradictory IRT recommendations for health enthusiasts and rehabilitation. A literature search was performed using MEDLINE, SPORT Discus, ScienceDirect, Web of Science, and Google Scholar databases from 1990 to 2012. Databases were searched using key terms, including "balance," "stability," "instability," "resistance training," "core," "trunk," and "functional performance." Additionally, relevant articles were extracted from reference lists. To be included, research questions addressed the effect of balance or IRT on performance, healthy and active participants, and physiologic or performance outcome measures and had to be published in English in a peer-reviewed journal. There is a dichotomy of opinions on the effectiveness and application of instability devices and conditions for health and performance training. Balance training without resistance has been shown to improve not only balance but functional performance as well. IRT studies document similar training adaptations as stable resistance training programs with recreationally active individuals. Similar progressions with lower resistance may improve balance and stability, increase core activation, and improve motor control. IRT is highly recommended for youth, elderly, recreationally active individuals, and highly trained enthusiasts.

4 CFR 9.1 - GAO Senior Executive Service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... measured on the basis of individual and organizational performance (including such factors as improvements... performance and success in meeting equal employment opportunity goals); (3) Assure that senior executives are...

Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review.

PubMed

Boaz, Annette; Hanney, Stephen; Jones, Teresa; Soper, Bryony

2015-12-09

There is a widely held assumption that engagement by clinicians and healthcare organisations in research improves healthcare performance at various levels, but little direct empirical evidence has previously been collated. The objective of this study was to address the question: Does research engagement (by clinicians and organisations) improve healthcare performance? An hourglass-shaped review was developed, consisting of three stages: (1) a planning and mapping stage; (2) a focused review concentrating on the core question of whether or not research engagement improves healthcare performance; and (3) a wider (but less systematic) review of papers identified during the two earlier stages, focusing on mechanisms. Of the 33 papers included in the focused review, 28 identified improvements in health services performance. Seven out of these papers reported some improvement in health outcomes, with others reporting improved processes of care. The wider review demonstrated that mechanisms such as collaborative and action research can encourage some progress along the pathway from research engagement towards improved healthcare performance. Organisations that have deliberately integrated the research function into organisational structures demonstrate how research engagement can, among other factors, contribute to improved healthcare performance. Current evidence suggests that there is an association between the engagement of individuals and healthcare organisations in research and improvements in healthcare performance. The mechanisms through which research engagement might improve healthcare performance overlap and rarely act in isolation, and their effectiveness often depends on the context in which they operate. 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/

Improved Remapping Processor For Digital Imagery

NASA Technical Reports Server (NTRS)

Fisher, Timothy E.

1991-01-01

Proposed digital image processor improved version of Programmable Remapper, which performs geometric and radiometric transformations on digital images. Features include overlapping and variably sized preimages. Overcomes some of limitations of image-warping circuit boards implementing only those geometric tranformations expressible in terms of polynomials of limited order. Also overcomes limitations of existing Programmable Remapper and made to perform transformations at video rate.

Active Music Therapy and Physical Improvements From Rehabilitation for Neurological Conditions.

PubMed

Kogutek, Demian Leandro; Holmes, Jeffrey David; Grahn, Jessica Adrienne; Lutz, Sara G; Ready, Emily

2016-01-01

Context • A variety of rehabilitation-based interventions are currently available for individuals with physical impairments resulting from neurological conditions, including physiotherapy, occupational therapy, and speech language pathology. Many individuals find participation in those therapies to be challenging. Alternative therapies have emerged as beneficial adjunctive treatments for individuals undergoing neurological rehabilitation, including music therapy (MT). Objective • The study intended to identify and collate systematically the evidence on MT interventions that address physical improvements in a rehabilitative setting. Design • The research team performed a literature review, searching electronic databases from their inception to April 2014, including Embase, CINAHL, PubMed, Scopus, and ProQuest. The review included original studies that examined the use of active MT as an intervention that promotes physical improvements for adults >18 y of age. Articles were excluded if the studies focused primarily on psychosocial, emotional, or spiritual therapeutic goals. The review identified the studies' outcome measures for different populations and the MT approaches and interventions and obtained a general description of the clinical sessions, such as the frequency and duration of the therapy, interventions performed, sessions designs, populations, equipment used, and credentials of the therapists. Results • Eleven studies identified 2 major categories for the delivery of MT sessions: individual and group. One study included group sessions, and 10 studies included individual sessions. The studies included a total of 290 participants, 32 in the group MT, and 258 in the individual MT. The one study that used group therapy was based on active MT improvisation. For the individual therapy, 2 studies had investigated therapeutic instrument music performance and 8 used music-supported therapy. Conclusions • The findings of the review suggested that active MT can improve motor skills and should be considered as a potential adjunctive treatment.

Device Engineering Towards Improved Tin Sulfide Solar Cell Performance and Performance Reproducibility

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

Steinmann, Vera; Chakraborty, Rupak; Rekemeyer, Paul

2016-11-21

As novel absorber materials are developed and screened for their photovoltaic (PV) properties, the challenge remains to rapidly test promising candidates in high-performing PV devices. There is a need to engineer new compatible device architectures, including the development of novel transparent conductive oxides and buffer layers. Here, we consider the two approaches of a substrate-style and a superstrate-style device architecture for novel thin-film solar cells. We use tin sulfide as a test absorber material. Upon device engineering, we demonstrate new approaches to improve device performance and performance reproducibility.

Experimental investigation of nozzle/plume aerodynamics at hypersonic speeds

NASA Technical Reports Server (NTRS)

Bogdanoff, David W.; Cambier, Jean-Luc; Papadopoulos, Perikles

1994-01-01

Much of the work involved the Ames 16-Inch Shock Tunnel facility. The facility was reactivated and upgraded, a data acquisition system was configured and upgraded several times, several facility calibrations were performed and test entries with a wedge model with hydrogen injection and a full scramjet combustor model, with hydrogen injection, were performed. Extensive CFD modeling of the flow in the facility was done. This includes modeling of the unsteady flow in the driver and driven tubes and steady flow modeling of the nozzle flow. Other modeling efforts include simulations of non-equilibrium flows and turbulence, plasmas, light gas guns and the use of non-ideal gas equations of state. New experimental techniques to improve the performance of gas guns, shock tubes and tunnels and scramjet combustors were conceived and studied computationally. Ways to improve scramjet engine performance using steady and pulsed detonation waves were also studied computationally. A number of studies were performed on the operation of the ram accelerator, including investigations of in-tube gasdynamic heating and the use of high explosives to raise the velocity capability of the device.

Irregular large-scale computed tomography on multiple graphics processors improves energy-efficiency metrics for industrial applications

NASA Astrophysics Data System (ADS)

Jimenez, Edward S.; Goodman, Eric L.; Park, Ryeojin; Orr, Laurel J.; Thompson, Kyle R.

2014-09-01

This paper will investigate energy-efficiency for various real-world industrial computed-tomography reconstruction algorithms, both CPU- and GPU-based implementations. This work shows that the energy required for a given reconstruction is based on performance and problem size. There are many ways to describe performance and energy efficiency, thus this work will investigate multiple metrics including performance-per-watt, energy-delay product, and energy consumption. This work found that irregular GPU-based approaches1 realized tremendous savings in energy consumption when compared to CPU implementations while also significantly improving the performance-per- watt and energy-delay product metrics. Additional energy savings and other metric improvement was realized on the GPU-based reconstructions by improving storage I/O by implementing a parallel MIMD-like modularization of the compute and I/O tasks.

Case base classification on digital mammograms: improving the performance of case base classifier

NASA Astrophysics Data System (ADS)

Raman, Valliappan; Then, H. H.; Sumari, Putra; Venkatesa Mohan, N.

2011-10-01

Breast cancer continues to be a significant public health problem in the world. Early detection is the key for improving breast cancer prognosis. The aim of the research presented here is in twofold. First stage of research involves machine learning techniques, which segments and extracts features from the mass of digital mammograms. Second level is on problem solving approach which includes classification of mass by performance based case base classifier. In this paper we build a case-based Classifier in order to diagnose mammographic images. We explain different methods and behaviors that have been added to the classifier to improve the performance of the classifier. Currently the initial Performance base Classifier with Bagging is proposed in the paper and it's been implemented and it shows an improvement in specificity and sensitivity.

Vegetarian and Omnivorous Nutrition - Comparing Physical Performance.

PubMed

Craddock, Joel C; Probst, Yasmine C; Peoples, Gregory E

2016-06-01

Humans consuming vegetarian-based diets are observed to have reduced relative risk for many chronic diseases. Similarly, regular physical activity has also been shown to assist in preventing, and reducing the severity of these conditions. Many people, including athletes, acknowledge these findings and are adopting a vegetarian-based diet to improve their health status. Furthermore, athletes are incorporating this approach with the specific aim of optimizing physical performance. To examine the evidence for the relationship between consuming a predominately vegetarian-based diet and improved physical performance, a systematic literature review was performed using the SCOPUS database. No date parameters were set. The keywords vegetarian OR vegan AND sport OR athlete OR training OR performance OR endurance were used to identify relevant literature. Included studies (i) directly compared a vegetarian-based diet to an omnivorous/mixed diet, (ii) directly assessed physical performance, not biomarkers of physical performance, and (iii) did not use supplementation emulating a vegetarian diet. Reference lists were hand searched for additional studies. Seven randomized controlled trials and one cross-sectional study met the inclusion criteria. No distinguished differences between vegetarian-based diets and omnivorous mixed diets were identified when physical performance was compared. Consuming a predominately vegetarian-based diet did not improve nor hinder performance in athletes. However, with only 8 studies identified, with substantial variability among the studies' experimental designs, aims and outcomes, further research is warranted.

Models for the Effects of G-seat Cuing on Roll-axis Tracking Performance

NASA Technical Reports Server (NTRS)

Levison, W. H.; Mcmillan, G. R.; Martin, E. A.

1984-01-01

Including whole-body motion in a flight simulator improves performance for a variety of tasks requiring a pilot to compensate for the effects of unexpected disturbances. A possible mechanism for this improvement is that whole-body motion provides high derivative vehicle state information whic allows the pilot to generate more lead in responding to the external disturbances. During development of motion simulating algorithms for an advanced g-cuing system it was discovered that an algorithm based on aircraft roll acceleration producted little or no performance improvement. On the other hand, algorithms based on roll position or roll velocity produced performance equivalent to whole-body motion. The analysis and modeling conducted at both the sensory system and manual control performance levels to explain the above results are described.

High Energy Density Additives for Hybrid Fuel Rockets to Improve Performance and Enhance Safety

NASA Technical Reports Server (NTRS)

Jaffe, Richard L.

2014-01-01

We propose a conceptual study of prototype strained hydrocarbon molecules as high energy density additives for hybrid rocket fuels to boost the performance of these rockets without compromising safety and reliability. Use of these additives could extend the range of applications for which hybrid rockets become an attractive alternative to conventional solid or liquid fuel rockets. The objectives of the study were to confirm and quantify the high enthalpy of these strained molecules and to assess improvement in rocket performance that would be expected if these additives were blended with conventional fuels. We confirmed the chemical properties (including enthalpy) of these additives. However, the predicted improvement in rocket performance was too small to make this a useful strategy for boosting hybrid rocket performance.

Improving the Academic Achievement of Third and Fourth Grade Underachievers as a Result of Improved Self-Esteem.

ERIC Educational Resources Information Center

Coakley, Barbara Fairfax

This study was designed to improve the academic achievement of 35 third- and fourth-grade underachievers through improved self-esteem. Specific goals included focusing on self-concept and learning skills reinforcement, with the ultimate goal of increasing academic performance and motivation. Large group sessions with students focused on…

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.

Automatic Information Processing and High Performance Skills: Individual Differences and Mechanisms of Performance Improvement in Search-Detection and Complex Task

DTIC Science & Technology

1992-09-01

abilities is fit along with the autoregressive process. Initially, the influences on search performance of within-group age and sex were included as control...Results: PerformanceLAbility Structure Measurement Model: Ability Structure The correlations between all the ability measures, age, and sex are...subsequent analyses for young adults. Age and sex were included as control variables. There was an age range of 15 years; this range is sufficiently large that

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

PubMed

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

2017-09-01

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

Precision Attitude Determination System (PADS) design and analysis. Two-axis gimbal star tracker

NASA Technical Reports Server (NTRS)

1973-01-01

Development of the Precision Attitude Determination System (PADS) focused chiefly on the two-axis gimballed star tracker and electronics design improved from that of Precision Pointing Control System (PPCS), and application of the improved tracker for PADS at geosynchronous altitude. System design, system analysis, software design, and hardware design activities are reported. The system design encompasses the PADS configuration, system performance characteristics, component design summaries, and interface considerations. The PADS design and performance analysis includes error analysis, performance analysis via attitude determination simulation, and star tracker servo design analysis. The design of the star tracker and electronics are discussed. Sensor electronics schematics are included. A detailed characterization of the application software algorithms and computer requirements is provided.

Cognitive and motor dual task gait training improve dual task gait performance after stroke - A randomized controlled pilot trial.

PubMed

Liu, Yan-Ci; Yang, Yea-Ru; Tsai, Yun-An; Wang, Ray-Yau

2017-06-22

This study investigated effects of cognitive and motor dual task gait training on dual task gait performance in stroke. Participants (n = 28) were randomly assigned to cognitive dual task gait training (CDTT), motor dual task gait training (MDTT), or conventional physical therapy (CPT) group. Participants in CDTT or MDTT group practiced the cognitive or motor tasks respectively during walking. Participants in CPT group received strengthening, balance, and gait training. The intervention was 30 min/session, 3 sessions/week for 4 weeks. Three test conditions to evaluate the training effects were single walking, walking while performing cognitive task (serial subtraction), and walking while performing motor task (tray-carrying). Parameters included gait speed, dual task cost of gait speed (DTC-speed), cadence, stride time, and stride length. After CDTT, cognitive-motor dual task gait performance (stride length and DTC-speed) was improved (p = 0.021; p = 0.015). After MDTT, motor dual task gait performance (gait speed, stride length, and DTC-speed) was improved (p = 0.008; p = 0.008; p = 0.008 respectively). It seems that CDTT improved cognitive dual task gait performance and MDTT improved motor dual task gait performance although such improvements did not reach significant group difference. Therefore, different types of dual task gait training can be adopted to enhance different dual task gait performance in stroke.

CFD Code Development for Combustor Flows

NASA Technical Reports Server (NTRS)

Norris, Andrew

2003-01-01

During the lifetime of this grant, work has been performed in the areas of model development, code development, code validation and code application. For model development, this has included the PDF combustion module, chemical kinetics based on thermodynamics, neural network storage of chemical kinetics, ILDM chemical kinetics and assumed PDF work. Many of these models were then implemented in the code, and in addition many improvements were made to the code, including the addition of new chemistry integrators, property evaluation schemes, new chemistry models and turbulence-chemistry interaction methodology. Validation of all new models and code improvements were also performed, while application of the code to the ZCET program and also the NPSS GEW combustor program were also performed. Several important items remain under development, including the NOx post processing, assumed PDF model development and chemical kinetic development. It is expected that this work will continue under the new grant.

Medical students review of formative OSCE scores, checklists, and videos improves with student-faculty debriefing meetings

PubMed Central

Bernard, Aaron W.; Ceccolini, Gabbriel; Feinn, Richard; Rockfeld, Jennifer; Rosenberg, Ilene; Thomas, Listy; Cassese, Todd

2017-01-01

ABSTRACT Background: Performance feedback is considered essential to clinical skills development. Formative objective structured clinical exams (F-OSCEs) often include immediate feedback by standardized patients. Students can also be provided access to performance metrics including scores, checklists, and video recordings after the F-OSCE to supplement this feedback. How often students choose to review this data and how review impacts future performance has not been documented. Objective: We suspect student review of F-OSCE performance data is variable. We hypothesize that students who review this data have better performance on subsequent F-OSCEs compared to those who do not. We also suspect that frequency of data review can be improved with faculty involvement in the form of student-faculty debriefing meetings. Design: Simulation recording software tracks and time stamps student review of performance data. We investigated a cohort of first- and second-year medical students from the 2015-16 academic year. Basic descriptive statistics were used to characterize frequency of data review and a linear mixed-model analysis was used to determine relationships between data review and future F-OSCE performance. Results: Students reviewed scores (64%), checklists (42%), and videos (28%) in decreasing frequency. Frequency of review of all metric and modalities improved when student-faculty debriefing meetings were conducted (p<.001). Among 92 first-year students, checklist review was associated with an improved performance on subsequent F-OSCEs (p = 0.038) by 1.07 percentage points on a scale of 0-100. Among 86 second year students, no review modality was associated with improved performance on subsequent F-OSCEs. Conclusion: Medical students review F-OSCE checklists and video recordings less than 50% of the time when not prompted. Student-faculty debriefing meetings increased student data reviews. First-year student’s review of checklists on F-OSCEs was associated with increases in performance on subsequent F-OSCEs, however this outcome was not observed among second-year students. PMID:28521646

Medical students review of formative OSCE scores, checklists, and videos improves with student-faculty debriefing meetings.

PubMed

Bernard, Aaron W; Ceccolini, Gabbriel; Feinn, Richard; Rockfeld, Jennifer; Rosenberg, Ilene; Thomas, Listy; Cassese, Todd

2017-01-01

Performance feedback is considered essential to clinical skills development. Formative objective structured clinical exams (F-OSCEs) often include immediate feedback by standardized patients. Students can also be provided access to performance metrics including scores, checklists, and video recordings after the F-OSCE to supplement this feedback. How often students choose to review this data and how review impacts future performance has not been documented. We suspect student review of F-OSCE performance data is variable. We hypothesize that students who review this data have better performance on subsequent F-OSCEs compared to those who do not. We also suspect that frequency of data review can be improved with faculty involvement in the form of student-faculty debriefing meetings. Simulation recording software tracks and time stamps student review of performance data. We investigated a cohort of first- and second-year medical students from the 2015-16 academic year. Basic descriptive statistics were used to characterize frequency of data review and a linear mixed-model analysis was used to determine relationships between data review and future F-OSCE performance. Students reviewed scores (64%), checklists (42%), and videos (28%) in decreasing frequency. Frequency of review of all metric and modalities improved when student-faculty debriefing meetings were conducted (p<.001). Among 92 first-year students, checklist review was associated with an improved performance on subsequent F-OSCEs (p = 0.038) by 1.07 percentage points on a scale of 0-100. Among 86 second year students, no review modality was associated with improved performance on subsequent F-OSCEs. Medical students review F-OSCE checklists and video recordings less than 50% of the time when not prompted. Student-faculty debriefing meetings increased student data reviews. First-year student's review of checklists on F-OSCEs was associated with increases in performance on subsequent F-OSCEs, however this outcome was not observed among second-year students.

Jet engine applications for materials with nanometer-scale dimensions

NASA Technical Reports Server (NTRS)

Appleby, J. W., Jr.

1995-01-01

The performance of advanced military and commercial gas turbine engines is often linked to advances in materials technology. High performance gas turbine engines being developed require major material advances in strength, toughness, reduced density and improved temperature capability. The emerging technology of nanostructured materials has enormous potential for producing materials with significant improvements in these properties. Extraordinary properties demonstrated in the laboratory include material strengths approaching theoretical limit, ceramics that demonstrate ductility and toughness, and materials with ultra-high hardness. Nanostructured materials and coatings have the potential for meeting future gas turbine engine requirements for improved performance, reduced weight and lower fuel consumption.

Jet engine applications for materials with nanometer-scale dimensions

NASA Technical Reports Server (NTRS)

Appleby, J. W., Jr.

1995-01-01

The performance of advanced military and commercial gas turbine engines is often linked to advances in materials technology. High performance gas turbine engines being developed require major material advances in strength, toughness, reduced density and improved temperature capability. The emerging technology of nanostructured materials has enormous potential for producing materials with significant improvements in these properties. Extraordinary properties demonstrated in the laboratory include material strengths approaching theoretical limit, ceramics that demonstrate ductility and toughness, and material with ultra-high hardness. Nanostructured materials and coatings have the potential for meeting future gas turbine engine requirements for improved performance, reduced weight and lower fuel consumption.

The Performance Improvement of the Lagrangian Particle Dispersion Model (LPDM) Using Graphics Processing Unit (GPU) Computing

DTIC Science & Technology

2017-08-01

access to the GPU for general purpose processing .5 CUDA is designed to work easily with multiple programming languages , including Fortran. CUDA is a...Using Graphics Processing Unit (GPU) Computing by Leelinda P Dawson Approved for public release; distribution unlimited...The Performance Improvement of the Lagrangian Particle Dispersion Model (LPDM) Using Graphics Processing Unit (GPU) Computing by Leelinda

Signature Tracking for Optimized Nutrition and Training (STRONG)

DTIC Science & Technology

2014-08-01

manufacture , use, or sell any patented invention that may relate to them. This report was cleared for public release by the 88th Air Base Wing Public...Opportunities for performance augmentation include continuous performance feedback for self- improvement and individualized training regimens in the...the application of advanced physical training methods used by elite athletes to improve fitness in Special Operators; such as functional weight

New Flexible Silicone-Based EEG Dry Sensor Material Compositions Exhibiting Improvements in Lifespan, Conductivity, and Reliability

PubMed Central

Yu, Yi-Hsin; Chen, Shih-Hsun; Chang, Che-Lun; Lin, Chin-Teng; Hairston, W. David; Mrozek, Randy A.

2016-01-01

This study investigates alternative material compositions for flexible silicone-based dry electroencephalography (EEG) electrodes to improve the performance lifespan while maintaining high-fidelity transmission of EEG signals. Electrode materials were fabricated with varying concentrations of silver-coated silica and silver flakes to evaluate their electrical, mechanical, and EEG transmission performance. Scanning electron microscope (SEM) analysis of the initial electrode development identified some weak points in the sensors’ construction, including particle pull-out and ablation of the silver coating on the silica filler. The newly-developed sensor materials achieved significant improvement in EEG measurements while maintaining the advantages of previous silicone-based electrodes, including flexibility and non-toxicity. The experimental results indicated that the proposed electrodes maintained suitable performance even after exposure to temperature fluctuations, 85% relative humidity, and enhanced corrosion conditions demonstrating improvements in the environmental stability. Fabricated flat (forehead) and acicular (hairy sites) electrodes composed of the optimum identified formulation exhibited low impedance and reliable EEG measurement; some initial human experiments demonstrate the feasibility of using these silicone-based electrodes for typical lab data collection applications. PMID:27809260

New Flexible Silicone-Based EEG Dry Sensor Material Compositions Exhibiting Improvements in Lifespan, Conductivity, and Reliability.

PubMed

Yu, Yi-Hsin; Chen, Shih-Hsun; Chang, Che-Lun; Lin, Chin-Teng; Hairston, W David; Mrozek, Randy A

2016-10-31

This study investigates alternative material compositions for flexible silicone-based dry electroencephalography (EEG) electrodes to improve the performance lifespan while maintaining high-fidelity transmission of EEG signals. Electrode materials were fabricated with varying concentrations of silver-coated silica and silver flakes to evaluate their electrical, mechanical, and EEG transmission performance. Scanning electron microscope (SEM) analysis of the initial electrode development identified some weak points in the sensors' construction, including particle pull-out and ablation of the silver coating on the silica filler. The newly-developed sensor materials achieved significant improvement in EEG measurements while maintaining the advantages of previous silicone-based electrodes, including flexibility and non-toxicity. The experimental results indicated that the proposed electrodes maintained suitable performance even after exposure to temperature fluctuations, 85% relative humidity, and enhanced corrosion conditions demonstrating improvements in the environmental stability. Fabricated flat (forehead) and acicular (hairy sites) electrodes composed of the optimum identified formulation exhibited low impedance and reliable EEG measurement; some initial human experiments demonstrate the feasibility of using these silicone-based electrodes for typical lab data collection applications.

An Intervention Including an Online Game to Improve Grade 6 Students' Performance in Early Algebra

ERIC Educational Resources Information Center

Kolovou, Angeliki; van den Heuvel-Panhuizen, Marja; Koller, Olaf

2013-01-01

This study investigated whether an intervention including an online game contributed to 236 Grade 6 students' performance in early algebra, that is, solving problems with covarying quantities. An exploratory quasi-experimental study was conducted with a pretest-posttest-control-group design. Students in the experimental group were asked to solve…

Discharge characteristics of 300 ampere-hour Ni-Zn traction cells

NASA Technical Reports Server (NTRS)

Ewashinka, J. G.

1979-01-01

Preliminary tests were performed on 300 amphere-hour nickel-zinc cells containing the Lewis improved inorganic-organic (I/O) separator. These cells also have other design features included to optimize performance and cycle life. The tests carried out were formation tests and characteristic discharge tests. Information obtained include case temperature and maximum power delivered.

School Health: Policy Issues.

ERIC Educational Resources Information Center

Baker, Constance M.

1994-01-01

Despite data suggesting a relationship between investment in children's health and improved academic performance, school health financing is inadequate, inequitable, and fragmented. Strategies for improving school health programs include leadership from the nursing profession; collaboration among health professionals; consolidation of funding…

Procedures for Developing Evidence-Informed Performance Checklists for Improving Early Childhood Intervention Practices

ERIC Educational Resources Information Center

Dunst, Carl J.

2017-01-01

A conceptualization-operationalization-measurement framework is described for developing evidence-informed early childhood intervention performance checklists. Performance checklists include lists of practice indicators where the indicators, taken together, operationally define particular types of intervention practices that, when used as…

Four years of Landsat-7 on-orbit geometric calibration and performance

USGS Publications Warehouse

Lee, D.S.; Storey, James C.; Choate, M.J.; Hayes, R.W.

2004-01-01

Unlike its predecessors, Landsat-7 has undergone regular geometric and radiometric performance monitoring and calibration since launch in April 1999. This ongoing activity, which includes issuing quarterly updates to calibration parameters, has generated a wealth of geometric performance data over the four-year on-orbit period of operations. A suite of geometric characterization (measurement and evaluation procedures) and calibration (procedures to derive improved estimates of instrument parameters) methods are employed by the Landsat-7 Image Assessment System to maintain the geometric calibration and to track specific aspects of geometric performance. These include geodetic accuracy, band-to-band registration accuracy, and image-to-image registration accuracy. These characterization and calibration activities maintain image product geometric accuracy at a high level - by monitoring performance to determine when calibration is necessary, generating new calibration parameters, and verifying that new parameters achieve desired improvements in accuracy. Landsat-7 continues to meet and exceed all geometric accuracy requirements, although aging components have begun to affect performance.

Getting a handle on DNFB strategies for boosting performance.

PubMed

2015-03-01

Keeping tabs on DNFB requires a commitment from multiple departments, including clinical documentation, health information management, utilization management, and patient financial services. Monitoring DNFB performance daily, weekly, and monthly can help an organization quickly resolve short-term problems and also identify and respond to more systemic issues. By leveraging historical and comparison data, including performance information from peer organizations, hospitals and health systems can set more realistic targets and further highlight improvement opportunities.

Combining Systems and Teamwork Approaches to Enhance the Effectiveness of Safety Improvement Interventions in Surgery: The Safer Delivery of Surgical Services (S3) Program.

PubMed

McCulloch, Peter; Morgan, Lauren; New, Steve; Catchpole, Ken; Roberston, Eleanor; Hadi, Mohammed; Pickering, Sharon; Collins, Gary; Griffin, Damian

2017-01-01

Patient safety improvement interventions usually address either work systems or team culture. We do not know which is more effective, or whether combining approaches is beneficial. To compare improvement in surgical team performance after interventions addressing teamwork culture, work systems, or both. Suite of 5 identical controlled before-after intervention studies, with preplanned analysis of pooled data for indirect comparisons of strategies. Operating theatres in 5 UK hospitals performing elective orthopedic, plastic, or vascular surgery PARTICIPANTS:: All operating theatres staff, including surgeons, nurses, anaesthetists, and others INTERVENTIONS:: 4-month safety improvement interventions, using teamwork training (TT), systems redesign and standardization (SOP), Lean quality improvement, SOP + TT combination, or Lean + TT combination. Team technical and nontechnical performance and World Health Organization (WHO) checklist compliance, measured for 3 months before and after intervention using validated scales. Pooled data analysis of before-after change in active and control groups, comparing combined versus single and systems versus teamwork interventions, using 2-way ANOVA. We studied 453 operations, (255 intervention, 198 control). TT improved nontechnical skills and WHO compliance (P < 0.001), but not technical performance; systems interventions (Lean & SOP, 2 & 3) improved nontechnical skills and technical performance (P < 0.001) but improved WHO compliance less. Combined interventions (4 & 5) improved all performance measures except WHO time-out attempts, whereas single approaches (1 & 2 & 3) improved WHO compliance less (P < 0.001) and failed to improve technical performance. Safety interventions combining teamwork training and systems rationalization are more effective than those adopting either approach alone. This has important implications for safety improvement strategies in hospitals.

Stereopsis cueing effects on hover-in-turbulence performance in a simulated rotorcraft

NASA Technical Reports Server (NTRS)

Parrish, Russell V.; Williams, Steven P.

1990-01-01

The efficacy of stereopsis cueing in pictorial displays was assessed in a real-time piloted simulation experiment of a rotorcraft precision hover-in-turbulence task. Seven pilots endeavored to maintain a hover by visually aligning a set of inner and outer wickets (major elements of a real-world pictorial display, thus attaining the desired hover position, in a full factorial experimental design. The display conditions examined included the presence or absence of a velocity display element (a velocity head-up display) as well as the stereopsis cueing conditions, which included non-stereo (binoptic or monoscopic - no depth cues other than those provided by a perspective, real-world display), stereo 3-D, and hyper stereo (telestereoscopic). Subjective and objective results indicated that the depth cues provided by the stereo displays enhanced the situational awareness of the pilot and enabled improved hover performance to be achieved. The velocity display element also improved the hover performance, with the best hover performance being achieved with the combined use of stereo and the velocity display element. Pilot control input data revealed that less control action was required to attain the improved hover performance with the stereo displays.

Rotary engine performance limits predicted by a zero-dimensional model

NASA Technical Reports Server (NTRS)

Bartrand, Timothy A.; Willis, Edward A.

1992-01-01

A parametric study was performed to determine the performance limits of a rotary combustion engine. This study shows how well increasing the combustion rate, insulating, and turbocharging increase brake power and decrease fuel consumption. Several generalizations can be made from the findings. First, it was shown that the fastest combustion rate is not necessarily the best combustion rate. Second, several engine insulation schemes were employed for a turbocharged engine. Performance improved only for a highly insulated engine. Finally, the variability of turbocompounding and the influence of exhaust port shape were calculated. Rotary engines performance was predicted by an improved zero-dimensional computer model based on a model developed at the Massachusetts Institute of Technology in the 1980's. Independent variables in the study include turbocharging, manifold pressures, wall thermal properties, leakage area, and exhaust port geometry. Additions to the computer programs since its results were last published include turbocharging, manifold modeling, and improved friction power loss calculation. The baseline engine for this study is a single rotor 650 cc direct-injection stratified-charge engine with aluminum housings and a stainless steel rotor. Engine maps are provided for the baseline and turbocharged versions of the engine.

Ideas for Future GPS Timing Improvements

NASA Technical Reports Server (NTRS)

Hutsell, Steven T.

1996-01-01

Having recently met stringent criteria for full operational capability (FOC) certification, the Global Positioning System (GPS) now has higher customer expectations than ever before. In order to maintain customer satisfaction, and the meet the even high customer demands of the future, the GPS Master Control Station (MCS) must play a critical role in the process of carefully refining the performance and integrity of the GPS constellation, particularly in the area of timing. This paper will present an operational perspective on several ideas for improving timing in GPS. These ideas include the desire for improving MCS - US Naval Observatory (USNO) data connectivity, an improved GPS-Coordinated Universal Time (UTC) prediction algorithm, a more robust Kalman Filter, and more features in the GPS reference time algorithm (the GPS composite clock), including frequency step resolution, a more explicit use of the basic time scale equation, and dynamic clock weighting. Current MCS software meets the exceptional challenge of managing an extremely complex constellation of 24 navigation satellites. The GPS community will, however, always seek to improve upon this performance and integrity.

HPT: The Power To Change.

ERIC Educational Resources Information Center

Chevalier, Roger

2000-01-01

Discusses human performance technology (HPT) and change strategies. Describes types of power, including personal power and position power; participative change strategies; directive change strategies; performance improvement; and examples of strategies to help change individual and organizational behavior. (LRW)

Expanding the scope of quality measurement in surgery to include nonoperative care: Results from the American College of Surgeons National Surgical Quality Improvement Program emergency general surgery pilot.

PubMed

Wandling, Michael W; Ko, Clifford Y; Bankey, Paul E; Cribari, Chris; Cryer, H Gill; Diaz, Jose J; Duane, Therese M; Hameed, S Morad; Hutter, Matthew M; Metzler, Michael H; Regner, Justin L; Reilly, Patrick M; Reines, H David; Sperry, Jason L; Staudenmayer, Kristan L; Utter, Garth H; Crandall, Marie L; Bilimoria, Karl Y; Nathens, Avery B

2017-11-01

Patients managed nonoperatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where nonoperative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed nonoperatively to evaluate variability in nonoperative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered. Using ACS NSQIP infrastructure and methodology, surgical consultations for acute appendicitis, acute cholecystitis, and small bowel obstruction (SBO) were sampled at 13 hospitals that volunteered to participate in the EGS clinical data registry. Standard NSQIP variables and 16 EGS-specific variables were abstracted with 30-day follow-up. To determine the influence of complications in nonoperative patients, rates of adverse outcomes were identified, and hospitals were ranked by performance with and then without including nonoperative cases. Two thousand ninety-one patients with EGS diagnoses were included, 46.6% with appendicitis, 24.3% with cholecystitis, and 29.1% with SBO. The overall rate of nonoperative management was 27.4%, 6.6% for appendicitis, 16.5% for cholecystitis, and 69.9% for SBO. Despite comprising only 27.4% of patients in the EGS pilot, nonoperative management accounted for 67.7% of deaths, 34.3% of serious morbidities, and 41.8% of hospital readmissions. After adjusting for patient characteristics and hospital diagnosis mix, addition of nonoperative management to hospital performance assessment resulted in 12 of 13 hospitals changing performance rank, with four hospitals changing by three or more positions. This study identifies a gap in performance evaluation when nonoperative patients are excluded from surgical quality assessment and demonstrates the feasibility of incorporating nonoperative care into existing surgical quality initiatives. Broadening the scope of hospital performance assessment to include nonoperative management creates an opportunity to improve the care of all surgical patients, not just those who have an operation. Care management, level IV; Epidemiologic, level III.

Student perceptions of secondary science: A performance technology application

NASA Astrophysics Data System (ADS)

Small, Belinda Rusnak

The primary purpose of this study was to identify influences blocking or promoting science performance from the lived K-12 classroom experience. Human Performance Technology protocols were used to understand factors promoting or hindering science performance. The goal was to gain information from the individual students' perspective to enhance opportunities for stakeholders to improve the current state of performance in science education. Individual perspectives of 10 secondary science students were examined using grounded theory protocols. Findings include students' science learning behaviors are influenced by two major themes, environmental supports and individual learning behaviors. The three environmental support factors identified include the methods students receive instruction, students' opportunities to access informal help apart from formal instruction, and students' feelings of teacher likability. Additionally, findings include three major factors causing individual learners to generate knowledge in science. Factors reported include personalizing information to transform data into knowledge, customizing learning opportunities to maximize peak performance, and tapping motivational opportunities to persevere through complex concepts. The emergent theory postulated is that if a performance problem exists in an educational setting, then integrating student perspectives into the cause analysis opens opportunity to align interventions for influencing student performance outcomes. An adapted version of Gilbert's Behavioral Engineering Model is presented as an organizational tool to display the findings. The boundaries of this Performance Technology application do not extend to the identification, selection, design, or implementation of solutions to improved science performance. However, as stakeholders begin to understand learner perspectives then aligned decisions may be created to support learners of science in a direct, cost effective manner.

Controllers, observers, and applications thereof

NASA Technical Reports Server (NTRS)

Gao, Zhiqiang (Inventor); Zhou, Wankun (Inventor); Miklosovic, Robert (Inventor); Radke, Aaron (Inventor); Zheng, Qing (Inventor)

2011-01-01

Controller scaling and parameterization are described. Techniques that can be improved by employing the scaling and parameterization include, but are not limited to, controller design, tuning and optimization. The scaling and parameterization methods described here apply to transfer function based controllers, including PID controllers. The parameterization methods also apply to state feedback and state observer based controllers, as well as linear active disturbance rejection (ADRC) controllers. Parameterization simplifies the use of ADRC. A discrete extended state observer (DESO) and a generalized extended state observer (GESO) are described. They improve the performance of the ESO and therefore ADRC. A tracking control algorithm is also described that improves the performance of the ADRC controller. A general algorithm is described for applying ADRC to multi-input multi-output systems. Several specific applications of the control systems and processes are disclosed.

National Combustion Code: Parallel Implementation and Performance

NASA Technical Reports Server (NTRS)

Quealy, A.; Ryder, R.; Norris, A.; Liu, N.-S.

2000-01-01

The National Combustion Code (NCC) is being developed by an industry-government team for the design and analysis of combustion systems. CORSAIR-CCD is the current baseline reacting flow solver for NCC. This is a parallel, unstructured grid code which uses a distributed memory, message passing model for its parallel implementation. The focus of the present effort has been to improve the performance of the NCC flow solver to meet combustor designer requirements for model accuracy and analysis turnaround time. Improving the performance of this code contributes significantly to the overall reduction in time and cost of the combustor design cycle. This paper describes the parallel implementation of the NCC flow solver and summarizes its current parallel performance on an SGI Origin 2000. Earlier parallel performance results on an IBM SP-2 are also included. The performance improvements which have enabled a turnaround of less than 15 hours for a 1.3 million element fully reacting combustion simulation are described.

Publicly reported quality-of-care measures influenced Wisconsin physician groups to improve performance

PubMed Central

Lamb, Geoffrey C.; Smith, Maureen; Weeks, William B.; Queram, Christopher

2014-01-01

Public reporting of performance on quality measures is increasingly common but little is known about the impact, especially among physician groups. The Wisconsin Collaborative for Healthcare Quality (Collaborative) is a voluntary consortium of physician groups which has publicly reported quality measures since 2004, providing an opportunity to study the effect of this effort on participating groups. Analyses included member performance on 14 ambulatory measures from 2004–2009, a survey regarding reporting and its relationship to improvement efforts, and use of Medicare billing data to independently compare Collaborative members to the rest of Wisconsin, neighboring states and the rest of the United States. Faced with limited resources, groups prioritized their efforts based on the nature of the measure and their performance compared to others. The outcomes demonstrated that public reporting was associated with improvement in health quality and that large physician group practices will engage in improvement efforts in response. PMID:23459733

Using provider performance incentives to increase HIV testing and counseling services in Rwanda.

PubMed

de Walque, Damien; Gertler, Paul J; Bautista-Arredondo, Sergio; Kwan, Ada; Vermeersch, Christel; de Dieu Bizimana, Jean; Binagwaho, Agnès; Condo, Jeanine

2015-03-01

Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient. Copyright © 2014. Published by Elsevier B.V.

Using wind plant data to increase reliability.

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

Peters, Valerie A.; Ogilvie, Alistair B.; McKenney, Bridget L.

2011-01-01

Operators interested in improving reliability should begin with a focus on the performance of the wind plant as a whole. To then understand the factors which drive individual turbine performance, which together comprise the plant performance, it is necessary to track a number of key indicators. Analysis of these key indicators can reveal the type, frequency, and cause of failures and will also identify their contributions to overall plant performance. The ideal approach to using data to drive good decisions includes first determining which critical decisions can be based on data. When those required decisions are understood, then the analysismore » required to inform those decisions can be identified, and finally the data to be collected in support of those analyses can be determined. Once equipped with high-quality data and analysis capabilities, the key steps to data-based decision making for reliability improvements are to isolate possible improvements, select the improvements with largest return on investment (ROI), implement the selected improvements, and finally to track their impact.« less

Component Repair Experiment-1: An Experiment Evaluating Electronic Component-Level Repair During Spaceflight

NASA Technical Reports Server (NTRS)

Easton, John W.; Struk, Peter M.

2012-01-01

The Component Repair Experiment-1 (CRE-1) examines the capability for astronauts to perform electronics repair tasks in space. The goal is to determine the current capabilities and limits for the crew, and to make recommendations to improve and expand the range of work that astronauts may perform. CRE-1 provided two-layer, functional circuit boards and replacement components, a small tool kit, written and video training materials, and 1 hr of hands on training for the crew slated to perform the experiment approximately 7 months prior to the mission. Astronauts Michael Fincke and Sandra Magnus performed the work aboard the International Space Station (ISS) in February and March 2009. The astronauts were able to remove and replace components successfully, demonstrating the feasibility of performing component-level electronics repairs within a spacecraft. Several unsuccessful tasks demonstrated areas in need of improvement. These include improved and longer training prior to a mission, an improved soldering iron with a higher operating temperature and steady power source, video training and practice boards for refresher work or practice before a repair, and improved and varied hand tools and containment system.

The JPSS CrIS Instrument and the Evolution of Space-Based Infrared Sounders

NASA Technical Reports Server (NTRS)

Glumb, Ronald; Suwinski, Lawrence; Wells, Steven; Glumb, Anna; Malloy, Rebecca; Colton, Marie

2018-01-01

This paper will summarize the development of infrared sounders since the 1970s, describe the technological hurdles that were overcome to provide ever-increasing performance capabilities, and highlight the radiometric performance of the CrIS instrument on JPSS-1 (CrIS-JPSS1). This includes details of the CrIS-JPSS1 measured noise-equivalent spectral radiance (NEdN) performance, radiometric uncertainty performance utilizing a new and improved internal calibration target, short-term and long-term repeatability, spectral uncertainty, and spectral stability. In addition, the full-resolution operating modes for CrIS-JPSS1 will be reviewed, including a discussion of how these modes will be used during on-orbit characterization tests. We will provide a brief update of CrIS-SNPP on-obit performance and the production status of the CrIS instruments for JPSS-2 through JPSS-4. Current technological challenges will also be reviewed, including how ongoing research and development is enabling improvements to future sounders. The expanding usage of infrared sounding data will also be discussed, including demonstration of value via data assimilation, the roles of the public/private sector in communicating the importance of sounding data for long-term observations, and the long road to success from research to operational data products.

High-precision radiometric tracking for planetary approach and encounter in the inner solar system

NASA Technical Reports Server (NTRS)

Christensen, C. S.; Thurman, S. W.; Davidson, J. M.; Finger, M. H.; Folkner, W. M.

1989-01-01

The benefits of improved radiometric tracking data have been studied for planetary approach within the inner Solar System using the Mars Rover Sample Return trajectory as a model. It was found that the benefit of improved data to approach and encounter navigation was highly dependent on the a priori uncertainties assumed for several non-estimated parameters, including those for frame-tie, Earth orientation, troposphere delay, and station locations. With these errors at their current levels, navigational performance was found to be insensitive to enhancements in data accuracy. However, when expected improvements in these errors are modeled, performance with current-accuracy data significantly improves, with substantial further improvements possible with enhancements in data accuracy.

A comparative study on methods of improving SCR for ship detection in SAR image

NASA Astrophysics Data System (ADS)

Lang, Haitao; Shi, Hongji; Tao, Yunhong; Ma, Li

2017-10-01

Knowledge about ship positions plays a critical role in a wide range of maritime applications. To improve the performance of ship detector in SAR image, an effective strategy is improving the signal-to-clutter ratio (SCR) before conducting detection. In this paper, we present a comparative study on methods of improving SCR, including power-law scaling (PLS), max-mean and max-median filter (MMF1 and MMF2), method of wavelet transform (TWT), traditional SPAN detector, reflection symmetric metric (RSM), scattering mechanism metric (SMM). The ability of SCR improvement to SAR image and ship detection performance associated with cell- averaging CFAR (CA-CFAR) of different methods are evaluated on two real SAR data.

Reading Performance of Career-Bound Students: Good News and Bad News from the 1996 High Schools That Work Assessment. Research Brief.

ERIC Educational Resources Information Center

Bottoms, Gene; Creech, Betty

Good news about reading achievement of career-bound students at High Schools That Work (HSTW) sites includes the following: (1) 60% of the 260 sites that tested students in 1993/94 and again in 1996 saw improvement in reading scores; (2) the performance of all students majority and minority improved significantly; (3) HSTW sites widened the gap…

Free-Mass and Interface Configurations of Hammering Mechanisms

NASA Technical Reports Server (NTRS)

Bao, Xiaoqi (Inventor); Sherrit, Stewart (Inventor); Badescu, Mircea (Inventor); Bar-Cohen, Yoseph (Inventor); Askins, Steve (Inventor); Ostlund, Patrick (Inventor)

2015-01-01

The design of the free-mass in an ultrasonic driller/corer (USDC) has been refined in order to improve the performance and operational reliability of the system. In one embodiment, the improvements in performance and operational reliability include decreasing the impact surface area of the free-mass to increase the transfer of impact energy from the piezoelectric transducer and reductions in the likelihood that the system will jam.

Electrolysis Performance Improvement Concept Study (EPICS) flight experiment phase C/D

NASA Technical Reports Server (NTRS)

Schubert, F. H.; Lee, M. G.

1995-01-01

The overall purpose of the Electrolysis Performance Improvement Concept Study flight experiment is to demonstrate and validate in a microgravity environment the Static Feed Electrolyzer concept as well as investigate the effect of microgravity on water electrolysis performance. The scope of the experiment includes variations in microstructural characteristics of electrodes and current densities in a static feed electrolysis cell configuration. The results of the flight experiment will be used to improve efficiency of the static feed electrolysis process and other electrochemical regenerative life support processes by reducing power and expanding the operational range. Specific technologies that will benefit include water electrolysis for propulsion, energy storage, life support, extravehicular activity, in-space manufacturing and in-space science in addition to other electrochemical regenerative life support technologies such as electrochemical carbon dioxide and oxygen separation, electrochemical oxygen compression and water vapor electrolysis. The Electrolysis Performance Improvement Concept Study flight experiment design incorporates two primary hardware assemblies: the Mechanical/Electrochemical Assembly and the Control/Monitor Instrumentation. The Mechanical/Electrochemical Assembly contains three separate integrated electrolysis cells along with supporting pressure and temperature control components. The Control/Monitor Instrumentation controls the operation of the experiment via the Mechanical/Electrochemical Assembly components and provides for monitoring and control of critical parameters and storage of experimental data.

Reinforcement learning algorithms for robotic navigation in dynamic environments.

PubMed

Yen, Gary G; Hickey, Travis W

2004-04-01

The purpose of this study was to examine improvements to reinforcement learning (RL) algorithms in order to successfully interact within dynamic environments. The scope of the research was that of RL algorithms as applied to robotic navigation. Proposed improvements include: addition of a forgetting mechanism, use of feature based state inputs, and hierarchical structuring of an RL agent. Simulations were performed to evaluate the individual merits and flaws of each proposal, to compare proposed methods to prior established methods, and to compare proposed methods to theoretically optimal solutions. Incorporation of a forgetting mechanism did considerably improve the learning times of RL agents in a dynamic environment. However, direct implementation of a feature-based RL agent did not result in any performance enhancements, as pure feature-based navigation results in a lack of positional awareness, and the inability of the agent to determine the location of the goal state. Inclusion of a hierarchical structure in an RL agent resulted in significantly improved performance, specifically when one layer of the hierarchy included a feature-based agent for obstacle avoidance, and a standard RL agent for global navigation. In summary, the inclusion of a forgetting mechanism, and the use of a hierarchically structured RL agent offer substantially increased performance when compared to traditional RL agents navigating in a dynamic environment.

Evaluating laboratory key performance using quality indicators in Alexandria University Hospital Clinical Chemistry Laboratories.

PubMed

Rizk, Mostafa M; Zaki, Adel; Hossam, Nermine; Aboul-Ela, Yasmin

2014-12-01

The performance of clinical laboratories plays a fundamental role in the quality and effectiveness of healthcare. To evaluate the laboratory performance in Alexandria University Hospital Clinical Laboratories using key quality indicators and to compare the performance before and after an improvement plan based on ISO 15189 standards. The study was carried out on inpatient samples for a period of 7 months that was divided into three phases: phase I included data collection for evaluation of the existing process before improvement (March-May 2012); an intermediate phase, which included corrective, preventive action, quality initiative and steps for improvement (June 2012); and phase II, which included data collection for evaluation of the process after improvement (July 2012-September 2012). In terms of the preanalytical indicators, incomplete request forms in phase I showed that the total number of received requests were 31 944, with a percentage of defected request of 33.66%; whereas in phase II, there was a significant reduction in all defected request items (P<0.001) with a percentage of defected requests of 9.64%. As for the analytical indicators, the proficiency testing accuracy score in phase I showed poor performance of 10 analytes in which total error (TE) exceeded total error allowable (TEa), with a corresponding sigma value of less than 3, which indicates test problems and an unreliable method. The remaining analytes showed an acceptable performance in which TE did not exceed the TEa, with a sigma value of more than 6. Following an intervention of 3 months, the performance showed marked improvement. Error tracking in phase I showed a TE of (5.11%), whereas in phase II it was reduced to 2.48% (P<0.001).For the postanalytical indicators, our results in phase I showed that the percentage of nonreported critical results was 26.07%. In phase II, there was a significant improvement (P<0.001). The percentage of nonreported results was 11.37%, the reasons were either inability to contact the authorized doctor (8.24%), wrong patient identification (1.0%), lack of reporting by lab doctor (1.11%), and finally, lack of reporting by the lab technician (1.03%). Standardization and monitoring of each step in the total testing process is very important and is associated with the most efficient and well-organized laboratories.

Upgrades to the ISS Water Recovery System

NASA Technical Reports Server (NTRS)

Kayatin, Matthew; Takada, Kevin; Carter, Layne

2017-01-01

The ISS Water Recovery System (WRS) includes the Water Processor Assembly (WPA) and the Urine Processor Assembly (UPA). The WRS produces potable water from a combination of crew urine (first processed through the UPA), crew latent, and Sabatier product water. Though the WRS has performed well since operations began in November 2008, several modifications have been identified to improve the overall system performance. These modifications can reduce resupply and improve overall system reliability, which is beneficial for the ongoing ISS mission as well as for future NASA manned missions. The following paper details efforts to improve the WPA through the use of Reverse Osmosis technology to reduce the resupply mass of the WPA Multifiltration Bed and improved catalyst for the WPA Catalytic Reactor to reduce the operational temperature and pressure. For the UPA, this paper discusses progress on various concepts for improving the reliability of the UPA, including the implementation of a more reliable drive belt, improved methods for managing condensate in the stationary bowl of the Distillation Assembly, deleting the Separator Plumbing Assembly, and evaluating upgrades to the UPA vacuum pump.

Upgrades to the International Space Station Water Recovery System

NASA Technical Reports Server (NTRS)

Kayatin, Matthew J.; Pruitt, Jennifer M.; Nur, Mononita; Takada, Kevin C.; Carter, Layne

2017-01-01

The International Space Station (ISS) Water Recovery System (WRS) includes the Water Processor Assembly (WPA) and the Urine Processor Assembly (UPA). The WRS produces potable water from a combination of crew urine (first processed through the UPA), crew latent, and Sabatier product water. Though the WRS has performed well since operations began in November 2008, several modifications have been identified to improve the overall system performance. These modifications aim to reduce resupply and improve overall system reliability, which is beneficial for the ongoing ISS mission as well as for future NASA manned missions. The following paper details efforts to improve the WPA through the use of reverse osmosis membrane technology to reduce the resupply mass of the WPA Multi-filtration Bed and improved catalyst for the WPA Catalytic Reactor to reduce the operational temperature and pressure. For the UPA, this paper discusses progress on various concepts for improving the reliability of the system, including the implementation of a more reliable drive belt, improved methods for managing condensate in the stationary bowl of the Distillation Assembly, and evaluating upgrades to the UPA vacuum pump.

Inclusion of Highest Glasgow Coma Scale Motor Component Score in Mortality Risk Adjustment for Benchmarking of Trauma Center Performance.

PubMed

Gomez, David; Byrne, James P; Alali, Aziz S; Xiong, Wei; Hoeft, Chris; Neal, Melanie; Subacius, Harris; Nathens, Avery B

2017-12-01

The Glasgow Coma Scale (GCS) is the most widely used measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor component (mGCS) score is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS score in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including the highest mGCS score on the performance of risk-adjustment models and subsequent external benchmarking results. Data were derived from the Trauma Quality Improvement Program analytic dataset (January 2014 through March 2015) and were limited to the severe TBI cohort (16 years or older, isolated head injury, GCS ≤8). Risk-adjustment models were created that varied in the mGCS covariates only (initial score, highest score, or both initial and highest mGCS scores). Model performance and fit, as well as external benchmarking results, were compared. There were 6,553 patients with severe TBI across 231 trauma centers included. Initial and highest mGCS scores were different in 47% of patients (n = 3,097). Model performance and fit improved when both initial and highest mGCS scores were included, as evidenced by improved C-statistic, Akaike Information Criterion, and adjusted R-squared values. Three-quarters of centers changed their adjusted odds ratio decile, 2.6% of centers changed outlier status, and 45% of centers exhibited a ≥0.5-SD change in the odds ratio of death after including highest mGCS score in the model. This study supports the concept that additional clinical information has the potential to not only improve the performance of current risk-adjustment models, but can also have a meaningful impact on external benchmarking strategies. Highest mGCS score is a good potential candidate for inclusion in additional models. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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.

Strategic Information Resources Management: Fundamental Practices.

ERIC Educational Resources Information Center

Caudle, Sharon L.

1996-01-01

Discusses six fundamental information resources management (IRM) practices in successful organizations that can improve government service delivery performance. Highlights include directing changes, integrating IRM decision making into a strategic management process, performance management, maintaining an investment philosophy, using business…

Errors in laboratory medicine: practical lessons to improve patient safety.

PubMed

Howanitz, Peter J

2005-10-01

Patient safety is influenced by the frequency and seriousness of errors that occur in the health care system. Error rates in laboratory practices are collected routinely for a variety of performance measures in all clinical pathology laboratories in the United States, but a list of critical performance measures has not yet been recommended. The most extensive databases describing error rates in pathology were developed and are maintained by the College of American Pathologists (CAP). These databases include the CAP's Q-Probes and Q-Tracks programs, which provide information on error rates from more than 130 interlaboratory studies. To define critical performance measures in laboratory medicine, describe error rates of these measures, and provide suggestions to decrease these errors, thereby ultimately improving patient safety. A review of experiences from Q-Probes and Q-Tracks studies supplemented with other studies cited in the literature. Q-Probes studies are carried out as time-limited studies lasting 1 to 4 months and have been conducted since 1989. In contrast, Q-Tracks investigations are ongoing studies performed on a yearly basis and have been conducted only since 1998. Participants from institutions throughout the world simultaneously conducted these studies according to specified scientific designs. The CAP has collected and summarized data for participants about these performance measures, including the significance of errors, the magnitude of error rates, tactics for error reduction, and willingness to implement each of these performance measures. A list of recommended performance measures, the frequency of errors when these performance measures were studied, and suggestions to improve patient safety by reducing these errors. Error rates for preanalytic and postanalytic performance measures were higher than for analytic measures. Eight performance measures were identified, including customer satisfaction, test turnaround times, patient identification, specimen acceptability, proficiency testing, critical value reporting, blood product wastage, and blood culture contamination. Error rate benchmarks for these performance measures were cited and recommendations for improving patient safety presented. Not only has each of the 8 performance measures proven practical, useful, and important for patient care, taken together, they also fulfill regulatory requirements. All laboratories should consider implementing these performance measures and standardizing their own scientific designs, data analysis, and error reduction strategies according to findings from these published studies.

Computerized Agility Training Improves Change-of-Direction and Balance Performance Independently of Footwear in Young Adults.

PubMed

Paquette, Max R; Schilling, Brian K; Bravo, Joshua D; Peel, Shelby A; Li, Yuhua; Townsend, Robert J

2017-03-01

Understanding the effects of training in different footwear on sporting performance would be useful to coaches and athletes. This study compared the effects of computerized agility training using 3 types of footwear on change-of-direction and balance performance in young adults. Thirty recreationally active young adults (M age  = 22.8 ± 3.1 years; M height  = 1.71 ± 0.7 m; M bodymass  = 73.4 ± 10.3 kg) were randomly assigned to a 6-week computerized agility training intervention in 1 of 3 footwear groups (n = 10/group): barefoot, minimal footwear, or traditional shoes. Participants had no previous barefoot or minimal-footwear training experience. Dependent variables included change-of-direction test time to completion, Star Excursion Balance Test, and single-leg stability evaluation. Testing was performed at the start of the training program, after 2 weeks, after 4 weeks, and at the end of the training program. No group or time interactions were found for any of the dependent variables. Time main effects were observed for the performance measures of change of direction, Star Excursion, and single-leg-with-eyes-open stability evaluation. Participants improved in all 3 tests as early as 2 weeks into the intervention, with improvements continuing through the entire 6-week intervention. The lack of interaction and footwear effects suggests that agility and balance improvements during foot agility training are independent of footwear in a recreationally active young-adult population. Computerized agility training improves change-of-direction and balance performance within 2 weeks of training implementation. Future studies should consider footwear training effects in different populations, including frail older adults and athletes.

Effects of curved-walking training on curved-walking performance and freezing of gait in individuals with Parkinson's disease: A randomized controlled trial.

PubMed

Cheng, Fang-Yu; Yang, Yea-Ru; Wu, Yih-Ru; Cheng, Shih-Jung; Wang, Ray-Yau

2017-10-01

The purpose of this study was to investigate the effects of curved-walking training (CWT) on curved-walking performance and freezing of gait (FOG) in people with Parkinson's disease (PD). Twenty-four PD subjects were recruited and randomly assigned to the CWT group or control exercise (CE) group and received 12 sessions of either CWT with a turning-based treadmill or general exercise training for 30 min followed by 10 min of over-ground walking in each session for 4-6 weeks. The primary outcomes included curved-walking performance and FOG. All measurements were assessed at baseline, after training, and at 1-month follow-up. Our results showed significant improvements in curved-walking performance (speed, p = 0.007; cadence, p = 0.003; step length, p < 0.001) and FOG, measured by a FOG questionnaire (p = 0.004). The secondary outcomes including straight-walking performance (speed, cadence and step length, p < 0.001), timed up and go test (p = 0.014), functional gait assessment (p < 0.001), Unified Parkinson's disease Rating Scale III (p = 0.001), and quality of life (p < 0.001) were also improved in the experimental group. We further noted that the improvements were maintained for at least one month after training (p < 0.05). A 12-session CWT program can improve curved-walking ability, FOG, and other measures of functional walking performance in individuals with PD. Most of the improvements were sustained for at least one month after training. Copyright © 2017 Elsevier Ltd. All rights reserved.

Antenna Calibration and Measurement Equipment

NASA Technical Reports Server (NTRS)

Rochblatt, David J.; Cortes, Manuel Vazquez

2012-01-01

A document describes the Antenna Calibration & Measurement Equipment (ACME) system that will provide the Deep Space Network (DSN) with instrumentation enabling a trained RF engineer at each complex to perform antenna calibration measurements and to generate antenna calibration data. This data includes continuous-scan auto-bore-based data acquisition with all-sky data gathering in support of 4th order pointing model generation requirements. Other data includes antenna subreflector focus, system noise temperature and tipping curves, antenna efficiency, reports system linearity, and instrument calibration. The ACME system design is based on the on-the-fly (OTF) mapping technique and architecture. ACME has contributed to the improved RF performance of the DSN by approximately a factor of two. It improved the pointing performances of the DSN antennas and productivity of its personnel and calibration engineers.

Healthcare managers' roles, competencies, and outputs in organizational performance improvement.

PubMed

Wallick, William G

2002-01-01

Healthcare CEOs recognize that managers are under increasing pressure to work smarter and more efficiently with fewer available resources. Jobs in the healthcare industry are in a constant state of change, requiring a workforce that is not only prepared to adjust quickly to the changing environment but to simultaneously maintain or improve overall organizational performance. Traditionally, trainers were viewed as the people with the primary responsibility for improving organizational performance. Today some CEOs believe healthcare managers should own that responsibility, and other CEOs believe the responsibility should be shared among healthcare managers and trainers. This shift in how accountability is viewed poses at least two important questions. Are managers aware of the various roles they need to enact to achieve successful organizational performance improvement? Do managers possess the competencies associated with those roles? The seven most contemporary trainer roles, now referred to as workplace learning and performance roles, are examined in this article to help managers increase their knowledge of the roles, competencies, and outputs expected of them. Based on findings of a study conducted to examine CEO's perceptions of managers' roles in the performance improvement process, this article provides theoretical backgrounds, includes verbatim study comments, and offers practical recommendations or tips for managers.

Pharmacological Approaches to Performance Enhancement in Animals,

DTIC Science & Technology

found to improve performance disrupted by exposure to hypoxia. These substances included piracetam , nimodipine, and ipsapirone. An additional...their low toxicity , and their lack of negative effects on normal cognitive performance, it is suggested that these drugs could prove to be useful therapeutic agents under conditions of high information processing load.

Creating Workplaces Where People Can Think: Cognitive Ergonomics.

ERIC Educational Resources Information Center

Kearny, Lynn; Smith, Phyl

1999-01-01

Presents ideas about how the workplace affects job performance, how to diagnose workplace-related problems, and how to make modest improvements. Highlights include: workplace-imposed limits on performance; the mental and physical steps of work; screening behavior; how adaptation interferes with performance; task- and human-based workspaces;…

A Hybrid Approach to Detect Driver Drowsiness Utilizing Physiological Signals to Improve System Performance and Wearability.

PubMed

Awais, Muhammad; Badruddin, Nasreen; Drieberg, Micheal

2017-08-31

Driver drowsiness is a major cause of fatal accidents, injury, and property damage, and has become an area of substantial research attention in recent years. The present study proposes a method to detect drowsiness in drivers which integrates features of electrocardiography (ECG) and electroencephalography (EEG) to improve detection performance. The study measures differences between the alert and drowsy states from physiological data collected from 22 healthy subjects in a driving simulator-based study. A monotonous driving environment is used to induce drowsiness in the participants. Various time and frequency domain feature were extracted from EEG including time domain statistical descriptors, complexity measures and power spectral measures. Features extracted from the ECG signal included heart rate (HR) and heart rate variability (HRV), including low frequency (LF), high frequency (HF) and LF/HF ratio. Furthermore, subjective sleepiness scale is also assessed to study its relationship with drowsiness. We used paired t -tests to select only statistically significant features ( p < 0.05), that can differentiate between the alert and drowsy states effectively. Significant features of both modalities (EEG and ECG) are then combined to investigate the improvement in performance using support vector machine (SVM) classifier. The other main contribution of this paper is the study on channel reduction and its impact to the performance of detection. The proposed method demonstrated that combining EEG and ECG has improved the system's performance in discriminating between alert and drowsy states, instead of using them alone. Our channel reduction analysis revealed that an acceptable level of accuracy (80%) could be achieved by combining just two electrodes (one EEG and one ECG), indicating the feasibility of a system with improved wearability compared with existing systems involving many electrodes. Overall, our results demonstrate that the proposed method can be a viable solution for a practical driver drowsiness system that is both accurate and comfortable to wear.

A Hybrid Approach to Detect Driver Drowsiness Utilizing Physiological Signals to Improve System Performance and Wearability

PubMed Central

Badruddin, Nasreen

2017-01-01

Driver drowsiness is a major cause of fatal accidents, injury, and property damage, and has become an area of substantial research attention in recent years. The present study proposes a method to detect drowsiness in drivers which integrates features of electrocardiography (ECG) and electroencephalography (EEG) to improve detection performance. The study measures differences between the alert and drowsy states from physiological data collected from 22 healthy subjects in a driving simulator-based study. A monotonous driving environment is used to induce drowsiness in the participants. Various time and frequency domain feature were extracted from EEG including time domain statistical descriptors, complexity measures and power spectral measures. Features extracted from the ECG signal included heart rate (HR) and heart rate variability (HRV), including low frequency (LF), high frequency (HF) and LF/HF ratio. Furthermore, subjective sleepiness scale is also assessed to study its relationship with drowsiness. We used paired t-tests to select only statistically significant features (p < 0.05), that can differentiate between the alert and drowsy states effectively. Significant features of both modalities (EEG and ECG) are then combined to investigate the improvement in performance using support vector machine (SVM) classifier. The other main contribution of this paper is the study on channel reduction and its impact to the performance of detection. The proposed method demonstrated that combining EEG and ECG has improved the system’s performance in discriminating between alert and drowsy states, instead of using them alone. Our channel reduction analysis revealed that an acceptable level of accuracy (80%) could be achieved by combining just two electrodes (one EEG and one ECG), indicating the feasibility of a system with improved wearability compared with existing systems involving many electrodes. Overall, our results demonstrate that the proposed method can be a viable solution for a practical driver drowsiness system that is both accurate and comfortable to wear. PMID:28858220

Better Measurement for Performance Improvement in Low- and Middle-Income Countries: The Primary Health Care Performance Initiative (PHCPI) Experience of Conceptual Framework Development and Indicator Selection.

PubMed

Veillard, Jeremy; Cowling, Krycia; Bitton, Asaf; Ratcliffe, Hannah; Kimball, Meredith; Barkley, Shannon; Mercereau, Laure; Wong, Ethan; Taylor, Chelsea; Hirschhorn, Lisa R; Wang, Hong

2017-12-01

Policy Points: Strengthening accountability through better measurement and reporting is vital to ensure progress in improving quality primary health care (PHC) systems and achieving universal health coverage (UHC). The Primary Health Care Performance Initiative (PHCPI) provides national decision makers and global stakeholders with opportunities to benchmark and accelerate performance improvement through better performance measurement. Results from the initial PHC performance assessments in low- and middle-income countries (LMICs) are helping guide PHC reforms and investments and improve the PHCPI's instruments and indicators. Findings from future assessment activities will further amplify cross-country comparisons and peer learning to improve PHC. New indicators and sources of data are needed to better understand PHC system performance in LMICs. The Primary Health Care Performance Initiative (PHCPI), a collaboration between the Bill and Melinda Gates Foundation, The World Bank, and the World Health Organization, in partnership with Ariadne Labs and Results for Development, was launched in 2015 with the aim of catalyzing improvements in primary health care (PHC) systems in 135 low- and middle-income countries (LMICs), in order to accelerate progress toward universal health coverage. Through more comprehensive and actionable measurement of quality PHC, the PHCPI stimulates peer learning among LMICs and informs decision makers to guide PHC investments and reforms. Instruments for performance assessment and improvement are in development; to date, a conceptual framework and 2 sets of performance indicators have been released. The PHCPI team developed the conceptual framework through literature reviews and consultations with an advisory committee of international experts. We generated 2 sets of performance indicators selected from a literature review of relevant indicators, cross-referenced against indicators available from international sources, and evaluated through 2 separate modified Delphi processes, consisting of online surveys and in-person facilitated discussions with experts. The PHCPI conceptual framework builds on the current understanding of PHC system performance through an expanded emphasis on the role of service delivery. The first set of performance indicators, 36 Vital Signs, facilitates comparisons across countries and over time. The second set, 56 Diagnostic Indicators, elucidates underlying drivers of performance. Key challenges include a lack of available data for several indicators and a lack of validated indicators for important dimensions of quality PHC. The availability of data is critical to assessing PHC performance, particularly patient experience and quality of care. The PHCPI will continue to develop and test additional performance assessment instruments, including composite indices and national performance dashboards. Through country engagement, the PHCPI will further refine its instruments and engage with governments to better design and finance primary health care reforms. © 2017 Milbank Memorial Fund.

Improving Primary Care Residents' Proficiency in the Diagnosis of Skin Cancer

PubMed Central

Gerbert, Barbara; Bronstone, Amy; Wolff, Mimi; Maurer, Toby; Berger, Timothy; Pantilat, Steven; McPhee, Stephen J

1998-01-01

OBJECTIVE To determine whether a brief, multicomponent intervention could improve the skin cancer diagnosis and evaluation planning performance of primary care residents to a level equivalent to that of dermatologists. PARTICIPANTS Fifty-two primary care residents (26 in the control group and 26 in the intervention group) and 13 dermatologists completed a pretest and posttest. DESIGN A randomized, controlled trial with pretest and posttest measurements of residents' ability to diagnose and make evaluation plans for lesions indicative of skin cancer. INTERVENTION The intervention included face-to-face feedback sessions focusing on residents' performance deficiencies; an interactive seminar including slide presentations, case examples, and live demonstrations; and the Melanoma Prevention Kit including a booklet, magnifying tool, measuring tool, and skin color guide. MEASUREMENTS AND MAIN RESULTS We compared the abilities of a control and an intervention group of primary care residents, and a group of dermatologists to diagnose and make evaluation plans for six categories of skin lesions including three types of skin cancer—malignant melanoma, squamous cell carcinoma, and basal cell carcinoma. At posttest, both the intervention and control group demonstrated improved performance, with the intervention group revealing significantly larger gains. The intervention group showed greater improvement than the control group across all six diagnostic categories (a gain of 13 percentage points vs 5, p < .05), and in evaluation planning for malignant melanoma (a gain of 46 percentage points vs 36, p < .05) and squamous cell carcinoma (a gain of 42 percentage points vs 21, p < .01). The intervention group performed as well as the dermatologists on five of the six skin cancer diagnosis and evaluation planning scores with the exception of the diagnosis of basal cell carcinoma. CONCLUSIONS Primary care residents can diagnose and make evaluation plans for cancerous skin lesions, including malignant melanoma, at a level equivalent to that of dermatologists if they receive relevant, targeted education. PMID:9502368

A performance improvement-based resuscitation programme reduces arrest incidence and increases survival from in-hospital cardiac arrest.

PubMed

Davis, Daniel P; Graham, Patricia G; Husa, Ruchika D; Lawrence, Brenna; Minokadeh, Anushirvan; Altieri, Katherine; Sell, Rebecca E

2015-07-01

Traditional resuscitation training models are inadequate to achieving and maintaining resuscitation competency. This analysis evaluates the effectiveness of a novel, performance improvement-based inpatient resuscitation programme. This was a prospective, before-and-after study conducted in an urban, university-affiliated hospital system. All inpatient adult cardiac arrest victims without an active Do Not Attempt Resuscitation order from July 2005 to June 2012 were included. The advanced resuscitation training (ART) programme was implemented in Spring 2007 and included a unique treatment algorithm constructed around the capabilities of our providers and resuscitation equipment, a training programme with flexible format and content including early recognition concepts, and a comprehensive approach to performance improvement feeding directly back into training. Our inpatient resuscitation registry and electronic patient care record were used to quantify arrest rates and survival-to-hospital discharge before and after ART programme implementation. Multiple logistic regression analysis was used to adjust for age, gender, location of arrest, initial rhythm, and time of day. A total of 556 cardiac arrest victims were included (182 pre- and 374 post-ART). Arrest incidence decreased from 2.7 to 1.2 per 1000 patient discharges in non-ICU inpatient units, with no change in ICU arrest rate. An increase in survival-to-hospital discharge from 21 to 45% (p < 0.01) was observed following ART programme implementation. Adjusted odds ratios for survival-to-discharge (OR 2.2, 95% CI 1.4-3.4) and good neurological outcomes (OR 3.0, 95% CI 1.7-5.3) reflected similar improvements. Arrest-related deaths decreased from 2.1 to 0.5 deaths per 1000 patient discharges in non-ICU areas and from 1.5 to 1.3 deaths per 1000 patient discharges in ICU areas, and overall hospital mortality decreased from 2.2% to 1.8%. Implementation of a novel, performance improvement-based inpatient resuscitation programme was associated with a decrease in the incidence of cardiac arrest and improved clinical outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Mobile Multicast in Hierarchical Proxy Mobile IPV6

NASA Astrophysics Data System (ADS)

Hafizah Mohd Aman, Azana; Hashim, Aisha Hassan A.; Mustafa, Amin; Abdullah, Khaizuran

2013-12-01

Mobile Internet Protocol Version 6 (MIPv6) environments have been developing very rapidly. Many challenges arise with the fast progress of MIPv6 technologies and its environment. Therefore the importance of improving the existing architecture and operations increases. One of the many challenges which need to be addressed is the need for performance improvement to support mobile multicast. Numerous approaches have been proposed to improve mobile multicast performance. This includes Context Transfer Protocol (CXTP), Hierarchical Mobile IPv6 (HMIPv6), Fast Mobile IPv6 (FMIPv6) and Proxy Mobile IPv6 (PMIPv6). This document describes multicast context transfer in hierarchical proxy mobile IPv6 (H-PMIPv6) to provide better multicasting performance in PMIPv6 domain.

Performance enhancement of pentacene-based organic thin-film transistors using 6,13-pentacenequinone as a carrier injection interlayer

NASA Astrophysics Data System (ADS)

Fan, Ching-Lin; Lin, Wei-Chun; Chen, Hao-Wei

2018-06-01

This work demonstrates pentacene-based organic thin-film transistors (OTFTs) fabricated by inserting a 6,13-pentacenequinone (PQ) carrier injection layer between the source/drain (S/D) metal Au electrodes and pentacene channel layer. Compared to devices without a PQ layer, the performance characteristics including field-effect mobility, threshold voltage, and On/Off current ratio were significantly improved for the device with a 5-nm-thick PQ interlayer. These improvements are attributed to significant reduction of hole barrier height at the Au/pentacene channel interfaces. Therefore, it is believed that using PQ as the carrier injection layer is a good candidate to improve the pentacene-based OTFTs electrical performance.

Development and Evaluation of a Sandia Cooler-based Refrigerator Condenser

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

Johnson, Terry A.; Kariya, Harumichi Arthur; Leick, Michael T.

This report describes the first design of a refrigerator condenser using the Sandia Cooler, i.e. air - bearing supported rotating heat - sink impeller. The project included ba seline performance testing of a residential refrigerator, analysis and design development of a Sandia Cooler condenser assembly including a spiral channel baseplate, and performance measurement and validation of this condenser system as incorporated into the residential refrigerator. Comparable performance was achieved in a 60% smaller volume package. The improved modeling parameters can now be used to guide more optimized designs and more accurately predict performance.

Can Technology Improve the Quality of Colonoscopy?

PubMed

Thirumurthi, Selvi; Ross, William A; Raju, Gottumukkala S

2016-07-01

In order for screening colonoscopy to be an effective tool in reducing colon cancer incidence, exams must be performed in a high-quality manner. Quality metrics have been presented by gastroenterology societies and now include higher adenoma detection rate targets than in the past. In many cases, the quality of colonoscopy can often be improved with simple low-cost interventions such as improved procedure technique, implementing split-dose bowel prep, and monitoring individuals' performances. Emerging technology has expanded our field of view and image quality during colonoscopy. We will critically review several technological advances in the context of quality metrics and discuss if technology can really improve the quality of colonoscopy.

Multidisciplinary in-hospital teams improve patient outcomes: A review.

PubMed

Epstein, Nancy E

2014-01-01

The use of multidisciplinary in-hospital teams limits adverse events (AE), improves outcomes, and adds to patient and employee satisfaction. Acting like "well-oiled machines," multidisciplinary in-hospital teams include "staff" from different levels of the treatment pyramid (e.g. staff including nurses' aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others). Their enhanced teamwork counters the "silo effect" by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality) while improving patient and healthcare worker satisfaction. Multiple articles across diverse disciplines incorporate a variety of concepts of "teamwork" for staff covering emergency rooms (ERs), hospital wards, intensive care units (ICUs), and most critically, operating rooms (ORs). Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS), and yielded greater patient "staff" satisfaction. Within hospitals, delivering the best medical/surgical care is a "team sport." The goals include: Maximizing patient safety (e.g. limiting AE) and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers' performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their "well-oiled machines" enhancing the quality/safety of patient care, while enabling "staff" to optimize their performance and enhance their job satisfaction.

VIDEO BLOGGING AND ENGLISH PRESENTATION PERFORMANCE: A PILOT STUDY.

PubMed

Alan Hung, Shao-Ting; Danny Huang, Heng-Tsung

2015-10-01

This study investigated the utility of video blogs in improving EFL students' performance in giving oral presentations and, further, examined the students' perceptions toward video blogging. Thirty-six English-major juniors participated in a semester-long video blog project for which they uploaded their 3-min. virtual presentation clips over 18 weeks. Their virtual presentation clips were rated by three raters using a scale for speaking performance that contained 14 presentation skills. Data sources included presentation clips, reflections, and interviews. The results indicated that the students' overall presentation performance improved significantly. In particular, among the 14 presentation skills projection, intonation, posture, introduction, conclusion, and purpose saw the most substantial improvement. Finally, the qualitative data revealed that learners perceived that the video blog project facilitated learning but increased anxiety.

Addition by Subtraction: The Relation Between Dropout Rates and School-Level Academic Achievement.

PubMed

Glennie, Elizabeth; Bonneau, Kara; Vandellen, Michelle; Dodge, Kenneth A

2012-01-01

Efforts to improve student achievement should increase graduation rates. However, work investigating the effects of student-level accountability has consistently demonstrated that increases in the standards for high school graduation are correlated with increases in dropout rates. The most favored explanation for this finding is that high-stakes testing policies that mandate grade repetition and high school exit exams may be the tipping point for students who are already struggling academically. These extra demands may, in fact, push students out of school. This article examines two hypotheses regarding the relation between school-level accountability and dropout rates. The first posits that improvements in school performance lead to improved success for everyone. If school-level accountability systems improve a school for all students, then the proportion of students performing at grade level increases, and the dropout rate decreases. The second hypothesis posits that schools facing pressure to improve their overall accountability score may pursue this increase at the cost of other student outcomes, including dropout rate. Our approach focuses on the dynamic relation between school-level academic achievement and dropout rates over time-that is, between one year's achievement and the subsequent year's dropout rate, and vice versa. This article employs longitudinal data of records on all students in North Carolina public schools over an 8-year period. Analyses employ fixed-effects models clustering schools and districts within years and controls each year for school size, percentage of students who were free/reduced-price lunch eligible, percentage of students who are ethnic minorities, and locale. This study finds partial evidence that improvements in school-level academic performance will lead to improvements (i.e., decreases) in school-level dropout rates. Schools with improved performance saw decreased dropout rates following these successes. However, we find more evidence of a negative side of the quest for improved academic performance. When dropout rates increase, the performance composites in subsequent years increase. Accountability systems need to remove any indirect benefit a school may receive from increasing its dropout rate. Schools should be held accountable for those who drop out of school. Given the personal and social costs of dropping out, accountability systems need to place more emphasis on dropout prevention. Such an emphasis could encompass increasing the dropout age and having the school's performance composite include scores of zero on end-of-grade tests for those who leave school.

Control and communication co-design: analysis and practice on performance improvement in distributed measurement and control system based on fieldbus and Ethernet.

PubMed

Liang, Geng

2015-01-01

In this paper, improving control performance of a networked control system by reducing DTD in a different perspective was investigated. Two different network architectures for system implementation were presented. Analysis and improvement dealing with DTD for the experimental control system were expounded. Effects of control scheme configuration on DTD in the form of FB were investigated and corresponding improvements by reallocation of FB and re-arrangement of schedule table are proposed. Issues of DTD in hybrid network were investigated and corresponding approaches to improve performance including (1) reducing DTD in PLC or PAC by way of IEC61499 and (2) cascade Smith predictive control with BPNN-based identification were proposed and investigated. Control effects under the proposed methodologies were also given. Experimental and field practices validated these methodologies. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

The effects of attractive vs. repulsive instructional cuing on balance performance.

PubMed

Kinnaird, Catherine; Lee, Jaehong; Carender, Wendy J; Kabeto, Mohammed; Martin, Bernard; Sienko, Kathleen H

2016-03-16

Torso-based vibrotactile feedback has been shown to improve postural performance during quiet and perturbed stance in healthy young and older adults and individuals with balance impairments. These systems typically include tactors distributed around the torso that are activated when body motion exceeds a predefined threshold. Users are instructed to "move away from the vibration". However, recent studies have shown that in the absence of instructions, vibrotactile stimulation induces small (~1°) non-volitional responses in the direction of its application location. It was hypothesized that an attractive cuing strategy (i.e., "move toward the vibration") could improve postural performance by leveraging this natural tendency. Eight healthy older adults participated in two non-consecutive days of computerized dynamic posturography testing while wearing a vibrotactile feedback system comprised of an inertial measurement unit and four tactors that were activated in pairs when body motion exceeded 1° anteriorly or posteriorly. A crossover design was used. On each day participants performed 24 repetitions of Sensory Organization Test condition 5 (SOT5), three repetitions each of SOT 1-6, three repetitions of the Motor Control Test, and five repetitions of the Adaptation Test. Performance metrics included A/P RMS, Time-in-zone and 95 % CI Ellipse. Performance improved with both cuing strategies but participants performed better when using repulsive cues. However, the rate of improvement was greater for attractive versus repulsive cuing. The results suggest that when the cutaneous signal is interpreted as an alarm, cognition overrides sensory information. Furthermore, although repulsive cues resulted in better performance, attractive cues may be as good, if not better, than repulsive cues following extended training.

A semi-active suspension control algorithm for vehicle comprehensive vertical dynamics performance

NASA Astrophysics Data System (ADS)

Nie, Shida; Zhuang, Ye; Liu, Weiping; Chen, Fan

2017-08-01

Comprehensive performance of the vehicle, including ride qualities and road-holding, is essentially of great value in practice. Many up-to-date semi-active control algorithms improve vehicle dynamics performance effectively. However, it is hard to improve comprehensive performance for the conflict between ride qualities and road-holding around the second-order resonance. Hence, a new control algorithm is proposed to achieve a good trade-off between ride qualities and road-holding. In this paper, the properties of the invariant points are analysed, which gives an insight into the performance conflicting around the second-order resonance. Based on it, a new control algorithm is proposed. The algorithm employs a novel frequency selector to balance suspension ride and handling performance by adopting a medium damping around the second-order resonance. The results of this study show that the proposed control algorithm could improve the performance of ride qualities and suspension working space up to 18.3% and 8.2%, respectively, with little loss of road-holding compared to the passive suspension. Consequently, the comprehensive performance can be improved by 6.6%. Hence, the proposed algorithm is of great potential to be implemented in practice.

Improving the Quality of Care for Patients Diagnosed With Glioma During the Perioperative Period

PubMed Central

Riblet, Natalie B.V.; Schlosser, Evelyn M.; Homa, Karen; Snide, Jennifer A.; Jarvis, Lesley A.; Simmons, Nathan E.; Sargent, David H.; Mason, Linda P.; Cooney, Tobi J.; Kennedy, Nancy L.; Fadul, Camilo E.

2014-01-01

Purpose: Although there is agreement on the oncologic management of patients with glioma, few guidelines exist to standardize other aspects of care, including supportive care. Methods: A quality improvement (QI) project was chartered to improve the care provided to patients with glioma. A multidisciplinary team was convened and identified 10 best-practice measures. Using a plan-do-study-act framework, the team brainstormed and implemented various improvement interventions between June 2011 and October 2012. Statistical process control charts were used to evaluate progress. A dashboard of quality measures was generated to allow for ongoing measurement and reporting. Results: The retrospective assessment phase consisted of 43 patients with diagnosis of glioma. A manual medical record review for these patients showed that compliance with 10 best-practice measures ranged from 23% to 100%. Several factors contributed to less-than-ideal process performance, including poor communication among disciplines and lack of familiarity with the larger system of care. After implementing improvement interventions, performance was measured in 96 consecutive patients with glioma. The proportion of patients who met criteria for 10 practice measures significantly improved (pre-QI work, 63%; post-QI work, 85%; P = .003). The largest improvement was observed in the measure assessing for preoperative notification of the neuro-oncology program (pre-QI work, 39%; post-QI work, 97%; P < .001). Conclusion: QI principles were used by a multidisciplinary team to improve the quality of care for patients with glioma during the perioperative period. Leadership involvement, ongoing dialogue across departments, and reporting of system performance were important for sustaining process improvements. PMID:25294392

Designing for resilience

NASA Astrophysics Data System (ADS)

Dwivedi, Anurag

2014-06-01

The motivation for this work comes from a desire to improve resilience of mission critical cyber enabled systems including those used in critical infrastructure domains such as cyber, power, water, fuel, financial, healthcare, agriculture, and manufacturing. Resilience can be defined as the ability of a system to persistently meet its performance requirements despite the occurrence of adverse events. Characterizing the resilience of a system requires a clear definition of the performance requirements of the system of interest and an ability to quantify the impact on performance by the adverse events of concern. A quantitative characterization of system resilience allows the resilience requirements to be included in the system design criteria. Resilience requirements of a system are derived from the service level agreements (SLAs), measures of effectiveness (MOEs), and measures of performance (MOPs) of the services or missions supported by the system. This paper describes a methodology for designing resilient systems. The components of the methodology include resilience characterization for threat models associated with various exposure modes, requirements mapping, subsystem ranking based on criticality, and selective implementation of mitigations to improve system resilience to a desired level.

Aqueous lithium air batteries

DOEpatents

Visco, Steven J.; Nimon, Yevgeniy S.; De Jonghe, Lutgard C.; Petrov, Alexei; Goncharenko, Nikolay

2017-05-23

Aqueous Li/Air secondary battery cells are configurable to achieve high energy density and prolonged cycle life. The cells include a protected a lithium metal or alloy anode and an aqueous catholyte in a cathode compartment. The aqueous catholyte comprises an evaporative-loss resistant and/or polyprotic active compound or active agent that partakes in the discharge reaction and effectuates cathode capacity for discharge in the acidic region. This leads to improved performance including one or more of increased specific energy, improved stability on open circuit, and prolonged cycle life, as well as various methods, including a method of operating an aqueous Li/Air cell to simultaneously achieve improved energy density and prolonged cycle life.

Applying model abstraction techniques to optimize monitoring networks for detecting subsurface contaminant transport

USDA-ARS?s Scientific Manuscript database

Improving strategies for monitoring subsurface contaminant transport includes performance comparison of competing models, developed independently or obtained via model abstraction. Model comparison and parameter discrimination involve specific performance indicators selected to better understand s...

Calcium supplementation improves clinical outcome in intensive care unit patients: a propensity score matched analysis of a large clinical database MIMIC-II.

PubMed

Zhang, Zhongheng; Chen, Kun; Ni, Hongying

2015-01-01

Observational studies have linked hypocalcemia with adverse clinical outcome in critically ill patients. However, calcium supplementation has never been formally investigated for its beneficial effect in critically ill patients. To investigate whether calcium supplementation can improve 28-day survival in adult critically ill patients. Secondary analysis of a large clinical database consisting over 30,000 critical ill patients was performed. Multivariable analysis was performed to examine the independent association of calcium supplementation and 28-day morality. Furthermore, propensity score matching technique was employed to investigate the role of calcium supplementation in improving survival. none. Primary outcome was the 28-day mortality. 90-day mortality was used as secondary outcome. A total of 32,551 adult patients, including 28,062 survivors and 4489 non-survivors (28-day mortality rate: 13.8 %) were included. Calcium supplementation was independently associated with improved 28-day mortality after adjusting for confounding variables (hazard ratio: 0.51; 95 % CI 0.47-0.56). Propensity score matching was performed and the after-matching cohort showed well balanced covariates. The results showed that calcium supplementation was associated with improved 28- and 90-day mortality (p < 0.05 for both Log-rank test). In adult critically ill patients, calcium supplementation during their ICU stay improved 28-day survival. This finding supports the use of calcium supplementation in critically ill patients.

The Effect of ISO 9001 and the EFQM Model on Improving Hospital Performance: A Systematic Review.

PubMed

Yousefinezhadi, Taraneh; Mohamadi, Efat; Safari Palangi, Hossein; Akbari Sari, Ali

2015-12-01

This study aimed to explore the effect of the International Organization for Standardization (ISO) ISO 9001 standard and the European foundation for quality management (EFQM) model on improving hospital performance. PubMed, Embase and the Cochrane Library databases were searched. In addition, Elsevier and Springer were searched as main publishers in the field of health sciences. We included empirical studies with any design that had used ISO 9001 or the EFQM model to improve the quality of healthcare. Data were collected and tabulated into a data extraction sheet that was specifically designed for this study. The collected data included authors' names, country, year of publication, intervention, improvement aims, setting, length of program, study design, and outcomes. Seven out of the 121 studies that were retrieved met the inclusion criteria. Three studies assessed the EFQM model and four studies assessed the ISO 9001 standard. Use of the EFQM model increased the degree of patient satisfaction and the number of hospital admissions and reduced the average length of stay, the delay on the surgical waiting list, and the number of emergency re-admissions. ISO 9001 also increased the degree of patient satisfaction and patient safety, increased cost-effectiveness, improved the hospital admissions process, and reduced the percentage of unscheduled returns to the hospital. Generally, there is a lack of robust and high quality empirical evidence regarding the effects of ISO 9001 and the EFQM model on the quality care provided by and the performance of hospitals. However, the limited evidence shows that ISO 9001 and the EFQM model might improve hospital performance.

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

Analyzing AQP Data to Improve Electronic Flight Bag (EFB) Operations and Training

NASA Technical Reports Server (NTRS)

Seamster, Thomas L.; Kanki, Barbara

2010-01-01

Key points include: Initiate data collection and analysis early in the implementation process. Use data to identify procedural and training refinements. Use a de-identified system to analyze longitudinal data. Use longitudinal I/E data to improve their standardization. Identify above average pilots and crews and use their performance to specify best practices. Analyze below average crew performance data to isolate problems with the training, evaluator standardization and pilot proficiency.

Improving Cover-Letter Writing Skills of Individuals with Intellectual Disabilities

ERIC Educational Resources Information Center

Pennington, Robert; Delano, Monica; Scott, Renee

2014-01-01

We evaluated a multicomponent intervention for improving the cover-letter writing skills of individuals with intellectual disabilities. An intervention that included modeling, self-monitoring, prompting, and feedback increased correct performance for all participants. In addition, the skill was demonstrated across audiences.

Analysis of spacecraft on-orbit anomalies and lifetimes

NASA Technical Reports Server (NTRS)

Bloomquist, C.; Graham, W.

1983-01-01

Analyses of the on-orbit performance of forty-four unmanned NASA spacecraft are presented. Included are detailed descriptions and classifications of over 600 anomalies; each anomalous incident represents one reported deviation from expected spacecraft performance. Charts depicting satellite lifetimes and the performance of their major subsystems are included. Engineering analyses to further investigate the kinds and frequencies of various classes of anomalies have been conducted. An improved method for charting spacecraft capability as a function of time on orbit is explored.

Improving Learner Handovers in Medical Education.

PubMed

Warm, Eric J; Englander, Robert; Pereira, Anne; Barach, Paul

2017-07-01

Multiple studies have demonstrated that the information included in the Medical Student Performance Evaluation fails to reliably predict medical students' future performance. This faulty transfer of information can lead to harm when poorly prepared students fail out of residency or, worse, are shuttled through the medical education system without an honest accounting of their performance. Such poor learner handovers likely arise from two root causes: (1) the absence of agreed-on outcomes of training and/or accepted assessments of those outcomes, and (2) the lack of standardized ways to communicate the results of those assessments. To improve the current learner handover situation, an authentic, shared mental model of competency is needed; high-quality tools to assess that competency must be developed and tested; and transparent, reliable, and safe ways to communicate this information must be created.To achieve these goals, the authors propose using a learner handover process modeled after a patient handover process. The CLASS model includes a description of the learner's Competency attainment, a summary of the Learner's performance, an Action list and statement of Situational awareness, and Synthesis by the receiving program. This model also includes coaching oriented towards improvement along the continuum of education and care. Just as studies have evaluated patient handover models using metrics that matter most to patients, studies must evaluate this learner handover model using metrics that matter most to providers, patients, and learners.

Bronchoscopic Lung Volume Reduction with Endobronchial Valves in Low-FEV1 Patients.

PubMed

Darwiche, Kaid; Karpf-Wissel, Rüdiger; Eisenmann, Stephan; Aigner, Clemens; Welter, Stefan; Zarogoulidis, Paul; Hohenforst-Schmidt, Wolfgang; Freitag, Lutz; Oezkan, Filiz

2016-01-01

Bronchoscopic lung volume reduction (BLVR) with valves has been shown to improve lung function, exercise capacity, and quality of life in patients with emphysema, but only few patients with forced expiratory volume in 1 s (FEV1) ≤20% predicted have been included in former studies. Although the procedure can be performed safely, pneumothorax is a frequent complication, which can be critical for these very severely diseased patients. The aim of the study was to assess the safety of BLVR in patients with a very advanced stage of emphysema, as indicated by FEV1 ≤20% predicted. Patients in whom BLVR was performed between January 2013 and August 2015 were included in this analysis if their baseline predicted FEV1 was ≤20%. BLVR, performed only if collateral ventilation was absent, achieved complete occlusion of the target lobe. All patients were closely monitored and were not discharged before the fourth day after BLVR. Twenty patients with FEV1 ≤20% predicted were included in the analysis. Lung volume reduction was achieved in 65% of the cases. Pneumothorax occurred in 4 cases (20%). No patient died. Lung function and exercise tolerance improved after 1 and 3 months, respectively. BLVR with valves can be safely performed in patients with FEV1 ≤20% predicted when close postprocedural monitoring is provided. Improvement in lung function and exercise capacity can be achieved. © 2016 S. Karger AG, Basel.

Green supply chain management in China

NASA Astrophysics Data System (ADS)

Zhu, Qinghua; Sarkis, Joseph

2004-02-01

Globalization results in both pressure and drivers for Chinese enterprise to improve their environmental performance. As a developing country, China has to balance economic and environmental performance. Green supply chain management (GSCM) is emerging to be an important approach for Chinese enterprises to improve performance, possibly on both these dimensions. Using empirical results from 89 respondents on GSCM practice in Chinese manufacturing enterprises, we examine the relationships between pressures, practice and performance. The results will look at multiple dimensions of GSCM practice and performance, as well as various pressures they face. Discussion of the results will include practical implications for organizations, not only in China, but internationally who face similar pressures and seek to implement similar programs.

Multicore Challenges and Benefits for High Performance Scientific Computing

DOE PAGES

Nielsen, Ida M. B.; Janssen, Curtis L.

2008-01-01

Until recently, performance gains in processors were achieved largely by improvements in clock speeds and instruction level parallelism. Thus, applications could obtain performance increases with relatively minor changes by upgrading to the latest generation of computing hardware. Currently, however, processor performance improvements are realized by using multicore technology and hardware support for multiple threads within each core, and taking full advantage of this technology to improve the performance of applications requires exposure of extreme levels of software parallelism. We will here discuss the architecture of parallel computers constructed from many multicore chips as well as techniques for managing the complexitymore » of programming such computers, including the hybrid message-passing/multi-threading programming model. We will illustrate these ideas with a hybrid distributed memory matrix multiply and a quantum chemistry algorithm for energy computation using Møller–Plesset perturbation theory.« less

RETScreen Plus Software Tutorial

NASA Technical Reports Server (NTRS)

Ganoe, Rene D.; Stackhouse, Paul W., Jr.; DeYoung, Russell J.

2014-01-01

Greater emphasis is being placed on reducing both the carbon footprint and energy cost of buildings. A building's energy usage depends upon many factors one of the most important is the local weather and climate conditions to which it's electrical, heating and air conditioning systems must respond. Incorporating renewable energy systems, including solar systems, to supplement energy supplies and increase energy efficiency is important to saving costs and reducing emissions. Also retrofitting technologies to buildings requires knowledge of building performance in its current state, potential future climate state, projection of potential savings with capital investment, and then monitoring the performance once the improvements are made. RETScreen Plus is a performance analysis software module that supplies the needed functions of monitoring current building performance, targeting projected energy efficiency improvements and verifying improvements once completed. This tutorial defines the functions of RETScreen Plus as well as outlines the general procedure for monitoring and reporting building energy performance.

Performance Optimization of Marine Science and Numerical Modeling on HPC Cluster

PubMed Central

Yang, Dongdong; Yang, Hailong; Wang, Luming; Zhou, Yucong; Zhang, Zhiyuan; Wang, Rui; Liu, Yi

2017-01-01

Marine science and numerical modeling (MASNUM) is widely used in forecasting ocean wave movement, through simulating the variation tendency of the ocean wave. Although efforts have been devoted to improve the performance of MASNUM from various aspects by existing work, there is still large space unexplored for further performance improvement. In this paper, we aim at improving the performance of propagation solver and data access during the simulation, in addition to the efficiency of output I/O and load balance. Our optimizations include several effective techniques such as the algorithm redesign, load distribution optimization, parallel I/O and data access optimization. The experimental results demonstrate that our approach achieves higher performance compared to the state-of-the-art work, about 3.5x speedup without degrading the prediction accuracy. In addition, the parameter sensitivity analysis shows our optimizations are effective under various topography resolutions and output frequencies. PMID:28045972

Recent Progress Towards Predicting Aircraft Ground Handling Performance

NASA Technical Reports Server (NTRS)

Yager, T. J.; White, E. J.

1981-01-01

The significant progress which has been achieved in development of aircraft ground handling simulation capability is reviewed and additional improvements in software modeling identified. The problem associated with providing necessary simulator input data for adequate modeling of aircraft tire/runway friction behavior is discussed and efforts to improve this complex model, and hence simulator fidelity, are described. Aircraft braking performance data obtained on several wet runway surfaces is compared to ground vehicle friction measurements and, by use of empirically derived methods, good agreement between actual and estimated aircraft braking friction from ground vehilce data is shown. The performance of a relatively new friction measuring device, the friction tester, showed great promise in providing data applicable to aircraft friction performance. Additional research efforts to improve methods of predicting tire friction performance are discussed including use of an instrumented tire test vehicle to expand the tire friction data bank and a study of surface texture measurement techniques.

Effect of a web-based audit and feedback intervention with outreach visits on the clinical performance of multidisciplinary teams: a cluster-randomized trial in cardiac rehabilitation.

PubMed

Gude, Wouter T; van Engen-Verheul, Mariëtte M; van der Veer, Sabine N; Kemps, Hareld M C; Jaspers, Monique W M; de Keizer, Nicolette F; Peek, Niels

2016-12-09

The objective of this study was to assess the effect of a web-based audit and feedback (A&F) intervention with outreach visits to support decision-making by multidisciplinary teams. We performed a multicentre cluster-randomized trial within the field of comprehensive cardiac rehabilitation (CR) in the Netherlands. Our participants were multidisciplinary teams in Dutch CR centres who were enrolled in the study between July 2012 and December 2013 and received the intervention for at least 1 year. The intervention included web-based A&F with feedback on clinical performance, facilities for goal setting and action planning, and educational outreach visits. Teams were randomized either to receive feedback that was limited to psychosocial rehabilitation (study group A) or to physical rehabilitation (study group B). The main outcome measure was the difference in performance between study groups in 11 care processes and six patient outcomes, measured at patient level. Secondary outcomes included effects on guideline concordance for the four main CR therapies. Data from 18 centres (14,847 patients) were analysed, of which 12 centres (9353 patients) were assigned to group A and six (5494 patients) to group B. During the intervention, a total of 233 quality improvement goals was identified by participating teams, of which 49 (21%) were achieved during the study period. Except for a modest improvement in data completeness (4.5% improvement per year; 95% CI 0.65 to 8.36), we found no effect of our intervention on any of our primary or secondary outcome measures. Within a multidisciplinary setting, our web-based A&F intervention engaged teams to define local performance improvement goals but failed to support them in actually completing the improvement actions that were needed to achieve those goals. Future research should focus on improving the actionability of feedback on clinical performance and on addressing the socio-technical perspective of the implementation process. NTR3251.

Quality of Care for PTSD and Depression in the Military Health System

DTIC Science & Technology

evaluate the receipt of recommended assessments and treatments. These measures draw on multiple data sources including administrative encounter data...services are effective in reducing symptoms. When comparing performance between 20122013 and 20132014, most measures demonstrated slight improvement ...in 20132014 for over 38,000 active-component service members with PTSD or depression. The assessment includes performance on 30 quality measures to

Gamma ray spectroscopy employing divalent europium-doped alkaline earth halides and digital readout for accurate histogramming

DOEpatents

Cherepy, Nerine Jane; Payne, Stephen Anthony; Drury, Owen B; Sturm, Benjamin W

2014-11-11

A scintillator radiation detector system according to one embodiment includes a scintillator; and a processing device for processing pulse traces corresponding to light pulses from the scintillator, wherein pulse digitization is used to improve energy resolution of the system. A scintillator radiation detector system according to another embodiment includes a processing device for fitting digitized scintillation waveforms to an algorithm based on identifying rise and decay times and performing a direct integration of fit parameters. A method according to yet another embodiment includes processing pulse traces corresponding to light pulses from a scintillator, wherein pulse digitization is used to improve energy resolution of the system. A method in a further embodiment includes fitting digitized scintillation waveforms to an algorithm based on identifying rise and decay times; and performing a direct integration of fit parameters. Additional systems and methods are also presented.

The effects of huperzine A and IDRA 21 on visual recognition memory in young macaques

PubMed Central

Malkova, Ludise; Kozikowski, Alan P.; Gale, Karen

2011-01-01

Nootropic agents or cognitive enhancers are purported to improve mental functions such as cognition, memory, or attention. The aim of our study was to determine the effects of two possible cognitive enhancers, huperzine A and IDRA 21, in normal young adult monkeys performing a visual memory task of varying degrees of difficulty. Huperzine A is a reversible acetylcholinesterase (AChE) inhibitor, its administration results in regionally specific increases in acetylcholine levels in the brain. In human clinical trials, Huperzine A resulted in cognitive improvement in patients with mild to moderate form of Alzheimer's disease (AD) showing its potential as a palliative agent in the treatment of AD. IDRA 21 is a positive allosteric modulator of glutamate AMPA receptors. It increases excitatory synaptic strength by attenuating rapid desensitization of AMPA receptors and may thus have beneficial therapeutic effects to ameliorate memory deficits in patients with cognitive impairments, including AD. The present study evaluated the effects of the two drugs in normal, intact, young adult monkeys to determine whether they can result in cognitive enhancement in a system that is presumably functioning optimally. Six young pigtail macaques (Macaca nemestrina) were trained on delayed non-matching-to-sample task, a measure of visual recognition memory, up to criterion of 90% correct responses on each of the four delays (10s, 30s, 60s, and 90s). They were then tested on two versions of the task: Task 1 included the four delays intermixed within a session and the monkeys performed it with the accuracy of 90%. Task 2 included, in each of 24 trials, a list of six objects presented in succession. Two objects from the list were then presented for choice paired with novel objects and following two of the four delays intermixed within a session. This task with a higher mnemonic demand yielded an average performance of 64% correct. Oral administration of huperzine A did not significantly affect the monkeys' performance on either task. However, a significant negative correlation was found between the baseline performance on each delay and the change in performance under huperzine A, suggesting that under conditions in which the subjects were performing poorly (55 – 69%), the drug resulted in improved performance, whereas no improvement was obtained when the baseline was close to 90%. In fact, when the subjects were performing very well, huperzine A tended to reduce the performance accuracy, indicating that in a system that functions optimally, the increased availability of acetylcholine does not improve performance or memory, especially when the animals are close to the maximum performance. In contrast, oral administration of IDRA 21 significantly improved performance on Task 2, especially on the longest delay. This finding supports the potential use of this drug in treatment of cognitive and memory disorders. PMID:21185313

The power of the National Surgical Quality Improvement Program--achieving a zero pneumonia rate in general surgery patients.

PubMed

Fuchshuber, Pascal R; Greif, William; Tidwell, Chantal R; Klemm, Michael S; Frydel, Cheryl; Wali, Abdul; Rosas, Efren; Clopp, Molly P

2012-01-01

The National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons provides risk-adjusted surgical outcome measures for participating hospitals that can be used for performance improvement of surgical mortality and morbidity. A surgical clinical nurse reviewer collects 135 clinical variables including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. A report on mortality and complications is prepared twice a year. This article summarizes briefly the history of NSQIP and how its report on surgical outcomes can be used for performance improvement within a hospital system. In particular, it describes how to drive performance improvement with NSQIP data using the example of postoperative respiratory complications--a major factor of postoperative mortality. In addition, this article explains the benefit of a collaborative of several participating NSQIP hospitals and describes how to develop a "playbook" on the basis of an outcome improvement project.

The quality of systematic reviews of health-related outcome measurement instruments.

PubMed

Terwee, C B; Prinsen, C A C; Ricci Garotti, M G; Suman, A; de Vet, H C W; Mokkink, L B

2016-04-01

Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.

METHODS FOR IMPROVEMENT OF TRICKLING FILTER PLANT PERFORMANCE. PART II. CHEMICAL ADDITION

EPA Science Inventory

An experimental program to explore potential methods for removing phosphorus and generally enhancing trickling filter plant performance was conducted at the Mason Farm Wastewater Treatment Plant, Chapel Hill, North Carolina. Preliminary investigations included jar testing with se...

A Tale of Two Technologies.

ERIC Educational Resources Information Center

Tosti, Donald T.; Jackson, Stephanie F.

2001-01-01

Discusses information technology and human performance technology (HPT) and considers the potential of performance technology to improve business results. Topics include the strategic value of HPT in organizational governance, developing leadership capability, team building, fostering collaboration, and corporate culture change; and the need to…

Caffeine and Bicarbonate for Speed. A Meta-Analysis of Legal Supplements Potential for Improving Intense Endurance Exercise Performance

PubMed Central

Christensen, Peter M.; Shirai, Yusuke; Ritz, Christian; Nordsborg, Nikolai B.

2017-01-01

A 1% change in average speed is enough to affect medal rankings in intense Olympic endurance events lasting ~45 s to 8 min which for example includes 100 m swimming and 400 m running (~1 min), 1,500 m running and 4000 m track cycling (~4 min) and 2,000 m rowing (~6-8 min). To maximize the likelihood of winning, athletes utilizes legal supplements with or without scientifically documented beneficial effects on performance. Therefore, a continued systematic evidence based evaluation of the possible ergogenic effects is of high importance. A meta-analysis was conducted with a strict focus on closed-end performance tests in humans in the time domain from 45 s to 8 min. These test include time-trials or total work done in a given time. This selection criterion results in a high relevance for athletic performance. Only peer-reviewed placebo controlled studies were included. The often applied and potentially ergogenic supplements beta-alanine, bicarbonate, caffeine and nitrate were selected for analysis. Following a systematic search in Pubmed and SportsDiscuss combined with evaluation of cross references a total of 7 (beta-alanine), 25 (bicarbonate), 9 (caffeine), and 5 (nitrate) studies was included in the meta-analysis. For each study, performance was converted to an average speed (km/h) from which an effect size (ES; Cohens d with 95% confidence intervals) was calculated. A small effect and significant performance improvement relative to placebo was observed for caffeine (ES: 0.41 [0.15–0.68], P = 0.002) and bicarbonate (ES: 0.40 [0.27–0.54], P < 0.001). Trivial and non-significant effects on performance was observed for nitrate (ES: 0.19 [−0.03–0.40], P = 0.09) and beta-alanine (ES: 0.17 [−0.12–0.46], P = 0.24). Thus, caffeine's and bicarbonate's ergogenic effect is clearly documented for intense endurance performance. Importantly, for all supplements an individualized approach may improve the ergogenic effect on performance. PMID:28536531

The Relative Performance of New and Used GMA Wood Pallets

Treesearch

Marshall S. White

1997-01-01

The USDA Forest Service, Southern Research Station at Virginia Tech has funded wood pallet recycling research which includes documenting the relative performance of new and used GMA style wood pallets. An understanding of the relationship between pallet repair methods and pallet performance will lead to improved procedures for the recycling of wood pallets.

Olympic Sports Coaching Education: An International Coach's Perspective

ERIC Educational Resources Information Center

Kiosoglous, Cameron

2016-01-01

The profession of high performance sports coaching is a complex process focused on performance improvement with the goal of producing international sporting success. Rising demand for top-level coaches has been matched with the increasing amount of resources allocated to producing world-class performances. This includes creating and sustaining a…

Nicotine effects on brain function and functional connectivity in schizophrenia.

PubMed

Jacobsen, Leslie K; D'Souza, D Cyril; Mencl, W Einar; Pugh, Kenneth R; Skudlarski, Pawel; Krystal, John H

2004-04-15

Nicotine in tobacco smoke can improve functioning in multiple cognitive domains. High rates of smoking among schizophrenic patients may reflect an effort to remediate cognitive dysfunction. Our primary aim was to determine whether nicotine improves cognitive function by facilitating activation of brain regions mediating task performance or by facilitating functional connectivity. Thirteen smokers with schizophrenia and 13 smokers with no mental illness were withdrawn from tobacco and underwent functional magnetic resonance imaging (fMRI) scanning twice, once after placement of a placebo patch and once after placement of a nicotine patch. During scanning, subjects performed an n-back task with two levels of working memory load and of selective attention load. During the most difficult (dichotic 2-back) task condition, nicotine improved performance of schizophrenic subjects and worsened performance of control subjects. Nicotine also enhanced activation of a network of regions, including anterior cingulate cortex and bilateral thalamus, and modulated thalamocortical functional connectivity to a greater degree in schizophrenic than in control subjects during dichotic 2-back task performance. In tasks that tax working memory and selective attention, nicotine may improve performance in schizophrenia patients by enhancing activation of and functional connectivity between brain regions that mediate task performance.

Performance management excellence among the Malcolm Baldrige National Quality Award Winners in Health Care.

PubMed

Duarte, Neville T; Goodson, Jane R; Arnold, Edwin W

2013-01-01

When carefully constructed, performance management systems can help health care organizations direct their efforts toward strategic goals, high performance, and continuous improvement needed to ensure high-quality patient care and cost control. The effective management of performance is an integral component in hospital and health care systems that are recognized for excellence by the Malcolm Baldrige National Quality Award in Health Care. Using the framework in the 2011-2012 Health Care Criteria for Performance Excellence, this article identifies the best practices in performance management demonstrated by 15 Baldrige recipients. The results show that all of the recipients base their performance management systems on strategic goals, outcomes, or competencies that cascade from the organizational to the individual level. At the individual level, each hospital or health system reinforces the strategic direction with performance evaluations of leaders and employees, including the governing board, based on key outcomes and competencies. Leader evaluations consistently include feedback from internal and external stakeholders, creating a culture of information sharing and performance improvement. The hospitals or health care systems also align their reward systems to promote high performance by emphasizing merit and recognition for contributions. Best practices can provide a guide for leaders in other health systems in developing high-performance work systems.

Leveraging organismal biology to forecast the effects of climate change.

PubMed

Buckley, Lauren B; Cannistra, Anthony F; John, Aji

2018-04-26

Despite the pressing need for accurate forecasts of ecological and evolutionary responses to environmental change, commonly used modelling approaches exhibit mixed performance because they omit many important aspects of how organisms respond to spatially and temporally variable environments. Integrating models based on organismal phenotypes at the physiological, performance and fitness levels can improve model performance. We summarize current limitations of environmental data and models and discuss potential remedies. The paper reviews emerging techniques for sensing environments at fine spatial and temporal scales, accounting for environmental extremes, and capturing how organisms experience the environment. Intertidal mussel data illustrate biologically important aspects of environmental variability. We then discuss key challenges in translating environmental conditions into organismal performance including accounting for the varied timescales of physiological processes, for responses to environmental fluctuations including the onset of stress and other thresholds, and for how environmental sensitivities vary across lifecycles. We call for the creation of phenotypic databases to parameterize forecasting models and advocate for improved sharing of model code and data for model testing. We conclude with challenges in organismal biology that must be solved to improve forecasts over the next decade.acclimation, biophysical models, ecological forecasting, extremes, microclimate, spatial and temporal variability.

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

Characterising and improving the performance of the Sentinel-3 SRAL altimeter: A Report from SCOOP, SHAPE & SPICE Projects

NASA Astrophysics Data System (ADS)

Restano, Marco; Ambrózio, Américo; Cotton, David; Scoop Team; Fabry, Pierre; Shape Team; McMillan, Malcolm; Spice Team; Benveniste, Jérôme

2017-04-01

Under the ESA Scientific Exploitation of Operational Missions (SEOM) Programme, 3 Projects are currently underway to accurately characterise and improve the performance of the Sentinel-3 SRAL SAR mode altimeter. They are: 1) SCOOP (SAR Altimetry Coastal & Open Ocean Performance Exploitation and Roadmap Study) for Coastal and Open Ocean; 2) SHAPE (Sentinel-3 Hydrologic Altimetry PrototypE) for Inland Water; 3) SPICE (Sentinel-3 Performance improvement for ICE sheets) for Ice Sheets. As projects started before the launch of Sentinel-3 (a full SAR mission), calibrated Cryosat-2 data have been used as input to a processor replicating the Sentinel-3 baseline processing. For the SCOOP project, a first test dataset has been released to end users including data from 10 regions of interest. The successful SAMOSA retracker, adopted in the previous CP4O Project (CryoSat Plus for Oceans), has been readapted to re-track Sentinel-3 waveforms. An improved version of SAMOSA will be released at the end of the project. The SHAPE project is working towards the design and assessment of alternative/innovative techniques not implemented in the Sentinel-3 ground segment (performing no Inland Water dedicated processing). Both rivers and lakes will be studied. Amazon, Brahmaputra and Danube have been selected as rivers, whereas Titicaca and Vanern have been chosen as lakes. The study will include the assimilation of output products into hydrological models for all regions of interest. A final dataset will be provided to end users. The SPICE project is addressing four high level objectives: 1) Assess and improve the Delay-Doppler altimeter processing for ice sheets. 2) Assess and develop SAR waveform retrackers for ice sheets. 3) Evaluate the performance of SAR altimetry relative to conventional pulse limited altimetry. 4) Assess the impact on SAR altimeter measurements of radar wave interaction with the snowpack. Dataset used for validation include ICESat and IceBridge products. Vostok, Dome C and the Spirit Sector (all located in Antarctica) have been selected, along with the Russell Glacier in Greenland, as regions of interest. In the frame of both SCOOP and SHAPE projects, improved wet troposphere corrections will be estimated for all regions of interest.

Improved NASTRAN plotting

NASA Technical Reports Server (NTRS)

Chan, Gordon C.

1991-01-01

The new 1991 COSMIC/NASTRAN version, compatible with the older versions, tries to remove some old constraints and make it easier to extract information from the plot file. It also includes some useful improvements and new enhancements. New features available in the 1991 version are described. They include a new PLT1 tape with simplified ASCII plot commands and short records, combined hidden and shrunk plot, an x-y-z coordinate system on all structural plots, element offset plot, improved character size control, improved FIND and NOFIND logic, a new NASPLOT post-prosessor to perform screen plotting or generate PostScript files, and a BASIC/NASTPLOT program for PC.

An audit and feedback system for effective quality improvement in head and neck surgery: Can we become better surgeons?

PubMed

Lewis, Carol M; Monroe, Marcus M; Roberts, Dianna B; Hessel, Amy C; Lai, Stephen Y; Weber, Randal S

2015-05-15

An evaluation system was established for measuring physician performance. This study was designed to determine whether an initial evaluation with surgeon feedback improved subsequent performance. After an evaluation of an initial cohort of procedures (2004-2008), surgeons were given risk-adjusted individual feedback. Procedures in a postfeedback cohort (2009-2010) were then assessed. Both groups were further stratified into high-acuity procedure (HAP) and low-acuity procedure (LAP) groups. Negative performance measures included the length of the perioperative stay (2 days or longer for LAPs and 11 days or longer for HAPs); perioperative blood transfusions; a return to the operating room within 7 days; and readmission, surgical site infections, and mortality within 30 days. There were 2618 procedures in the initial cohort and 1389 procedures in the postfeedback cohort. Factors affecting performance included the surgeon, the procedure's acuity, and patient comorbidities. There were no significant differences in the proportions of LAPs and HAPs or in the prevalence of patient comorbidities between the 2 assessment periods. The mean length of stay significantly decreased for LAPs from 2.1 to 1.5 days (P = .005) and for HAPs from 10.5 to 7 days (P = .003). The incidence of 1 or more negative performance indicators decreased significantly for LAPs from 39.1% to 28.6% (P < .001) and trended downward for HAPs from 60.9% to 53.5% (P = .081). Periodic assessments of performance and outcomes are essential for continual quality improvement. Significant decreases in the length of stay and negative performance indicators were seen after feedback. Therefore, an audit and feedback system may be an effective means of improving quality of care and reducing practice variability within a surgical department. © 2015 American Cancer Society.

90-Day Cycle Handbook

ERIC Educational Resources Information Center

Park, Sandra; Takahashi, Sola

2013-01-01

90-Day Cycles are a disciplined and structured form of inquiry designed to produce and test knowledge syntheses, prototyped processes, or products in support of improvement work. With any type of activity, organizations inevitably encounter roadblocks to improving performance and outcomes. These barriers might include intractable problems at…

Pointers for Parenting.

ERIC Educational Resources Information Center

Bessant, Helen P., Ed.

Presented are 11 brief articles designed to help parents enhance their children's school performance and generally improve the home environment. Included is information on the following topics: the role of the social worker in parent education, home activities to improve a child's reading skills, developing listening skill through instructional…

Improving Science Education through Accountability Relationships in Schools.

ERIC Educational Resources Information Center

Wildy, Helen; Wallace, John

1997-01-01

Presents a contrast between bureaucratic and professional models of accountability and their impact on the science education enterprise. Topics include improving performance, climate of trust, principles and consequences, demonstrating acceptance of responsibilities, and feedback. Concludes that it is necessary to develop the skills and processes…

The Business of Art Education: A Fairytale Adventure

ERIC Educational Resources Information Center

Buda, Sharon; Fedorenko, Jan; Sheridan, Mary A.

2012-01-01

School reform initiatives designed to improve school quality require strong leadership, strategic planning, data analysis, and systemized performance accountability. Utilizing school reforms includes rethinking curriculum and instruction to improve quality and promote equality, restructuring school operations with a focus on both the students and…

Reengineering the laboratory: strategic process and systems innovation to improve performance. Recreating our role on the health-care team.

PubMed

Johnson, E

1995-01-01

The author describes reengineering efforts in the laboratory of a 550-bed hospital. Key benefits include reduced costs, improved turnaround time, and redirection of staff into new roles in information management and outreach.

Safety culture and care: a program to prevent surgical errors.

PubMed

Hemingway, Maureen White; O'Malley, Catherine; Silvestri, Sandra

2015-04-01

Surgical errors are under scrutiny in health care as part of ensuring a culture of safety in which patients receive quality care. Hospitals use safety measures to compare their performance against industry benchmarks. To understand patient safety issues, health care providers must have processes in place to analyze and evaluate the quality of the care they provide. At one facility, efforts made to improve its quality and safety led to the development of a robust safety program with resources devoted to enhancing the culture of safety in the Perioperative Services department. Improvement initiatives included changing processes for safety reporting and performance improvement plans, adding resources and nurse roles, and creating communication strategies around adverse safety events and how to improve care. One key outcome included a 54% increase in the percentage of personnel who indicated in a survey that they would speak up if they saw something negatively affecting patient care. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Computational Models of Neuron-Astrocyte Interactions Lead to Improved Efficacy in the Performance of Neural Networks

PubMed Central

Alvarellos-González, Alberto; Pazos, Alejandro; Porto-Pazos, Ana B.

2012-01-01

The importance of astrocytes, one part of the glial system, for information processing in the brain has recently been demonstrated. Regarding information processing in multilayer connectionist systems, it has been shown that systems which include artificial neurons and astrocytes (Artificial Neuron-Glia Networks) have well-known advantages over identical systems including only artificial neurons. Since the actual impact of astrocytes in neural network function is unknown, we have investigated, using computational models, different astrocyte-neuron interactions for information processing; different neuron-glia algorithms have been implemented for training and validation of multilayer Artificial Neuron-Glia Networks oriented toward classification problem resolution. The results of the tests performed suggest that all the algorithms modelling astrocyte-induced synaptic potentiation improved artificial neural network performance, but their efficacy depended on the complexity of the problem. PMID:22649480

Performance Evaluation of an Intel Haswell- and Ivy Bridge-Based Supercomputer Using Scientific and Engineering Applications

NASA Technical Reports Server (NTRS)

Saini, Subhash; Hood, Robert T.; Chang, Johnny; Baron, John

2016-01-01

We present a performance evaluation conducted on a production supercomputer of the Intel Xeon Processor E5- 2680v3, a twelve-core implementation of the fourth-generation Haswell architecture, and compare it with Intel Xeon Processor E5-2680v2, an Ivy Bridge implementation of the third-generation Sandy Bridge architecture. Several new architectural features have been incorporated in Haswell including improvements in all levels of the memory hierarchy as well as improvements to vector instructions and power management. We critically evaluate these new features of Haswell and compare with Ivy Bridge using several low-level benchmarks including subset of HPCC, HPCG and four full-scale scientific and engineering applications. We also present a model to predict the performance of HPCG and Cart3D within 5%, and Overflow within 10% accuracy.

Computational models of neuron-astrocyte interactions lead to improved efficacy in the performance of neural networks.

PubMed

Alvarellos-González, Alberto; Pazos, Alejandro; Porto-Pazos, Ana B

2012-01-01

The importance of astrocytes, one part of the glial system, for information processing in the brain has recently been demonstrated. Regarding information processing in multilayer connectionist systems, it has been shown that systems which include artificial neurons and astrocytes (Artificial Neuron-Glia Networks) have well-known advantages over identical systems including only artificial neurons. Since the actual impact of astrocytes in neural network function is unknown, we have investigated, using computational models, different astrocyte-neuron interactions for information processing; different neuron-glia algorithms have been implemented for training and validation of multilayer Artificial Neuron-Glia Networks oriented toward classification problem resolution. The results of the tests performed suggest that all the algorithms modelling astrocyte-induced synaptic potentiation improved artificial neural network performance, but their efficacy depended on the complexity of the problem.

Algorithm improvement program nuclide identification algorithm scoring criteria and scoring application.

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

Enghauser, Michael

2016-02-01

The goal of the Domestic Nuclear Detection Office (DNDO) Algorithm Improvement Program (AIP) is to facilitate gamma-radiation detector nuclide identification algorithm development, improvement, and validation. Accordingly, scoring criteria have been developed to objectively assess the performance of nuclide identification algorithms. In addition, a Microsoft Excel spreadsheet application for automated nuclide identification scoring has been developed. This report provides an overview of the equations, nuclide weighting factors, nuclide equivalencies, and configuration weighting factors used by the application for scoring nuclide identification algorithm performance. Furthermore, this report presents a general overview of the nuclide identification algorithm scoring application including illustrative examples.

A conative educational model for an intervention program in obese youth.

PubMed

Vanhelst, Jérémy; Béghin, Laurent; Fardy, Paul Stephen; Bui-Xuan, Gilles; Mikulovic, Jacques

2012-06-07

Obesity in children has increased in recent years throughout the world and is associated with adverse health consequences. Early interventions, including appropriate pedagogy strategies, are important for a successful intervention program. The aim of this study was to assess changes in body mass index, the ability to perform sport activities, behavior in the classroom and academic performance following one year of a health-wellness intervention program in obese youth. The CEMHaVi program included 37 obese children (19 girls and 18 boys). Participants received an intervention program consisting of physical activity and health education. Assessment included body mass index, academic performance, classroom performance and ability to perform sport activities. Paired t tests were used to assess the effects of intervention, and chi square was used to assess inter-action between measures. Findings of the study suggest significant decrease in Z scores of Body Mass Index and an improvement of academic performance, classroom behavior and the ability to perform sport activities (p < 0.05). Chi square testing showed significant positive inter-actions between body mass index, classroom behavior and academic performance. Results following year one of CEMHaVi showed that a program of physical activity and health education had positive effects on obesity, behavior in the classroom and the ability to perform sport activities in obese adolescents. Significant inter-action in changes between variables was observed. Findings are important for designing intervention models to improve health in obese youth.

42 CFR 460.62 - Governing body.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Management and provision of all services, including the management of contractors. (4) Establishment of... participants. (7) Quality assessment and performance improvement program. (b) Participant advisory committee... provide the liaison to the governing body with meeting minutes that include participant issues. (c...

Upgrades to the ISS Water Recovery System

NASA Technical Reports Server (NTRS)

Pruitt, Jennifer M.; Carter, Layne; Bagdigian, Robert M.; Kayatin, Mattthew J.

2015-01-01

The ISS Water Recovery System (WRS) includes the Water Processor Assembly (WPA) and the Urine Processor Assembly (UPA). The WRS produces potable water from a combination of crew urine (first processed through the UPA), crew latent, and Sabatier product water. The WRS has been operational on ISS since November 2008, producing over 21,000 L of potable water during that time. Though the WRS has performed well during this time, several modifications have been identified to improve the overall system performance. These modifications can reduce resupply and improve overall system reliability, which is beneficial for the ongoing ISS mission as well as for future NASA manned missions. The following paper lists these modifications, how they improve WRS performance, and a status on the ongoing development effort.

New PDC bit optimizes drilling performance

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

Besson, A.; Gudulec, P. le; Delwiche, R.

1996-05-01

The lithology in northwest Argentina contains a major section where polycrystalline diamond compact (PDC) bits have not succeeded in the past. The section consists of dense shales and cemented sandstone stringers with limestone laminations. Conventional PDC bits experienced premature failures in the section. A new generation PDC bit tripled rate of penetration (ROP) and increased by five times the potential footage per bit. Recent improvements in PDC bit technology that enabled the improved performance include: the ability to control the PDC cutter quality; use of an advanced cutter lay out defined by 3D software; using cutter face design code formore » optimized cleaning and cooling; and, mastering vibration reduction features, including spiraled blades.« less

Machine learning in heart failure: ready for prime time.

PubMed

Awan, Saqib Ejaz; Sohel, Ferdous; Sanfilippo, Frank Mario; Bennamoun, Mohammed; Dwivedi, Girish

2018-03-01

The aim of this review is to present an up-to-date overview of the application of machine learning methods in heart failure including diagnosis, classification, readmissions and medication adherence. Recent studies have shown that the application of machine learning techniques may have the potential to improve heart failure outcomes and management, including cost savings by improving existing diagnostic and treatment support systems. Recently developed deep learning methods are expected to yield even better performance than traditional machine learning techniques in performing complex tasks by learning the intricate patterns hidden in big medical data. The review summarizes the recent developments in the application of machine and deep learning methods in heart failure management.

Early experience with pay-for-performance: from concept to practice.

PubMed

Rosenthal, Meredith B; Frank, Richard G; Li, Zhonghe; Epstein, Arnold M

2005-10-12

The adoption of pay-for-performance mechanisms for quality improvement is growing rapidly. Although there is intense interest in and optimism about pay-for-performance programs, there is little published research on pay-for-performance in health care. To evaluate the impact of a prototypical physician pay-for-performance program on quality of care. We evaluated a natural experiment with pay-for-performance using administrative reports of physician group quality from a large health plan for an intervention group (California physician groups) and a contemporaneous comparison group (Pacific Northwest physician groups). Quality improvement reports were included from October 2001 through April 2004 issued to approximately 300 large physician organizations. Three process measures of clinical quality: cervical cancer screening, mammography, and hemoglobin A1c testing. Improvements in clinical quality scores were as follows: for cervical cancer screening, 5.3% for California vs 1.7% for Pacific Northwest; for mammography, 1.9% vs 0.2%; and for hemoglobin A1c, 2.1% vs 2.1%. Compared with physician groups in the Pacific Northwest, the California network demonstrated greater quality improvement after the pay-for-performance intervention only in cervical cancer screening (a 3.6% difference in improvement [P = .02]). In total, the plan awarded 3.4 million dollars (27% of the amount set aside) in bonus payments between July 2003 and April 2004, the first year of the program. For all 3 measures, physician groups with baseline performance at or above the performance threshold for receipt of a bonus improved the least but garnered the largest share of the bonus payments. Paying clinicians to reach a common, fixed performance target may produce little gain in quality for the money spent and will largely reward those with higher performance at baseline.

Rapid Deployment of Optimal Control for Building HVAC Systems using Innovative Software Tools and a Hybrid Heuristic/Model Based Control Approach

DTIC Science & Technology

2017-03-21

Energy and Water Projects March 21, 2017 REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of...included reduced system energy use and cost as well as improved performance driven by autonomous commissioning and optimized system control. In the end...improve system performance and reduce energy use and cost. However, implementing these solutions into the extremely heterogeneous and often

Simulation-Based Cryosurgery Training: Variable Insertion-Depth Planning in Prostate Cryosurgery

PubMed Central

Sehrawat, Anjali; Keelan, Robert; Shimada, Kenji; Wilfong, Dona M.; McCormick, James T.; Rabin, Yoed

2015-01-01

A proof-of-concept for an advanced-level computerized training tool for cryosurgery is demonstrated, based on three-dimensional cryosurgery simulations and a variable insertion-depth strategy for cryoprobes. The objective for system development is twofold: to identify a cryoprobe layout in order to best-match a planning isotherm with the target region shape, and to verify that cryoprobe placement does not violate accepted geometric constraints. System validation has been performed by collecting training data from 17 surgical residents, having no prior experience or advanced knowledge of cryosurgery. This advanced-level study includes an improved training-session design, in order to enhance knowledge dissemination and elevate participant motivation to excel. In terms of match between a planning isotherm and the target region shape, results of this demonstrate trainee performance improvement from 4.4% in a pretest to 44.4% in a posttest over a course of 50 minutes of training. In terms of combined performance, including the above geometrical match and constraints on cryoprobe placement, this study demonstrates trainee performance improvement from 2.2% in the pretest to 31.1% in the posttest. Given the relatively short training session and the lack of prior knowledge, these improvements are significant and encouraging. These results are of particular significance, as they have been obtained from a surgical resident population, which are exposed to the typical stress and constraints in advanced surgical education. PMID:26546576

Balanced RAP/RAS mix design and performance evaluation for project - specific service conditions.

DOT National Transportation Integrated Search

2013-01-01

This presentation summarizes Projects 0-6092/0-6614. It includes accomplishments, best practices, field performance data of RAP/RAS test sections, balanced RAP/RAS mix design for project-specific conditions, and approaches for improving RAP/RAS mix p...

Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects.

PubMed

Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

2017-09-27

To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades-while not inexpensive-contributed to greater system efficiency and modest savings. © Mwencha et al.

Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects

PubMed Central

Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

2017-01-01

ABSTRACT Background: To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. Methods: We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. Results: The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Conclusion: Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades—while not inexpensive—contributed to greater system efficiency and modest savings. PMID:28877933

An official American Thoracic Society policy statement: pay-for-performance in pulmonary, critical care, and sleep medicine.

PubMed

Kahn, Jeremy M; Scales, Damon C; Au, David H; Carson, Shannon S; Curtis, J Randall; Dudley, R Adams; Iwashyna, Theodore J; Krishnan, Jerry A; Maurer, Janet R; Mularski, Richard; Popovich, John; Rubenfeld, Gordon D; Sinuff, Tasnim; Heffner, John E

2010-04-01

Pay-for-performance is a model for health care financing that seeks to link reimbursement to quality. The American Thoracic Society and its members have a significant stake in the development of pay-for-performance programs. To develop an official ATS policy statement addressing the role of pay-for-performance in pulmonary, critical care and sleep medicine. The statement was developed by the ATS Health Policy Committee using an iterative consensus process including an expert workshop and review by ATS committees and assemblies. Pay-for-performance is increasingly utilized by health care purchasers including the United States government. Published studies generally show that programs result in small but measurable gains in quality, although the data are heterogeneous. Pay-for-performance may result in several negative consequences, including the potential to increase costs, worsen health outcomes, and widen health disparities, among others. Future research should be directed at developing reliable and valid performance measures, increasing the efficacy of pay-for-performance programs, minimizing negative unintended consequences, and examining issues of costs and cost-effectiveness. The ATS and its members can play a key role in the design and evaluation of these programs by advancing the science of performance measurement, regularly developing quality metrics alongside clinical practice guidelines, and working with payors to make performance improvement a routine part of clinical practice. Pay-for-performance programs will expand in the coming years. Pulmonary, critical care and sleep practitioners can use these programs as an opportunity to partner with purchasers to improve health care quality.

Does adding clinical data to administrative data improve agreement among hospital quality measures?

PubMed

Hanchate, Amresh D; Stolzmann, Kelly L; Rosen, Amy K; Fink, Aaron S; Shwartz, Michael; Ash, Arlene S; Abdulkerim, Hassen; Pugh, Mary Jo V; Shokeen, Priti; Borzecki, Ann

2017-09-01

Hospital performance measures based on patient mortality and readmission have indicated modest rates of agreement. We examined if combining clinical data on laboratory tests and vital signs with administrative data leads to improved agreement with each other, and with other measures of hospital performance in the nation's largest integrated health care system. We used patient-level administrative and clinical data, and hospital-level data on quality indicators, for 2007-2010 from the Veterans Health Administration (VA). For patients admitted for acute myocardial infarction (AMI), heart failure (HF) and pneumonia we examined changes in hospital performance on 30-d mortality and 30-d readmission rates as a result of adding clinical data to administrative data. We evaluated whether this enhancement yielded improved measures of hospital quality, based on concordance with other hospital quality indicators. For 30-d mortality, data enhancement improved model performance, and significantly changed hospital performance profiles; for 30-d readmission, the impact was modest. Concordance between enhanced measures of both outcomes, and with other hospital quality measures - including Joint Commission process measures, VA Surgical Quality Improvement Program (VASQIP) mortality and morbidity, and case volume - remained poor. Adding laboratory tests and vital signs to measure hospital performance on mortality and readmission did not improve the poor rates of agreement across hospital quality indicators in the VA. Efforts to improve risk adjustment models should continue; however, evidence of validation should precede their use as reliable measures of quality. Published by Elsevier Inc.

Rapid core measure improvement through a "business case for quality".

PubMed

Perlin, Jonathan B; Horner, Stephen J; Englebright, Jane D; Bracken, Richard M

2014-01-01

Incentives to improve performance are emerging as revenue or financial penalties are linked to the measured quality of service provided. The HCA "Getting to Green" program was designed to rapidly increase core measure performance scores. Program components included (1) the "business case for quality"-increased awareness of how quality drives financial performance; (2) continuous communication of clinical and financial performance data; and (3) evidence-based clinical protocols, incentives, and tools for process improvement. Improvement was measured by comparing systemwide rates of adherence to national quality measures for heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and surgical care (SCIP) to rates from all facilities reporting to the Centers for Medicare and Medicaid Services (CMS). As of the second quarter of 2011, 70% of HCA total measure set composite scores were at or above the 90th percentile of CMS scores. A test of differences in regression coefficients between the CMS national average and the HCA average revealed significant differences for AMI (p = .001), HF (p = .012), PN (p < .001), and SCIP (p = .015). This program demonstrated that presentation of the financial implications of quality, transparency in performance data, and clearly defined goals could cultivate the desire to use improvement tools and resources to raise performance. © 2012 National Association for Healthcare Quality.

Prediction of changes in memory performance by plasma homovanillic acid levels in clozapine-treated patients with schizophrenia.

PubMed

Sumiyoshi, Tomiki; Roy, A; Kim, C-H; Jayathilake, K; Lee, M A; Sumiyoshi, C; Meltzer, H Y

2004-12-01

Cognitive dysfunction in schizophrenia has been demonstrated to be dependent, in part, on dopaminergic activity. Clozapine has been found to improve some domains of cognition, including verbal memory, in patients with schizophrenia. This study tested the hypothesis that plasma homovanillic acid (pHVA) levels, a peripheral measure of central dopaminergic activity, would predict the change in memory performance in patients with schizophrenia treated with clozapine. Twenty-seven male patients with schizophrenia received clozapine treatment for 6 weeks. Verbal list learning (VLL)-Delayed Recall (VLL-DR), a test of secondary verbal memory, was administered before and after clozapine treatment. Blood samples to measure pHVA levels were collected at baseline. Baseline pHVA levels were negatively correlated with change in performance on VLL-DR; the lower baseline pHVA level was associated with greater improvement in performance on VLL-DR during treatment with clozapine. Baseline pHVA levels in subjects who showed improvement in verbal memory during clozapine treatment ( n=13) were significantly lower than those in subjects whose memory performance did not improve ( n=14). The results of this study indicate that baseline pHVA levels predict the ability of clozapine to improve memory performance in patients with schizophrenia.

Enhancing cognition with video games: a multiple game training study.

PubMed

Oei, Adam C; Patterson, Michael D

2013-01-01

Previous evidence points to a causal link between playing action video games and enhanced cognition and perception. However, benefits of playing other video games are under-investigated. We examined whether playing non-action games also improves cognition. Hence, we compared transfer effects of an action and other non-action types that required different cognitive demands. We instructed 5 groups of non-gamer participants to play one game each on a mobile device (iPhone/iPod Touch) for one hour a day/five days a week over four weeks (20 hours). Games included action, spatial memory, match-3, hidden- object, and an agent-based life simulation. Participants performed four behavioral tasks before and after video game training to assess for transfer effects. Tasks included an attentional blink task, a spatial memory and visual search dual task, a visual filter memory task to assess for multiple object tracking and cognitive control, as well as a complex verbal span task. Action game playing eliminated attentional blink and improved cognitive control and multiple-object tracking. Match-3, spatial memory and hidden object games improved visual search performance while the latter two also improved spatial working memory. Complex verbal span improved after match-3 and action game training. Cognitive improvements were not limited to action game training alone and different games enhanced different aspects of cognition. We conclude that training specific cognitive abilities frequently in a video game improves performance in tasks that share common underlying demands. Overall, these results suggest that many video game-related cognitive improvements may not be due to training of general broad cognitive systems such as executive attentional control, but instead due to frequent utilization of specific cognitive processes during game play. Thus, many video game training related improvements to cognition may be attributed to near-transfer effects.

A hydrologic tracer study in a small, natural wetland in the humid tropics of Costa Rica

USDA-ARS?s Scientific Manuscript database

Growing populations combined with increasing food demand are leading to increased environmental pressures on tropical wetland ecosystems, including a greater reliance on natural wetlands for water quality improvement. Effective assessment of their performance requires an improved understanding of h...

SPAR improved structure-fluid dynamic analysis capability, phase 2

NASA Technical Reports Server (NTRS)

Pearson, M. L.

1984-01-01

An efficient and general method of analyzing a coupled dynamic system of fluid flow and elastic structures is investigated. The improvement of Structural Performance Analysis and Redesign (SPAR) code is summarized. All error codes are documented and the SPAR processor/subroutine cross reference is included.

Mindful Learning: Why Attention Matters in Education

ERIC Educational Resources Information Center

Hassed, Craig

2016-01-01

Mindfulness is a generic skill with a wide range of applications relevant to education. These include fostering mental health; improving communication, empathy, and emotional development, improving physical health; and enhancing learning and performance. This article will give a brief overview of the science, practice, and philosophy of…

The Business Value of Superior Energy Performance

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

McKane, Aimee; Scheihing, Paul; Evans, Tracy

Industrial facilities participating in the U.S. Department of Energy’s (US DOE) Superior Energy Performance (SEP) program are finding that it provides them with significant business value. This value starts with the implementation of ISO 50001-Energy management system standard, which provides an internationally-relevant framework for integration of energy management into an organization’s business processes. The resulting structure emphasizes effective use of available data and supports continual improvement of energy performance. International relevance is particularly important for companies with a global presence or trading interests, providing them with access to supporting ISO standards and a growing body of certified companies representing themore » collective knowledge of communities of practice. This paper examines the business value of SEP, a voluntary program that builds on ISO 50001, inviting industry to demonstrate an even greater commitment through third-party verification of energy performance improvement to a specified level of achievement. Information from 28 facilities that have already achieved SEP certification will illustrate key findings concerning both the value and the challenges from SEP/ISO 50001 implementation. These include the facilities’ experience with implementation, internal and external value of third-party verification of energy performance improvement; attractive payback periods and the importance of SEP tools and guidance. US DOE is working to bring the program to scale, including the Enterprise-Wide Accelerator (SEP for multiple facilities in a company), the Ratepayer-Funded Program Accelerator (supporting tools for utilities and program administrators to include SEP in their program offerings), and expansion of the program to other sectors and industry supply chains.« less

Titan I propulsion system modeling and possible performance improvements

NASA Astrophysics Data System (ADS)

Giusti, Oreste

This thesis features the Titan I propulsion systems and offers data-supported suggestions for improvements to increase performance. The original propulsion systems were modeled both graphically in CAD and via equations. Due to the limited availability of published information, it was necessary to create a more detailed, secondary set of models. Various engineering equations---pertinent to rocket engine design---were implemented in order to generate the desired extra detail. This study describes how these new models were then imported into the ESI CFD Suite. Various parameters are applied to these imported models as inputs that include, for example, bi-propellant combinations, pressure, temperatures, and mass flow rates. The results were then processed with ESI VIEW, which is visualization software. The output files were analyzed for forces in the nozzle, and various results were generated, including sea level thrust and ISP. Experimental data are provided to compare the original engine configuration models to the derivative suggested improvement models.

Focused process improvement events: sustainability of impact on process and performance in an academic radiology department.

PubMed

Rosenkrantz, Andrew B; Lawson, Kirk; Ally, Rosina; Chen, David; Donno, Frank; Rittberg, Steven; Rodriguez, Joan; Recht, Michael P

2015-01-01

To evaluate sustainability of impact of rapid, focused process improvement (PI) events on process and performance within an academic radiology department. Our department conducted PI during 2011 and 2012 in CT, MRI, ultrasound, breast imaging, and research billing. PI entailed participation by all stakeholders, facilitation by the department chair, collection of baseline data, meetings during several weeks, definition of performance metrics, creation of an improvement plan, and prompt implementation. We explore common themes among PI events regarding initial impact and durability of changes. We also assess performance in each area pre-PI, immediately post-PI, and at the time of the current study. All PI events achieved an immediate improvement in performance metrics, often entailing both examination volumes and on-time performance. IT-based solutions, process standardization, and redefinition of staff responsibilities were often central in these changes, and participants consistently expressed improved internal leadership and problem-solving ability. Major environmental changes commonly occurred after PI, including a natural disaster with equipment loss, a change in location or services offered, and new enterprise-wide electronic medical record system incorporating new billing and radiology informatics systems, requiring flexibility in the PI implementation plan. Only one PI team conducted regular post-PI follow-up meetings. Sustained improvement was frequently, but not universally, observed: in the long-term following initial PI, measures of examination volume showed continued progressive improvements, whereas measures of operational efficiency remained stable or occasionally declined. Focused PI is generally effective in achieving performance improvement, although a changing environment influences the sustainability of impact. Thus, continued process evaluation and ongoing workflow modifications are warranted. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Microbial fuel cell (MFC) power performance improvement through enhanced microbial electrogenicity.

PubMed

Li, Ming; Zhou, Minghua; Tian, Xiaoyu; Tan, Chaolin; McDaniel, Cameron T; Hassett, Daniel J; Gu, Tingyue

Within the past 5 years, tremendous advances have been made to maximize the performance of microbial fuel cells (MFCs) for both "clean" bioenergy production and bioremediation. Most research efforts have focused on parameters including (i) optimizing reactor configuration, (ii) electrode construction, (iii) addition of redox-active, electron donating mediators, (iv) biofilm acclimation and feed nutrient adjustment, as well as (v) other parameters that contribute to enhanced MFC performance. To date, tremendous advances have been made, but further improvements are needed for MFCs to be economically practical. In this review, the diversity of electrogenic microorganisms and microbial community changes in mixed cultures are discussed. More importantly, different approaches including chemical/genetic modifications and gene regulation of exoelectrogens, synthetic biology approaches and bacterial community cooperation are reviewed. Advances in recent years in metagenomics and microbiomes have allowed researchers to improve bacterial electrogenicity of robust biofilms in MFCs using novel, unconventional approaches. Taken together, this review provides some important and timely information to researchers who are examining additional means to enhance power production of MFCs. Copyright © 2018 Elsevier Inc. All rights reserved.

Effects of Cognitive Training with and without Aerobic Exercise on Cognitively-Demanding Everyday Activities

PubMed Central

McDaniel, Mark A.; Binder, Ellen F.; Bugg, Julie M.; Waldum, Emily R.; Dufault, Carolyn; Meyer, Amanda; Johanning, Jennifer; Zheng, Jie; Schechtman, Kenneth B.; Kudelka, Chris

2015-01-01

We investigated the potential benefits of a novel cognitive training protocol and an aerobic exercise intervention, both individually and in concert, on older adults’ performances in laboratory simulations of select real-world tasks. The cognitive training focused on a range of cognitive processes, including attentional coordination, prospective memory, and retrospective-memory retrieval, processes that are likely involved in many everyday tasks, and that decline with age. Primary outcome measures were three laboratory tasks that simulated everyday activities: Cooking Breakfast, Virtual Week, and Memory for Health Information. Two months of cognitive training improved older adults’ performance on prospective memory tasks embedded in Virtual Week. Cognitive training, either alone or in combination with six months of aerobic exercise, did not significantly improve Cooking Breakfast or Memory for Health Information. Although gains in aerobic power were comparable to previous reports, aerobic exercise did not produce improvements for the primary outcome measures. Discussion focuses on the possibility that cognitive training programs that include explicit strategy instruction and varied practice contexts may confer gains to older adults for performance on cognitively challenging everyday tasks. PMID:25244489

The Effect of ISO 9001 and the EFQM Model on Improving Hospital Performance: A Systematic Review

PubMed Central

Yousefinezhadi, Taraneh; Mohamadi, Efat; Safari Palangi, Hossein; Akbari Sari, Ali

2015-01-01

Context: This study aimed to explore the effect of the International Organization for Standardization (ISO) ISO 9001 standard and the European foundation for quality management (EFQM) model on improving hospital performance. Evidence Acquisition: PubMed, Embase and the Cochrane Library databases were searched. In addition, Elsevier and Springer were searched as main publishers in the field of health sciences. We included empirical studies with any design that had used ISO 9001 or the EFQM model to improve the quality of healthcare. Data were collected and tabulated into a data extraction sheet that was specifically designed for this study. The collected data included authors’ names, country, year of publication, intervention, improvement aims, setting, length of program, study design, and outcomes. Results: Seven out of the 121 studies that were retrieved met the inclusion criteria. Three studies assessed the EFQM model and four studies assessed the ISO 9001 standard. Use of the EFQM model increased the degree of patient satisfaction and the number of hospital admissions and reduced the average length of stay, the delay on the surgical waiting list, and the number of emergency re-admissions. ISO 9001 also increased the degree of patient satisfaction and patient safety, increased cost-effectiveness, improved the hospital admissions process, and reduced the percentage of unscheduled returns to the hospital. Conclusions: Generally, there is a lack of robust and high quality empirical evidence regarding the effects of ISO 9001 and the EFQM model on the quality care provided by and the performance of hospitals. However, the limited evidence shows that ISO 9001 and the EFQM model might improve hospital performance. PMID:26756012

Transforming and Turning around Low-Performing Schools: The Role of Online Learning

ERIC Educational Resources Information Center

Corry, Michael; Carlson-Bancroft, Angela

2014-01-01

This review of the literature examines online learning as a core strategy for bold, dramatic curricular reform within transformational or turnaround models in improving low-performing K-12 schools. The analysis of the literature in this area found benefits of online learning in transforming and turning around low-performing schools to include: (a)…

Feasibility study of a synthesis procedure for array feeds to improve radiation performance of large distorted reflector antennas

NASA Technical Reports Server (NTRS)

Stutzman, W. L.; Takamizawa, K.; Werntz, P.; Lapean, J.; Barts, R.; Shen, B.; Dunn, D.

1992-01-01

The topics covered include the following: (1) performance analysis of the Gregorian tri-reflector; (2) design and performance of the type 6 reflector antenna; (3) a new spherical main reflector system design; (4) optimization of reflector configurations using physical optics; (5) radiometric array design; and (7) beam efficiency studies.

The Relationship between Learning Effectiveness, Teacher Competence and Teachers Performance Madrasah Tsanawiyah at Serang, Banten, Indonesia

ERIC Educational Resources Information Center

Rahmatullah, Mamat

2016-01-01

In this study, the problem is limited factors relating to the learning effectiveness and teacher competence in improving the teacher performance. Therefore, this study will try to get explanations from some main issues which include the learning effectiveness issue, and teacher competence to increase teacher performance in Madrasah Tsanawiyah at…

Performance-Based Contracting in Residential Care and Treatment: Driving Policy and Practice Change through Public-Private Partnership in Illinois

ERIC Educational Resources Information Center

Kearney, Kathleen A.; McEwen, Erwin; Bloom-Ellis, Brice; Jordan, Neil

2010-01-01

The National Quality Improvement Center on the Privatization of Child Welfare Services selected Illinois as a demonstration site in 2007 to evaluate performance-based contracting in residential treatment services. This article discusses the first two years of project implementation including developing residential treatment performance indicators,…

Improved Clinical Performance and Teamwork of Pediatric Interprofessional Resuscitation Teams With a Simulation-Based Educational Intervention.

PubMed

Gilfoyle, Elaine; Koot, Deanna A; Annear, John C; Bhanji, Farhan; Cheng, Adam; Duff, Jonathan P; Grant, Vincent J; St George-Hyslop, Cecilia E; Delaloye, Nicole J; Kotsakis, Afrothite; McCoy, Carolyn D; Ramsay, Christa E; Weiss, Matthew J; Gottesman, Ronald D

2017-02-01

To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. Multicenter prospective interventional study. Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams). A 1-day simulation-based team training course was delivered, involving an interactive lecture, group discussions, and four simulated resuscitation scenarios, each followed by a debriefing. The first scenario of the day (PRE) was conducted prior to any team training. The final scenario of the day (POST) was the same scenario, with a slightly modified patient history. All scenarios included standardized distractors designed to elicit and challenge specific teamwork behaviors. Primary outcome measure was change (before and after training) in adherence to Pediatric Advanced Life Support guidelines, as measured by the Clinical Performance Tool. Secondary outcome measures were as follows: 1) change in times to initiation of chest compressions and defibrillation and 2) teamwork performance, as measured by the Clinical Teamwork Scale. Correlation between Clinical Performance Tool and Clinical Teamwork Scale scores was also analyzed. Teams significantly improved Clinical Performance Tool scores (67.3-79.6%; p < 0.0001), time to initiation of chest compressions (60.8-27.1 s; p < 0.0001), time to defibrillation (164.8-122.0 s; p < 0.0001), and Clinical Teamwork Scale scores (56.0-71.8%; p < 0.0001). A positive correlation was found between Clinical Performance Tool and Clinical Teamwork Scale (R = 0.281; p < 0.0001). Participation in a simulation-based team training educational intervention significantly improved surrogate measures of clinical performance, time to initiation of key clinical tasks, and teamwork during simulated pediatric resuscitation. A positive correlation between clinical and teamwork performance suggests that effective teamwork improves clinical performance of resuscitation teams.

A plan for application system verification tests: The value of improved meteorological information, volume 1. [economic consequences of improved meteorological information

NASA Technical Reports Server (NTRS)

1976-01-01

The framework within which the Applications Systems Verification Tests (ASVTs) are performed and the economic consequences of improved meteorological information demonstrated is described. This framework considers the impact of improved information on decision processes, the data needs to demonstrate the economic impact of the improved information, the data availability, the methodology for determining and analyzing the collected data and demonstrating the economic impact of the improved information, and the possible methods of data collection. Three ASVTs are considered and program outlines and plans are developed for performing experiments to demonstrate the economic consequences of improved meteorological information. The ASVTs are concerned with the citrus crop in Florida, the cotton crop in Mississippi and a group of diverse crops in Oregon. The program outlines and plans include schedules, manpower estimates and funding requirements.

A systematic review to evaluate the effectiveness of carnitine supplementation in improving walking performance among individuals with intermittent claudication.

PubMed

Delaney, Christopher L; Spark, J Ian; Thomas, Jolene; Wong, Yew Toh; Chan, Lok Tsung; Miller, Michelle D

2013-07-01

To evaluate the evidence for the use of carnitine supplementation in improving walking performance among individuals with intermittent claudication. Systematic review. An electronic search of the literature was performed using MEDLINE (PubMed), Scopus, Cochrane Central Register of Controlled Trials and The Cochrane Library from inception through to November 2012. Search terms included peripheral arterial disease, intermittent claudication and carnitine. Reference lists of review articles and primary studies were also examined. Full reports of published experimental studies including randomized controlled trials and pre-test/post-test trials were selected for inclusion. A quality assessment was undertaken according to the Jadad scale. A total of 40 articles were retrieved, of which 23 did not meet the inclusion criteria. The 17 included articles reported on a total of 18 experimental studies of carnitine supplementation (5 pre-test/post-test; 8 parallel RCT; 5 cross-over RCT) for improving walking performance in adults with intermittent claudication. For pre-test/post-test studies, 300-2000 mg propionyl-L-carnitine (PLC) was administered orally or intravenously for a maximum of 90 days (7-42 participants) with statistically significant improvements of between 74 m and 157 m in pain free walking distance and between 71 m and 135 m in maximal walking distance across 3 out of 5 studies. Similarly, PLC (600 mg-3000 mg) was administered orally in 7 out of 8 parallel RCTs (22-485 participants), the longest duration being 12 months. All but one of the smallest trials demonstrated statistically significant improvements in walking performance between 31 and 54 m greater than placebo for pain free walking distance and between 9 and 86 m greater than placebo for maximal walking distance. A double-blind parallel RCT of cilostazol plus 2000 mg oral L-carnitine or placebo for 180 days (145 participants) did not demonstrate any significant improvement in walking performance. Of 5 cross-over RCTs (8-20 participants), 4 demonstrated significant improvements in walking performance following administration of 300-6000 mg L-carnitine or PLC. Compared to placebo, pain free walking distance and maximal walking distance improved by 23-132 m and 104 m respectively following carnitine intervention. Most trials demonstrated a small or modest improvement in walking performance with administration of PLC or L-carnitine. These findings were largely independent of level or quality of evidence, while there was some evidence that intravenous administration was more effective than oral administration and those with severe claudication may achieve greater benefits than those with moderate claudication. Routine carnitine supplementation in the form of PLC may therefore be a useful adjunct therapy for management of intermittent claudication. Further research is warranted to determine the optimal form, duration, dose and safety of carnitine supplementation across the spectrum of peripheral arterial disease severity and its effect with concurrent supervised exercise programs and best medical therapy. These studies should be supplemented with cost effectiveness studies to ensure that the return on the investment is acceptable. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

Rubisco activity and regulation as targets for crop improvement.

PubMed

Parry, Martin A J; Andralojc, P John; Scales, Joanna C; Salvucci, Michael E; Carmo-Silva, A Elizabete; Alonso, Hernan; Whitney, Spencer M

2013-01-01

Rubisco (ribulose-1,5-bisphosphate (RuBP) carboxylase/oxygenase) enables net carbon fixation through the carboxylation of RuBP. However, some characteristics of Rubisco make it surprisingly inefficient and compromise photosynthetic productivity. For example, Rubisco catalyses a wasteful reaction with oxygen that leads to the release of previously fixed CO(2) and NH(3) and the consumption of energy during photorespiration. Furthermore, Rubisco is slow and large amounts are needed to support adequate photosynthetic rates. Consequently, Rubisco has been studied intensively as a prime target for manipulations to 'supercharge' photosynthesis and improve both productivity and resource use efficiency. The catalytic properties of Rubiscos from diverse sources vary considerably, suggesting that changes in turnover rate, affinity, or specificity for CO(2) can be introduced to improve Rubisco performance in specific crops and environments. While attempts to manipulate plant Rubisco by nuclear transformation have had limited success, modifying its catalysis by targeted changes to its catalytic large subunit via chloroplast transformation have been much more successful. However, this technique is still in need of development for most major food crops including maize, wheat, and rice. Other bioengineering approaches for improving Rubisco performance include improving the activity of its ancillary protein, Rubisco activase, in addition to modulating the synthesis and degradation of Rubisco's inhibitory sugar phosphate ligands. As the rate-limiting step in carbon assimilation, even modest improvements in the overall performance of Rubisco pose a viable pathway for obtaining significant gains in plant yield, particularly under stressful environmental conditions.

23 CFR 972.214 - Federal lands congestion management system (CMS).

Code of Federal Regulations, 2011 CFR

2011-04-01

... management strategies; (v) Determine methods to monitor and evaluate the performance of the multi-modal... means the level at which transportation system performance is no longer acceptable due to traffic... improve existing transportation system efficiency. Approaches may include the use of alternate mode...

23 CFR 972.214 - Federal lands congestion management system (CMS).

Code of Federal Regulations, 2010 CFR

2010-04-01

... management strategies; (v) Determine methods to monitor and evaluate the performance of the multi-modal... means the level at which transportation system performance is no longer acceptable due to traffic... improve existing transportation system efficiency. Approaches may include the use of alternate mode...

High and Dry

ERIC Educational Resources Information Center

Johnson, Robert L.

2005-01-01

High-performance schools are facilities that improve the learning environment while saving energy, resources and money. Creating a high-performance school requires an integrated design approach. Key systems--including lighting, HVAC, electrical and plumbing--must be considered from the beginning of the design process. According to William H.…

34 CFR 645.32 - How does the Secretary evaluate prior experience?

Code of Federal Regulations, 2010 CFR

2010-07-01

... performance under its expiring Upward Bound grant. This information includes information derived from annual performance reports, audit reports, site visit reports, project evaluation reports, and any other verifiable... project participants have demonstrated improvement in academic skills and competencies as measured by...

Performance Testing of Yardney MCMB-LiNiCoAlO2 Lithium-ion Cells Possessing Electrolytes with Improved Safety Characteristics

NASA Technical Reports Server (NTRS)

Smart, Marshall C.; Whitcanack, Larry D.; Krause, Frederick C.; Hwang, Constanza; Bugga, Ratnakumar V.; Santee, Stuart; Puglia, Frank J.; Gitzendanner, Rob

2012-01-01

Many future NASA missions aimed at exploring the Moon and Mars require high specific energy rechargeable batteries that possess enhanced safety characteristics. There is also a strong desire to develop Li-ion batteries with improved safety characteristics for terrestrial applications, most notably for HEV and PHEV automotive applications. In previous work focused upon evaluating various potential flame retardant additives1, triphenyl phosphate (TPP)2 was observed to have the most desirable attributes, including good life characteristics and resilience to high voltage operation. We have employed a number of approaches in the design of promising TPP-based electrolytes with improved safety, including: (a) varying the flame retardant additive (FRA) content (from 5 to 15%), (b) the use of fluorinated co-solvents, (c) the use of additives to improve compatibility, and (c) the use of ester co-solvents to decrease the viscosity and increase the conductivity. In recent work, we have demonstrated a number of these electrolyte formulations to be compatible with a number of chemistries, including: MCMB carbon-LiNi0.8Co0.2O2, graphite-LiNi0.8Co0.15Al0.05O2, Li-Li(Li0.17Ni 0.25 Mn 0.58 )O2, Li-LiNiCoMnO2 and graphite- LiNiCoMnO2.3,4 In the current study, we have demonstrated the performance of a number of TPP-containing electrolytes in 7 Ah prototype MCMB-LiNiCoO2 cells. We will describe the results of a number of performance tests, including: a) 100% DOD cycle life testing at various temperatures, b) discharge rate characterization as a function of temperature, c) charge rate characterization as a function of temperature, and d) impedance as a function of temperature. In addition to displaying good life characteristics, being comparable to baseline chemistries, a number of cells were observed to provide good performance over a wide temperature range.

Performance Analysis of Ivshmem for High-Performance Computing in Virtual Machines

NASA Astrophysics Data System (ADS)

Ivanovic, Pavle; Richter, Harald

2018-01-01

High-Performance computing (HPC) is rarely accomplished via virtual machines (VMs). In this paper, we present a remake of ivshmem which can change this. Ivshmem was a shared memory (SHM) between virtual machines on the same server, with SHM-access synchronization included, until about 5 years ago when newer versions of Linux and its virtualization library libvirt evolved. We restored that SHM-access synchronization feature because it is indispensable for HPC and made ivshmem runnable with contemporary versions of Linux, libvirt, KVM, QEMU and especially MPICH, which is an implementation of MPI - the standard HPC communication library. Additionally, MPICH was transparently modified by us to get ivshmem included, resulting in a three to ten times performance improvement compared to TCP/IP. Furthermore, we have transparently replaced MPI_PUT, a single-side MPICH communication mechanism, by an own MPI_PUT wrapper. As a result, our ivshmem even surpasses non-virtualized SHM data transfers for block lengths greater than 512 KBytes, showing the benefits of virtualization. All improvements were possible without using SR-IOV.

MPAS-Ocean NESAP Status Report

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

Petersen, Mark Roger; Arndt, William; Keen, Noel

NESAP performance improvements on MPAS-Ocean have resulted in a 5% to 7% speed-up on each of the examined systems including Cori-KNL, Cori-Haswell, and Edison. These tests were configured to emulate a production workload by using 128 nodes and a high-resolution ocean domain. Overall, the gap between standard and many-core architecture performance has been narrowed, but Cori-KNL remains considerably under-performing relative to Edison. NESAP code alterations affected 600 lines of code, and most of these improvements will benefit other MPAS codes (sea ice, land ice) that are also components within ACME. Modifications are fully tested within MPAS. Testing in ACME acrossmore » many platforms is underway, and must be completed before the code is merged. In addition, a ten-year production ACME global simulation was conducted on Cori-KNL in late 2016 with the pre-NESAP code in order to test readiness and configurations for scientific studies. Next steps include assessing performance across a range of nodes, threads per node, and ocean resolutions on Cori-KNL.« less

An Ada inference engine for expert systems

NASA Technical Reports Server (NTRS)

Lavallee, David B.

1986-01-01

The purpose is to investigate the feasibility of using Ada for rule-based expert systems with real-time performance requirements. This includes exploring the Ada features which give improved performance to expert systems as well as optimizing the tradeoffs or workarounds that the use of Ada may require. A prototype inference engine was built using Ada, and rule firing rates in excess of 500 per second were demonstrated on a single MC68000 processor. The knowledge base uses a directed acyclic graph to represent production lines. The graph allows the use of AND, OR, and NOT logical operators. The inference engine uses a combination of both forward and backward chaining in order to reach goals as quickly as possible. Future efforts will include additional investigation of multiprocessing to improve performance and creating a user interface allowing rule input in an Ada-like syntax. Investigation of multitasking and alternate knowledge base representations will help to analyze some of the performance issues as they relate to larger problems.

Effects of pilates on patients with chronic non-specific low back pain: a systematic review

PubMed Central

Lin, Hui-Ting; Hung, Wei-Ching; Hung, Jia-Ling; Wu, Pei-Shan; Liaw, Li-Jin; Chang, Jia-Hao

2016-01-01

[Purpose] To evaluate the effects of Pilates on patients with chronic low back pain through a systematic review of high-quality articles on randomized controlled trials. [Subjects and Methods] Keywords and synonyms for “Pilates” and “Chronic low back pain” were used in database searches. The databases included PubMed, Physiotherapy Evidence Database (PEDro), Medline, and the Cochrane Library. Articles involving randomized controlled trials with higher than 5 points on the PEDro scale were reviewed for suitability and inclusion. The methodological quality of the included randomized controlled trials was evaluated using the PEDro scale. Relevant information was extracted by 3 reviewers. [Results] Eight randomized controlled trial articles were included. Patients with chronic low back pain showed statistically significant improvement in pain relief and functional ability compared to patients who only performed usual or routine health care. However, other forms of exercise were similar to Pilates in the improvement of pain relief and functional capacity. [Conclusion] In patients with chronic low back pain, Pilates showed significant improvement in pain relief and functional enhancement. Other exercises showed effects similar to those of Pilates, if waist or torso movement was included and the exercises were performed for 20 cumulative hours. PMID:27821970

Attention enhancing effects of methylphenidate are age-dependent

PubMed Central

Bhattacharya, Shevon E.; Shumsky, Jed S.; Waterhouse, Barry D.

2014-01-01

The psychostimulant methylphenidate (MPH, Ritalin®) is used to treat a variety of cognitive disorders. MPH is also popular among healthy individuals, including the elderly, for its ability to focus attention and improve concentration, but these effects have not been shown to be comparable between aged and adult subjects. Thus, we tested whether MPH would improve performance in sustained attention in both adult and aged rats. In addition, we tested the impact of visual distraction on performance in this task and the ability of MPH to mitigate the effects of distraction. Adult (6–12 months) and aged (18–22 months) male Sprague-Dawley rats were given oral MPH, and their cognitive and motor abilities were tested. Results suggest that while MPH improves task performance in adults; there is no improvement in the aged animals. These outcomes suggest that use of MPH for cognitive enhancement in elderly individuals may be ineffective. PMID:25449855

Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

PubMed

Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

2015-07-01

Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

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

PubMed Central

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

2018-01-01

Introduction Patients admitted to a critical care medicine (CCM) environment, including an intensive care unit (ICU), are susceptible to harm and significant resource utilisation. Therefore, a strategy to optimise provider performance is required. Performance scorecards are used by institutions for the purposes of driving quality improvement. There is no widely accepted or standardised scorecard that has been used for overall CCM performance. We aim to improve quality of care, patient safety and patient/family experience in CCM practice through the utilisation of a standardised, repeatable and multidimensional performance scorecard, designed to provide a continuous review of ICU physician and nurse practice, as well as departmental metrics. Methods and analysis This will be a mixed-methods, controlled before and after study to assess the impact of a CCM-specific quality scorecard. Scorecard metrics were developed through expert consensus and existing literature. The study will include 19 attending CCM physicians and approximately 300 CCM nurses. Patient data for scorecard compilation are collected daily from bedside flow sheets. Preintervention baseline data will be collected for 6 months for each participant. After this, each participant will receive their scorecard measures. Following a 3-month washout period, postintervention data will be collected for 6 months. The primary outcome will be change in performance metrics following the provision of scorecard feedback to subjects. A cost analysis will also be performed, with the purpose of comparing total ICU costs prior to implementation of the scorecard with total ICU costs following implementation of the scorecard. The qualitative portion will include interviews with participants following the intervention phase. Interviews will be analysed in order to identify recurrent themes and subthemes, for the purposes of driving scorecard improvement. Ethics and dissemination This protocol has been approved by the local research ethics board. Publication of results is anticipated in 2019. If this intervention is found to improve patient- and unit-directed outcomes, with evidence of cost-effectiveness, it would support the utilisation of such a scorecard as a quality standard in CCM. PMID:29358441

A systematic review of the efficacy of ergogenic aids for improving running performance.

PubMed

Schubert, Matthew M; Astorino, Todd A

2013-06-01

Running is a common form of activity worldwide, and participants range from "weekend warriors" to Olympians. Unfortunately, few studies have examined efficacy of various ergogenic aids in runners because the majority of the literature consists of cycling-based protocols, which do not relate to running performance. The majority of running studies conducted markedly vary in regards to specific distance completed, subject fitness level, and effectiveness of the ergogenic aid examined. The aim of this article was to systematically examine the literature concerning utility of several ergogenic aids on middle-distance running (400-5,000 m) and long-distance running (10,000 meters marathon = 42.2 km) performance. In addition, this article highlights the dearth of running-specific studies in the literature and addresses recommendations for future research to optimize running performance through nutritional intervention. Results revealed 23 studies examining effects of various ergogenic aids on running performance, with a mean Physiotherapy Evidence Database score equal to 7.85 ± 0.70. Of these studies, 71% (n = 15) demonstrated improved running performance with ergogenic aid ingestion when compared with a placebo trial. The most effective ergogenic aids for distances from 400 m to 40 km included sodium bicarbonate (4 studies; 1.5 ± 1.1% improvement), sodium citrate (6 studies; 0.3 ± 1.7% improvement), caffeine (CAFF) (7 studies; 1.1 ± 0.4% improvement), and carbohydrate (CHO) (6 studies; 4.1 ± 4.4% improvement). Therefore, runners may benefit from ingestion of sodium bicarbonate to enhance middle distance performance and caffeine and carbohydrate to enhance performance at multiple distances.

Some Improvements in H-PDLCs

NASA Technical Reports Server (NTRS)

Crawford, Gregory P.; Li, Liuliu

2005-01-01

Some improvements have been made in the formulation of holographically formed polymer-dispersed liquid crystals (H-PDLCs) and in the fabrication of devices made from these materials, with resulting improvements in performance. H-PDLCs are essentially volume Bragg gratings. Devices made from H-PDLCs function as electrically switchable reflective filters. Heretofore, it has been necessary to apply undesirably high drive voltages in order to switch H-PDLC devices. Many scientific papers on H-PDLCs and on the potential utility of H-PDLC devices for display and telecommunication applications have been published. However, until now, little has been published about improving quality control in synthesis of H-PDLCs and fabrication of H-PDLC devices to minimize (1) spatial nonuniformities within individual devices, (2) nonuniformities among nominally identical devices, and (3) variations in performance among nominally identical devices. The improvements reported here are results of a research effort directed partly toward solving these quality-control problems and partly toward reducing switching voltages. The quality-control improvements include incorporation of a number of process controls to create a relatively robust process, such that the H-PDLC devices fabricated in this process are more nearly uniform than were those fabricated in a prior laboratory-type process. The improved process includes ultrasonic mixing, ultrasonic cleaning, the use of a micro dispensing technique, and the use of a bubble press.

Addition by Subtraction: The Relation Between Dropout Rates and School-Level Academic Achievement

PubMed Central

GLENNIE, ELIZABETH; BONNEAU, KARA; VANDELLEN, MICHELLE; DODGE, KENNETH A.

2013-01-01

Background/Context Efforts to improve student achievement should increase graduation rates. However, work investigating the effects of student-level accountability has consistently demonstrated that increases in the standards for high school graduation are correlated with increases in dropout rates. The most favored explanation for this finding is that high-stakes testing policies that mandate grade repetition and high school exit exams may be the tipping point for students who are already struggling academically. These extra demands may, in fact, push students out of school. Purpose/Objective/Focus This article examines two hypotheses regarding the relation between school-level accountability and dropout rates. The first posits that improvements in school performance lead to improved success for everyone. If school-level accountability systems improve a school for all students, then the proportion of students performing at grade level increases, and the dropout rate decreases. The second hypothesis posits that schools facing pressure to improve their overall accountability score may pursue this increase at the cost of other student outcomes, including dropout rate. Research Design Our approach focuses on the dynamic relation between school-level academic achievement and dropout rates over time—that is, between one year’s achievement and the subsequent year’s dropout rate, and vice versa. This article employs longitudinal data of records on all students in North Carolina public schools over an 8-year period. Analyses employ fixed-effects models clustering schools and districts within years and controls each year for school size, percentage of students who were free/reduced-price lunch eligible, percentage of students who are ethnic minorities, and locale. Findings/Results This study finds partial evidence that improvements in school-level academic performance will lead to improvements (i.e., decreases) in school-level dropout rates. Schools with improved performance saw decreased dropout rates following these successes. However, we find more evidence of a negative side of the quest for improved academic performance. When dropout rates increase, the performance composites in subsequent years increase. Conclusions/recommendations Accountability systems need to remove any indirect benefit a school may receive from increasing its dropout rate. Schools should be held accountable for those who drop out of school. Given the personal and social costs of dropping out, accountability systems need to place more emphasis on dropout prevention. Such an emphasis could encompass increasing the dropout age and having the school’s performance composite include scores of zero on end-of-grade tests for those who leave school. PMID:24013958

Progress in performance enhancement methods for capacitive silicon resonators

NASA Astrophysics Data System (ADS)

Van Toan, Nguyen; Ono, Takahito

2017-11-01

In this paper, we review the progress in recent studies on the performance enhancement methods for capacitive silicon resonators. We provide information on various fabrication technologies and design considerations that can be employed to improve the performance of capacitive silicon resonators, including low motional resistance, small insertion loss, and high quality factor (Q). This paper contains an overview of device structures and working principles, fabrication technologies consisting of hermetic packaging, deep reactive-ion etching and neutral beam etching, and design considerations including mechanically coupled, movable electrode structures and piezoresistive heat engines.

Improved Steam Turbine Leakage Control with a Brush Seal Design

NASA Astrophysics Data System (ADS)

Turnquist, Norman; Chupp, Raymond E.; Pastrana, Ryan; Wolfe, Chris; Burnett, Mark

2002-10-01

This paper presents an improved steam turbine leakage control system with a brush seal design. The contents include: 1) Typical Design Characteristics; 2) Typical Brush Seal Locations; 3) Reduced Leakage Rates; 4) Performance Benefits; 5) System Considerations; 6) Rotor Dynamics; 7) Laboratory Tests and 8) Field Experience.

Minding Their Business: What Employers Look for in School-to-Career Programs.

ERIC Educational Resources Information Center

Kazis, Richard

1999-01-01

Besides providing work experiences, employers can help educators improve student performance by influencing public-policy decisions and changing their own employment policies. Employers' reasons for participating in work-based-learning programs include philanthropic interest, particular labor needs, and desire to improve a community's labor…

Voices from the Field: How School Boards Can Support Districtwide School Improvement Efforts. Newsletter

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2009

2009-01-01

Leadership is crucial for effective, lasting school improvement. Although research has established that strong, competent principals are vital for high-performing schools (Hallinger, 2003; Leithwood, 1994), attention is turning increasingly to the importance of effective district leadership, including school boards and their contributions to…

Traditional Labs + New Questions = Improved Student Performance.

ERIC Educational Resources Information Center

Rezba, Richard J.; And Others

1992-01-01

Presents three typical lab activities involving the breathing rate of fish, the behavior of electromagnets, and tests for water hardness to demonstrate how labs can be modified to teach process skills. Discusses how basic concepts about experimentation are developed and ways of generating and improving science experiments. Includes a laboratory…

Method of improving fuel cell performance by removing at least one metal oxide contaminant from a fuel cell electrode

DOEpatents

Kim, Yu Seung [Los Alamos, NM; Choi, Jong-Ho [Los Alamos, NM; Zelenay, Piotr [Los Alamos, NM

2009-08-18

A method of removing contaminants from a fuel cell catalyst electrode. The method includes providing a getter electrode and a fuel cell catalyst electrode having at least one contaminant to a bath and applying a voltage sufficient to drive the contaminant from the fuel cell catalyst electrode to the getter electrode. Methods of removing contaminants from a membrane electrode assembly of a fuel cell and of improving performance of a fuel cell are also provided.

Tool Efficiency Analysis model research in SEMI industry

NASA Astrophysics Data System (ADS)

Lei, Ma; Nana, Zhang; Zhongqiu, Zhang

2018-06-01

One of the key goals in SEMI industry is to improve equipment through put and ensure equipment production efficiency maximization. This paper is based on SEMI standards in semiconductor equipment control, defines the transaction rules between different tool states, and presents a TEA system model which is to analysis tool performance automatically based on finite state machine. The system was applied to fab tools and verified its effectiveness successfully, and obtained the parameter values used to measure the equipment performance, also including the advices of improvement.

Solar Technology Validation Project - USS Data, LLC: Cooperative Research and Development Final Report, CRADA Number CRD-09-367-04

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

Wilcox, S.

2013-08-01

Under this Agreement, NREL will work with Participant to improve concentrating solar power system performance characterizations. This work includes, but is not limited to, research and development of methods for acquiring renewable resource characterization information using site-specific measurements of solar radiation and meteorological conditions; collecting system performance data; and developing tools for improving the design, installation, operation, and maintenance of solar energy conversion systems. This work will be conducted at NREL and Participant facilities.

Solar Technology Validation Project - RES Americas: Cooperative Research and Development Final Report, CRADA Number CRD-09-367-11

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

Wilcox, S.

Under this Agreement, NREL will work with Participant to improve concentrating solar power system performance characterizations. This work includes, but is not limited to, research and development of methods for acquiring renewable resource characterization information using site-specific measurements of solar radiation and meteorological conditions; collecting system performance data; and developing tools for improving the design, installation, operation, and maintenance of solar energy conversion systems. This work will be conducted at NREL and Participant facilities.

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis.

PubMed

Vanderveen, J A; Bassler, D; Robertson, C M T; Kirpalani, H

2009-05-01

To determine in a systematic review, whether interventions for infant development that involve parents, improve neurodevelopment at 12 months corrected age or older. Randomized trials were identified where an infant intervention was aimed to improve development and involved parents of preterms; and long-term neurodevelopment using standardized tests at 12 months (or longer) was reported. Identified studies (n=25) used a variety of interventions including parent education, infant stimulation, home visits or individualized developmental care. Meta-analysis at 12 months (N=2198 infants) found significantly higher mental (N=2198) and physical (N=1319) performance scores favoring the intervention group. At 24 months, the mental (N=1490) performance scores were improved, but physical (N=1025) performance scores were not statistically significant. The improvement in neurodevelopmental outcome was not sustained at 36 months (N=961) and 5 years (N=1017). Positive clinically meaningful effects (>5 points) are seen to an age of 36 months, but are no longer present at 5 years.

Cockpit integration from a pilot's point of view

NASA Technical Reports Server (NTRS)

Green, D. L.

1982-01-01

Extensive experience in both operational and engineering test flight was used to suggest straightforward changes to helicopter cockpit and control system design that would improve pilot performance in marginal and instrument flight conditions. Needed control system improvements considered include: (1) separation of yaw from cyclic force trim; (2) pedal force proportional to displacement rate; and (3) integration of engine controls in collective stick. Display improvements needed include: (1) natural cuing of yaw rate in attitude indicator; (2) collective position indication and radar altimeter placed within primary scan; and (3) omnidirectional display of full range airspeed data.

Electron beam curing — taking good ideas to the manufacturing floor

NASA Astrophysics Data System (ADS)

Saunders, C.; Lopata, V.; Barnard, J.; Stepanik, T.

2000-03-01

Acsion is exploiting several emerging electron beam EB applications ranging from composite curing and repair to viscose manufacturing. EB curing of composite structures offers several advantages: significantly reduced curing times; improvements in part quality and performance; reduced environmental and health concerns; improvements in material handling; and reduced overall manufacturing costs compared to thermal curing. The aerospace industry is developing EB technology in all of their market sectors, including military aviation and space products. Some specific products include cryogenic fuel tanks, improved canopy frames for jet aircraft, and the all-composite military aircraft. This paper discusses each of these opportunities.

Improving Use of Prehospital 12-Lead Electrocardiography for Early Identification and Treatment of Acute Coronary Syndrome and ST-Elevation Myocardial Infarction

PubMed Central

Daudelin, Denise H.; Sayah, Assaad J.; Kwong, Manlik; Restuccia, Marc C.; Porcaro, William A.; Ruthazer, Robin; Goetz, Jessica D.; Lane, William M.; Beshansky, Joni R.; Selker, Harry P.

2010-01-01

Background Performance of Prehospital electrocardiograms (PH-ECGs) expedites identification of ST-elevation myocardial infarction (STEMI) and reduces door-to-balloon (D2B) times for patients receiving reperfusion therapy. To fully realize this benefit, emergency medical service (EMS) performance must be measured and used in feedback reporting and quality improvement (QI). Methods and Results This quasi-experimental design trial tested an approach to improving EMS PH-ECG using feedback reporting and QI interventions in two cities' EMS agencies and receiving hospitals. All patients ≥ 30 years, calling 9-1-1 with possible acute coronary syndrome (ACS) were included. In total 6,994 patients were included: 1,589 patients in the baseline period without feedback and 5,405 in the intervention period when there were feedback reports and QI interventions. Mean age (SD) was 66 (±17) and women represented 51%. Feedback and QI increased PH-ECG performance for patients with ACS from 76% to 93% (p=<.0001) and for patients with STEMI from 77% to 99% (p= <.0001). Aspirin administration increased from 75% to 82% (p=0.001) but the median total EMS run time remained the same at 22 minutes. The proportion of patients with D2B times of ≤90 minutes increased from 27% to 67% (p=0.006). Conclusion Feedback reports and QI improved PH-ECG performance for patients with ACS and STEMI and increased aspirin administration, without prehospital transport delays. Improvements in D2B times were also seen. PMID:20484201

What is 3D good for? A review of human performance on stereoscopic 3D displays

NASA Astrophysics Data System (ADS)

McIntire, John P.; Havig, Paul R.; Geiselman, Eric E.

2012-06-01

This work reviews the human factors-related literature on the task performance implications of stereoscopic 3D displays, in order to point out the specific performance benefits (or lack thereof) one might reasonably expect to observe when utilizing these displays. What exactly is 3D good for? Relative to traditional 2D displays, stereoscopic displays have been shown to enhance performance on a variety of depth-related tasks. These tasks include judging absolute and relative distances, finding and identifying objects (by breaking camouflage and eliciting perceptual "pop-out"), performing spatial manipulations of objects (object positioning, orienting, and tracking), and navigating. More cognitively, stereoscopic displays can improve the spatial understanding of 3D scenes or objects, improve memory/recall of scenes or objects, and improve learning of spatial relationships and environments. However, for tasks that are relatively simple, that do not strictly require depth information for good performance, where other strong cues to depth can be utilized, or for depth tasks that lie outside the effective viewing volume of the display, the purported performance benefits of 3D may be small or altogether absent. Stereoscopic 3D displays come with a host of unique human factors problems including the simulator-sickness-type symptoms of eyestrain, headache, fatigue, disorientation, nausea, and malaise, which appear to effect large numbers of viewers (perhaps as many as 25% to 50% of the general population). Thus, 3D technology should be wielded delicately and applied carefully; and perhaps used only as is necessary to ensure good performance.

Handling performance control for hybrid 8-wheel-drive vehicle and simulation verification

NASA Astrophysics Data System (ADS)

Ni, Jun; Hu, Jibin

2016-08-01

In order to improve handling performance of a hybrid 8-Wheel-Drive vehicle, the handling performance control strategy was proposed. For armoured vehicle, besides handling stability in high speed, the minimum steer radius in low speed is also a key tactical and technical index. Based on that, the proposed handling performance control strategy includes 'Handling Stability' and 'Radius Minimization' control modes. In 'Handling Stability' control mode, 'Neutralsteer Radio' is defined to adjust the steering characteristics to satisfy different demand in different speed range. In 'Radius Minimization' control mode, the independent motors are controlled to provide an additional yaw moment to decrease the minimum steer radius. In order to verify the strategy, a simulation platform was built including engine and continuously variable transmission systems, generator and battery systems, independent motors and controllers systems, vehicle dynamic and tyre mechanical systems. The simulation results show that the handling performance of the vehicle can be enhanced significantly, and the minimum steer radius can be decreased by 20% which is significant improvement compared to the common level of main battle armoured vehicle around the world.

Fluid infusion system

NASA Technical Reports Server (NTRS)

1974-01-01

Performance testing carried out in the development of the prototype zero-g fluid infusion system is described and summarized. Engineering tests were performed in the course of development, both on the original breadboard device and on the prototype system. This testing was aimed at establishing baseline system performance parameters and facilitating improvements. Acceptance testing was then performed on the prototype system to verify functional performance. Acceptance testing included a demonstration of the fluid infusion system on a laboratory animal.

Transforming cold chain performance and management in lower-income countries.

PubMed

Brison, Mike; LeTallec, Yann

2017-04-19

In many countries, one of the common factors limiting full and equitable access to effective immunization is the existence of gaps in cold chain and logistics (CCL) systems. This article focuses on the critical contribution that better management of CCL performance can make in addressing these barriers, as well as some essential practices needed to achieve and sustain these gains. These include (i) an emphasis on continuous improvement in CCL performance indicators, (ii) strong coordination and accountability across multiple stakeholders, and (iii) making the most of limited financial resources. This article is informed by the Clinton Health Access Initiative's (CHAI's) experience working with National Immunization Programs (NIPs) and immunization partners to improve the effectiveness and efficiency of CCL systems (including CCE deployment and maintenance, temperature monitoring and control, stock management and distribution) across ten Gavi-supported "focus" countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Analysing the performance of in vitro fertilization clinics in the United Kingdom.

PubMed

Mohammed, Mohammed A; Leary, Christine

2006-09-01

During the past century, the manufacturing industry has achieved major successes in improving the quality of its products. An essential factor in these successes has been the use of Walter A. Shewhart's pioneering work in the economic control of variation, which culminated in the development of a simple yet powerful theory of variation, which classifies variation as having a common or special cause and thus guides the user to the most appropriate action to effect improvement. Using publicly available performance data, which includes percentage of live births and multiple births, for in vitro fertilization (IVF) clinics in the United Kingdom, we show a central role for Shewhart's approach in moving away from the limitations and controversies associated with performance league tables towards data analyses to support continual improvement. We outline strategies for dealing with common and special causes of variation in IVF clinic performance data.

Monolayer-Mediated Growth of Organic Semiconductor Films with Improved Device Performance.

PubMed

Huang, Lizhen; Hu, Xiaorong; Chi, Lifeng

2015-09-15

Increased interest in wearable and smart electronics is driving numerous research works on organic electronics. The control of film growth and patterning is of great importance when targeting high-performance organic semiconductor devices. In this Feature Article, we summarize our recent work focusing on the growth, crystallization, and device operation of organic semiconductors intermediated by ultrathin organic films (in most cases, only a monolayer). The site-selective growth, modified crystallization and morphology, and improved device performance of organic semiconductor films are demonstrated with the help of the inducing layers, including patterned and uniform Langmuir-Blodgett monolayers, crystalline ultrathin organic films, and self-assembled polymer brush films. The introduction of the inducing layers could dramatically change the diffusion of the organic semiconductors on the surface and the interactions between the active layer with the inducing layer, leading to improved aggregation/crystallization behavior and device performance.

Multiparametric ultrasound in the detection of prostate cancer: a systematic review.

PubMed

Postema, Arnoud; Mischi, Massimo; de la Rosette, Jean; Wijkstra, Hessel

2015-11-01

To investigate the advances and clinical results of the different ultrasound modalities and the progress in combining them into multiparametric UltraSound (mpUS). A systematic literature search on mpUS and the different ultrasound modalities included: greyscale ultrasound, computerized transrectal ultrasound, Doppler and power Doppler techniques, dynamic contrast-enhanced ultrasound and (shear wave) elastography. Limited research available on combining ultrasound modalities has presented improvement in diagnostic performance. The data of two studies suggest that even adding a lower performing ultrasound modality to a better performing modality using crude methods can already improve the sensitivity by 13-51 %. The different modalities detect different tumours. No study has tried to combine ultrasound modalities employing a system similar to the PIRADS system used for mpMRI or more advanced classifying algorithms. Available evidence confirms that combining different ultrasound modalities significantly improves diagnostic performance.

Hybrid Power Management Program Continued

NASA Technical Reports Server (NTRS)

Eichenberg, Dennis J.

2002-01-01

Hybrid Power Management (HPM) is the innovative integration of diverse, state-of-the-art power devices in an optimal configuration for space and terrestrial applications. The appropriate application and control of the various power devices significantly improves overall system performance and efficiency. The advanced power devices include ultracapacitors and photovoltaics. HPM has extremely wide potential with applications including power-generation, transportation, biotechnology, and space power systems. It may significantly alleviate global energy concerns, improve the environment, and stimulate the economy.

A multistage approach to improve performance of computer-aided detection of pulmonary embolisms depicted on CT images: preliminary investigation.

PubMed

Park, Sang Cheol; Chapman, Brian E; Zheng, Bin

2011-06-01

This study developed a computer-aided detection (CAD) scheme for pulmonary embolism (PE) detection and investigated several approaches to improve CAD performance. In the study, 20 computed tomography examinations with various lung diseases were selected, which include 44 verified PE lesions. The proposed CAD scheme consists of five basic steps: 1) lung segmentation; 2) PE candidate extraction using an intensity mask and tobogganing region growing; 3) PE candidate feature extraction; 4) false-positive (FP) reduction using an artificial neural network (ANN); and 5) a multifeature-based k-nearest neighbor for positive/negative classification. In this study, we also investigated the following additional methods to improve CAD performance: 1) grouping 2-D detected features into a single 3-D object; 2) selecting features with a genetic algorithm (GA); and 3) limiting the number of allowed suspicious lesions to be cued in one examination. The results showed that 1) CAD scheme using tobogganing, an ANN, and grouping method achieved the maximum detection sensitivity of 79.2%; 2) the maximum scoring method achieved the superior performance over other scoring fusion methods; 3) GA was able to delete "redundant" features and further improve CAD performance; and 4) limiting the maximum number of cued lesions in an examination reduced FP rate by 5.3 times. Combining these approaches, CAD scheme achieved 63.2% detection sensitivity with 18.4 FP lesions per examination. The study suggested that performance of CAD schemes for PE detection depends on many factors that include 1) optimizing the 2-D region grouping and scoring methods; 2) selecting the optimal feature set; and 3) limiting the number of allowed cueing lesions per examination.

Use of Bacillus Subtilis PB6 as a potential antibiotic growth promoter replacement in improving performance of broiler birds.

PubMed

Jayaraman, Sathishkumar; Das, Partha Pratim; Saini, Prakash Chandra; Roy, Barun; Chatterjee, Paresh Nath

2017-08-01

The intestinal gut health is one of the primary determinants of broiler growth and performance. Among the various enteric diseases, necrotic enteritis (NE) is an enterotoxemic disease caused by Clostridium perfringens, which can result in severe economic losses in poultry farming. Antibiotics like bacitracin methylene disalicylate (BMD) and avilamycin (AVL) are commonly used antibiotic growth promoters (AGP) in poultry feed to control necrotic enteritis in birds. Bacillus subtilis PB6 was reported to prevent necrotic enteritis and improve performance in birds. This paper investigated the influence of Bacillus subtilis PB6 in improving the performance of broiler birds in comparison with BMD and avilamycin. A 35 day trial was conducted with 240 day-old commercial broiler chicks (VenCobb 400), which were divided into four treatment groups, where each treatment group was composed of 6 replicates each containing 10 birds, for a total of 60 birds per treatment. The treatment groups included a negative control (no AGP), Bacillus subtilis PB6, BMD, and avilamycin. The parameters analyzed included body weight, feed conversion ratio (FCR), mortality, villus histomorphometry, and European efficiency factor (EEF). Bacillus subtilis PB6 significantly (P < 0.05) improved body weight and FCR (8 points) compared to the control. The group supplemented with B. subtilis PB6 or BMD had higher (P < 0.05) body weight compared to all other treatment groups. The supplementation of B. subtilis PB6 significantly improved the villus height (P < 0.05) compared to control and other AGP groups. The EEF was found to be the highest in the B. subtilis PB6 supplemented group at 35th day as compared to other treatment groups. The combined data from this study indicate that supplementation of B. subtilis PB6 improves overall performance of broilers compared to BMD and avilamycin, and can be used as potential AGP replacement in poultry farming. © 2017 Poultry Science Association Inc.

Recent Development of Augmented Reality in Surgery: A Review.

PubMed

Vávra, P; Roman, J; Zonča, P; Ihnát, P; Němec, M; Kumar, J; Habib, N; El-Gendi, A

2017-01-01

The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms "augmented reality" and "surgery." Results . The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice.

The effect of Tai Chi on four chronic conditions-cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses.

PubMed

Chen, Yi-Wen; Hunt, Michael A; Campbell, Kristin L; Peill, Kortni; Reid, W Darlene

2016-04-01

Many middle-aged and older persons have more than one chronic condition. Thus, it is important to synthesise the effectiveness of interventions across several comorbidities. The aim of this systematic review was to summarise current evidence regarding the effectiveness of Tai Chi in individuals with four common chronic conditions-cancer, osteoarthritis (OA), heart failure (HF) and chronic obstructive pulmonary disease (COPD). 4 databases (MEDLINE, EMBASE, CINAHL and SPORTDiscus) were searched for original articles. Two reviewers independently screened the titles and abstracts and then conducted full-text reviews, quality assessment and finally data abstraction. 33 studies met the inclusion criteria. Meta-analyses were performed on disease-specific symptoms, physiological outcomes and physical performance of each chronic condition. Subgroup analyses on disease-specific symptoms were conducted by categorising studies into subsets based on the type of comparison groups. Meta-analyses showed that Tai Chi improved or showed a tendency to improve physical performance outcomes, including 6-min walking distance (6MWD) and knee extensor strength, in most or all four chronic conditions. Tai Chi also improved disease-specific symptoms of pain and stiffness in OA. The results demonstrated a favourable effect or tendency of Tai Chi to improve physical performance and showed that this type of exercise could be performed by individuals with different chronic conditions, including COPD, HF and OA. 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/

Benchmark for Strategic Performance Improvement.

ERIC Educational Resources Information Center

Gohlke, Annette

1997-01-01

Explains benchmarking, a total quality management tool used to measure and compare the work processes in a library with those in other libraries to increase library performance. Topics include the main groups of upper management, clients, and staff; critical success factors for each group; and benefits of benchmarking. (Author/LRW)

Methods for identifying high collision concentrations for identifying potential safety improvements : development of advanced type 2 safety performance functions.

DOT National Transportation Integrated Search

2016-06-30

This research developed advanced type 2 safety performance functions (SPF) for roadway segments, intersections and ramps on the entire Caltrans network. The advanced type 2 SPFs included geometrics, traffic volume and hierarchical random effects, whi...

Using Internet Technologies To Enhance Training.

ERIC Educational Resources Information Center

Pollock, Carl; Masters, Robert

1997-01-01

Describes how to use Internet technologies to create an intranet, or an online training database system, for improving company communications, effectiveness, and job performance. Topics include technology and performance; educating managers and key decision makers; creating a graphic model of the training system; and fitting into the existing…

The E-business Revolution and Human Performance.

ERIC Educational Resources Information Center

Harmon, Paul

2001-01-01

Provides an overview of the electronic business (e-business) revolution and suggests ways it will affect human performance improvement professionals. Highlights include customer reliance on the Web; use of the Internet and associated software to link employees, applications, and companies; information access and sharing; business-to-consumer and…

Stronger by Degrees: 2012-13 Accountability Report

ERIC Educational Resources Information Center

Kentucky Council on Postsecondary Education, 2014

2014-01-01

The annual "Accountability Report" produced by the Council on Postsecondary Education highlights the system's performance on the state-level metrics included in "Stronger by Degrees: A Strategic Agenda for Kentucky Postsecondary and Adult Education." For each metric, we outline steps taken to improve performance, as well as…

School Gardens Enhance Academic Performance and Dietary Outcomes in Children.

PubMed

Berezowitz, Claire K; Bontrager Yoder, Andrea B; Schoeller, Dale A

2015-08-01

Schools face increasing demands to provide education on healthy living and improve core academic performance. Although these appear to be competing concerns, they may interact beneficially. This article focuses on school garden programs and their effects on students' academic and dietary outcomes. Database searches in CABI, Web of Science, Web of Knowledge, PubMed, Education Full Text, Education Resources Information Center (ERIC), and PsychINFO were conducted through May 2013 for peer-reviewed literature related to school-day garden interventions with measures of dietary and/or academic outcomes. Among 12 identified garden studies with dietary measures, all showed increases/improvements in predictors of fruit and vegetable (FV) consumption. Seven of these also included self-reported FV intake with 5 showing an increase and 2 showing no change. Four additional interventions that included a garden component measured academic outcomes; of these, 2 showed improvements in science achievement and 1 measured and showed improvements in math scores. This small set of studies offers evidence that garden-based learning does not negatively impact academic performance or FV consumption and may favorably impact both. Additional studies with more robust experimental designs and outcome measures are necessary to understand the effects of experiential garden-based learning on children's academic and dietary outcomes. © 2015, American School Health Association.

Perceptual learning improves visual performance in juvenile amblyopia.

PubMed

Li, Roger W; Young, Karen G; Hoenig, Pia; Levi, Dennis M

2005-09-01

To determine whether practicing a position-discrimination task improves visual performance in children with amblyopia and to determine the mechanism(s) of improvement. Five children (age range, 7-10 years) with amblyopia practiced a positional acuity task in which they had to judge which of three pairs of lines was misaligned. Positional noise was produced by distributing the individual patches of each line segment according to a Gaussian probability function. Observers were trained at three noise levels (including 0), with each observer performing between 3000 and 4000 responses in 7 to 10 sessions. Trial-by-trial feedback was provided. Four of the five observers showed significant improvement in positional acuity. In those four observers, on average, positional acuity with no noise improved by approximately 32% and with high noise by approximately 26%. A position-averaging model was used to parse the improvement into an increase in efficiency or a decrease in equivalent input noise. Two observers showed increased efficiency (51% and 117% improvements) with no significant change in equivalent input noise across sessions. The other two observers showed both a decrease in equivalent input noise (18% and 29%) and an increase in efficiency (17% and 71%). All five observers showed substantial improvement in Snellen acuity (approximately 26%) after practice. Perceptual learning can improve visual performance in amblyopic children. The improvement can be parsed into two important factors: decreased equivalent input noise and increased efficiency. Perceptual learning techniques may add an effective new method to the armamentarium of amblyopia treatments.

Algorithm Improvement Program Nuclide Identification Algorithm Scoring Criteria And Scoring Application - DNDO.

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

Enghauser, Michael

2015-02-01

The goal of the Domestic Nuclear Detection Office (DNDO) Algorithm Improvement Program (AIP) is to facilitate gamma-radiation detector nuclide identification algorithm development, improvement, and validation. Accordingly, scoring criteria have been developed to objectively assess the performance of nuclide identification algorithms. In addition, a Microsoft Excel spreadsheet application for automated nuclide identification scoring has been developed. This report provides an overview of the equations, nuclide weighting factors, nuclide equivalencies, and configuration weighting factors used by the application for scoring nuclide identification algorithm performance. Furthermore, this report presents a general overview of the nuclide identification algorithm scoring application including illustrative examples.

A Global Evaluation of Coral Reef Management Performance: Are MPAs Producing Conservation and Socio-Economic Improvements?

NASA Astrophysics Data System (ADS)

Hargreaves-Allen, Venetia; Mourato, Susana; Milner-Gulland, Eleanor Jane

2011-04-01

There is a consensus that Marine Protected Area (MPA) performance needs regular evaluation against clear criteria, incorporating counterfactual comparisons of ecological and socio-economic performance. However, these evaluations are scarce at the global level. We compiled self-reports from managers and researchers of 78 coral reef-based MPAs world-wide, on the conservation and welfare improvements that their MPAs provide. We developed a suite of performance measures including fulfilment of design and management criteria, achievement of aims, the cessation of banned or destructive activities, change in threats, and measurable ecological and socio-economic changes in outcomes, which we evaluated with respect to the MPA's age, geographical location and main aims. The sample was found to be broadly representative of MPAs generally, and suggests that many MPAs do not achieve certain fundamental aims including improvements in coral cover over time (in 25% of MPAs), and conflict reduction (in 25%). However, the large majority demonstrated improvements in terms of slowing coral loss, reducing destructive uses and increasing tourism and local employment, despite many being small, underfunded and facing multiple large scale threats beyond the control of managers. However spatial comparisons suggest that in some regions MPAs are simply mirroring outside changes, with demonstrates the importance of testing for additionality. MPA benefits do not appear to increase linearly over time. In combination with other management efforts and regulations, especially those relating to large scale threat reduction and targeted fisheries and conflict resolution instruments, MPAs are an important tool to achieve coral reef conservation globally. Given greater resources and changes which incorporate best available science, such as larger MPAs and no-take areas, networks and reduced user pressure, it is likely that performance could further be enhanced. Performance evaluation should test for the generation of additional ecological and socio-economic improvements over time and compared to unmanaged areas as part of an adaptive management regime.

Seizing market shaping opportunities for vaccine cold chain equipment.

PubMed

Azimi, Tara; Franzel, Lauren; Probst, Nina

2017-04-19

Gavi, the Vaccine Alliance, supports immunisation programmes in eligible countries to reach children with lifesaving vaccines. Dramatic improvement in the scale and performance of current cold chain systems is required to extend the reach of immunisation services - especially for children living in remote locations - to advance progress towards full vaccine coverage. Achieving these improvements will require a healthier market for cold chain equipment where the products meet user needs, are sustainably priced, and are available in sufficient quantities to meet demand. Yet evidence suggests that the cold chain market has suffered from several failures including limited demand visibility, fragmented procurement, and insufficient information exchange between manufacturers and buyers on needs and equipment performance. One of Gavi's strategic goals is to shape markets for vaccines and other immunisation products, including cold chain equipment and in 2015, Gavi created a new mechanism - the Cold Chain Equipment (CCE) Optimisation Platform - to strengthen country cold chain systems by offering financial support and incentives for higher performing CCE. The main objective of the CCE Platform is to get more equipment that is efficient, sustainable, and better performing deployed to every health facility where it is required at an affordable price. To achieve these objectives, Gavi is putting in place tested market shaping approaches and tools adapted for the CCE market: the development of market strategies or 'roadmaps'; improvement of product performance through the development of target product profiles (TPPs); strategic engagement with CCE manufacturers and countries to enhance information sharing; and tailoring procurement tactics to the CCE market. These approaches and tools will allow for increased demand and supply of higher-performing, cost-effective and quality products. By strengthening immunisation systems with improved cold chain equipment, Gavi countries can begin to address the underlying problems limiting vaccine availability and improve the coverage and equity of vaccines. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

[Evolution of type 2 diabetes and carbohydrate intolerance following bariatric surgery in a Mexican mestizo population].

PubMed

Ramírez-Avilés, Eva; Espinosa-González, Omar; Amado-Galván, Mónica; Maydón-González, Hernán; Sepúlveda-Guerrero, Elisa; Zerrweck-López, Carlos

Bariatric surgery continues to be the best treatment for weight loss and control of obesity related comorbidities. Gastric bypass and sleeve gastrectomy have demonstrated to be the most effective surgeries, but this has not been established in a Mexican (non-American) population. To analyse the improvement in type 2 diabetes mellitus and carbohydrate intolerance in obese patients after bariatric surgery. A retrospective analysis was performed on the data collected prospectively between 2013 and 2015 on every obese patient with diabetes and carbohydrate intolerance submitted for bariatric surgery. Analysis was performed at baseline, and at 1, 3, 6, 9 and 12 months, and included metabolic, clinical, lipid, and anthropometrical parameters. A peri-operative and morbidity and mortality analysis was also performed. Remission rates for patients with diabetes were also established. The analysis included 73 patients, 46 with diabetes and 27 with carbohydrate intolerance. Sixty-two patients were female with a mean age of 42 years. Baseline glucose and glycosylated haemoglobin were 123±34mg/dl and 6.8±1.6%, and at 12 months they were 90.1±8mg/dl and 5.4±0.3%, respectively. Diabetes remission was observed in 68.7% of patients, including 9.3% with partial remission and 21.8% with an improvement. There was also a significant improvement in all metabolic and non-metabolic parameters. Bariatric surgery safely improves the metabolic status of patients with diabetes mellitus or carbohydrate intolerance during the first year, inducing high rates of complete remission. It has also shown a significant improvement on blood pressure, lipid, and anthropometric parameters during the first year of follow-up. Copyright © 2017 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Improved ETA-II accelerator performance

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

Paul, A C; Boyd, J K; Chen, Y J

1999-03-22

Improvements have been made in the performance of the ETA-II accelerator that allow a nominal 2 kA, 6 MeV beam to be focused to a spot size less that 1 mm in diameter. The improvements include reducing the energy sweep to less than +/- 0.5 & over 40 ns of the pulse using a real time energy diagnostic and improving the magnetic tune of the accelerator to reduce the emittance to 8 cm-mrad. Finally, an automated tuning system (MAESTRO) was run to minimize the time dependent centroid motion (corkscrew) by adjusting the steering dipoles over the focusing solenoids. The corkscrewmore » motion was reduced to less than +/- 0.5 mm at the output of the accelerator.« less

47 CFR 32.6720 - General and administrative.

Code of Federal Regulations, 2013 CFR

2013-10-01

... corporate image advertising activities; (4) Administering relations, including negotiating contracts, with... improvements. (j) Performing general administrative activities not directly charged to the user, and not...

47 CFR 32.6720 - General and administrative.

Code of Federal Regulations, 2011 CFR

2011-10-01

... corporate image advertising activities; (4) Administering relations, including negotiating contracts, with... improvements. (j) Performing general administrative activities not directly charged to the user, and not...

47 CFR 32.6720 - General and administrative.

Code of Federal Regulations, 2014 CFR

2014-10-01

... corporate image advertising activities; (4) Administering relations, including negotiating contracts, with... improvements. (j) Performing general administrative activities not directly charged to the user, and not...

47 CFR 32.6720 - General and administrative.

Code of Federal Regulations, 2012 CFR

2012-10-01

... corporate image advertising activities; (4) Administering relations, including negotiating contracts, with... improvements. (j) Performing general administrative activities not directly charged to the user, and not...

Training Compliance Control Yields Improvements in Drawing as a Function of Beery Scores

PubMed Central

Snapp-Childs, Winona; Flatters, Ian; Fath, Aaron; Mon-Williams, Mark; Bingham, Geoffrey P.

2014-01-01

Many children have difficulty producing movements well enough to improve in sensori-motor learning. Previously, we developed a training method that supports active movement generation to allow improvement at a 3D tracing task requiring good compliance control. Here, we tested 7–8 year old children from several 2nd grade classrooms to determine whether 3D tracing performance could be predicted using the Beery VMI. We also examined whether 3D tracing training lead to improvements in drawing. Baseline testing included Beery, a drawing task on a tablet computer, and 3D tracing. We found that baseline performance in 3D tracing and drawing co-varied with the visual perception (VP) component of the Beery. Differences in 3D tracing between children scoring low versus high on the Beery VP replicated differences previously found between children with and without motor impairments, as did post-training performance that eliminated these differences. Drawing improved as a result of training in the 3D tracing task. The training method improved drawing and reduced differences predicted by Beery scores. PMID:24651280

Automated mixed traffic transit vehicle microprocessor controller

NASA Technical Reports Server (NTRS)

Marks, R. A.; Cassell, P.; Johnston, A. R.

1981-01-01

An improved Automated Mixed Traffic Vehicle (AMTV) speed control system employing a microprocessor and transistor chopper motor current controller is described and its performance is presented in terms of velocity versus time curves. The on board computer hardware and software systems are described as is the software development system. All of the programming used in this controller was implemented using FORTRAN. This microprocessor controller made possible a number of safety features and improved the comfort associated with starting and shopping. In addition, most of the vehicle's performance characteristics can be altered by simple program parameter changes. A failure analysis of the microprocessor controller was generated and the results are included. Flow diagrams for the speed control algorithms and complete FORTRAN code listings are also included.

Implementation of a professional portfolio: a tool to demonstrate professional development for advanced practice.

PubMed

Chamblee, Tracy B; Dale, Juanita Conkin; Drews, Barbie; Spahis, Joanna; Hardin, Teri

2015-01-01

The literature has a gap related to professional development for APRNs. In the United States, many health care organizations use clinical advancement programs for registered nurses, but APRNs are not often included in these programs. If APRNs are included, advancement opportunities are very limited. At CMC, implementation of a professional portfolio resulted in increased satisfaction among APPs regarding their ability to showcase professional growth and expertise, as well as the uniqueness of their advanced practice. Use of the professional portfolio led to improved recognition by APS and organizational leaders of APP performance excellence during the annual performance evaluation, as well as improved recognition among APP colleagues in terms of nominations for honors and awards.

Adaptations in athletic performance after ballistic power versus strength training.

PubMed

Cormie, Prue; McGuigan, Michael R; Newton, Robert U

2010-08-01

To determine whether the magnitude of improvement in athletic performance and the mechanisms driving these adaptations differ in relatively weak individuals exposed to either ballistic power training or heavy strength training. Relatively weak men (n = 24) who could perform the back squat with proficient technique were randomized into three groups: strength training (n = 8; ST), power training (n = 8; PT), or control (n = 8). Training involved three sessions per week for 10 wk in which subjects performed back squats with 75%-90% of one-repetition maximum (1RM; ST) or maximal-effort jump squats with 0%-30% 1RM (PT). Jump and sprint performances were assessed as well as measures of the force-velocity relationship, jumping mechanics, muscle architecture, and neural drive. Both experimental groups showed significant (P < or = 0.05) improvements in jump and sprint performances after training with no significant between-group differences evident in either jump (peak power: ST = 17.7% +/- 9.3%, PT = 17.6% +/- 4.5%) or sprint performance (40-m sprint: ST = 2.2% +/- 1.9%, PT = 3.6% +/- 2.3%). ST also displayed a significant increase in maximal strength that was significantly greater than the PT group (squat 1RM: ST = 31.2% +/- 11.3%, PT = 4.5% +/- 7.1%). The mechanisms driving these improvements included significant (P < or = 0.05) changes in the force-velocity relationship, jump mechanics, muscle architecture, and neural activation that showed a degree of specificity to the different training stimuli. Improvements in athletic performance were similar in relatively weak individuals exposed to either ballistic power training or heavy strength training for 10 wk. These performance improvements were mediated through neuromuscular adaptations specific to the training stimulus. The ability of strength training to render similar short-term improvements in athletic performance as ballistic power training, coupled with the potential long-term benefits of improved maximal strength, makes strength training a more effective training modality for relatively weak individuals.

Theory of constraints for publicly funded health systems.

PubMed

Sadat, Somayeh; Carter, Michael W; Golden, Brian

2013-03-01

Originally developed in the context of publicly traded for-profit companies, theory of constraints (TOC) improves system performance through leveraging the constraint(s). While the theory seems to be a natural fit for resource-constrained publicly funded health systems, there is a lack of literature addressing the modifications required to adopt TOC and define the goal and performance measures. This paper develops a system dynamics representation of the classical TOC's system-wide goal and performance measures for publicly traded for-profit companies, which forms the basis for developing a similar model for publicly funded health systems. The model is then expanded to include some of the factors that affect system performance, providing a framework to apply TOC's process of ongoing improvement in publicly funded health systems. Future research is required to more accurately define the factors affecting system performance and populate the model with evidence-based estimates for various parameters in order to use the model to guide TOC's process of ongoing improvement.

Clinical Effectiveness of Occupational Therapy in Mental Health: A Meta-Analysis.

PubMed

Ikiugu, Moses N; Nissen, Ranelle M; Bellar, Cali; Maassen, Alexya; Van Peursem, Katlin

The purpose of this study was to estimate the effectiveness of theory-based occupational therapy interventions in improving occupational performance and well-being among people with a mental health diagnosis. The meta-analysis included 11 randomized controlled trials with a total of 520 adult participants with a mental health diagnosis. Outcomes were occupational performance, well-being, or both. We conducted meta-analyses using Comprehensive Meta-Analysis software (Version 3.0) with occupational performance and well-being as the dependent variables. Results indicated a medium effect of intervention on improving occupational performance (mean Hedge's g = 0.50, Z = 4.05, p < .001) and a small effect on well-being (mean Hedge's g = 0.46, Z = 4.96, p < .001). Theory-based occupational therapy interventions may be effective in improving occupational performance and well-being among people with a mental health diagnosis and should be an integral part of rehabilitation services in mental health. Copyright © 2017 by the American Occupational Therapy Association, Inc.

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

Elliott, C.

The Rocky Flats Environmental Technology Site (RFETS) has initiated a major work process improvement campaign using the tools of formalized benchmarking and streamlining. This paper provides insights into some of the process improvement activities performed at Rocky Flats from November 1995 through December 1996. It reviews the background, motivation, methodology, results, and lessons learned from this ongoing effort. The paper also presents important gains realized through process analysis and improvement including significant cost savings, productivity improvements, and an enhanced understanding of site work processes.

HRA Aerospace Challenges

NASA Technical Reports Server (NTRS)

DeMott, Diana

2013-01-01

Compared to equipment designed to perform the same function over and over, humans are just not as reliable. Computers and machines perform the same action in the same way repeatedly getting the same result, unless equipment fails or a human interferes. Humans who are supposed to perform the same actions repeatedly often perform them incorrectly due to a variety of issues including: stress, fatigue, illness, lack of training, distraction, acting at the wrong time, not acting when they should, not following procedures, misinterpreting information or inattention to detail. Why not use robots and automatic controls exclusively if human error is so common? In an emergency or off normal situation that the computer, robotic element, or automatic control system is not designed to respond to, the result is failure unless a human can intervene. The human in the loop may be more likely to cause an error, but is also more likely to catch the error and correct it. When it comes to unexpected situations, or performing multiple tasks outside the defined mission parameters, humans are the only viable alternative. Human Reliability Assessments (HRA) identifies ways to improve human performance and reliability and can lead to improvements in systems designed to interact with humans. Understanding the context of the situation that can lead to human errors, which include taking the wrong action, no action or making bad decisions provides additional information to mitigate risks. With improved human reliability comes reduced risk for the overall operation or project.

Exemplar pediatric collaborative improvement networks: achieving results.

PubMed

Billett, Amy L; Colletti, Richard B; Mandel, Keith E; Miller, Marlene; Muething, Stephen E; Sharek, Paul J; Lannon, Carole M

2013-06-01

A number of pediatric collaborative improvement networks have demonstrated improved care and outcomes for children. Regionally, Cincinnati Children's Hospital Medical Center Physician Hospital Organization has sustained key asthma processes, substantially increased the percentage of their asthma population receiving "perfect care," and implemented an innovative pay-for-performance program with a large commercial payor based on asthma performance measures. The California Perinatal Quality Care Collaborative uses its outcomes database to improve care for infants in California NICUs. It has achieved reductions in central line-associated blood stream infections (CLABSI), increased breast-milk feeding rates at hospital discharge, and is now working to improve delivery room management. Solutions for Patient Safety (SPS) has achieved significant improvements in adverse drug events and surgical site infections across all 8 Ohio children's hospitals, with 7700 fewer children harmed and >$11.8 million in avoided costs. SPS is now expanding nationally, aiming to eliminate all events of serious harm at children's hospitals. National collaborative networks include ImproveCareNow, which aims to improve care and outcomes for children with inflammatory bowel disease. Reliable adherence to Model Care Guidelines has produced improved remission rates without using new medications and a significant increase in the proportion of Crohn disease patients not taking prednisone. Data-driven collaboratives of the Children's Hospital Association Quality Transformation Network initially focused on CLABSI in PICUs. By September 2011, they had prevented an estimated 2964 CLABSI, saving 355 lives and $103,722,423. Subsequent improvement efforts include CLABSI reductions in additional settings and populations.

Automotive Emission Control.

ERIC Educational Resources Information Center

Lee, Billy D.; Ragazzi, Ronald

This guide designed to assist teachers in improving instruction in the area of automotive emission control curriculum includes four areas. Each area consists of one or more units of instruction, with each instructional unit including some or all of the following basic components: Performance objectives, suggested activities for teacher and…

Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits: A Quality Improvement Project.

PubMed

Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M

2016-10-01

In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.

The use of nanoparticles in polymeric and ceramic membrane structures: review of manufacturing procedures and performance improvement for water treatment.

PubMed

Kim, Jeonghwan; Van der Bruggen, Bart

2010-07-01

Membrane separations are powerful tools for various applications, including wastewater treatment and the removal of contaminants from drinking water. The performance of membranes is mainly limited by material properties. Recently, successful attempts have been made to add nanoparticles or nanotubes to polymers in membrane synthesis, with particle sizes ranging from 4 nm up to 100 nm. Ceramic membranes have been fabricated with catalytic nanoparticles for synergistic effects on the membrane performance. Breakthrough effects that have been reported in the field of water and wastewater treatment include fouling mitigation, improvement of permeate quality and flux enhancement. Nanomaterials that have been used include titania, alumina, silica, silver and many others. This paper reviews the role of engineered nanomaterials in (pressure driven) membrane technology for water treatment, to be applied in drinking water production and wastewater recycling. Benefits and drawbacks are described, which should be taken into account in further studies on potential risks related to release of nanoparticles into the environment. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels

PubMed Central

Rankin, Kristin M.; Gavin, Loretta; Moran, John W.; Kroelinger, Charlan D.; Vladutiu, Catherine J.; Goodman, David A.; Sappenfield, William M.

2018-01-01

Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists’ contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes. PMID:27423235

Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels.

PubMed

Rankin, Kristin M; Gavin, Loretta; Moran, John W; Kroelinger, Charlan D; Vladutiu, Catherine J; Goodman, David A; Sappenfield, William M

2016-11-01

Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists' contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes.

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.

Characteristics of a 30-cm thruster operated with small hole accelerator grid ion optics

NASA Technical Reports Server (NTRS)

Vahrenkamp, R. P.

1976-01-01

Small hole accelerator grid ion optical systems have been tested as a possible means of improving 30-cm ion thruster performance. The effects of small hole grids on the critical aspects of thruster operation including discharge chamber performance, doubly-charged ion concentration, effluent beam characteristics, and plasma properties have been evaluated. In general, small hole accelerator grids are beneficial in improving thruster performance while maintaining low double ion ratios. However, extremely small accelerator aperture diameters tend to degrade beam divergence characteristics. A quantitative discussion of these advantages and disadvantages of small hole accelerator grids, as well as resulting variations in thruster operation characteristics, is presented.

Overview of a stirling engine test project

NASA Technical Reports Server (NTRS)

Slaby, J. G.

1980-01-01

Tests were conducted on three Stirling engines ranging in size from 1.33 to 53 horsepower (1 to 40 kW). The tests were directed toward developing alternative, backup component concepts to improve engine efficiency and performance or to reduce costs. Some of the activities included investigating attractive concepts and materials for cooler-regenerator units, installing a jet impingement device on a Stirling engine to determine its potential for improved engine performance, and presenting performance maps for initial characterization of Stirling engines. The experiment results of the tests are presented along with predictions of results of future tests to be conducted on the Stirling engines.

Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure

PubMed Central

Stringham, James M.; Stringham, Nicole T.; O’Brien, Kevin J.

2017-01-01

The dramatic rise in the use of smartphones, tablets, and laptop computers over the past decade has raised concerns about potentially deleterious health effects of increased “screen time” (ST) and associated short-wavelength (blue) light exposure. We determined baseline associations and effects of 6 months’ supplementation with the macular carotenoids (MC) lutein, zeaxanthin, and mesozeaxanthin on the blue-absorbing macular pigment (MP) and measures of sleep quality, visual performance, and physical indicators of excessive ST. Forty-eight healthy young adults with at least 6 h of daily near-field ST exposure participated in this placebo-controlled trial. Visual performance measures included contrast sensitivity, critical flicker fusion, disability glare, and photostress recovery. Physical indicators of excessive screen time and sleep quality were assessed via questionnaire. MP optical density (MPOD) was assessed via heterochromatic flicker photometry. At baseline, MPOD was correlated significantly with all visual performance measures (p < 0.05 for all). MC supplementation (24 mg daily) yielded significant improvement in MPOD, overall sleep quality, headache frequency, eye strain, eye fatigue, and all visual performance measures, versus placebo (p < 0.05 for all). Increased MPOD significantly improves visual performance and, in turn, improves several undesirable physical outcomes associated with excessive ST. The improvement in sleep quality was not directly related to increases in MPOD, and may be due to systemic reduction in oxidative stress and inflammation. PMID:28661438

Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure.

PubMed

Stringham, James M; Stringham, Nicole T; O'Brien, Kevin J

2017-06-29

The dramatic rise in the use of smartphones, tablets, and laptop computers over the past decade has raised concerns about potentially deleterious health effects of increased "screen time" (ST) and associated short-wavelength (blue) light exposure. We determined baseline associations and effects of 6 months' supplementation with the macular carotenoids (MC) lutein, zeaxanthin, and mesozeaxanthin on the blue-absorbing macular pigment (MP) and measures of sleep quality, visual performance, and physical indicators of excessive ST. Forty-eight healthy young adults with at least 6 h of daily near-field ST exposure participated in this placebo-controlled trial. Visual performance measures included contrast sensitivity, critical flicker fusion, disability glare, and photostress recovery. Physical indicators of excessive screen time and sleep quality were assessed via questionnaire. MP optical density (MPOD) was assessed via heterochromatic flicker photometry. At baseline, MPOD was correlated significantly with all visual performance measures ( p < 0.05 for all). MC supplementation (24 mg daily) yielded significant improvement in MPOD, overall sleep quality, headache frequency, eye strain, eye fatigue, and all visual performance measures, versus placebo ( p < 0.05 for all). Increased MPOD significantly improves visual performance and, in turn, improves several undesirable physical outcomes associated with excessive ST. The improvement in sleep quality was not directly related to increases in MPOD, and may be due to systemic reduction in oxidative stress and inflammation.

Information Input and Performance in Small Decision Making Groups.

ERIC Educational Resources Information Center

Ryland, Edwin Holman

It was hypothesized that increases in the amount and specificity of information furnished to a discussion group would facilitate group decision making and improve other aspects of group and individual performance. Procedures in testing these assumptions included varying the amounts of statistics, examples, testimony, and augmented information…

Food Power. A Coach's Guide to Improving Performance.

ERIC Educational Resources Information Center

National Dairy Council, Rosemont, IL.

This guide looks at the athlete's nutrient needs and presents recent findings from physiology- and nutrition-related research which have direct bearing on athletic performance. Contents include sections on: (1) nutrition basics; (2) water needs of athletes; (3) nutrient fuels for sports; (4) diets for athletes; (5) body composition; (6) weight…

Rationale and Resources for Teaching the Mathematical Modeling of Athletic Training and Performance

ERIC Educational Resources Information Center

Clarke, David C.; Skiba, Philip F.

2013-01-01

A number of professions rely on exercise prescription to improve health or athletic performance, including coaching, fitness/personal training, rehabilitation, and exercise physiology. It is therefore advisable that the professionals involved learn the various tools available for designing effective training programs. Mathematical modeling of…

Toward an Ecological Perspective of Resident Teaching Clinic

ERIC Educational Resources Information Center

Smith, C. Scott; Francovich, Chris; Morris, Magdalena; Hill, William; Langlois-Winkle, Francine; Rupper, Randall; Roth, Craig; Wheeler, Stephanie; Vo, Anthony

2010-01-01

Teaching clinic managers struggle to convert performance data into meaningful behavioral change in their trainees, and quality improvement measures in medicine have had modest results. This may be due to several factors including clinical performance being based more on team function than individual action, models of best practice that are…

Cognitive Performance across the Life Course of Bolivian Forager-Farmers with Limited Schooling

ERIC Educational Resources Information Center

Gurven, Michael; Fuerstenberg, Eric; Trumble, Benjamin; Stieglitz, Jonathan; Beheim, Bret; Davis, Helen; Kaplan, Hillard

2017-01-01

Cognitive performance is characterized by at least two distinct life course trajectories. Many cognitive abilities (e.g., "effortful processing" abilities, including fluid reasoning and processing speed) improve throughout early adolescence and start declining in early adulthood, whereas other abilities (e.g., "crystallized"…

International Space Station Major Constituent Analyzer On-Orbit Performance

NASA Technical Reports Server (NTRS)

Gardner, Ben D.; Erwin, Phillip M.; Thoresen, Souzan; Granahan, John; Matty, Chris

2012-01-01

The Major Constituent Analyzer is a mass spectrometer based system that measures the major atmospheric constituents on the International Space Station. A number of limited-life components require periodic changeout, including the ORU 02 analyzer and the ORU 08 Verification Gas Assembly. Over the past two years, two ORU 02 analyzer assemblies have operated nominally while two others have experienced premature on-orbit failures. These failures as well as nominal performances demonstrate that ORU 02 performance remains a key determinant of MCA performance and logistical support. It can be shown that monitoring several key parameters can maximize the capacity to monitor ORU health and properly anticipate end of life. Improvements to ion pump operation and ion source tuning are expected to improve lifetime performance of the current ORU 02 design.

Clinical performance improvement series. Classic CQI integrated with comprehensive disease management as a model for performance improvement.

PubMed

Joshi, M S; Bernard, D B

1999-08-01

In recent years, health and disease management has emerged as an effective means of delivering, integrating, and improving care through a population-based approach. Since 1997 the University of Pennsylvania Health System (UPHS) has utilized the key principles and components of continuous quality improvement (CQI) and disease management to form a model for health care improvement that focuses on designing best practices, using best practices to influence clinical decision making, changing processes and systems to deploy and deliver best practices, and measuring outcomes to improve the process. Experience with 28 programs and more than 14,000 patients indicates significant improvement in outcomes, including high physician satisfaction, increased patient satisfaction, reduced costs, and improved clinical process and outcome measures across multiple diseases. DIABETES DISEASE MANAGEMENT: In three months a UPHS multidisciplinary diabetes disease management team developed a best practice approach for the treatment of all patients with diabetes in the UPHS. After the program was pilot tested in three primary care physician sites, it was then introduced progressively to additional practice sites throughout the health system. The establishment of the role of the diabetes nurse care managers (certified diabetes educators) was central to successful program deployment. Office-based coordinators ensure incorporation of the best practice protocols into routine flow processes. A disease management intranet disseminates programs electronically. Outcomes of the UPHS health and disease management programs so far demonstrate success across multiple dimensions of performance-service, clinical quality, access, and value. The task of health care leadership today is to remove barriers and enable effective implementation of key strategies, such as health and disease management. Substantial effort and resources must be dedicated to gain physician buy-in and achieve compliance. The challenge is to provide leadership support, to reward and recognize best practice performers, and to emphasize the use of data for feedback and improvement. As these processes are implemented successfully, and evidence of improved outcomes is documented, it is likely that this approach will be more widely embraced and that organizationwide performance improvement will increase significantly. Health care has traditionally invested extraordinary resources in developing best practice approaches, including guidelines, education programs, or other tangible products and services. Comparatively little time, effort, and resources have been targeted to implementation and use, the stage at which most efforts fail. CQI's emphasis on data, rapid diffusion of innovative programs, and rapid cycle improvements enhance the implementation and effectiveness of disease management.

Improving perioperative performance: the use of operations management and the electronic health record.

PubMed

Foglia, Robert P; Alder, Adam C; Ruiz, Gardito

2013-01-01

Perioperative services require the orchestration of multiple staff, space and equipment. Our aim was to identify whether the implementation of operations management and an electronic health record (EHR) improved perioperative performance. We compared 2006, pre operations management and EHR implementation, to 2010, post implementation. Operations management consisted of: communication to staff of perioperative vision and metrics, obtaining credible data and analysis, and the implementation of performance improvement processes. The EHR allows: identification of delays and the accountable service or person, collection and collation of data for analysis in multiple venues, including operational, financial, and quality. Metrics assessed included: operative cases, first case on time starts; reason for delay, and operating revenue. In 2006, 19,148 operations were performed (13,545 in the Main Operating Room (OR) area, and 5603, at satellite locations); first case on time starts were 12%; reasons for first case delay were not identifiable; and operating revenue was $115.8M overall, with $78.1M in the Main OR area. In 2010, cases increased to 25,856 (+35%); Main OR area increased to 13,986 (+3%); first case on time starts improved to 46%; operations outside the Main OR area increased to 11,870 (112%); case delays were ascribed to nurses 7%, anesthesiologists 22%, surgeons 33%, and other (patient, hospital) 38%. Five surgeons (7%) accounted for 29% of surgical delays and 4 anesthesiologists (8%) for 45% of anesthesiology delays; operating revenue increased to $177.3M (+53%) overall, and in the Main OR area rose to $101.5M (+30%). The use of operations management and EHR resulted in improved processes, credible data, promptly sharing the metrics, and pinpointing individual provider performance. Implementation of these strategies allowed us to shift cases between facilities, reallocate OR blocks, increase first case on time starts four fold and operative cases by 35%, and these changes were associated with a 53% increase in operating revenue. The fact that revenue increase was greater than case volume (53% vs. 35%) speaks for improved performance. Copyright © 2013 Elsevier Inc. All rights reserved.

Effectiveness of external cues to facilitate task performance in people with neurological disorders: a systematic review and meta-analysis.

PubMed

Harrison, Stephanie L; Laver, Kate E; Ninnis, Kayla; Rowett, Cherie; Lannin, Natasha A; Crotty, Maria

2018-03-09

To examine in people with neurological disorders, which method/s of providing external cues to improve task performance are most effective. Medline, EMBASE, and PsycINFO were systematically searched. Two reviewers independently screened, extracted data, and assessed the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Twenty six studies were included. Studies examined a wide-range of cues including visual, tactile, auditory, verbal, and multi-component cues. Cueing (any type) improved walking speed when comparing cues to no cues (mean difference (95% confidence interval): 0.08 m/s (0.06-0.10), I 2  = 68%, low quality of evidence). Remaining evidence was analysed narratively; evidence that cueing improves activity-related outcomes was inconsistent and rated as very low quality. It was not possible to determine which form of cueing may be more effective than others. Providing cues to encourage successful task performance is a core component of rehabilitation, however there is limited evidence on the type of cueing or which tasks benefit most from external cueing. Low-quality evidence suggests there may be a beneficial effect of cueing (any type) on walking speed. Sufficiently powered randomised controlled trials are needed to inform therapists of the most effective cueing strategies to improve activity performance in populations with a neurological disorder. Implications for rehabilitation Providing cues is a core component of rehabilitation and may improve successful task performance and activities in people with neurological conditions including stroke, Parkinson's disease, Alzheimer's disease, traumatic brain injury, and multiple sclerosis, but evidence is limited for most neurological conditions with much research focusing on stroke and Parkinson's disease. Therapists should consider using a range of different types of cues depending on the aims of treatment and the neurological condition. There is currently insufficient evidence to suggest one form of cueing is superior to other forms. Therapists should appreciate that responding optimally to cues may take many sessions to have an effect on activities such as walking. Further studies should be conducted over a longer timeframe to examine the effects of different types of cues towards task performance and activities in people with neurological conditions.

Space Shuttle development update

NASA Technical Reports Server (NTRS)

Brand, V.

1984-01-01

The development efforts, since the STS-4 flight, in the Space Shuttle (SS) program are presented. The SS improvements introduced in the last two years include lower-weight loads, communication through the Tracking and Data Relay Satellite, expanded extravehicular activity capability, a maneuvering backpack and the manipulator foot restraint, the improvements in thermal projection system, the 'optional terminal area management targeting' guidance software, a rendezvous system with radar and star tracker sensors, and improved on-orbit living conditions. The flight demonstrations include advanced launch techniques (e.g., night launch and direct insertion to orbit); the on-orbit demonstrations; and added entry and launching capabilities. The entry aerodynamic analysis and entry flight control fine tuning are described. Reusability, improved ascent performance, intact abort and landing flexibility, rollout control, and 'smart speedbrakes' are among the many improvements planned for the future.

Going beyond the vertical: leveraging a national HIV quality improvement programme to address other health priorities in Haiti.

PubMed

Joseph, Jean Paul; Jerome, Gregory; Lambert, Wesler; Almazor, Patrick; Cupidon, Colette Eugene; Hirschhorn, Lisa R

2015-07-01

Although the central role of quality to achieve targeted population health goals is widely recognized, how to spread the capacity to measure and improve quality across programmes has not been widely studied. We describe the successful leveraging of expertise and framework of a national HIV quality improvement programme to spread capacity and improve quality across a network of clinics in HIV and other targeted areas of healthcare delivery in rural Haiti.The work was led by Zamni LaSante, a Haitian nongovernment organization and its sister organization, Partners In Health working in partnership with the Haitian Ministry of Health in the Plateau Central and Lower Artibonite regions in 12 public sector facilities.Data included routinely collected organizational assessments of facility quality improvement capacity, national HIV performance measures and Zamni LaSante programme records.We found that facility quality improvement capacity increased with spread from HIV to other areas of inpatient and outpatient care, including tuberculosis (TB), maternal health and inpatient services in all 12 supported healthcare facilities. A significant increase in the quality of HIV care was also seen in most areas, including CD4 monitoring, TB screening, HIV treatment (all P < 0.01) and nutritional assessment and prevention of mother-to-child transmission (both P < .05), with an increase in average facility performance from 39 to 72% (P < .01).In conclusion, using a diagonal approach to leverage a national vertical programme for wider benefit resulted in accelerated change in professional culture and increased capacity to spread quality improvement activities across facilities and areas of healthcare delivery. This led to improvement within and beyond HIV care and contributed to the goal of quality of care for all.

An updated geospatial liquefaction model for global application

USGS Publications Warehouse

Zhu, Jing; Baise, Laurie G.; Thompson, Eric M.

2017-01-01

We present an updated geospatial approach to estimation of earthquake-induced liquefaction from globally available geospatial proxies. Our previous iteration of the geospatial liquefaction model was based on mapped liquefaction surface effects from four earthquakes in Christchurch, New Zealand, and Kobe, Japan, paired with geospatial explanatory variables including slope-derived VS30, compound topographic index, and magnitude-adjusted peak ground acceleration from ShakeMap. The updated geospatial liquefaction model presented herein improves the performance and the generality of the model. The updates include (1) expanding the liquefaction database to 27 earthquake events across 6 countries, (2) addressing the sampling of nonliquefaction for incomplete liquefaction inventories, (3) testing interaction effects between explanatory variables, and (4) overall improving model performance. While we test 14 geospatial proxies for soil density and soil saturation, the most promising geospatial parameters are slope-derived VS30, modeled water table depth, distance to coast, distance to river, distance to closest water body, and precipitation. We found that peak ground velocity (PGV) performs better than peak ground acceleration (PGA) as the shaking intensity parameter. We present two models which offer improved performance over prior models. We evaluate model performance using the area under the curve under the Receiver Operating Characteristic (ROC) curve (AUC) and the Brier score. The best-performing model in a coastal setting uses distance to coast but is problematic for regions away from the coast. The second best model, using PGV, VS30, water table depth, distance to closest water body, and precipitation, performs better in noncoastal regions and thus is the model we recommend for global implementation.

Techniques for improving transients in learning control systems

NASA Technical Reports Server (NTRS)

Chang, C.-K.; Longman, Richard W.; Phan, Minh

1992-01-01

A discrete modern control formulation is used to study the nature of the transient behavior of the learning process during repetitions. Several alternative learning control schemes are developed to improve the transient performance. These include a new method using an alternating sign on the learning gain, which is very effective in limiting peak transients and also very useful in multiple-input, multiple-output systems. Other methods include learning at an increasing number of points progressing with time, or an increasing number of points of increasing density.

76 FR 3211 - Federal Motor Vehicle Safety Standards, Ejection Mitigation; Phase-In Reporting Requirements...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

... be tethered near the base of the vehicle's pillars or otherwise designed to keep the impactor within... performance and occupant behavior, and with the FHWA taking the lead, improving roadway designs. Vehicle... remaining in the vehicle during a rollover included improved roof crush resistance and research on whether...

Making the Grade: Texas Early College High Schools Prepare Students for College. Executive Summary

ERIC Educational Resources Information Center

Jobs for the Future, 2011

2011-01-01

Early college high schools are improving student outcomes in Texas. This performance is being achieved by youth who are underrepresented in college, including Hispanic youth, economically disadvantaged students, and first-generation college goers. In improving readiness for college and careers, early college schools have become an essential part…

Does Teacher Evaluation Improve School Performance? Experimental Evidence from Chicago's Excellence in Teaching Project

ERIC Educational Resources Information Center

Steinberg, Matthew P.; Sartain, Lauren

2015-01-01

Chicago Public Schools initiated the Excellence in Teaching Project, a teacher evaluation program designed to increase student learning by improving classroom instruction through structured principal-teacher dialogue. The pilot began in forty-four elementary schools in 2008-09 (cohort 1) and scaled up to include an additional forty-eight…

Teacher Quality, Job-Embedded Professional Development, and School-University Partnerships

ERIC Educational Resources Information Center

Dana, Nancy Fichtman

2010-01-01

There are few conversations about teaching these days that do not include talk about teacher quality. Yet, within the conversations about improving teacher quality, the dialogue is often political--consumed with one-dimensional solutions for improving teacher quality, such as linking teacher pay to student performance. Absent from the pervasive…

Combinatorial optimization problem solution based on improved genetic algorithm

NASA Astrophysics Data System (ADS)

Zhang, Peng

2017-08-01

Traveling salesman problem (TSP) is a classic combinatorial optimization problem. It is a simplified form of many complex problems. In the process of study and research, it is understood that the parameters that affect the performance of genetic algorithm mainly include the quality of initial population, the population size, and crossover probability and mutation probability values. As a result, an improved genetic algorithm for solving TSP problems is put forward. The population is graded according to individual similarity, and different operations are performed to different levels of individuals. In addition, elitist retention strategy is adopted at each level, and the crossover operator and mutation operator are improved. Several experiments are designed to verify the feasibility of the algorithm. Through the experimental results analysis, it is proved that the improved algorithm can improve the accuracy and efficiency of the solution.

Delivering safety

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

Baldwin, N.D.; Spooner, K.G.; Walkden, P.

2007-07-01

In the United Kingdom there have been significant recent changes to the management of civil nuclear liabilities. With the formation in April 2005 of the Nuclear Decommissioning Authority (NDA), ownership of the civil nuclear licensed sites in the UK, including the Magnox Reactor Stations, passed to this new organisation. The NDAs mission is to seek acceleration of the nuclear clean up programme and deliver increased value for money and, consequently, are driving their contractors to seek more innovative ways of performing work. British Nuclear Group manages the UK Magnox stations under contract to the NDA. This paper summarises the approachmore » being taken within its Reactor Sites business to work with suppliers to enhance working arrangements at sites, improve the delivery of decommissioning programmes and deliver improvements in safety and environmental performance. The UK Magnox stations are 1. generation gas-graphite reactors, constructed in the 1950's and 1960's. Two stations are currently still operating, three are shut-down undergoing defueling and the other five are being decommissioned. Despite the distractions of industry restructuring, an uncompromising policy of demanding improved performance in conjunction with improved safety and environmental standards has been adopted. Over the past 5 years, this policy has resulted in step-changes in performance at Reactor Sites, with increased electrical output and accelerated defueling and decommissioning. The improvements in performance have been mirrored by improvements in safety (DACR of 0 at 5 sites); environmental standards (reductions in energy and water consumption, increased waste recycling) and the overall health of the workforce (20% reduction in sickness absence). These achievements have, in turn, been recognised by external bodies, resulting in several awards, including: the world's first ISRS and IERS level 10 awards (Sizewell, 2006), the NUMEX plant maintenance award (Bradwell, 2006), numerous RoSPA awards at site and sector level and nomination, at Company level, for the RoSPA George Earle trophy for outstanding performance in Health and Safety (Reactor Sites, 2006). After 'setting the scene' and describing the challenges that the company has had to respond to, the paper explains how these improvements have been delivered. Specifically it explains the process that has been followed and the parts played by sites and suppliers to deliver improved performance. With the experience of already having transitioned several Magnox stations from operations to defueling and then to decommissioning, the paper describes the valuable experience that has been gained in achieving an optimum change process and maintaining momentum. (authors)« less

Beyond Measurement and Reward: Methods of Motivating Quality Improvement and Accountability.

PubMed

Berenson, Robert A; Rice, Thomas

2015-12-01

The article examines public policies designed to improve quality and accountability that do not rely on financial incentives and public reporting of provider performance. Payment policy should help temper the current "more is better" attitude of physicians and provider organizations. Incentive neutrality would better support health professionals' intrinsic motivation to act in their patients' best interests to improve overall quality than would pay-for-performance plans targeted to specific areas of clinical care. Public policy can support clinicians' intrinsic motivation through approaches that support systematic feedback to clinicians and provide concrete opportunities to collaborate to improve care. Some programs administered by the Centers for Medicare & Medicaid Services, including Partnership for Patients and Conditions of Participation, deserve more attention; they represent available, but largely ignored, approaches to support providers to improve quality and protect beneficiaries against substandard care. Public policies related to quality improvement should focus more on methods of enhancing professional intrinsic motivation, while recognizing the potential role of organizations to actively promote and facilitate that motivation. Actually achieving improvement, however, will require a reexamination of the role played by financial incentives embedded in payments and the unrealistic expectations placed on marginal incentives in pay-for-performance schemes. © Health Research and Educational Trust.

Inside the Black Box of Audit and Feedback: a Laboratory Study to Explore Determinants of Improvement Target Selection by Healthcare Professionals in Cardiac Rehabilitation.

PubMed

Gude, Wouter T; van der Veer, Sabine N; van Engen-Verheul, Mariëtte M; de Keizer, Nicolette F; Peek, Niels

2015-01-01

Audit and feedback (A&F) is widely used to aid healthcare professionals in improving clinical performance, but there is little understanding of the underlying mechanism that determines its effectiveness. The aim of this paper is to investigate the process by which healthcare professionals select indicators as improvement targets based on A&F. We performed a laboratory study among 41 healthcare professionals in the context of a web-based A&F intervention designed to improve the quality of cardiac rehabilitation care in the Netherlands. Feedback was provided on eighteen quality indicators, including a score and a colour (representing a recommendation for selection (red and yellow) or non-selection (green)). Indicators with more room for improvement were more likely to be selected, although this varied substantially between participants. In more than a quarter of the cases, participants did not select indicators with obvious room for improvement (yellow or red colour), or selected indicators without apparent room for improvement (green colour). We conclude that personal preferences and beliefs concerning quality and performance targets may dilute the efficiency of A&F.

Performance monitoring can boost turboexpander efficiency

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

McIntire, R.

1982-07-05

This paper discusses ways of improving the productivity of the turboexpander/refrigeration system's radial expander and radial compressor through systematic review of component performance. It reviews several techniques to determine the performance of an expander and compressor. It suggests that any performance improvement program requires quantifying the performance of separate components over a range of operating conditions; estimating the increase in performance associated with any hardware change; and developing an analytical (computer) model of the entire system by using the performance curve of individual components. The model is used to quantify the economic benefits of any change in the system, eithermore » a change in operating procedures or a hardware modification. Topics include proper ways of using antisurge control valves and modifying flow rate/shaft speed (Q/N). It is noted that compressor efficiency depends on the incidence angle of blade at the rotor leading edge and the angle of the incoming gas stream.« less

Improving balance, mobility, and dual-task performance in an adolescent with cerebral palsy: A case report.

PubMed

Fisher-Pipher, Sarah; Kenyon, Lisa K; Westman, Marci

2017-07-01

Improving functional mobility is often a desired outcome for adolescents with cerebral palsy (CP). Traditional neurorehabilitation approaches are frequently directed at impairments; however, improvements may not be carried over into functional mobility. The purpose of this case report was to describe the examination, intervention, and outcomes of a task-oriented physical therapy intervention program to improve dynamic balance, functional mobility, and dual-task performance in an adolescent with CP. The participant was a 15-year-old girl with spastic triplegic CP (Gross Motor Classification System Level II). Examination procedures included the Canadian Occupational Performance Measure, 6-minute walk test, Muscle Power Sprint Test, 10 x 5-meter sprint test, Timed Up and Down Stairs Test, Gross Motor Function Measure, Gillette Functional Assessment Questionnaire, and functional lower extremity strength tests. Intervention focused on task-oriented dynamic balance and mobility tasks that incorporated coordination and speed demands as well as task-specific lower extremity and trunk strengthening activities. Dual task demands were integrated into all intervention activities. Post-intervention testing revealed improvements in cardiovascular endurance, anaerobic power, agility, stair climbing, gross motor skills, and mobility. The participant appeared to benefit from a task-oriented program to improve dynamic balance, functional mobility, and dual-task performance.

Improving Performance Of Industrial Enterprises With CGT

NASA Astrophysics Data System (ADS)

Dolgih, I. N.; Bannova, K. A.; Kuzmina, N. A.; Zdanova, A. B.

2016-04-01

At the present day, a falling in the overall level of efficiency production activities, especially in the machine-building companies makes it necessary to development various actions in the State support, including through the creation consolidated taxation system. Such support will help improve efficiency of activity not only the industrial companies, but also will allow improve economic and social situation in regions where often large engineering factories is city-forming.

Patient and family involvement in contemporary health care.

PubMed

Angood, Peter; Dingman, Jennifer; Foley, Mary E; Ford, Dan; Martins, Becky; O'Regan, Patti; Salamendra, Arlene; Sheridan, Sue; Denham, Charles R

2010-03-01

The objective of this article was to provide a guide to health care providers on patient and family involvement in health care. This article evaluated the latest published studies for patient and family involvement and reexamined the objectives, the requirements for achieving these objectives, and the evidence of how to involve patients and families. Critical components for patient safety include changing the organizational culture; including patients and families on teams; listening to patients and families; incorporating their input into leadership structures and systems; providing full detail about treatment, procedures, and medication adverse effects; involving them on patient safety and performance improvement committees; and disclosing medical errors. The conclusion of this article is that, for the future, patient and family involvement starts with educating patients and families and ends with listening to them and taking them seriously. If patient and family input is emphatically built into systems of performance improvement, and if patients and families are taken seriously and are respected for their valuable perspectives about how care can be improved, then organizations can improve at improving. Resources in health care are in short supply, yet the resources of patient and family help and time are almost limitless, are ready to be tapped, and can have a huge impact on improving the reliability and overall success for any health care organization.

Back to basics: does decentralization improve health system performance? Evidence from Ceara in north-east Brazil.

PubMed Central

Atkinson, Sarah; Haran, Dave

2004-01-01

OBJECTIVE: To examine whether decentralization has improved health system performance in the State of Ceara, north-east Brazil. METHODS: Ceara is strongly committed to decentralization. A survey across 45 local (municipio) health systems collected data on performance and formal organization, including decentralization, informal management and local political culture. The indicators for informal management and local political culture were based on prior ethnographic research. Data were analysed using analysis of variance, Duncan's post-hoc test and multiple regression. FINDINGS: Decentralization was associated with improved performance, but only for 5 of our 22 performance indicators. Moreover, in the multiple regression, decentralization explained the variance in only one performance indicator; indicators for informal management and political culture appeared to be more important influences. However, some indicators for informal management were themselves associated with decentralization but not any of the political culture indicators. CONCLUSION: Good management practices in the study led to decentralized local health systems rather than vice versa. Any apparent association between decentralization and performance seems to be an artefact of the informal management, and the wider political culture in which a local health system is embedded strongly influences the performance of local health systems. PMID:15640917

Parametric Study and Design of Tab Shape for Improving Aerodynamic Performance of Rotor Blade

NASA Astrophysics Data System (ADS)

Han, Jaeseong; Kwon, Oh Joon

2018-04-01

In the present study, the parametric study was performed to analyze the effect of the tab on the aerodynamic performance and characteristics of rotor blades. Also, the tab shape was designed to improve the aerodynamic performance of rotor blades. A computational fluid dynamics solver based on three-dimensional Reynolds averaged Navier-Stokes equation using an unstructured mesh was used for the parametric study and the tab design. For airfoils, the effect of length and angle of a tab was studied on the aerodynamic characteristics of airfoils. In addition, including those parameters, the effect of a span of a tab was studied for rotor blades in hovering flight. The results of the parametric study were analyzed in terms of change of the aerodynamic performance and characteristics to understand the effect of a tab. Considering the analysis, the design of tab shape was conducted to improve the aerodynamic performance of rotor blades. The simply attached tab to trailing edge of the rotor blades increases the thrust of the rotor blades without significant changing of aerodynamic characteristics of the rotor blades in hovering and forward flight.

Effects of a psychophysiological system for adaptive automation on performance, workload, and the event-related potential P300 component

NASA Technical Reports Server (NTRS)

Prinzel, Lawrence J 3rd; Freeman, Frederick G.; Scerbo, Mark W.; Mikulka, Peter J.; Pope, Alan T.

2003-01-01

The present study examined the effects of an electroencephalographic- (EEG-) based system for adaptive automation on tracking performance and workload. In addition, event-related potentials (ERPs) to a secondary task were derived to determine whether they would provide an additional degree of workload specificity. Participants were run in an adaptive automation condition, in which the system switched between manual and automatic task modes based on the value of each individual's own EEG engagement index; a yoked control condition; or another control group, in which task mode switches followed a random pattern. Adaptive automation improved performance and resulted in lower levels of workload. Further, the P300 component of the ERP paralleled the sensitivity to task demands of the performance and subjective measures across conditions. These results indicate that it is possible to improve performance with a psychophysiological adaptive automation system and that ERPs may provide an alternative means for distinguishing among levels of cognitive task demand in such systems. Actual or potential applications of this research include improved methods for assessing operator workload and performance.

Novel algorithm implementations in DARC: the Durham AO real-time controller

NASA Astrophysics Data System (ADS)

Basden, Alastair; Bitenc, Urban; Jenkins, David

2016-07-01

The Durham AO Real-time Controller has been used on-sky with the CANARY AO demonstrator instrument since 2010, and is also used to provide control for several AO test-benches, including DRAGON. Over this period, many new real-time algorithms have been developed, implemented and demonstrated, leading to performance improvements for CANARY. Additionally, the computational performance of this real-time system has continued to improve. Here, we provide details about recent updates and changes made to DARC, and the relevance of these updates, including new algorithms, to forthcoming AO systems. We present the computational performance of DARC when used on different hardware platforms, including hardware accelerators, and determine the relevance and potential for ELT scale systems. Recent updates to DARC have included algorithms to handle elongated laser guide star images, including correlation wavefront sensing, with options to automatically update references during AO loop operation. Additionally, sub-aperture masking options have been developed to increase signal to noise ratio when operating with non-symmetrical wavefront sensor images. The development of end-user tools has progressed with new options for configuration and control of the system. New wavefront sensor camera models and DM models have been integrated with the system, increasing the number of possible hardware configurations available, and a fully open-source AO system is now a reality, including drivers necessary for commercial cameras and DMs. The computational performance of DARC makes it suitable for ELT scale systems when implemented on suitable hardware. We present tests made on different hardware platforms, along with the strategies taken to optimise DARC for these systems.

Improving trends in gender disparities in the Department of Veterans Affairs: 2008-2013.

PubMed

Whitehead, Alison M; Czarnogorski, Maggie; Wright, Steve M; Hayes, Patricia M; Haskell, Sally G

2014-09-01

Increasing numbers of women veterans using Department of Veterans Affairs (VA) services has contributed to the need for equitable, high-quality care for women. The VA has evaluated performance measure data by gender since 2006. In 2008, the VA launched a 5-year women's health redesign, and, in 2011, gender disparity improvement was included on leadership performance plans. We examined data from VA Office of Analytics and Business Intelligence quarterly gender reports for trends in gender disparities in gender-neutral performance measures from 2008 to 2013. Through reporting of data by gender, leadership involvement, electronic reminders, and population management dashboards, VA has seen a decreasing trend in gender inequities on most Health Effectiveness Data and Information Set performance measures.

Differential Die-Away Instrument: Report on Neutron Detector Recovery Performance and Proposed Improvements

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

Goodsell, Alison Victoria; Swinhoe, Martyn Thomas; Henzl, Vladimir

2014-09-22

Four helium-3 ( 3He) detector/preamplifier packages (¾”/KM200, DDSI/PDT-A111, DDA/PDT-A111, and DDA/PDT10A) were experimentally tested to determine the deadtime effects at different DT neutron generator output settings. At very high count rates, the ¾”/KM200 package performed best. At high count rates, the ¾”/KM200 and the DDSI/PDT-A111 packages performed very well, with the DDSI/PDT-A111 operating with slightly higher efficiency. All of the packages performed similarly at mid to low count rates. Proposed improvements include using a fast recovery LANL-made dual channel preamplifier, testing smaller diameter 3He tubes, and further investigating quench gases.

GPS vertical axis performance enhancement for helicopter precision landing approach

NASA Technical Reports Server (NTRS)

Denaro, Robert P.; Beser, Jacques

1986-01-01

Several areas were investigated for improving vertical accuracy for a rotorcraft using the differential Global Positioning System (GPS) during a landing approach. Continuous deltaranging was studied and the potential improvement achieved by estimating acceleration was studied by comparing the performance on a constant acceleration turn and a rough landing profile of several filters: a position-velocity (PV) filter, a position-velocity-constant acceleration (PVAC) filter, and a position-velocity-turning acceleration (PVAT) filter. In overall statistics, the PVAC filter was found to be most efficient with the more complex PVAT performing equally well. Vertical performance was not significantly different among the filters. Satellite selection algorithms based on vertical errors only (vertical dilution of precision or VDOP) and even-weighted cross-track and vertical errors (XVDOP) were tested. The inclusion of an altimeter was studied by modifying the PVAC filter to include a baro bias estimate. Improved vertical accuracy during degraded DOP conditions resulted. Flight test results for raw differential results excluding filter effects indicated that the differential performance significantly improved overall navigation accuracy. A landing glidepath steering algorithm was devised which exploits the flexibility of GPS in determining precise relative position. A method for propagating the steering command over the GPS update interval was implemented.

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.

Snowmobile Repair.

ERIC Educational Resources Information Center

Helbling, Wayne

This guide is designed to provide and/or improve instruction for occupational training in the area of snowmobile repair, and includes eight areas. Each area consists of one or more units of instruction, with each instructional unit including some or all of the following basic components: Performance objectives, suggested activities for teacher and…

Participation and Family Education in School: Successful Educational Actions

ERIC Educational Resources Information Center

Garcia, Lars Bonell; Ríos, Oriol

2014-01-01

The research "INCLUD-ED, Strategies for Inclusion and Social Cohesion in Europe from Education" (2006-11) identified several forms of family participation that contribute to the improvement of school performance and living together in schools: participation in decision-making processes, participation in the evaluation of educational…

Long-Term Outcomes of Laser Prostatectomy for Storage Symptoms: Comparison of Serial 5-Year Followup Data between High Performance System Photoselective Vaporization and Holmium Laser Enucleation of the Prostate.

PubMed

Cho, Min Chul; Song, Won Hoon; Park, Juhyun; Cho, Sung Yong; Jeong, Hyeon; Oh, Seung-June; Paick, Jae-Seung; Son, Hwancheol

2018-06-01

We compared long-term storage symptom outcomes between photoselective laser vaporization of the prostate with a 120 W high performance system and holmium laser enucleation of the prostate. We also determined factors influencing postoperative improvement of storage symptoms in the long term. Included in our study were 266 men, including 165 treated with prostate photoselective laser vaporization using a 120 W high performance system and 101 treated with holmium laser enucleation of the prostate, on whom 60-month followup data were available. Outcomes were assessed serially 6, 12, 24, 36, 48 and 60 months postoperatively using the International Prostate Symptom Score, uroflowmetry and the serum prostate specific antigen level. Postoperative improvement in storage symptoms was defined as a 50% or greater reduction in the subtotal storage symptom score at each followup visit after surgery compared to baseline. Improvements in frequency, urgency, nocturia, subtotal storage symptom scores and the quality of life index were maintained up to 60 months after photoselective laser vaporization or holmium laser enucleation of the prostate. There was no difference in the degree of improvement in storage symptoms or the percent of patients with postoperative improvement in storage symptoms between the 2 groups throughout the long-term followup. However, the holmium laser group showed greater improvement in voiding symptoms and quality of life than the laser vaporization group. On logistic regression analysis a higher baseline subtotal storage symptom score and a higher BOOI (Bladder Outlet Obstruction Index) were the factors influencing the improvement in storage symptoms 5 years after prostate photoselective laser vaporization or holmium laser enucleation. Our serial followup data suggest that storage symptom improvement was maintained throughout the long-term postoperative period for prostate photoselective laser vaporization with a 120 W high performance system and holmium laser enucleation without any difference between the 2 surgeries. Also, more severe storage symptoms at baseline and a more severe BOOI predicted improved storage symptoms in the long term after each surgery. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A Meta-analytic Review of Non-specific Effects in Randomized Controlled Trials of Cognitive Remediation for Schizophrenia.

PubMed

Radhakrishnan, Rajiv; Kiluk, Brian D; Tsai, Jack

2016-03-01

Cognitive remediation (CR) has been found to improve cognitive performance among adults with schizophrenia in randomized controlled trials (RCTs). However, improvements in cognitive performance are often observed in the control groups of RCTs as well. There has been no comprehensive examination of change in control groups for CR, which may inform trial methodology and improve our understanding of measured outcomes for cognitive remediation. In this meta-analysis, we calculated pre-post change in cognitive test performance within control groups of RCTs in 32 CR trials (n = 794 participants) published between 1970 and 2011, and examined the association between pre-post change and sample size, duration of treatment, type of control group, and participants' age, intelligence, duration of illness, and psychiatric symptoms. Results showed that control groups in CR trials showed small effect size changes (Cohen's d = 0.12 ± 0.16) in cognitive test performance over the trial duration. Study characteristics associated with pre-post change included participant age and sample size. These findings suggest attention to change in control groups may help improve detection of cognitive remediation effects for schizophrenia.

GASNet-EX Performance Improvements Due to Specialization for the Cray Aries Network

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

Hargrove, Paul H.; Bonachea, Dan

This document is a deliverable for milestone STPM17-6 of the Exascale Computing Project, delivered by WBS 2.3.1.14. It reports on the improvements in performance observed on Cray XC-series systems due to enhancements made to the GASNet-EX software. These enhancements, known as “specializations”, primarily consist of replacing network-independent implementations of several recently added features with implementations tailored to the Cray Aries network. Performance gains from specialization include (1) Negotiated-Payload Active Messages improve bandwidth of a ping-pong test by up to 14%, (2) Immediate Operations reduce running time of a synthetic benchmark by up to 93%, (3) non-bulk RMA Put bandwidth ismore » increased by up to 32%, (4) Remote Atomic performance is 70% faster than the reference on a point-to-point test and allows a hot-spot test to scale robustly, and (5) non-contiguous RMA interfaces see up to 8.6x speedups for an intra-node benchmark and 26% for inter-node. These improvements are available in the GASNet-EX 2018.3.0 release.« less

Effects of mindfulness-based intervention to improve task performance for children with intellectual disabilities.

PubMed

Kim, Jeongil; Kwon, Miyoung

2018-01-01

Task performance is a critical factor for learning in individuals with intellectual disabilities. This study aimed to examine mindfulness-based intervention (MBI) to improve task performance for children with intellectual disability (ID). Three elementary school children with ID participated in the study. A multiple baseline design across subjects was used. The intervention was consisted of "understanding the necessary concept of mindfulness, practice of awareness and attention, and practice focusing on mindful behaviours." Mediating materials including expressive arts supplies were used to help each subject to understand the content and the progress of the intervention programme. The results showed that all of the three subjects showed an improvement in task performance and a decrease in task-avoidance behaviours. The mothers reported that her children's daily life behaviours were distinctively improved as he/she participated in the intervention. The finding suggests that MBI would be a valuable adjunct to a wide range of applications to support individuals with ID to learn a variety of adaptive behaviour. © 2017 John Wiley & Sons Ltd.

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.

Working memory plasticity and aging.

PubMed

Rhodes, Rebecca E; Katz, Benjamin

2017-02-01

The present research explores how the trajectory of learning on a working memory task changes throughout the life span, and whether gains in working memory performance are exclusively a question of initial working memory capacity (WMC) or whether age exerts an independent effect. In a large, cross-sectional study of younger, middle-aged, and older adults, we examined learning on a widely used working memory task-the dual n-back task-over 20 sessions of practice. We found that, while all age groups improved on the task, older adults demonstrated less improvement on the task, and also reached a lower asymptotic maximum performance than younger adults. After controlling for initial WMC, we found that age exerted independent effects on training gains and asymptotic performance; older adults tended to improve less and reached lower levels of performance than younger adults. The difference between younger and older adults' rates of learning depended in part on initial WMC. These results suggest that age-related effects on working memory include not only effects on capacity, but also plasticity and the ability to improve on a task. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Airborne Particulate Threat Assessment

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

Patrick Treado; Oksana Klueva; Jeffrey Beckstead

Aerosol threat detection requires the ability to discern between threat agents and ambient background particulate matter (PM) encountered in the environment. To date, Raman imaging technology has been demonstrated as an effective strategy for the assessment of threat agents in the presence of specific, complex backgrounds. Expanding our understanding of the composition of ambient particulate matter background will improve the overall performance of Raman Chemical Imaging (RCI) detection strategies for the autonomous detection of airborne chemical and biological hazards. Improving RCI detection performance is strategic due to its potential to become a widely exploited detection approach by several U.S. governmentmore » agencies. To improve the understanding of the ambient PM background with subsequent improvement in Raman threat detection capability, ChemImage undertook the Airborne Particulate Threat Assessment (APTA) Project in 2005-2008 through a collaborative effort with the National Energy Technology Laboratory (NETL), under cooperative agreement number DE-FC26-05NT42594. During Phase 1 of the program, a novel PM classification based on molecular composition was developed based on a comprehensive review of the scientific literature. In addition, testing protocols were developed for ambient PM characterization. A signature database was developed based on a variety of microanalytical techniques, including scanning electron microscopy, FT-IR microspectroscopy, optical microscopy, fluorescence and Raman chemical imaging techniques. An automated particle integrated collector and detector (APICD) prototype was developed for automated collection, deposition and detection of biothreat agents in background PM. During Phase 2 of the program, ChemImage continued to refine the understanding of ambient background composition. Additionally, ChemImage enhanced the APICD to provide improved autonomy, sensitivity and specificity. Deliverables included a Final Report detailing our findings and APICD Gen II subsystems for automated collection, deposition and detection of ambient particulate matter. Key findings from the APTA Program include: Ambient biological PM taxonomy; Demonstration of key subsystems needed for autonomous bioaerosol detection; System design; Efficient electrostatic collection; Automated bioagent recognition; Raman analysis performance validating Td<9 sec; Efficient collection surface regeneration; and Development of a quantitative bioaerosol defection model. The objective of the APTA program was to advance the state of our knowledge of ambient background PM composition. Operation of an automated aerosol detection system was enhanced by a more accurate assessment of background variability, especially for sensitive and specific sensing strategies like Raman detection that are background-limited in performance. Based on this improved knowledge of background, the overall threat detection performance of Raman sensors was improved.« less

Sustainability of quality improvement following removal of pay-for-performance incentives.

PubMed

Benzer, Justin K; Young, Gary J; Burgess, James F; Baker, Errol; Mohr, David C; Charns, Martin P; Kaboli, Peter J

2014-01-01

Although pay-for-performance (P4P) has become a central strategy for improving quality in US healthcare, questions persist about the effectiveness of these programs. A key question is whether quality improvement that occurs as a result of P4P programs is sustainable, particularly if incentives are removed. To investigate sustainability of performance levels following removal of performance-based incentives. Observational cohort study that capitalized on a P4P program within the Veterans Health Administration (VA) that included adoption and subsequent removal of performance-based incentives for selected inpatient quality measures. The study sample comprised 128 acute care VA hospitals where performance was assessed between 2004 and 2010. VA system managers set annual performance goals in consultation with clinical leaders, and report performance scores to medical centers on a quarterly basis. These scores inform performance-based incentives for facilities and their managers. Bonuses are distributed based on the attainment of these performance goals. Seven quality of care measures for acute coronary syndrome, heart failure, and pneumonia linked to performance-based incentives. Significant improvements in performance were observed for six of seven quality of care measures following adoption of performance-based incentives and were maintained up to the removal of the incentive; subsequently, the observed performance levels were sustained. This is a quasi-experimental study without a comparison group; causal conclusions are limited. The maintenance of performance levels after removal of a performance-based incentive has implications for the implementation of Medicare's value-based purchasing initiative and other P4P programs. Additional research is needed to better understand human and system-level factors that mediate sustainability of performance-based incentives.

The recalibration of the IUE scientific instrument

NASA Technical Reports Server (NTRS)

Imhoff, Catherine L.; Oliversen, Nancy A.; Nichols-Bohlin, Joy; Casatella, Angelo; Lloyd, Christopher

1988-01-01

The IUE instrument was recalibrated because of long time-scale changes in the scientific instrument, a better understanding of the performance of the instrument, improved sets of calibration data, and improved analysis techniques. Calibrations completed or planned include intensity transfer functions (ITF), low-dispersion absolute calibrations, high-dispersion ripple corrections and absolute calibrations, improved geometric mapping of the ITFs to spectral images, studies to improve the signal-to-noise, enhanced absolute calibrations employing corrections for time, temperature, and aperture dependence, and photometric and geometric calibrations for the FES.

Improving outcomes for patients with type 2 diabetes using general practice networks: a quality improvement project in east London.

PubMed

Hull, Sally; Chowdhury, Tahseen A; Mathur, Rohini; Robson, John

2014-02-01

Structured diabetes care can improve outcomes and reduce risk of complications, but improving care in a deprived, ethnically diverse area can prove challenging. This report evaluates a system change to enhance diabetes care delivery in a primary care setting. All 35 practices in one inner London Primary Care Trust were geographically grouped into eight networks of four to five practices, each supported by a network manager, clerical staff and an educational budget. A multidisciplinary team developed a 'care package' for type 2 diabetes management, with financial incentives based on network achievement of targets. Monthly electronic performance dashboards enabled networks to track and improve performance. Network multidisciplinary team meetings including the diabetic specialist team supported case management and education. Key measures for improvement included the number of diabetes care plans completed, proportion of patients attending for digital retinal screen and proportions of patients achieving a number of biomedical indices (blood pressure, cholesterol, glycated haemoglobin). Between 2009 and 2012, completed care plans rose from 10% to 88%. The proportion of patients attending for digital retinal screen rose from 72% to 82.8%. The proportion of patients achieving a combination of blood pressure ≤ 140/80 mm Hg and cholesterol ≤ 4 mmol/L rose from 35.3% to 46.1%. Mean glycated haemoglobin dropped from 7.80% to 7.66% (62-60 mmol/mol). Investment of financial, organisational and education resources into primary care practice networks can achieve clinically important improvements in diabetes care in deprived, ethnically diverse communities. This success is predicated on collaborative working between practices, purposively designed high-quality information on network performance and engagement between primary and secondary care clinicians.

Continuous positive airway pressure improves gait control in severe obstructive sleep apnoea: A prospective study

PubMed Central

Wuyam, Bernard; Pépin, Jean-Louis; Marillier, Mathieu; Tamisier, Renaud; Pérennou, Dominic; Verges, Samuel

2018-01-01

Study aim Severe obstructive sleep apnoea (OSA) can lead to neurocognitive alterations, including gait impairments. The beneficial effects of continuous positive airway pressure (CPAP) on improving excessive daytime sleepiness and daily functioning have been documented. However, a demonstration of CPAP treatment efficacy on gait control is still lacking. This study aims to test the hypothesis that CPAP improves gait control in severe OSA patients. Material and methods In this prospective controlled study, twelve severe OSA patients (age = 57.2±8.9 years, body mass index = 27.4±3.1 kg·m-2, apnoea-hypopnoea index = 46.3±11.7 events·h-1) and 10 healthy matched subjects were included. Overground gait parameters were recorded at spontaneous speed and stride time variability, a clinical marker of gait control, was calculated. To assess the role of executive functions in gait and postural control, a dual-task paradigm was applied using a Stroop test as secondary cognitive task. All assessments were performed before and after 8 weeks of CPAP treatment. Results Before CPAP treatment, OSA patients had significantly larger stride time variability (3.1±1.1% vs 2.1±0.5%) and lower cognitive performances under dual task compared to controls. After CPAP treatment, stride time variability was significantly improved and no longer different compared to controls. Cognitive performance under dual task also improved after CPAP treatment. Conclusion Eight weeks of CPAP treatment improves gait control of severe OSA patients, suggesting morphological and functional cerebral improvements. Our data provide a rationale for further mechanistic studies and the use of gait as a biomarker of OSA brain consequences. PMID:29474363

Preventing hospital-acquired venous thromboembolism: Improving patient safety with interdisciplinary teamwork, quality improvement analytics, and data transparency.

PubMed

Schleyer, Anneliese M; Robinson, Ellen; Dumitru, Roxana; Taylor, Mark; Hayes, Kimberly; Pergamit, Ronald; Beingessner, Daphne M; Zaros, Mark C; Cuschieri, Joseph

2016-12-01

Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE. Pre/post assessment. Urban academic tertiary referral center, level 1 trauma center, safety net hospital; all patients. We formed a multidisciplinary VTE task force to review all HA-VTE events, assess prevention practices relative to evidence-based institutional guidelines, and identify improvement opportunities. The task force developed an electronic tool to facilitate efficient VTE event review and designed decision-support and reporting tools, now integrated into the electronic health record, to bring optimal VTE prevention practices to the point of care. Performance is shared transparently across the institution. Harborview benchmarks process and outcome performance, including patient safety indicators and core measures, against hospitals nationally using Hospital Compare and Vizient data. Our program has resulted in >90% guideline-adherent VTE prevention and zero preventable HA-VTEs. Initiatives have resulted in a 15% decrease in HA-VTE and a 21% reduction in postoperative VTE. Keys to success include the multidisciplinary approach, clinical roles of task force members, senior leadership support, and use of quality improvement analytics for retrospective review, prospective reporting, and performance transparency. Ongoing task force collaboration with frontline providers is critical to sustained improvements. Journal of Hospital Medicine 2016;11:S38-S43. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Perceptual Learning in Children With Infantile Nystagmus: Effects on Visual Performance.

PubMed

Huurneman, Bianca; Boonstra, F Nienke; Goossens, Jeroen

2016-08-01

To evaluate whether computerized training with a crowded or uncrowded letter-discrimination task reduces visual impairment (VI) in 6- to 11-year-old children with infantile nystagmus (IN) who suffer from increased foveal crowding, reduced visual acuity, and reduced stereopsis. Thirty-six children with IN were included. Eighteen had idiopathic IN and 18 had oculocutaneous albinism. These children were divided in two training groups matched on age and diagnosis: a crowded training group (n = 18) and an uncrowded training group (n = 18). Training occurred two times per week during 5 weeks (3500 trials per training). Eleven age-matched children with normal vision were included to assess baseline differences in task performance and test-retest learning. Main outcome measures were task-specific performance, distance and near visual acuity (DVA and NVA), intensity and extent of (foveal) crowding at 5 m and 40 cm, and stereopsis. Training resulted in task-specific improvements. Both training groups also showed uncrowded and crowded DVA improvements (0.10 ± 0.02 and 0.11 ± 0.02 logMAR) and improved stereopsis (670 ± 249″). Crowded NVA improved only in the crowded training group (0.15 ± 0.02 logMAR), which was also the only group showing a reduction in near crowding intensity (0.08 ± 0.03 logMAR). Effects were not due to test-retest learning. Perceptual learning with or without distractors reduces the extent of crowding and improves visual acuity in children with IN. Training with distractors improves near vision more than training with single optotypes. Perceptual learning also transfers to DVA and NVA under uncrowded and crowded conditions and even stereopsis. Learning curves indicated that improvements may be larger after longer training.

Improved Portable Ultrasonic Leak Detectors

NASA Technical Reports Server (NTRS)

Youngquist, Robert C.; Moerk, John S.; Haskell, William D.; Cox, Robert B.; Polk, Jimmy D.; Strobel, James P.; Luaces, Frank

1995-01-01

Improved portable ultrasonic leak detector features three interchangeable ultrasonic-transducer modules, each suited for operation in unique noncontact or contact mode. One module equipped with ultrasound-collecting horn for use in scanning to detect leaks from distance; horn provides directional sensitivity pattern with sensitivity multiplied by factor of about 6 in forward direction. Another module similar, does not include horn; this module used for scanning close to suspected leak, where proximity of leak more than offsets loss of sensitivity occasioned by lack of horn. Third module designed to be pressed against leaking vessel; includes rugged stainless-steel shell. Improved detectors perform significantly better, smaller, more rugged, and greater sensitivity.

Has compliance with CLIA requirements really improved quality in US clinical laboratories?

PubMed

Ehrmeyer, Sharon S; Laessig, Ronald H

2004-08-02

The Clinical Laboratory Improvement Amendments of 1988 (CLIA'88) mandate universal requirements for all U.S. clinical laboratory-testing sites. The intent of CLIA'88 is to ensure quality testing through a combination of minimum quality practices that incorporate total quality management concepts. These regulations do not contain established, objective indicators or measures to assess quality. However, there is an implicit assumption that compliance with traditionally accepted good laboratory practices--following manufacturers' directions, routinely analysing quality control materials, applying quality assurance principles, employing and assessing competent testing personnel, and participating in external quality assessment or proficiency testing (PT)--will result in improved test quality. The CLIA'88 regulations do include PT performance standards, which intentionally or unintentionally, define intra-laboratory performance. Passing PT has become a prime motivation for improving laboratory performance; it can also be used as an objective indicator to assess whether compliance to CLIA has improved intra-laboratory quality. Data from 1994 through 2002 indicate that the percentage of laboratories passing PT has increased. In addition to PT performance, subjective indicators of improved quality--frequency of inspection deficiencies, the number of government sanctions for non-compliance, and customer satisfaction--were evaluated. The results from these subjective indicators are more difficult to interpret but also seem to show improved quality in US clinical laboratories eleven years post-CLIA'88.

Satellite-tracking and Earth dynamics research programs

NASA Technical Reports Server (NTRS)

1982-01-01

The activities carried out by the Smithsonian Astrophysical Observatory (SAO) are described. The SAO network continued to track LAGEOS at highest priority for polar motion and Earth rotation studies, and for other geophysical investigations, including crustal dynamics, Earth and ocean tides, and the general development of precision orbit determination. The network performed regular tracking of several other retroreflector satellites including GEOS-1, GEOS-3, BE-C, and Starlette for refined determinations of station coordinates and the Earth's gravity field and for studies of solid Earth dynamics. A major program in laser upgrading continued to improve ranging accuracy and data yield. This program includes an increase in pulse repetition rate from 8 ppm to 30 ppm, a reduction in laser pulse width from 6 nsec to 2 to 3 nsec, improvements in the photoreceiver and the electronics to improve daylight ranging, and an analog pulse detection system to improve range noise and accuracy. Data processing hardware and software are discussed.

Lasting effect of an oral hygiene care program for patients with stroke during in-hospital rehabilitation: a randomized single-center clinical trial.

PubMed

Kim, Eun-Kyong; Park, Eun Young; Sa Gong, Jung-Whan; Jang, Sung-Ho; Choi, Youn-Hee; Lee, Hee-Kyung

2017-11-01

Because the oral hygiene is poorly prioritized in the immediate post-stroke period, we implemented an oral hygiene care program (OHCP) for stroke in-patients and evaluated its persistence after discharge. In all, 62 patients with stroke who were admitted to the rehabilitation ward were randomly assigned to two groups: 33 patients to the intervention group and 29 to the control group. The OHCP, including tooth brushing education and professional tooth cleaning, was administered to the intervention group twice a week six times during in-hospital rehabilitation. Oral health status was examined both at baseline and three months after discharge from the hospital. Oral hygiene status was examined at three- to four-day intervals five times during the hospitalization period. After OHCP, oral hygiene status including the plaque index, calculus index, and O'Leary plaque index improved significantly in the intervention group, compared to the control group (p < 0.05). In the intervention group, after administration of the OHCP for the fourth time, the O'Leary index improved significantly, and remained high when checked three months after discharge (p < 0.001). An OHCP conducted during in-hospital rehabilitation was effective in improving oral health and plaque control performance among patients with stroke, with effects still seen three months after discharge from the hospital. Implications for Rehabilitation Initial oral hygiene status and plaque control performance were poor in stroke patients who were in rehabilitation center. An oral hygiene care program during in-hospital rehabilitation was effective in improving oral hygiene status and plaque control performance among stroke patients at three months after discharge. Repeated tooth brushing education and professional tooth cleaning were necessary to improve plaque control performance of stroke patients.

Thermal barrier coating on high temperature industrial gas turbine engines

NASA Technical Reports Server (NTRS)

Carlson, N.; Stoner, B. L.

1977-01-01

The thermal barrier coating used was a yttria stabilized zirconia material with a NiCrAlY undercoat, and the base engine used to establish improvements was the P&WA FT50A-4 industrial gas turbine engine. The design benefits of thermal barrier coatings include simplified cooling schemes and the use of conventional alloys in the engine hot section. Cooling flow reductions and improved heating rates achieved with thermal barrier coating result in improved performance. Economic benefits include reduced power production costs and reduced fuel consumption. Over the 30,000 hour life of the thermal barrier coated parts, fuel savings equivalent to $5 million are projected and specific power (megawatts/mass of engine airflow) improvements on the order of 13% are estimated.

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

Perrin, Tess E.; Davis, Robert G.; Wilkerson, Andrea M.

This GATEWAY project evaluated four field installations to better understand the long-term performance of a number of LED products, which can hopefully stimulate improvements in designing, manufacturing, specifying, procuring, and installing LED products. Field studies provide the opportunity to discover and investigate issues that cannot be simulated or uncovered in a laboratory, but the installed performance over time of commercially available LED products has not been well documented. Improving long-term performance can provide both direct energy savings by reducing the need to over-light to account for light loss and indirect energy savings through better market penetration due to SSL’s competitivemore » advantages over less-efficient light source technologies. The projects evaluated for this report illustrate that SSL use is often motivated by advantages other than energy savings, including maintenance savings, easier integration with control systems, and improved lighting quality.« less

The Case for Unit-Based Teams: A Model for Front-line Engagement and Performance Improvement

PubMed Central

Cohen, Paul M; Ptaskiewicz, Mark; Mipos, Debra

2010-01-01

Unit-based teams (UBTs)—defined as natural work groups of physicians, managers, and frontline staff who work collaboratively to solve problems, improve performance, and enhance quality—were established by the 2005 national agreement between Kaiser Permanente (KP) and the Coalition of KP Unions. They use established performance-improvement techniques and employee-engagement principles (including social-movement theory) to achieve clinical and operational goals. UBT members identify performance gaps and opportunities within their purview—issues they can address in the course of the day-to-day work, such as workflow or process improvement. By focusing on clear, agreed-on goals, UBTs encourage greater accountability and allow members to perform their full scope of work. UBTs are designed to deliver measurable benefits in clinical outcomes and operations, patient-experience enhancements, and physician-team performance or work life. For many physicians, UBTs will require new ways of engaging with their teams. However, evidence suggests that with organizational and physician support, these teams can achieve their goals. This article presents case examples of successful UBTs' outcomes; physicians' comments on their experience working with teams; an overview of UBTs' employee-engagement principles; and advice on how physicians can support and participate in the work of such teams. PMID:20740124

Introducing an accountability framework for polio eradication in Ethiopia: results from the first year of implementation 2014-2015

PubMed Central

Kassahun, Aron; Braka, Fiona; Gallagher, Kathleen; Gebriel, Aregai Wolde; Nsubuga, Peter; M’pele-Kilebou, Pierre

2017-01-01

Introduction the World Health Organization (WHO), Ethiopia country office, introduced an accountability framework into its Polio Eradication Program in 2014 with the aim of improving the program's performance. Our study aims to evaluate staff performance and key program indicators following the introduction of the accountability framework. Methods the impact of the WHO accountability framework was reviewed after its first year of implementation from June 2014 to June 2015. We analyzed selected program and staff performance indicators associated with acute flaccid paralysis (AFP) surveillance from a database available at WHO. Data on managerial actions taken were also reviewed. Performance of a total of 38 staff was evaluated during our review. Results our review of results for the first four quarters of implementation of the polio eradication accountability framework showed improvement both at the program and individual level when compared with the previous year. Managerial actions taken during the study period based on the results from the monitoring tool included eleven written acknowledgments, six discussions regarding performance improvement, six rotations of staff, four written first-warning letters and nine non-renewal of contracts. Conclusion the introduction of the accountability framework resulted in improvement in staff performance and overall program indicators for AFP surveillance. PMID:28890753

Martial Art Training and Cognitive Performance in Middle-Aged Adults.

PubMed

Douris, Peter; Douris, Christopher; Balder, Nicole; LaCasse, Michael; Rand, Amir; Tarapore, Freya; Zhuchkan, Aleskey; Handrakis, John

2015-09-29

Cognitive performance includes the processes of attention, memory, processing speed, and executive functioning, which typically declines with aging. Previous research has demonstrated that aerobic and resistance exercise improves cognitive performance immediately following exercise. However, there is limited research examining the effect that a cognitively complex exercise such as martial art training has on these cognitive processes. Our study compared the acute effects of 2 types of martial art training to aerobic exercise on cognitive performance in middle-aged adults. We utilized a repeated measures design with the order of the 3 exercise conditions randomly assigned and counterbalanced. Ten recreational middle-aged martial artists (mean age = 53.5 ± 8.6 years) participated in 3 treatment conditions: a typical martial art class, an atypical martial art class, and a one-hour walk at a self-selected speed. Cognitive performance was assessed by the Stroop Color and Word test. While all 3 exercise conditions improved attention and processing speed, only the 2 martial art conditions improved the highest order of cognitive performance, executive function. The effect of the 2 martial art conditions on executive function was not different. The improvement in executive function may be due to the increased cortical demand required by the more complex, coordinated motor tasks of martial art exercise compared to the more repetitive actions of walking.

Martial Art Training and Cognitive Performance in Middle-Aged Adults

PubMed Central

Douris, Peter; Douris, Christopher; Balder, Nicole; LaCasse, Michael; Rand, Amir; Tarapore, Freya; Zhuchkan, Aleskey; Handrakis, John

2015-01-01

Cognitive performance includes the processes of attention, memory, processing speed, and executive functioning, which typically declines with aging. Previous research has demonstrated that aerobic and resistance exercise improves cognitive performance immediately following exercise. However, there is limited research examining the effect that a cognitively complex exercise such as martial art training has on these cognitive processes. Our study compared the acute effects of 2 types of martial art training to aerobic exercise on cognitive performance in middle-aged adults. We utilized a repeated measures design with the order of the 3 exercise conditions randomly assigned and counterbalanced. Ten recreational middle-aged martial artists (mean age = 53.5 ± 8.6 years) participated in 3 treatment conditions: a typical martial art class, an atypical martial art class, and a one-hour walk at a self-selected speed. Cognitive performance was assessed by the Stroop Color and Word test. While all 3 exercise conditions improved attention and processing speed, only the 2 martial art conditions improved the highest order of cognitive performance, executive function. The effect of the 2 martial art conditions on executive function was not different. The improvement in executive function may be due to the increased cortical demand required by the more complex, coordinated motor tasks of martial art exercise compared to the more repetitive actions of walking. PMID:26672872

Rowing performance, body composition, and bone mineral density outcomes in college-level rowers after a season of concurrent training.

PubMed

Young, Kaelin C; Kendall, Kristina L; Patterson, Kaitlyn M; Pandya, Priyanka D; Fairman, Ciaran M; Smith, Samuel W

2014-11-01

To assess changes in body composition, lumbar-spine bone mineral density (BMD), and rowing performance in college-level rowers over a competition season. Eleven Division I college rowers (mean ± SD 21.4 ± 3.7 y) completed 6 testing sessions throughout the course of their competition season. Testing included measurements of fat mass, bone-free lean mass (BFLM), body fat (%BF), lumbar-spine BMD, and 2000-m time-trial performance. After preseason testing, rowers participated in a periodized training program, with the addition of resistance training to the traditional aerobic-training program. Significant (P < .05) improvements in %BF, total mass, and BFLM were observed at midseason and postseason compared with preseason. Neither lumbar-spine BMD nor BMC significantly changed over the competitive season (P > .05). Finally, rowing performance (as measured by 2000-m time and average watts achieved) significantly improved at midseason and postseason compared with preseason. Our results highlight the efficacy of a seasonal concurrent training program serving to improve body composition and rowing performance, as measured by 2000-m times and average watts, among college-level rowers. Our findings offer practical applications for coaches and athletes looking to design a concurrent strength and aerobic training program to improve rowing performance across a season.

Analysing organisational context: case studies on the contribution of absorptive capacity theory to understanding inter-organisational variation in performance improvement.

PubMed

Harvey, Gill; Jas, Pauline; Walshe, Kieran

2015-01-01

Organisational context is frequently cited as an important consideration when implementing and evaluating quality improvement interventions in healthcare, but limited guidance is available on which aspects of context are most influential or modifiable. This paper examines how internal and external contextual factors mediate organisational-level performance improvement through applying the knowledge-based theory of absorptive capacity (AC). Three healthcare case studies are presented. Each case is a UK National Health Service organisation that had been identified as having performance problems. Qualitative data were collected through semi-structured interviews with general and clinical managers within the organisation and members of external teams supporting or overseeing performance improvement (n=22). Interview data were analysed using an existing AC framework from the literature. The organisation with the highest AC showed the quickest and most comprehensive performance improvement. Internal characteristics including strategic priorities, processes for managing information, communication and orientation to learning and development impacted on the organisation's ability to engage successfully with external stakeholders and make use of available knowledge. This enabled the organisation to thrive despite the challenging external environment. Lower levels of AC appeared to delay or limit the improvement trajectory. Developing a more detailed and nuanced understanding of how context influences improvement is an important step towards achieving more effective and sustainable quality improvement programmes in healthcare. AC, with its focus on knowledge and organisational learning, provides a useful way to explore the relationship between context and quality improvement and represents a potentially valuable area for future research and development. 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.

Examining the Effects of the Flipped Model of Instruction on Student Engagement and Performance in the Secondary Mathematics Classroom: An Action Research Study

ERIC Educational Resources Information Center

Clark, Kevin R.

2013-01-01

In many of the secondary classrooms across the country, including the research site for this study, students are passively engaged in the mathematics content, and academic performance can be described, at best, as mediocre. This action research study sought to bring about improvements in student engagement and performance in the secondary…

The United States Air Force Officer Effectiveness Report as Promotion Selection Tool

DTIC Science & Technology

1986-03-01

Force <USAF) Officer Effectiveness Report (OER) is the performance appraisal system for the officer corps. Uses of the ÜBR include r personnel...studies in performance appraisal; discusses the extent to which the present OER addresses leadership; and, makes recommendations for improving the... performance factors. T’iese traits are: knowledge, planning ability, goal setting, communicative ability, personal contacts, initiative, delegation, and

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

Maloney, J.; Kiepper, A.F.; Simonetta, R.J.

The volume examines monitoring and reporting procedures applicable to performance and productivity. The managers of three transit systems of varying sizes discuss how productivity has been increased within their systems. The Pittsburgh discussion reviews a variety of capital projects and management improvement initiatives undertaken by Port Authority Transit, including development of maintenance manuals and an absenteeism reduction project. The Houston discussion describes how the property used a management study to identify needed organizational change and restructuring. The Ann Arbor discussion focuses on a set of service standards and performance indicators adopted to focus the management improvement process.

Using a balanced scorecard to improve the performance of an emergency department.

PubMed

Huang, Shu-Hsin; Chen, Ping-Ling; Yang, Ming-Chin; Chang, Wen-Yin; Lee, Haw-Jenn

2004-01-01

The performance of the emergency department significantly improved after implementing the balanced scorecard including hours of continuing education attended by the staff, staff job satisfaction, the rate of incomplete laboratory tests within 30 minutes, the average monthly inappropriate return rate, and hospital profit. The results can assist administrators plan for the future. Although this was a pilot program for implementing a balanced scorecard in an emergency department, the indicators used in this study may also be reasonable for a hospital that has limited resources.

A Study to Determine the Best Way for Letterman Army Medical Center to Comply with the 1981 JCAH (Joint Commission on Accreditation of Hospitals) Quality Assurance Standard

DTIC Science & Technology

1980-08-01

follow-up action taken would be prima facie evidence of the program’s positive impact on patient care/ clinical performance. Direct and indirect...demonstration of improved patient care/clinical performance must be shown. Prima facie evidence 57 of such improvement would include a summary of identified...even in relation to the seven other HSC medical cen- ters, because of the following reasons: - Active duty patients cannot- claim or file a law- suit

Optimization of Mud Hammer Drilling Performance--A Program to Benchmark the Viability of Advanced Mud Hammer Drilling

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

Arnis Judzis

2006-03-01

Operators continue to look for ways to improve hard rock drilling performance through emerging technologies. A consortium of Department of Energy, operator and industry participants put together an effort to test and optimize mud driven fluid hammers as one emerging technology that has shown promise to increase penetration rates in hard rock. The thrust of this program has been to test and record the performance of fluid hammers in full scale test conditions including, hard formations at simulated depth, high density/high solids drilling muds, and realistic fluid power levels. This paper details the testing and results of testing two 7more » 3/4 inch diameter mud hammers with 8 1/2 inch hammer bits. A Novatek MHN5 and an SDS Digger FH185 mud hammer were tested with several bit types, with performance being compared to a conventional (IADC Code 537) tricone bit. These tools functionally operated in all of the simulated downhole environments. The performance was in the range of the baseline ticone or better at lower borehole pressures, but at higher borehole pressures the performance was in the lower range or below that of the baseline tricone bit. A new drilling mode was observed, while operating the MHN5 mud hammer. This mode was noticed as the weight on bit (WOB) was in transition from low to high applied load. During this new ''transition drilling mode'', performance was substantially improved and in some cases outperformed the tricone bit. Improvements were noted for the SDS tool while drilling with a more aggressive bit design. Future work includes the optimization of these or the next generation tools for operating in higher density and higher borehole pressure conditions and improving bit design and technology based on the knowledge gained from this test program.« less

Hemoglobin Regulates the Metabolic, Synthetic, Detoxification, and Biotransformation Functions of Hepatoma Cells Cultured in a Hollow Fiber Bioreactor

PubMed Central

Chen, Guo

2010-01-01

Hepatic hollow fiber (HF) bioreactors constitute one type of extracorporeal bioartificial liver assist device (BLAD). Ideally, cultured hepatocytes in a BLAD should closely mimic the in vivo oxygenation environment of the liver sinusoid to yield a device with optimal performance. However, most BLADs, including hepatic HF bioreactors, suffer from O2 limited transport toward cultured hepatocytes, which reduces their performance. We hypothesize that supplementation of hemoglobin-based O2 carriers into the circulating cell culture medium of hepatic HF bioreactors is a feasible and effective strategy to improve bioreactor oxygenation and performance. We examined the effect of bovine hemoglobin (BvHb) supplementation (15 g/L) in the circulating cell culture medium of hepatic HF bioreactors on hepatocyte proliferation, metabolism, and varied liver functions, including biosynthesis, detoxification, and biotransformation. It was observed that BvHb supplementation supported the maintenance of a higher cell mass in the extracapillary space, improved hepatocyte metabolic efficiency (i.e., hepatocytes consumed much less glucose), improved hepatocyte capacity for drug metabolism, and conserved both albumin synthesis and ammonia detoxification functions compared to controls (no BvHb supplementation) under the same experimental conditions. PMID:20528678

Effect of a submaximal half-squats warm-up program on vertical jumping ability.

PubMed

Gourgoulis, Vassilios; Aggeloussis, Nickos; Kasimatis, Panagiotis; Mavromatis, Giorgos; Garas, Athanasios

2003-05-01

The purpose of the current research was to study the effect of a warm-up program including submaximal half-squats on vertical jumping ability. Twenty physically active men participated in the study. Each subject performed 5 sets of half-squats with 2 repetitions at each of the following intensities: 20, 40, 60, 80, and 90% of the 1 repetition maximum (1RM) load. Prior to the first set and immediately after the end of the last set, the subjects performed 2 countermovement jumps on a Kistler force platform; the primary goal was to jump as high as possible. The results showed that mean vertical jumping ability improved by 2.39% after the warm-up period. Subjects were then divided into 2 groups according to their 1RM values for the half-squat. Subjects with greater maximal strength ability improved their vertical jumping ability (4.01%) more than did subjects with lower maximal strength (0.42%). A warm-up protocol including half-squats with submaximal loads and explosive execution can be used for short-term improvements of vertical jumping performance, and this effect is greater in athletes with a relatively high strength ability.

Recent advances in PC-Linux systems for electronic structure computations by optimized compilers and numerical libraries.

PubMed

Yu, Jen-Shiang K; Yu, Chin-Hui

2002-01-01

One of the most frequently used packages for electronic structure research, GAUSSIAN 98, is compiled on Linux systems with various hardware configurations, including AMD Athlon (with the "Thunderbird" core), AthlonMP, and AthlonXP (with the "Palomino" core) systems as well as the Intel Pentium 4 (with the "Willamette" core) machines. The default PGI FORTRAN compiler (pgf77) and the Intel FORTRAN compiler (ifc) are respectively employed with different architectural optimization options to compile GAUSSIAN 98 and test the performance improvement. In addition to the BLAS library included in revision A.11 of this package, the Automatically Tuned Linear Algebra Software (ATLAS) library is linked against the binary executables to improve the performance. Various Hartree-Fock, density-functional theories, and the MP2 calculations are done for benchmarking purposes. It is found that the combination of ifc with ATLAS library gives the best performance for GAUSSIAN 98 on all of these PC-Linux computers, including AMD and Intel CPUs. Even on AMD systems, the Intel FORTRAN compiler invariably produces binaries with better performance than pgf77. The enhancement provided by the ATLAS library is more significant for post-Hartree-Fock calculations. The performance on one single CPU is potentially as good as that on an Alpha 21264A workstation or an SGI supercomputer. The floating-point marks by SpecFP2000 have similar trends to the results of GAUSSIAN 98 package.

Utilization of waste heat in trucks for increased fuel economy

NASA Technical Reports Server (NTRS)

Leising, C. J.; Purohit, G. P.; Degrey, S. P.; Finegold, J. G.

1978-01-01

The waste heat utilization concepts include preheating, regeneration, turbocharging, turbocompounding, and Rankine engine compounding. Predictions are based on fuel-air cycle analyses, computer simulation, and engine test data. All options are evaluated in terms of maximum theoretical improvements, but the Diesel and adiabatic Diesel are also compared on the basis of maximum expected improvement and expected improvement over a driving cycle. The study indicates that Diesels should be turbocharged and aftercooled to the maximum possible level. The results reveal that Diesel driving cycle performance can be increased by 20% through increased turbocharging, turbocompounding, and Rankine engine compounding. The Rankine engine compounding provides about three times as much improvement as turbocompounding but also costs about three times as much. Performance for either can be approximately doubled if applied to an adiabatic Diesel.

Improved pulmonary nodule classification utilizing quantitative lung parenchyma features.

PubMed

Dilger, Samantha K N; Uthoff, Johanna; Judisch, Alexandra; Hammond, Emily; Mott, Sarah L; Smith, Brian J; Newell, John D; Hoffman, Eric A; Sieren, Jessica C

2015-10-01

Current computer-aided diagnosis (CAD) models for determining pulmonary nodule malignancy characterize nodule shape, density, and border in computed tomography (CT) data. Analyzing the lung parenchyma surrounding the nodule has been minimally explored. We hypothesize that improved nodule classification is achievable by including features quantified from the surrounding lung tissue. To explore this hypothesis, we have developed expanded quantitative CT feature extraction techniques, including volumetric Laws texture energy measures for the parenchyma and nodule, border descriptors using ray-casting and rubber-band straightening, histogram features characterizing densities, and global lung measurements. Using stepwise forward selection and leave-one-case-out cross-validation, a neural network was used for classification. When applied to 50 nodules (22 malignant and 28 benign) from high-resolution CT scans, 52 features (8 nodule, 39 parenchymal, and 5 global) were statistically significant. Nodule-only features yielded an area under the ROC curve of 0.918 (including nodule size) and 0.872 (excluding nodule size). Performance was improved through inclusion of parenchymal (0.938) and global features (0.932). These results show a trend toward increased performance when the parenchyma is included, coupled with the large number of significant parenchymal features that support our hypothesis: the pulmonary parenchyma is influenced differentially by malignant versus benign nodules, assisting CAD-based nodule characterizations.

Strategy for the Management of Macular Edema in Retinal Vein Occlusion: The European VitreoRetinal Society Macular Edema Study

PubMed Central

Adelman, Ron A.; Parnes, Aaron J.; Bopp, Silvia; Saad Othman, Ihab; Ducournau, Didier

2015-01-01

Objective. To compare the efficacy of different therapies in the treatment of macular edema associated with retinal vein occlusion (RVO). Design. This is a nonrandomized, multicenter collaborative study. Participants. 86 retina specialists from 29 countries provided clinical information, including choice of treatment and outcome, on 2,603 patients with macular edema including 738 cases of RVO. Methods. Reported data included the type and number of treatments performed, visual acuities, and other clinical and diagnostic findings. Main Outcome Measures. The mean increase in visual acuity and mean number of treatments performed. Results. 358 cases of central retinal vein occlusion (CRVO) and 380 cases of branch retinal vein occlusion (BRVO) were included in this investigation. Taking all RVO cases together, pars plana vitrectomy with internal limiting membrane (ILM) peeling alone resulted in an improvement in vision greater than other therapies. Those treated with intravitreal antivascular endothelial growth factor (anti-VEGF) injection alone showed the second greatest improvement in vision. Dexamethasone intravitreal implant alone and intravitreal triamcinolone alone both resulted in modest visual gains. Conclusions. In the treatment of macular edema in RVO, vitrectomy with ILM peeling may achieve visual improvement and may be a good option for certain cases. Anti-VEGF injection is the most effective of the nonsurgical treatments. PMID:25705695

Strategy for the management of macular edema in retinal vein occlusion: the European VitreoRetinal Society macular edema study.

PubMed

Adelman, Ron A; Parnes, Aaron J; Bopp, Silvia; Saad Othman, Ihab; Ducournau, Didier

2015-01-01

To compare the efficacy of different therapies in the treatment of macular edema associated with retinal vein occlusion (RVO). This is a nonrandomized, multicenter collaborative study. 86 retina specialists from 29 countries provided clinical information, including choice of treatment and outcome, on 2,603 patients with macular edema including 738 cases of RVO. Reported data included the type and number of treatments performed, visual acuities, and other clinical and diagnostic findings. The mean increase in visual acuity and mean number of treatments performed. 358 cases of central retinal vein occlusion (CRVO) and 380 cases of branch retinal vein occlusion (BRVO) were included in this investigation. Taking all RVO cases together, pars plana vitrectomy with internal limiting membrane (ILM) peeling alone resulted in an improvement in vision greater than other therapies. Those treated with intravitreal antivascular endothelial growth factor (anti-VEGF) injection alone showed the second greatest improvement in vision. Dexamethasone intravitreal implant alone and intravitreal triamcinolone alone both resulted in modest visual gains. In the treatment of macular edema in RVO, vitrectomy with ILM peeling may achieve visual improvement and may be a good option for certain cases. Anti-VEGF injection is the most effective of the nonsurgical treatments.

Qualitative evaluation of just-in-time simulation-based learning: the learners' perspective.

PubMed

Kamdar, Gunjan; Kessler, David O; Tilt, Lindsey; Srivastava, Geetanjali; Khanna, Kajal; Chang, Todd P; Balmer, Dorene; Auerbach, Marc

2013-02-01

Just-in-time training (JITT) is an educational strategy where training occurs in close temporal proximity to a clinical encounter. A multicenter study evaluated the impact of simulation-based JITT on interns' infant lumbar puncture (LP) success rates. Concurrent with this multicenter study, we conducted a qualitative evaluation to describe learner perceptions of this modality of skills training. Eleven interns from a single institution participated in a face-to-face semistructured interview exploring their JITT experience. Interviews were audio-recorded and transcribed. Two investigators reviewed the transcripts, assigned codes to the data, and categorized the codes. Categories were modified by 4 emergency physicians. As a means of data triangulation, we performed focus groups at a second institution. Benefits of JITT included review of anatomic landmarks, procedural rehearsal, and an opportunity to ask questions. These perceived benefits improved confidence with infant LP. Deficits of the training included lack of mannequin fidelity and unrealistic context when compared with an actual LP. An unexpected category, which emerged from our analysis, was that of barriers to JITT performance. Barriers included lack of time in a busy clinical setting and various instructor factors. The focus group findings confirmed and elaborated the benefits and deficits of JITT and the barriers to JITT performance. Just-in-time training improved procedural confidence with infant LP, but work place busyness and instructor lack of support or unawareness were barriers to JITT performance. Optimal LP JITT would occur with improved contextual fidelity. More research is needed to determine optimal training strategies that are effective for the learner and maximize clinical outcomes for the patient.

Micronutrient supplementation improves physical performance measures in Asian Indian school-age children.

PubMed

Vaz, Mario; Pauline, Maria; Unni, Uma S; Parikh, Panam; Thomas, Tinku; Bharathi, A V; Avadhany, Sandhya; Muthayya, Sumithra; Mehra, Ruchika; Kurpad, Anura V

2011-11-01

Micronutrients are important in physical work capacity and therefore performance. The impact of a multi-micronutrient-fortified nutritional beverage on physical performance measures among clinically healthy school-age children was assessed in a double-blind (for test and placebo groups), placebo-controlled, randomized trial in children aged between 7 and 10.5 y (n = 300). The participants with height- and weight-for-age Z-scores between 0 and ≥ -3 were randomized to 1 of 3 study arms: fortified choco-malt beverage powder (F), matched energy equivalent unfortified placebo (U), and untreated control (C). Participants in the F and C groups were given 40 g fortified (19 key vitamins and minerals) and unfortified choco-malt beverage, respectively, daily for 120 d. Primary efficacy outcomes included endurance and aerobic capacity using a 20-m shuttle test and step test. Other physical performance measures included speed (40-m sprint), visual reaction time, maximal hand grip, and forearm static endurance. Micronutrient status included thiamin, riboflavin, folate, niacin, iron, pyridoxal phosphate, and vitamins B-12 and C. All measurements were made at baseline and the end of the intervention. There was a within-subject increase in aerobic capacity and whole body endurance (P < 0.05) accompanied by a significant improvement in the status of iron thiamin, riboflavin, pyridoxal phosphate, folate, and vitamins C and B-12 in the F group compared to the within-subject changes in the other 2 groups (P < 0.05). The study suggests that multiple micronutrient supplementation in similar populations may be beneficial in improving micronutrient status and enhancing aerobic capacity and endurance in children.

The psychology behind doping in sport.

PubMed

Ehrnborg, Christer; Rosén, Thord

2009-08-01

Drugs and methods to improve physical performance among athletes have been used since the beginning of sport history, but the use of performance enhancing drugs has not always been regarded as cheating. In short, the motives for doping are improving and maintaining physical functioning, coping with the social/psychological pressures and striving for social and psychological goals, including economic benefits. Factors such as, "doping dilemma", "win at all costs", cost versus benefit, and the specificity of some specific doping agents, also play major roles. It seems that action on the athletes' attitude about the achievement of physical improvement and creating effective methods to reveal the drug abuse, are two main ways in winning the struggle against doping.

Quality improvement project to reduce infiltration and extravasation events in a pediatric hospital.

PubMed

Tofani, Barbara F; Rineair, Sylvia A; Gosdin, Craig H; Pilcher, Patricia M; McGee, Susan; Varadarajan, Kartik R; Schoettker, Pamela J

2012-12-01

A safety event response team at Cincinnati Children's Hospital Medical Center developed and tested improvement strategies to reduce peripheral intravenous (PIV) infiltration and extravasation injuries. Improvement activities included development of the touch-look-compare method for hourly PIV site assessment, staff education and mandatory demonstration of PIV site assessment, and performance monitoring and sharing of compliance results. We observed a significant reduction in the injury rate immediately following implementation of the interventions that corresponded with monitoring compliance in performing hourly assessments on patients with a PIV, but this was not sustained. The team is currently examining other strategies to reduce PIV injuries. Copyright © 2012 Elsevier Inc. All rights reserved.

Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study.

PubMed

Chaisson, Lelia H; Katamba, Achilles; Haguma, Priscilla; Ochom, Emmanuel; Ayakaka, Irene; Mugabe, Frank; Miller, Cecily; Vittinghoff, Eric; Davis, J Lucian; Handley, Margaret A; Cattamanchi, Adithya

2015-01-01

Tuberculosis (TB) remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda. We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care (ISTC): performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough ≥ 2 weeks' duration. The performance feedback evaluation included 1,446 adults; 838 (58%) were evaluated during the pre-intervention period and 608 (42%) during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10% to +20%, p<0.001) increase in the proportion of patients receiving ISTC-adherent care. The same-day microscopy evaluation included 1,950 adults; 907 (47%) were evaluated during the pre-intervention period and 1,043 (53%) during the post-intervention period. Same-day microscopy was associated with a 14% (95%CI +10% to +18%, p<0.001) increase in the proportion of patients receiving ISTC-adherent care. Performance feedback and same-day microscopy should be considered along with ISTC training as part of a multi-faceted intervention to improve the quality of TB evaluation in other high TB burden countries.

Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study

PubMed Central

Haguma, Priscilla; Ochom, Emmanuel; Ayakaka, Irene; Mugabe, Frank; Miller, Cecily; Vittinghoff, Eric; Davis, J. Lucian; Handley, Margaret A.; Cattamanchi, Adithya

2015-01-01

Background Tuberculosis (TB) remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda. Methods We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care (ISTC): performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough ≥ 2 weeks’ duration. Results The performance feedback evaluation included 1,446 adults; 838 (58%) were evaluated during the pre-intervention period and 608 (42%) during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10% to +20%, p<0.001) increase in the proportion of patients receiving ISTC-adherent care. The same-day microscopy evaluation included 1,950 adults; 907 (47%) were evaluated during the pre-intervention period and 1,043 (53%) during the post-intervention period. Same-day microscopy was associated with a 14% (95%CI +10% to +18%, p<0.001) increase in the proportion of patients receiving ISTC-adherent care. Conclusions Performance feedback and same-day microscopy should be considered along with ISTC training as part of a multi-faceted intervention to improve the quality of TB evaluation in other high TB burden countries. PMID:26172948

Functional training improves club head speed and functional fitness in older golfers.

PubMed

Thompson, Christian J; Cobb, Karen Myers; Blackwell, John

2007-02-01

Functional training programs have been used in a variety of rehabilitation settings with documented success. Based on that success, the concept of functional training has gained popularity in applied fitness settings to enhance sport performance. However, there has been little or no research studying the efficacy of functional training programs on the improvement of sport performance or functional fitness. Thus, it was the purpose of this study to determine the effect of a progressive functional training program on club head speed and functional fitness in older male golfers. Eighteen male golfers (age: 70.7 +/- 9.1 [SD] years) were randomly assigned to an exercise (N = 11) or control (N = 7) group. The exercise group participated in an 8-week progressive functional training program including flexibility exercises, core stability exercises, balance exercises, and resistance exercises. Pre- and postmeasurements included club head speed of a driver by radar (exercise and Control) and Fullerton Senior Fitness Test measurements (exercise only). One-way analysis of covariance was performed on club head speed measurements using pretest measurements as the covariate. Paired t-tests were performed to analyze Senior Fitness Test variables. After the intervention, maximal club head speed increased in the exercise group (127.3 +/- 13.4 to 133.6 +/- 14.2 km x hr(-1)) compared with the control group (134.5 +/- 14.6 to 133.3 +/- 11.2 km x hr(-1); p < 0.05). Additionally, improvements (p < 0.05) were detected for most Senior Fitness Test variables in the exercise group. In summary, this functional training program resulted in significant improvements in club head speed and several components of functional fitness. Future research should continue to examine the effect of functional training programs on sport performance and functional fitness in older adults.

Impact of pay for performance on access at first dialysis in Queensland.

PubMed

Haarsager, Jennie; Krishnasamy, Rathika; Gray, Nicholas A

2018-05-01

Commencement of haemodialysis with an arteriovenous fistula (AVF) or arteriovenous graft (AVG) is associated with improved survival compared with commencement with a central venous catheter. In 2011-2012, Queensland Health made incentive payments to renal units for early referred patients who commenced peritoneal dialysis (PD), or haemodialysis with an AVF/AVG. The aim of this study was to determine if pay for performance improved clinical care. All patients who commenced dialysis in Australia between 2009 and 2014 and were registered with the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) were included. A multivariable regression model was used to compare rates of commencing dialysis with a PD catheter or permanent AVF/AVG during the pay-for-performance period (2011-2012) with periods prior (2009-2010) and after (2013-2014). A total of 10 858 early referred patients commenced dialysis during the study period, including 2058 in Queensland. In Queensland, PD as first modality increased with time (P < 0.001) but there was no change in AVF/AVG rate at first haemodialysis (P = 0.5). In a multivariate model using the pay-for-performance period as reference, the odds ratio for commencement with PD or haemodialysis with an AVF/AVG in Queensland was 1.02 (95% CI 0.81-1.29) in 2009-2010 and 1.28 (95% CI 1.01-1.61) in 2013-2014. There was no change for the rest of Australia (0.97 95% CI 0.87-1.09 in 2009-2010 and 1.00 95% CI 0.90-1.11 in 2013-14). Pay for performance did not improve rates of commencement of dialysis with PD or an AVF/AVG during the payment period. A lag effect on clinical care may explain the improvement in later years. © 2017 Asian Pacific Society of Nephrology.

Tough Composite Materials

NASA Technical Reports Server (NTRS)

Vosteen, L. F. (Compiler); Johnson, N. J. (Compiler); Teichman, L. A. (Compiler)

1984-01-01

Papers and working group summaries are presented which address composite material behavior and performance improvement. Topic areas include composite fracture toughness and impact characterization, constituent properties and interrelationships, and matrix synthesis and characterization.

Development of new methodologies for evaluating the energy performance of new commercial buildings

NASA Astrophysics Data System (ADS)

Song, Suwon

The concept of Measurement and Verification (M&V) of a new building continues to become more important because efficient design alone is often not sufficient to deliver an efficient building. Simulation models that are calibrated to measured data can be used to evaluate the energy performance of new buildings if they are compared to energy baselines such as similar buildings, energy codes, and design standards. Unfortunately, there is a lack of detailed M&V methods and analysis methods to measure energy savings from new buildings that would have hypothetical energy baselines. Therefore, this study developed and demonstrated several new methodologies for evaluating the energy performance of new commercial buildings using a case-study building in Austin, Texas. First, three new M&V methods were developed to enhance the previous generic M&V framework for new buildings, including: (1) The development of a method to synthesize weather-normalized cooling energy use from a correlation of Motor Control Center (MCC) electricity use when chilled water use is unavailable, (2) The development of an improved method to analyze measured solar transmittance against incidence angle for sample glazing using different solar sensor types, including Eppley PSP and Li-Cor sensors, and (3) The development of an improved method to analyze chiller efficiency and operation at part-load conditions. Second, three new calibration methods were developed and analyzed, including: (1) A new percentile analysis added to the previous signature method for use with a DOE-2 calibration, (2) A new analysis to account for undocumented exhaust air in DOE-2 calibration, and (3) An analysis of the impact of synthesized direct normal solar radiation using the Erbs correlation on DOE-2 simulation. Third, an analysis of the actual energy savings compared to three different energy baselines was performed, including: (1) Energy Use Index (EUI) comparisons with sub-metered data, (2) New comparisons against Standards 90.1-1989 and 90.1-2001, and (3) A new evaluation of the performance of selected Energy Conservation Design Measures (ECDMs). Finally, potential energy savings were also simulated from selected improvements, including: minimum supply air flow, undocumented exhaust air, and daylighting.

Data on the natural ventilation performance of windcatcher with anti-short-circuit device (ASCD).

PubMed

Nejat, Payam; Calautit, John Kaiser; Majid, Muhd Zaimi Abd; Hughes, Ben Richard; Jomehzadeh, Fatemeh

2016-12-01

This article presents the datasets which were the results of the study explained in the research paper 'Anti-short-circuit device: a new solution for short-circuiting in windcatcher and improvement of natural ventilation performance' (P. Nejat, J.K. Calautit, M.Z. Abd. Majid, B.R. Hughes, F. Jomehzadeh, 2016) [1] which introduces a new technique to reduce or prevent short-circuiting in a two-sided windcatcher and also lowers the indoor CO2 concentration and improve the ventilation distribution. Here, we provide details of the numerical modeling set-up and data collection method to facilitate reproducibility. The datasets includes indoor airflow, ventilation rates and CO2 concentration data at several points in the flow field. The CAD geometry of the windcatcher models are also included.

Organic solvents, electrolytes, and lithium ion cells with good low temperature performance

NASA Technical Reports Server (NTRS)

Huang, Chen-Kuo (Inventor); Smart, Marshall C. (Inventor); Surampudi, Subbarao (Inventor); Bugga, Ratnakumar V. (Inventor)

2002-01-01

Multi-component organic solvent systems, electrolytes and electrochemical cells characterized by good low temperature performance are provided. In one embodiment, an improved organic solvent system contains a ternary mixture of ethylene carbonate, dimethyl carbonate and diethyl carbonate. In other embodiments, quaternary systems include a fourth component, i.e, an aliphatic ester, an asymmetric alkyl carbonate or a compound of the formula LiOX, where X is R, COOR, or COR, where R is alkyl or fluoroalkyl. Electrolytes based on such organic solvent systems are also provided and contain therein a lithium salt of high ionic mobility, such as LiPF.sub.6. Reversible electrochemical cells, particularly lithium ion cells, are constructed with the improved electrolytes, and preferably include a carbonaceous anode, an insertion type cathode, and an electrolyte interspersed therebetween.

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2012 CFR

2012-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... standards, including areas needing improvement; and (2) The institution's or program's performance with...

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2013 CFR

2013-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... standards, including areas needing improvement; and (2) The institution's or program's performance with...

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2011 CFR

2011-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... standards, including areas needing improvement; and (2) The institution's or program's performance with...

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2014 CFR

2014-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... standards, including areas needing improvement; and (2) The institution's or program's performance with...

Wearable Performance Devices in Sports Medicine.

PubMed

Li, Ryan T; Kling, Scott R; Salata, Michael J; Cupp, Sean A; Sheehan, Joseph; Voos, James E

2016-01-01

Wearable performance devices and sensors are becoming more readily available to the general population and athletic teams. Advances in technology have allowed individual endurance athletes, sports teams, and physicians to monitor functional movements, workloads, and biometric markers to maximize performance and minimize injury. Movement sensors include pedometers, accelerometers/gyroscopes, and global positioning satellite (GPS) devices. Physiologic sensors include heart rate monitors, sleep monitors, temperature sensors, and integrated sensors. The purpose of this review is to familiarize health care professionals and team physicians with the various available types of wearable sensors, discuss their current utilization, and present future applications in sports medicine. Data were obtained from peer-reviewed literature through a search of the PubMed database. Included studies searched development, outcomes, and validation of wearable performance devices such as GPS, accelerometers, and physiologic monitors in sports. Clinical review. Level 4. Wearable sensors provide a method of monitoring real-time physiologic and movement parameters during training and competitive sports. These parameters can be used to detect position-specific patterns in movement, design more efficient sports-specific training programs for performance optimization, and screen for potential causes of injury. More recent advances in movement sensors have improved accuracy in detecting high-acceleration movements during competitive sports. Wearable devices are valuable instruments for the improvement of sports performance. Evidence for use of these devices in professional sports is still limited. Future developments are needed to establish training protocols using data from wearable devices. © 2015 The Author(s).

A review of hospital characteristics associated with improved performance.

PubMed

Brand, Caroline A; Barker, Anna L; Morello, Renata T; Vitale, Michael R; Evans, Sue M; Scott, Ian A; Stoelwinder, Johannes U; Cameron, Peter A

2012-10-01

The objective of this review was to critically appraise the literature relating to associations between high-level structural and operational hospital characteristics and improved performance. The Cochrane Library, MEDLINE (Ovid), CINAHL, proQuest and PsychINFO were searched for articles published between January 1996 and May 2010. Reference lists of included articles were reviewed and key journals were hand searched for relevant articles. and data extraction Studies were included if they were systematic reviews or meta-analyses, randomized controlled trials, controlled before and after studies or observational studies (cohort and cross-sectional) that were multicentre, comparative performance studies. Two reviewers independently extracted data, assigned grades of evidence according to the Australian National Health and Medical Research Council guidelines and critically appraised the included articles. Data synthesis Fifty-seven studies were reported within 12 systematic reviews and 47 observational articles. There was heterogeneity in use and definition of performance outcomes. Hospital characteristics investigated were environment (incentives, market characteristics), structure (network membership, ownership, teaching status, geographical setting, service size) and operational design (innovativeness, leadership, organizational culture, public reporting and patient safety practices, information technology systems and decision support, service activity and planning, workforce design, staff training and education). The strongest evidence for an association with overall performance was identified for computerized physician order entry systems. Some evidence supported the associations with workforce design, use of financial incentives, nursing leadership and hospital volume. There is limited, mainly low-quality evidence, supporting the associations between hospital characteristics and healthcare performance. Further characteristic-specific systematic reviews are indicated.

Wearable Performance Devices in Sports Medicine

PubMed Central

Li, Ryan T.; Kling, Scott R.; Salata, Michael J.; Cupp, Sean A.; Sheehan, Joseph; Voos, James E.

2016-01-01

Context: Wearable performance devices and sensors are becoming more readily available to the general population and athletic teams. Advances in technology have allowed individual endurance athletes, sports teams, and physicians to monitor functional movements, workloads, and biometric markers to maximize performance and minimize injury. Movement sensors include pedometers, accelerometers/gyroscopes, and global positioning satellite (GPS) devices. Physiologic sensors include heart rate monitors, sleep monitors, temperature sensors, and integrated sensors. The purpose of this review is to familiarize health care professionals and team physicians with the various available types of wearable sensors, discuss their current utilization, and present future applications in sports medicine. Evidence Acquisition: Data were obtained from peer-reviewed literature through a search of the PubMed database. Included studies searched development, outcomes, and validation of wearable performance devices such as GPS, accelerometers, and physiologic monitors in sports. Study Design: Clinical review. Level of Evidence: Level 4. Results: Wearable sensors provide a method of monitoring real-time physiologic and movement parameters during training and competitive sports. These parameters can be used to detect position-specific patterns in movement, design more efficient sports-specific training programs for performance optimization, and screen for potential causes of injury. More recent advances in movement sensors have improved accuracy in detecting high-acceleration movements during competitive sports. Conclusion: Wearable devices are valuable instruments for the improvement of sports performance. Evidence for use of these devices in professional sports is still limited. Future developments are needed to establish training protocols using data from wearable devices. PMID:26733594

Potential clinical impact of advanced imaging and computer-aided diagnosis in chest radiology: importance of radiologist's role and successful observer study.

PubMed

Li, Feng

2015-07-01

This review paper is based on our research experience in the past 30 years. The importance of radiologists' role is discussed in the development or evaluation of new medical images and of computer-aided detection (CAD) schemes in chest radiology. The four main topics include (1) introducing what diseases can be included in a research database for different imaging techniques or CAD systems and what imaging database can be built by radiologists, (2) understanding how radiologists' subjective judgment can be combined with technical objective features to improve CAD performance, (3) sharing our experience in the design of successful observer performance studies, and (4) finally, discussing whether the new images and CAD systems can improve radiologists' diagnostic ability in chest radiology. In conclusion, advanced imaging techniques and detection/classification of CAD systems have a potential clinical impact on improvement of radiologists' diagnostic ability, for both the detection and the differential diagnosis of various lung diseases, in chest radiology.

Quality measurement and improvement in liver transplantation.

PubMed

Mathur, Amit K; Talwalkar, Jayant

2018-06-01

There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centres. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models. We outline the status quo including the current regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities. Additionally, we further discuss unintended consequences and opportunities for growth in quality measurement. Quality measurement and the integration of quality improvement strategies into liver transplant programmes hold significant promise, but multiple challenges to successful implementation must be addressed to optimise value. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Can an anti-gravity treadmill improve stability of children with cerebral palsy?

PubMed

Birgani, P M; Ashtiyani, M; Rasooli, A; Shahrokhnia, M; Shahrokhi, A; Mirbagheri, M M

2016-08-01

We aimed to study the effects of an anti-gravity treadmill (AlterG) training on balance and postural stability in children with cerebral palsy (CP). AlterG training was performed 3 days/week for 8 weeks, with up to 45 minutes of training per session. The subject was evaluated before and after the 8-week training. The effects of training on the balance and postural stability was evaluated based on the Romberg test that was performed by using a posturography device. The parameters quantifying Center-of-Pressure (CoP) were calculated using different analytical approaches including power spectral density and principal components analyses. All of the key parameters including the Stabilogram, the Fast Fourier Transform (FFT) Energy, the Eigenvectors, and the Eigenvalues of CoP were modified between 14%-84%. The results indicated that the balance features were improved substantially after training. The clinical implication is that the AlterG has the potential to effectively improve postural stability in children with cerebral palsy.

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

Agalgaonkar, Yashodhan P.; Hammerstrom, Donald J.

The Pacific Northwest Smart Grid Demonstration (PNWSGD) was a smart grid technology performance evaluation project that included multiple U.S. states and cooperation from multiple electric utilities in the northwest region. One of the local objectives for the project was to achieve improved distribution system reliability. Toward this end, some PNWSGD utilities automated their distribution systems, including the application of fault detection, isolation, and restoration and advanced metering infrastructure. In light of this investment, a major challenge was to establish a correlation between implementation of these smart grid technologies and actual improvements of distribution system reliability. This paper proposes using Welch’smore » t-test to objectively determine and quantify whether distribution system reliability is improving over time. The proposed methodology is generic, and it can be implemented by any utility after calculation of the standard reliability indices. The effectiveness of the proposed hypothesis testing approach is demonstrated through comprehensive practical results. It is believed that wider adoption of the proposed approach can help utilities to evaluate a realistic long-term performance of smart grid technologies.« less

Major Management Challenges and Program Risks, Department of Education. Performance and Accountability Series.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

This report addresses the major performance and management challenges that have limited the effectiveness of the Department of Education in carrying out its mission. The booklet addresses corrective actions that Education has taken or initiated on these challenges--including a number of management initiatives to improve controls over the…

A survey to determine the impact of changes in specifications and construction practices on the performance of concrete in bridge decks.

DOT National Transportation Integrated Search

1974-01-01

In response to its own research and observations in the early 1960's the Virginia Department of Highways mounted an intensive and extensive effort to improve the performance of concrete in bridge decks. Major elements of this effort included (1) a tr...

Case Study: Wallace-Rose Hill High School, Teachey, N.C.

ERIC Educational Resources Information Center

Southern Regional Education Board, Atlanta, GA.

In 1992, school leaders and teachers at Wallace-Rose High School in Teachey, North Carolina, began a multi-year whole-school improvement initiative that included the following actions: (1) identify low-performing students; (2) develop a team of faculty and administrators to work with low-performing students; (3) reduce class size for…

Internal Branding: Using Performance Technology To Create an Organization Focused on Customer Value.

ERIC Educational Resources Information Center

Tosti, Donald T.; Stotz, Rodger

2000-01-01

Presents a performance technology approach to revenue enhancement, with the goal of improving customer retention through building customer value. Topics include internal branding, a way to make sure that what the company delivers matches what's promised in the advertising; product versus service brands; and customer satisfaction, including…

And Then a Miracle Occurs! Ensuring the Successful Implementation of Enterpisewide EPSS and E-Learning from Day One.

ERIC Educational Resources Information Center

Stone, Deborah L.; Villachica, Steven W.

2003-01-01

Provides suggestions to ensure the success of electronic performance support systems (EPSS) and electronic learning, including creating hybrid solutions; aligning EPSS with business objectives and performance requirements; change management efforts; and rapid application development to lower costs, shrink schedules, and improve quality.…

Management by Objectives for Colleges and Universities.

ERIC Educational Resources Information Center

Schroeder, Roger G.

Management by Objectives (MBO) has been used by many businesses as a means of improving performance by managers. MBO involves setting agreed performance objectives in writing and includes a periodic review of the degree of achievement of those objectives. This document argues that MBO principles should be used by colleges and universities, and it…

How the Organizational Learning Process Mediates the Impact of Strategic Human Resource Management Practices on Performance in Korean Organizations

ERIC Educational Resources Information Center

Cho, Sei Hyoung; Song, Ji Hoon; Yun, Suk Chun; Lee, Cheol Ki

2013-01-01

The primary purpose of this research is to examine the structural relationships among several workplace-related constructs, including strategic human resource management (HRM) practices, organizational learning processes, and performance improvement in the Korean business context. More specifically, the research examined the mediating effect of…

Improving Student Performance in Public Primary Schools in Developing Countries: Evidence from Indonesia

ERIC Educational Resources Information Center

Suryadarma, Daniel; Suryahadi, Asep; Sumarto, Sudarno; Rogers, F. Halsey

2006-01-01

This paper investigates the correlates of student performance in mathematics and dictation tests among schoolchildren in Indonesia. This is the first such study to use a new nationally representative sample of Indonesian primary-school students. Our dataset includes unique data on teacher absenteeism collected through direct observation, the first…

Does Performance-Based Pay Improve Teaching? PISA in Focus. No. 16

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2012

2012-01-01

The Programme for International Student Assessment (PISA) has long established that high-performing education systems tend to pay their teachers more. They also often prioritise the quality of teaching over other choices, including class size. But in the current budgetary climate, paying everybody more may not be a viable alternative. So many…

A systematic approach to training: A training needs assessment

NASA Technical Reports Server (NTRS)

Manning, Margaret H.

1989-01-01

In an effort to determine the gap between the actual performance and the necessary performance of employees for the effective and efficient accomplishment of an organization's mission and goals, an organization-wide Training Needs Assessment must be conducted. The purpose of this work was to conduct a training needs analysis and prepare a NASA Langley Catalog of On-Site Training programs. The work included developing a Training Needs Assessment Survey, implementing the survey, analyzing and researching the training needs, identifying the courses to meet the needs, and preparing and designing an On-Site Training Catalog. This needs analysis attempted to identify performance weaknesses and deficits; seek out and provide opportunities for improved performance; anticipate and avoid future problems; enhance and create new strengths. The end product is a user-friendly catalog of on-site training available. The results include: top-down approach to needs assessment; improved communication with training coordinators; 98 percent return rate of the Training Needs Assessment survey; complete, newly designed, user-friendly catalog; 167 catalog descriptions advertised; 82 new courses advertised; training logo; and request for the training application form.

Physiological properties of brain-machine interface input signals.

PubMed

Slutzky, Marc W; Flint, Robert D

2017-08-01

Brain-machine interfaces (BMIs), also called brain-computer interfaces (BCIs), decode neural signals and use them to control some type of external device. Despite many experimental successes and terrific demonstrations in animals and humans, a high-performance, clinically viable device has not yet been developed for widespread usage. There are many factors that impact clinical viability and BMI performance. Arguably, the first of these is the selection of brain signals used to control BMIs. In this review, we summarize the physiological characteristics and performance-including movement-related information, longevity, and stability-of multiple types of input signals that have been used in invasive BMIs to date. These include intracortical spikes as well as field potentials obtained inside the cortex, at the surface of the cortex (electrocorticography), and at the surface of the dura mater (epidural signals). We also discuss the potential for future enhancements in input signal performance, both by improving hardware and by leveraging the knowledge of the physiological characteristics of these signals to improve decoding and stability. Copyright © 2017 the American Physiological Society.

Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.

PubMed

Pawa, Jasmine; Robson, John; Hull, Sally

2017-11-01

Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives. A qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population. Nineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes. Interviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between 'a given structure' and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload. Commissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale. © British Journal of General Practice 2017.

Method for improving performance of high temperature superconductors within a magnetic field

DOEpatents

Wang, Haiyan; Foltyn, Stephen R.; Maiorov, Boris A.; Civale, Leonardo

2010-01-05

The present invention provides articles including a base substrate including a layer of an oriented cubic oxide material having a rock-salt-like structure layer thereon; and, a buffer layer upon the oriented cubic oxide material having a rock-salt-like structure layer, the buffer layer having an outwardly facing surface with a surface morphology including particulate outgrowths of from 10 nm to 500 run in size at the surface, such particulate outgrowths serving as flux pinning centers whereby the article maintains higher performance within magnetic fields than similar articles without the necessary density of such outgrowths.

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

Smith, Kandler A; Santhanagopalan, Shriram; Yang, Chuanbo

Computer models are helping to accelerate the design and validation of next generation batteries and provide valuable insights not possible through experimental testing alone. Validated 3-D physics-based models exist for predicting electrochemical performance, thermal and mechanical response of cells and packs under normal and abuse scenarios. The talk describes present efforts to make the models better suited for engineering design, including improving their computation speed, developing faster processes for model parameter identification including under aging, and predicting the performance of a proposed electrode material recipe a priori using microstructure models.

Preliminary evaluation of the Community Multiscale Air Quality model for 2002 over the Southeastern United States.

PubMed

Morris, Ralph E; McNally, Dennis E; Tesche, Thomas W; Tonnesen, Gail; Boylan, James W; Brewer, Patricia

2005-11-01

The Visibility Improvement State and Tribal Association of the Southeast (VISTAS) is one of five Regional Planning Organizations that is charged with the management of haze, visibility, and other regional air quality issues in the United States. The VISTAS Phase I work effort modeled three episodes (January 2002, July 1999, and July 2001) to identify the optimal model configuration(s) to be used for the 2002 annual modeling in Phase II. Using model configurations recommended in the Phase I analysis, 2002 annual meteorological (Mesoscale Meterological Model [MM5]), emissions (Sparse Matrix Operator Kernal Emissions [SMOKE]), and air quality (Community Multiscale Air Quality [CMAQ]) simulations were performed on a 36-km grid covering the continental United States and a 12-km grid covering the Eastern United States. Model estimates were then compared against observations. This paper presents the results of the preliminary CMAQ model performance evaluation for the initial 2002 annual base case simulation. Model performance is presented for the Eastern United States using speciated fine particle concentration and wet deposition measurements from several monitoring networks. Initial results indicate fairly good performance for sulfate with fractional bias values generally within +/-20%. Nitrate is overestimated in the winter by approximately +50% and underestimated in the summer by more than -100%. Organic carbon exhibits a large summer underestimation bias of approximately -100% with much improved performance seen in the winter with a bias near zero. Performance for elemental carbon is reasonable with fractional bias values within +/- 40%. Other fine particulate (soil) and coarse particular matter exhibit large (80-150%) overestimation in the winter but improved performance in the summer. The preliminary 2002 CMAQ runs identified several areas of enhancements to improve model performance, including revised temporal allocation factors for ammonia emissions to improve nitrate performance and addressing missing processes in the secondary organic aerosol module to improve OC performance.

Performance of Malaysian Medical Journals

PubMed Central

Abrizah, Abdullah

2016-01-01

Indexation status matters for scholarly journal prestige and trust. The performance of Malaysian medical journals at the international level is gauged through the global citation databases, and at the national level through MyCite, a national citation indexing system. The performance indicators include journals publication productivity, the citations they garner, and their scores on other bibliometric indices such as journal impact factor (IF), and h-index. There is a growing consciousness amongst journal editorials to improve quality and increase chances of getting indexed in MyCite. Although it is now possible to gauge journal performance within Malaysia, through MyCite, the government and public are concerned about journal performance in international databases. Knowing the performance of journals in MyCite will help the editors and publishers to improve the quality and visibility of Malaysian journals and strategise to bring their journal to the international level of indexation. PMID:27547108

Cardiomyoplasty: first clinical case with new cardiomyostimulator.

PubMed

Chekanov, Valeri S; Sands, Duane E; Brown, Conville S; Brum, Fernando; Arzuaga, Pedro; Gava, Sebastian; Eugenio, Ferdinand P; Melamed, Vladimir; Spencer, Howard W

2002-09-01

Dynamic cardiomyoplasty was performed in a patient using a new cardio-myostimulator (LD-PACE II) designed to enable a novel stimulation regimen that utilizes a new range of stimulation options, including cessation during sleep. After treatment, left ventricular ejection fraction improved in 24 months from 15% to 25% and New York Heart Association classification improved from class IV to II.

Advanced missile technology. A review of technology improvement areas for cruise missiles. [including missile design, missile configurations, and aerodynamic characteristics

NASA Technical Reports Server (NTRS)

Cronvich, L. L.; Liepman, H. P.

1979-01-01

Technology assessments in the areas of aerodynamics, propulsion, and structures and materials for cruise missile systems are discussed. The cruise missiles considered cover the full speed, altitude, and target range. The penetrativity, range, and maneuverability of the cruise missiles are examined and evaluated for performance improvements.

Supermath: An Alternative Approach to Improving Math Performance in Grades 4 through 9

ERIC Educational Resources Information Center

Pogrow, Stanley

2004-01-01

In this article, the author shares a decade's worth of experience in developing an approach to teaching math to upper-elementary and middle school students that simultaneously increases basic skills, improves problem solving, raises test scores, and sparks student interest in math. Sections include: (1) Background Of Supermath; (2) Description Of…

Data and Learning That Affords Program Improvement: A Response to the U.S. Accountability Movement in Teacher Education

ERIC Educational Resources Information Center

Sloan, Tine Falk

2015-01-01

The current U.S. education agenda places unprecedented attention on improving the quality of its roughly fifteen hundred teacher preparation programs. The effort places considerable weight on measuring program effectiveness and includes a push to hold programs accountable for their graduates' effects on student performance. Concerns regarding the…

Quantitative evaluation of vision-related and health-related quality of life after endoscopic transsphenoidal surgery for pituitary adenoma.

PubMed

Wolf, Amparo; Coros, Alexandra; Bierer, Joel; Goncalves, Sandy; Cooper, Paul; Van Uum, Stan; Lee, Donald H; Proulx, Alain; Nicolle, David; Fraser, J Alexander; Rotenberg, Brian W; Duggal, Neil

2017-08-01

OBJECTIVE Endoscopic resection of pituitary adenomas has been reported to improve vision function in up to 80%-90% of patients with visual impairment due to these adenomas. It is unclear how these reported rates translate into improvement in visual outcomes and general health as perceived by the patients. The authors evaluated self-assessed health-related quality of life (HR-QOL) and vision-related QOL (VR-QOL) in patients before and after endoscopic resection of pituitary adenomas. METHODS The authors prospectively collected data from 50 patients who underwent endoscopic resection of pituitary adenomas. This cohort included 32 patients (64%) with visual impairment preoperatively. Twenty-seven patients (54%) had pituitary dysfunction, including 17 (34%) with hormone-producing tumors. Patients completed the National Eye Institute Visual Functioning Questionnaire and the 36-Item Short Form Health Survey preoperatively and 6 weeks and 6 months after surgery. RESULTS Patients with preoperative visual impairment reported a significant impact of this condition on VR-QOL preoperatively, including general vision, near activities, and peripheral vision; they also noted vision-specific impacts on mental health, role difficulties, dependency, and driving. After endoscopic resection of adenomas, patients reported improvement across all these categories 6 weeks postoperatively, and this improvement was maintained by 6 months postoperatively. Patients with preoperative pituitary dysfunction, including hormone-producing tumors, perceived their general health and physical function as poorer, with some of these patients reporting improvement in perceived general health after the endoscopic surgery. All patients noted that their ability to work or perform activities of daily living was transiently reduced 6 weeks postoperatively, followed by significant improvement by 6 months after the surgery. CONCLUSIONS Both VR-QOL and patient's perceptions of their ability to do work and perform other daily activities as a result of their physical health significantly improved by 6 months after endoscopic resection of pituitary adenoma. The use of multidimensional QOL questionnaires provides a precise assessment of perceived outcomes after endoscopic surgery.

Rotor design optimization using a free wake analysis

NASA Technical Reports Server (NTRS)

Quackenbush, Todd R.; Boschitsch, Alexander H.; Wachspress, Daniel A.; Chua, Kiat

1993-01-01

The aim of this effort was to develop a comprehensive performance optimization capability for tiltrotor and helicopter blades. The analysis incorporates the validated EHPIC (Evaluation of Hover Performance using Influence Coefficients) model of helicopter rotor aerodynamics within a general linear/quadratic programming algorithm that allows optimization using a variety of objective functions involving the performance. The resulting computer code, EHPIC/HERO (HElicopter Rotor Optimization), improves upon several features of the previous EHPIC performance model and allows optimization utilizing a wide spectrum of design variables, including twist, chord, anhedral, and sweep. The new analysis supports optimization of a variety of objective functions, including weighted measures of rotor thrust, power, and propulsive efficiency. The fundamental strength of the approach is that an efficient search for improved versions of the baseline design can be carried out while retaining the demonstrated accuracy inherent in the EHPIC free wake/vortex lattice performance analysis. Sample problems are described that demonstrate the success of this approach for several representative rotor configurations in hover and axial flight. Features that were introduced to convert earlier demonstration versions of this analysis into a generally applicable tool for researchers and designers is also discussed.

An Integrated Gate Turnaround Management Concept Leveraging Big Data/Analytics for NAS Performance Improvements

NASA Technical Reports Server (NTRS)

Chung, William; Chachad, Girish; Hochstetler, Ronald

2016-01-01

The Integrated Gate Turnaround Management (IGTM) concept was developed to improve the gate turnaround performance at the airport by leveraging relevant historical data to support optimization of airport gate operations, which include: taxi to the gate, gate services, push back, taxi to the runway, and takeoff, based on available resources, constraints, and uncertainties. By analyzing events of gate operations, primary performance dependent attributes of these events were identified for the historical data analysis such that performance models can be developed based on uncertainties to support descriptive, predictive, and prescriptive functions. A system architecture was developed to examine system requirements in support of such a concept. An IGTM prototype was developed to demonstrate the concept using a distributed network and collaborative decision tools for stakeholders to meet on time pushback performance under uncertainties.

Enhancing Cognition with Video Games: A Multiple Game Training Study

PubMed Central

Oei, Adam C.; Patterson, Michael D.

2013-01-01

Background Previous evidence points to a causal link between playing action video games and enhanced cognition and perception. However, benefits of playing other video games are under-investigated. We examined whether playing non-action games also improves cognition. Hence, we compared transfer effects of an action and other non-action types that required different cognitive demands. Methodology/Principal Findings We instructed 5 groups of non-gamer participants to play one game each on a mobile device (iPhone/iPod Touch) for one hour a day/five days a week over four weeks (20 hours). Games included action, spatial memory, match-3, hidden- object, and an agent-based life simulation. Participants performed four behavioral tasks before and after video game training to assess for transfer effects. Tasks included an attentional blink task, a spatial memory and visual search dual task, a visual filter memory task to assess for multiple object tracking and cognitive control, as well as a complex verbal span task. Action game playing eliminated attentional blink and improved cognitive control and multiple-object tracking. Match-3, spatial memory and hidden object games improved visual search performance while the latter two also improved spatial working memory. Complex verbal span improved after match-3 and action game training. Conclusion/Significance Cognitive improvements were not limited to action game training alone and different games enhanced different aspects of cognition. We conclude that training specific cognitive abilities frequently in a video game improves performance in tasks that share common underlying demands. Overall, these results suggest that many video game-related cognitive improvements may not be due to training of general broad cognitive systems such as executive attentional control, but instead due to frequent utilization of specific cognitive processes during game play. Thus, many video game training related improvements to cognition may be attributed to near-transfer effects. PMID:23516504

Nitrate supplementation improves physical performance specifically in non-athletes during prolonged open-ended tests: a systematic review and meta-analysis.

PubMed

Campos, Helton O; Drummond, Lucas R; Rodrigues, Quezia T; Machado, Frederico S M; Pires, Washington; Wanner, Samuel P; Coimbra, Cândido C

2018-03-01

Nitrate (NO3 -) is an ergogenic nutritional supplement that is widely used to improve physical performance. However, the effectiveness of NO3 - supplementation has not been systematically investigated in individuals with different physical fitness levels. The present study analysed whether different fitness levels (non-athletes v. athletes or classification of performance levels), duration of the test used to measure performance (short v. long duration) and the test protocol (time trials v. open-ended tests v. graded-exercise tests) influence the effects of NO3 - supplementation on performance. This systematic review and meta-analysis was conducted and reported according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A systematic search of electronic databases, including PubMed, Web of Science, SPORTDiscus and ProQuest, was performed in August 2017. On the basis of the search and inclusion criteria, fifty-four and fifty-three placebo-controlled studies evaluating the effects of NO3 - supplementation on performance in humans were included in the systematic review and meta-analysis, respectively. NO3 - supplementation was ergogenic in non-athletes (mean effect size (ES) 0·25; 95 % CI 0·11, 0·38), particularly in evaluations of performance using long-duration open-ended tests (ES 0·47; 95 % CI 0·23, 0·71). In contrast, NO3 - supplementation did not enhance the performance of athletes (ES 0·04; 95 % CI -0·05, 0·15). After objectively classifying the participants into different performance levels, the frequency of trials showing ergogenic effects in individuals classified at lower levels was higher than that in individuals classified at higher levels. Thus, the present study indicates that dietary NO3 - supplementation improves physical performance in non-athletes, particularly during long-duration open-ended tests.

48 CFR 1401.7001-4 - Acquisition performance measurement systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-pronged approach that includes self assessment, statistical data for validation and flexible quality... regulations governing the acquisition process; and (3) Identify and implement changes necessary to improve the...

Infrastructure for quality transformation: measurement and reporting in veterans administration intensive care units.

PubMed

Render, Marta L; Freyberg, Ron W; Hasselbeck, Rachael; Hofer, Timothy P; Sales, Anne E; Deddens, James; Levesque, Odette; Almenoff, Peter L

2011-06-01

BACKGROUND Veterans Health Administration (VA) intensive care units (ICUs) develop an infrastructure for quality improvement using information technology and recruiting leadership. METHODS Setting Participation by the 183 ICUs in the quality improvement program is required. Infrastructure includes measurement (electronic data extraction, analysis), quarterly web-based reporting and implementation support of evidence-based practices. Leaders prioritise measures based on quality improvement objectives. The electronic extraction is validated manually against the medical record, selecting hospitals whose data elements and measures fall at the extremes (10th, 90th percentile). results are depicted in graphic, narrative and tabular reports benchmarked by type and complexity of ICU. RESULTS The VA admits 103 689±1156 ICU patients/year. Variation in electronic business practices, data location and normal range of some laboratory tests affects data quality. A data management website captures data elements important to ICU performance and not available electronically. A dashboard manages the data overload (quarterly reports ranged 106-299 pages). More than 85% of ICU directors and nurse managers review their reports. Leadership interest is sustained by including ICU targets in executive performance contracts, identification of local improvement opportunities with analytic software, and focused reviews. CONCLUSION Lessons relevant to non-VA institutions include the: (1) need for ongoing data validation, (2) essential involvement of leadership at multiple levels, (3) supplementation of electronic data when key elements are absent, (4) utility of a good but not perfect electronic indicator to move practice while improving data elements and (5) value of a dashboard.

As good as it gets? Managing risks of cardiovascular disease in California's top-performing physician organizations.

PubMed

Rodriguez, Hector P; Ivey, Susan L; Raffetto, Brian J; Vaughn, Jennifer; Knox, Margae; Hanley, Hattie Rees; Mangione, Carol M; Shortell, Stephen M

2014-04-01

The California Right Care Initiative (RCI) accelerates the adoption of evidence-based guidelines and improved care management practices for conditions for which the gap between science and practice is significant, resulting in preventable disability and death. Medical directors and quality improvement leaders from 11 of the 12 physician organizations that met the 2010 national 90th percentile performance benchmarks for control of hyperlipidemia and glycated hemoglobin in 2011 were interviewed in 2012. Interviews, as well as surveys, assessed performance reporting and feedback to individual physicians; medication management protocols; team-based care management; primary care team huddles; coordination of care between primary care clinicians and specialists; implementation of shared medical appointments; and telephone visits for high-risk patients. All but 1 of 11 organizations implemented electronic health records. Electronic information exchange between primary care physicians and specialists, however, was uncommon. Few organizations routinely used interdisciplinary team approaches, shared medical appointments, or telephonic strategies for managing cardiovascular risks among patients. Implementation barriers included physicians' resistance to change, limited resources and reimbursement for team approaches, and limited organizational capacity for change. Implementation facilitators included routine use of reliable data to guide improvement, leadership facilitation of change, physician buy-in, health information technology use, and financial incentives. To accelerate improvements in managing cardiovascular risks, physician organizations may need to implement strategies involving extensive practice reorganization and work flow redesign.

Memorial Hermann: high reliability from board to bedside.

PubMed

Shabot, M Michael; Monroe, Douglas; Inurria, Juan; Garbade, Debbi; France, Anne-Claire

2013-06-01

In 2006 the Memorial Hermann Health System (MHHS), which includes 12 hospitals, began applying principles embraced by high reliability organizations (HROs). Three factors support its HRO journey: (1) aligned organizational structure with transparent management systems and compressed reporting processes; (2) Robust Process Improvement (RPI) with high-reliability interventions; and (3) cultural establishment, sustainment, and evolution. The Quality and Safety strategic plan contains three domains, each with a specific set of measures that provide goals for performance: (1) "Clinical Excellence;" (2) "Do No Harm;" and (3) "Saving Lives," as measured by the Serious Safety Event rate. MHHS uses a uniform approach to performance improvement--RPI, which includes Six Sigma, Lean, and change management, to solve difficult safety and quality problems. The 9 acute care hospitals provide multiple opportunities to integrate high-reliability interventions and best practices across MHHS. For example, MHHS partnered with the Joint Commission Center for Transforming Healthcare in its inaugural project to establish reliable hand hygiene behaviors, which improved MHHS's average hand hygiene compliance rate from 44% to 92% currently. Soon after compliance exceeded 85% at all 12 hospitals, the average rate of central line-associated bloodstream and ventilator-associated pneumonias decreased to essentially zero. MHHS's size and diversity require a disciplined approach to performance improvement and systemwide achievement of measurable success. The most significant cultural change at MHHS has been the expectation for 100% compliance with evidence-based quality measures and 0% incidence of patient harm.

How different is cancer control across Canada? Comparing performance indicators for prevention, screening, diagnosis, and treatment.

PubMed

Rahal, R; Chadder, J; DeCaria, K; Lockwood, G; Bryant, H

2017-04-01

Meaningful performance measures are an important part of the toolkit for health system improvement. The Canadian Partnership Against Cancer has been reporting on pan-Canadian cancer system performance indicators since 2009-work that has led to the availability of standardized measures that can help to shed light on the extent of variation and opportunities for quality improvement across the country. Those measures include a core set of system indicators ranging from prevention and screening, through diagnosis and treatment, to survivorship and end-of-life care. Key indicators were calculated and graphed, showing the range from worst to best result for the provinces and territories included in the data. There were often significant differences in cancer system performance between provinces and territories. For example, smoking prevalence rates ranged from 14% to 62%. The 90th percentile wait times from an abnormal breast screen to resolution (without biopsy) ranged from 4 weeks to 8 weeks. The percentage of breast cancer resections that used breast-conserving surgery rather than mastectomy ranged from 38% to 75%. Clinical trial participation rates for adults ranged from 0.2% to 6.6%. Variations in performance indicators between Canadian jurisdictions suggest potential differences in the planning and delivery of cancer control services and in clinical practice patterns and patient outcomes. Understanding sources of variation can help to identify opportunities for improvements in the quality and outcomes of cancer control service delivery in each province and territory.

Effect of vinpocetine (cognitol™) on cognitive performances of a nigerian population.

PubMed

Ogunrin, Ao

2014-07-01

Chronic medical disorders are often complicated by cognitive impairments, making medical intervention that can alleviate cognitive disturbances desirable. Vinpocetine enhances cerebral utilization of oxygen and glucose and consequently improves cerebral functions including memory. This study assessed the efficacy of vinpocetine (Cognitol™) in improving memory and concentration in cognitively impaired patients. A prospective analytical study of 56 cognitively impaired patients compared with age, sex and level of education matched 56 controls. Cognitive performance was assessed with the Short Blessed Test, which was pilot-tested. Baseline cognitive performances of the patients and controls were obtained and thereafter cognitive performances of the patients were assessed at 6 and 12 weeks after administration of vinpocetine at a dose of 5 mg twice-a-day. Comparative analysis of their performances at baseline was done using the Student t-test, while the improvement in patients' performances and effect of disease variables on cognitive performances were analyzed with one-way analysis of variance and likelihood ratio analysis respectively. The mean (standard deviation) [SD] ages of the cognitively impaired patients (56/112) and controls (56/112) were 49.5 (18.9) and 53.8 (15.8) years respectively (P = 0.19; 95% confidence interval [CI]: 2.2-10.8). The pilot study yielded an optimal cut-off error score of 6 with a sensitivity of 71.4%, specificity of 96.4% and accuracy of 83.9%. Patients performed significantly worse than the controls (P < 0.001; 95% CI 6.7-11.4). There were significant improvements in memory and concentration with vinpocetine therapy (P < 0.05). The clinical variables of the patients had no effect on the trend of cognitive performances. Vinpocetine was effective in improving memory and concentration of patients with epilepsy and dementia although the efficacy was minimal in demented patients.

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

PubMed

Noh, Wonjung; Seomun, Gyeongae

2015-06-01

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

No effect on performance tests from a neuromuscular warm-up programme in youth female football: a randomised controlled trial.

PubMed

Lindblom, Hanna; Waldén, Markus; Hägglund, Martin

2012-10-01

The objective of the present randomised controlled trial was to study the effect of a neuromuscular warm-up programme on performance tests in youth female football. Four youth female football teams with players aged 12-16 years were randomised into an intervention group and control group. The intervention was a 15-min neuromuscular warm-up programme carried out twice a week during the 11-week study period. Baseline and follow-up measurements of performance were made indoors and included the star excursion balance test, a countermovement jump test, a triple-hop for distance test, a modified Illinois agility test, and 10- and 20-m sprint tests. Fifty-two players (intervention 28; control 24) took part in baseline measurements, and after dropout, 41 players (intervention 23; control 18) were included for analysis. Minor positive changes were seen in the control group compared to the intervention group for a sub-score of the star excursion balance test (P < 0.05) and in the modified Illinois agility test (P < 0.05). No improvement was seen in the intervention group from baseline to follow-up. The study showed that a neuromuscular warm-up programme carried out during 11 weeks did not improve performance in youth female football. This could indicate that the programme does not contain sufficient stimulus to improve performance. A low player attendance at training sessions, and low specificity between exercises in the warm-up programme and the evaluated performance tests may also contribute to the lack of effect. I.

Idaho National Laboratory Integrated Safety Management System FY 2013 Effectiveness Review and Declaration Report

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

Hunt, Farren

2013-12-01

Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for Fiscal Year (FY) 2014. Results of the FY 2013 annual effectiveness review demonstrate that the INL’s ISMS program is “Effective” and continually improving and shows signs of being significantly strengthened. Although there have been unacceptable serious events in themore » past, there has also been significant attention, dedication, and resources focused on improvement, lessons learned and future prevention. BEA’s strategy of focusing on these improvements includes extensive action and improvement plans that include PLN 4030, “INL Sustained Operational Improvement Plan, PLN 4058, “MFC Strategic Excellence Plan,” PLN 4141, “ATR Sustained Excellence Plan,” and PLN 4145, “Radiological Control Road to Excellence,” and the development of LWP 20000, “Conduct of Research.” As a result of these action plans, coupled with other assurance activities and metrics, significant improvement in operational performance, organizational competence, management oversight and a reduction in the number of operational events is being realized. In short, the realization of the fifth core function of ISMS (feedback and continuous improvement) and the associated benefits are apparent.« less

Redesigning the care of fragility fracture patients to improve osteoporosis management: a health care improvement project.

PubMed

Harrington, J Timothy; Barash, Harvey L; Day, Sherry; Lease, Joellen

2005-04-15

To develop new processes that assure more reliable, population-based care of fragility fracture patients. A 4-year clinical improvement project was performed in a multispecialty, community practice health system using evidence-based guidelines and rapid cycle process improvement methods (plan-do-study-act cycles). Prior to this project, appropriate osteoporosis care was provided to only 5% of our 1999 hip fracture patients. In 2001, primary physicians were provided prompts about appropriate care (cycle 1), which resulted in improved care for only 20% of patients. A process improvement pilot in 2002 (cycle 2) and full program implementation in 2003 (cycle 3) have assured osteoporosis care for all willing and able patients with any fragility fracture. Altogether, 58% of 2003 fragility fracture patients, including 46% of those with hip fracture, have had a bone measurement, have been assigned to osteoporosis care with their primary physician or a consultant, and are being monitored regularly. Only 19% refused osteoporosis care. Key process improvements have included using orthopedic billings to identify patients, referring patients directly from orthopedics to an osteoporosis care program, organizing care with a nurse manager and process management computer software, assigning patients to primary or consultative physician care based on disease severity, and monitoring adherence to therapy by telephone. Reliable osteoporosis care is achievable by redesigning clinical processes. Performance data motivate physicians to reconsider traditional approaches. Improving the care of osteoporosis and other chronic diseases requires coordinated care across specialty boundaries and health system support.

[Lung Abscess with Acute Empyema Which Improved after Performing by Video Assissted Thoracic Surgery( Including Pneumonotomy and Lung Abscess Drainage);Report of a Case].

PubMed

Gabe, Atsushi; Nagamine, Naoji

2017-05-01

We herein report the case of a patient demonstrating a lung abscess with acute empyema which improved after performing pnemumonotomy and lung abscess drainage. A 60-year-old male was referred to our hospital to receive treatment for a lung abscess with acute empyema. At surgery, the lung parenchyma was slightly torn with pus leakage. After drainage of lung abscess by enlarging the injured part, curettage in the thoracic cavity and decortication were performed. The postoperative course was uneventful. Direct drainage of an abscess into the thoracic cavity is thought to be a choice for the treatment of lung abscesses.

International Space Station Major Constituent Analyzer On-Orbit Performance

NASA Technical Reports Server (NTRS)

Gardner, Ben D.; Erwin, Phillip M.; Thoresen, Souzan; Wiedemann, Rachel; Matty, Chris

2015-01-01

The Major Constituent Analyzer is a mass spectrometer based system that measures the major atmospheric constituents on the International Space Station. A number of limited-life components require periodic change-out, including the ORU 02 analyzer and the ORU 08 Verification Gas Assembly. Improvements to ion pump operation and ion source tuning have improved lifetime performance of the current ORU 02 design. The most recent ORU 02 analyzer assemblies, as well as ORU 08, have operated nominally. For ORU 02, the ion source filaments and ion pump lifetime continue to be key determinants of MCA performance and logistical support. Monitoring several key parameters provides the capacity to monitor ORU health and properly anticipate end of life.

Improvement of surgical margin with a coupled saline-radio-frequency device for multiple colorectal liver metastases.

PubMed

Ogata, Satoshi; Kianmanesh, Reza; Varma, Deepak; Belghiti, Jacques

2005-01-01

Complete resection of colorectal liver metastases (LM) has been the only curative treatment. However, when LM are multiple and bilobar, only a few patients are candidates for curative surgery. We report on a 53-year-old woman with synchronous multiple and bilobar LM from sigmoidal cancer who became resectable after a multimodal strategy including preoperative systemic chemotherapy and two-step surgery. The spectacular decrease in tumor size after systemic chemotherapy led us to perform two-step surgery, including right portal-vein ligation and left liver metastasectomies, with a coupled saline-radiofrequency device, in order to improve the surgical margin. An extended right hepatectomy was performed later to remove the remaining right liver lesions. The patient was discharged after 28 days without major complication and was recurrence-free 14 months later. We conclude that improving the surgical margin with a coupled saline-radiofrequency device is feasible and effective, avoiding small remnant liver even after multiple tumorectomies. The multimodal strategy, including preoperative chemotherapy, two-step surgery, and tumorectomies, using a coupled saline-radiofrequency device, could increase the number of patients with diffuse bilobar liver metastases who can benefit from liver resection.

Recent Development of Augmented Reality in Surgery: A Review

PubMed Central

Vávra, P.; Zonča, P.; Ihnát, P.; El-Gendi, A.

2017-01-01

Introduction The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. Methods We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms “augmented reality” and “surgery.” Results. The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. Conclusions The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice. PMID:29065604

Developing Emergency Room Key Performance Indicators: What to Measure and Why Should We Measure It?

PubMed

Khalifa, Mohamed; Zabani, Ibrahim

2016-01-01

Emergency Room (ER) performance has been a timely topic for both healthcare practitioners and researchers. King Faisal Specialist Hospital and Research Center, Saudi Arabia worked on developing a comprehensive set of KPIs to monitor, evaluate and improve the performance of the ER. A combined approach using quantitative and qualitative methods was used to collect and analyze the data. 34 KPIs were developed and sorted into the three components of the ER patient flow model; input, throughput and output. Input indicators included number and acuity of ER patients, patients leaving without being seen and revisit rates. Throughput indicators included number of active ER beds, ratio of ER patients to ER staff and the length of stay including waiting time and treatment time. The turnaround time of supportive services, such as lab, radiology and medications, were also included. Output indicators include boarding time and available hospital beds, ICU beds and patients waiting for admission.

Performance evaluation capabilities for the design of physical systems

NASA Technical Reports Server (NTRS)

Pilkey, W. D.; Wang, B. P.

1972-01-01

The results are presented of a study aimed at developing and formulating a capability for the limiting performance of large steady state systems. The accomplishments reported include: (1) development of a theory of limiting performance of large systems subject to steady state inputs; (2) application and modification of PERFORM, the computational capability for the limiting performance of systems with transient inputs; and (3) demonstration that use of an inherently smooth control force for a limiting performance calculation improves the system identification phase of the design process for physical systems subjected to transient loading.

Effectiveness of Interventions to Address Visual and Visual-Perceptual Impairments to Improve Occupational Performance in Adults With Traumatic Brain Injury: A Systematic Review.

PubMed

Berger, Sue; Kaldenberg, Jennifer; Selmane, Romeissa; Carlo, Stephanie

2016-01-01

Visual and visual-perceptual impairments occur frequently with traumatic brain injury (TBI) and influence occupational performance. This systematic review examined the effectiveness of interventions within the scope of occupational therapy to improve occupational performance for adults with visual and visual-perceptual impairments as a result of TBI. Medline, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews were searched, and 66 full text articles were reviewed. Sixteen articles were included in the review. Strong evidence supports the use of scanning, limited evidence supports the use of adaptive strategies, and mixed evidence supports the use of cognitive interventions to improve occupational performance for adults with TBI. Evidence related to vision therapy varies on the basis of the specific intervention implemented. Although the strength of the research varied, implications are discussed for practice, education, and research. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Techniques for Enhancing Implosion Performance on High-Foot Ignition Capsules on NIF

NASA Astrophysics Data System (ADS)

Dittrich, T. R.; Hurricane, O.; Berzak Hopkins, L. F.; Callahan, D. A.; Clark, D.; Haan, S. W.; Hinkel, D. E.; Ma, T.; Nikroo, A.; Pak, A. E.; Park, H. S.; Salmonson, J. D.; Weber, C. R.

2016-10-01

Two options that have the potential to improve implosion performance in the High-Foot series of ignition capsules on NIF will be presented. The first option explores changing the shape of the x-ray drive to include a 4th and even a 5th shock in the implosion. According to simulations, these extra shocks improve the configuration of the assembled fuel and lead to improved confinement and performance. A ``ramp compression'' between the foot of the drive and the main pulse is also investigated. The second option studies the effect of increasing the Si dopant in a thin-shell capsule. NIF shot N150211 produced relatively high fusion yield (7.6E15 neutrons) but may have suffered from shell burn through. Increasing the Si dopant may delay this burn through yet preserve high implosion velocity. This work was performed under the auspices of the Department of Energy by Lawrence Livermore National Laboratory under contract DE-AC52-07NA27344.

Accurate and dynamic predictive model for better prediction in medicine and healthcare.

PubMed

Alanazi, H O; Abdullah, A H; Qureshi, K N; Ismail, A S

2018-05-01

Information and communication technologies (ICTs) have changed the trend into new integrated operations and methods in all fields of life. The health sector has also adopted new technologies to improve the systems and provide better services to customers. Predictive models in health care are also influenced from new technologies to predict the different disease outcomes. However, still, existing predictive models have suffered from some limitations in terms of predictive outcomes performance. In order to improve predictive model performance, this paper proposed a predictive model by classifying the disease predictions into different categories. To achieve this model performance, this paper uses traumatic brain injury (TBI) datasets. TBI is one of the serious diseases worldwide and needs more attention due to its seriousness and serious impacts on human life. The proposed predictive model improves the predictive performance of TBI. The TBI data set is developed and approved by neurologists to set its features. The experiment results show that the proposed model has achieved significant results including accuracy, sensitivity, and specificity.

Full-scale transmission testing to evaluate advanced lubricants

NASA Technical Reports Server (NTRS)

Lewicki, David G.; Decker, Harry J.; Shimski, John T.

1992-01-01

Experimental tests were performed on the OH-58A helicopter main rotor transmission in the NASA Lewis 500 hp helicopter transmission test stand. The testing was part of a lubrication program. The objectives are to develop and show a separate lubricant for gearboxes with improved performance in life and load carrying capacity. The goal was to develop a testing procedure to fail certain transmission components using a MIL-L-23699 based reference oil and then to run identical tests with improved lubricants and show improved performance. The tests were directed at parts that failed due to marginal lubrication from Navy field experience. These failures included mast shaft bearing micropitting, sun gear and planet bearing fatigue, and spiral bevel gear scoring. A variety of tests were performed and over 900 hrs of total run time accumulated for these tests. Some success was achieved in developing a testing procedure to produce sun gear and planet bearing fatigue failures. Only marginal success was achieved in producing mast shaft bearing micropitting and spiral bevel gear scoring.

Landsat-8 Operational Land Imager (OLI) radiometric performance on-orbit

USGS Publications Warehouse

Morfitt, Ron; Barsi, Julia A.; Levy, Raviv; Markham, Brian L.; Micijevic, Esad; Ong, Lawrence; Scaramuzza, Pat; Vanderwerff, Kelly

2015-01-01

Expectations of the Operational Land Imager (OLI) radiometric performance onboard Landsat-8 have been met or exceeded. The calibration activities that occurred prior to launch provided calibration parameters that enabled ground processing to produce imagery that met most requirements when data were transmitted to the ground. Since launch, calibration updates have improved the image quality even more, so that all requirements are met. These updates range from detector gain coefficients to reduce striping and banding to alignment parameters to improve the geometric accuracy. This paper concentrates on the on-orbit radiometric performance of the OLI, excepting the radiometric calibration performance. Topics discussed in this paper include: signal-to-noise ratios that are an order of magnitude higher than previous Landsat missions; radiometric uniformity that shows little residual banding and striping, and continues to improve; a dynamic range that limits saturation to extremely high radiance levels; extremely stable detectors; slight nonlinearity that is corrected in ground processing; detectors that are stable and 100% operable; and few image artifacts.

Improving prospective memory performance with future event simulation in traumatic brain injury patients.

PubMed

Mioni, Giovanna; Bertucci, Erica; Rosato, Antonella; Terrett, Gill; Rendell, Peter G; Zamuner, Massimo; Stablum, Franca

2017-06-01

Previous studies have shown that traumatic brain injury (TBI) patients have difficulties with prospective memory (PM). Considering that PM is closely linked to independent living it is of primary interest to develop strategies that can improve PM performance in TBI patients. This study employed Virtual Week task as a measure of PM, and we included future event simulation to boost PM performance. Study 1 evaluated the efficacy of the strategy and investigated possible practice effects. Twenty-four healthy participants performed Virtual Week in a no strategy condition, and 24 healthy participants performed it in a mixed condition (no strategy - future event simulation). In Study 2, 18 TBI patients completed the mixed condition of Virtual Week and were compared with the 24 healthy controls who undertook the mixed condition of Virtual Week in Study 1. All participants also completed a neuropsychological evaluation to characterize the groups on level of cognitive functioning. Study 1 showed that participants in the future event simulation condition outperformed participants in the no strategy condition, and these results were not attributable to practice effects. Results of Study 2 showed that TBI patients performed PM tasks less accurately than controls, but that future event simulation can substantially reduce TBI-related deficits in PM performance. The future event simulation strategy also improved the controls' PM performance. These studies showed the value of future event simulation strategy in improving PM performance in healthy participants as well as in TBI patients. TBI patients performed PM tasks less accurately than controls, confirming prospective memory impairment in these patients. Participants in the future event simulation condition out-performed participants in the no strategy condition. Future event simulation can substantially reduce TBI-related deficits in PM performance. Future event simulation strategy also improved the controls' PM performance. © 2017 The British Psychological Society.

Physiological implications of altitude training for endurance performance at sea level: a review.

PubMed Central

Bailey, D M; Davies, B

1997-01-01

Acclimatisation to environmental hypoxia initiates a series of metabolic and musculocardio-respiratory adaptations that influence oxygen transport and utilisation, or better still, being born and raised at altitude, is necessary to achieve optimal physical performance at altitude, scientific evidence to support the potentiating effects after return to sea level is at present equivocal. Despite this, elite athletes continue to spend considerable time and resources training at altitude, misled by subjective coaching opinion and the inconclusive findings of a large number of uncontrolled studies. Scientific investigation has focused on the optimisation of the theoretically beneficial aspects of altitude acclimatisation, which include increases in blood haemoglobin concentration, elevated buffering capacity, and improvements in the structural and biochemical properties of skeletal muscle. However, not all aspects of altitude acclimatisation are beneficial; cardiac output and blood flow to skeletal muscles decrease, and preliminary evidence has shown that hypoxia in itself is responsible for a depression of immune function and increased tissue damage mediated by oxidative stress. Future research needs to focus on these less beneficial aspects of altitude training, the implications of which pose a threat to both the fitness and the health of the elite competitor. Paul Bert was the first investigator to show that acclimatisation to a chronically reduced inspiratory partial pressure of oxygen (P1O2) invoked a series of central and peripheral adaptations that served to maintain adequate tissue oxygenation in healthy skeletal muscle, physiological adaptations that have been subsequently implicated in the improvement in exercise performance during altitude acclimatisation. However, it was not until half a century later that scientists suggested that the additive stimulus of environmental hypoxia could potentially compound the normal physiological adaptations to endurance training and accelerate performance improvements after return to sea level. This has stimulated an exponential increase in scientific research, and, since 1984, 22 major reviews have summarised the physiological implications of altitude training for both aerobic and anaerobic performance at altitude and after return to sea level. Of these reviews, only eight have specifically focused on physical performance changes after return to sea level, the most comprehensive of which was recently written by Wolski et al. Few reviews have considered the potentially less favourable physiological responses to moderate altitude exposure, which include decreases in absolute training intensity, decreased plasma volume, depression of haemopoiesis and increased haemolysis, increases in sympathetically mediated glycogen depletion at altitude, and increased respiratory muscle work after return to sea level. In addition, there is a risk of developing more serious medical complications at altitude, which include acute mountain sickness, pulmonary oedema, cardiac arrhythmias, and cerebral hypoxia. The possible implications of changes in immune function at altitude have also been largely ignored, despite accumulating evidence of hypoxia mediated immunosuppression. In general, altitude training has been shown to improve performance at altitude, whereas no unequivocal evidence exists to support the claim that performance at sea level is improved. Table 1 summarises the theoretical advantages and disadvantages of altitude training for sea level performance. This review summarises the physiological rationale for altitude training as a means of enhancing endurance performance after return to sea level. Factors that have been shown to affect the acclimatisation process and the subsequent implications for exercise performance at sea level will also be discussed. Studies were located using five major database searches, which included Medline, Embase, Science Citation Index, Sports Discus, and Sport, in Images Figure 1 Figure 2 PMID:9298550

Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy.

PubMed

Yudkowsky, Rachel; Luciano, Cristian; Banerjee, Pat; Schwartz, Alan; Alaraj, Ali; Lemole, G Michael; Charbel, Fady; Smith, Kelly; Rizzi, Silvio; Byrne, Richard; Bendok, Bernard; Frim, David

2013-02-01

Ventriculostomy is a neurosurgical procedure for providing therapeutic cerebrospinal fluid drainage. Complications may arise during repeated attempts at placing the catheter in the ventricle. We studied the impact of simulation-based practice with a library of virtual brains on neurosurgery residents' performance in simulated and live surgical ventriculostomies. Using computed tomographic scans of actual patients, we developed a library of 15 virtual brains for the ImmersiveTouch system, a head- and hand-tracked augmented reality and haptic simulator. The virtual brains represent a range of anatomies including normal, shifted, and compressed ventricles. Neurosurgery residents participated in individual simulator practice on the library of brains including visualizing the 3-dimensional location of the catheter within the brain immediately after each insertion. Performance of participants on novel brains in the simulator and during actual surgery before and after intervention was analyzed using generalized linear mixed models. Simulator cannulation success rates increased after intervention, and live procedure outcomes showed improvement in the rate of successful cannulation on the first pass. However, the incidence of deeper, contralateral (simulator) and third-ventricle (live) placements increased after intervention. Residents reported that simulations were realistic and helpful in improving procedural skills such as aiming the probe, sensing the pressure change when entering the ventricle, and estimating how far the catheter should be advanced within the ventricle. Simulator practice with a library of virtual brains representing a range of anatomies and difficulty levels may improve performance, potentially decreasing complications due to inexpert technique.

The Hohlraum Drive Campaign on the National Ignition Facility

NASA Astrophysics Data System (ADS)

Moody, John D.

2013-10-01

The Hohlraum drive effort on the National Ignition Facility (NIF) laser has three primary goals: 1) improve hohlraum performance by improving laser beam propagation, reducing backscatter from laser plasma interactions (LPI), controlling x-ray and electron preheat, and modifying the x-ray drive spectrum; 2) improve understanding of crossbeam energy transfer physics to better evaluate this as a symmetry tuning method; and 3) improve modeling in order to find optimum designs. Our experimental strategy for improving performance explores the impact of significant changes to the hohlraum shape, wall material, gasfill composition, and gasfill density on integrated implosion experiments. We are investigating the performance of a rugby-shaped design that has a significantly larger diameter (7 mm) at the waist than our standard 5.75 mm diameter cylindrical-shaped hohlraum but maintains approximately the same wall area. We are also exploring changes to the gasfill composition in cylindrical hohlraums by using neopentane at room temperature to compare with our standard helium gasfill. In addition, we are also investigating higher He gasfill density (1.6 mg/cc vs nominal 0.96 mg/cc) and increased x-ray drive very early in the pulse. Besides these integrated experiments, our strategy includes experiments testing separate aspects of the hohlraum physics. These include time-resolved and time-integrated measurements of cross-beam transfer rates and laser-beam spatial power distribution at early and late times using modified targets. Non-local thermal equilibrium modeling and heat transport relevant to ignition experiments are being studied using sphere targets on the Omega laser system. These simpler targets provide benchmarks for improving our modeling tools. This talk will summarize the results of the Hohlraum Drive campaign and discuss future directions. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA2-344.

Using the Eclipse Parallel Tools Platform to Assist Earth Science Model Development and Optimization on High Performance Computers

NASA Astrophysics Data System (ADS)

Alameda, J. C.

2011-12-01

Development and optimization of computational science models, particularly on high performance computers, and with the advent of ubiquitous multicore processor systems, practically on every system, has been accomplished with basic software tools, typically, command-line based compilers, debuggers, performance tools that have not changed substantially from the days of serial and early vector computers. However, model complexity, including the complexity added by modern message passing libraries such as MPI, and the need for hybrid code models (such as openMP and MPI) to be able to take full advantage of high performance computers with an increasing core count per shared memory node, has made development and optimization of such codes an increasingly arduous task. Additional architectural developments, such as many-core processors, only complicate the situation further. In this paper, we describe how our NSF-funded project, "SI2-SSI: A Productive and Accessible Development Workbench for HPC Applications Using the Eclipse Parallel Tools Platform" (WHPC) seeks to improve the Eclipse Parallel Tools Platform, an environment designed to support scientific code development targeted at a diverse set of high performance computing systems. Our WHPC project to improve Eclipse PTP takes an application-centric view to improve PTP. We are using a set of scientific applications, each with a variety of challenges, and using PTP to drive further improvements to both the scientific application, as well as to understand shortcomings in Eclipse PTP from an application developer perspective, to drive our list of improvements we seek to make. We are also partnering with performance tool providers, to drive higher quality performance tool integration. We have partnered with the Cactus group at Louisiana State University to improve Eclipse's ability to work with computational frameworks and extremely complex build systems, as well as to develop educational materials to incorporate into computational science and engineering codes. Finally, we are partnering with the lead PTP developers at IBM, to ensure we are as effective as possible within the Eclipse community development. We are also conducting training and outreach to our user community, including conference BOF sessions, monthly user calls, and an annual user meeting, so that we can best inform the improvements we make to Eclipse PTP. With these activities we endeavor to encourage use of modern software engineering practices, as enabled through the Eclipse IDE, with computational science and engineering applications. These practices include proper use of source code repositories, tracking and rectifying issues, measuring and monitoring code performance changes against both optimizations as well as ever-changing software stacks and configurations on HPC systems, as well as ultimately encouraging development and maintenance of testing suites -- things that have become commonplace in many software endeavors, but have lagged in the development of science applications. We view that the challenge with the increased complexity of both HPC systems and science applications demands the use of better software engineering methods, preferably enabled by modern tools such as Eclipse PTP, to help the computational science community thrive as we evolve the HPC landscape.

Effectiveness of interventions to improve occupational performance of people with cognitive impairments after stroke: an evidence-based review.

PubMed

Gillen, Glen; Nilsen, Dawn M; Attridge, Jessica; Banakos, Erasmia; Morgan, Marie; Winterbottom, Lauren; York, Wesley

2015-01-01

This evidence-based review was conducted to determine which interventions are effective in improving occupational performance after stroke. Forty-six articles met the inclusion criteria and were examined. Interventions for the following impairments were reviewed: general cognitive deficits, executive dysfunction, apraxia, memory loss, attention deficits, visual field deficits (included because of their close relationship with neglect), and unilateral neglect. Evidence is available from a variety of clinical trials to guide interventions regarding general cognition, apraxia, and neglect. The evidence regarding interventions for executive dysfunction and memory loss is limited. There is insufficient evidence regarding impairments of attention and mixed evidence regarding interventions for visual field deficits. The effective interventions have some commonalities, including being performance focused, involving strategy training, and using a compensatory as opposed to a remediation approach. The implications of the findings for practice, research, and education are discussed. Copyright © 2015 by the American Occupational Therapy Association, Inc.

SYNAPTIC DEPRESSION IN DEEP NEURAL NETWORKS FOR SPEECH PROCESSING.

PubMed

Zhang, Wenhao; Li, Hanyu; Yang, Minda; Mesgarani, Nima

2016-03-01

A characteristic property of biological neurons is their ability to dynamically change the synaptic efficacy in response to variable input conditions. This mechanism, known as synaptic depression, significantly contributes to the formation of normalized representation of speech features. Synaptic depression also contributes to the robust performance of biological systems. In this paper, we describe how synaptic depression can be modeled and incorporated into deep neural network architectures to improve their generalization ability. We observed that when synaptic depression is added to the hidden layers of a neural network, it reduces the effect of changing background activity in the node activations. In addition, we show that when synaptic depression is included in a deep neural network trained for phoneme classification, the performance of the network improves under noisy conditions not included in the training phase. Our results suggest that more complete neuron models may further reduce the gap between the biological performance and artificial computing, resulting in networks that better generalize to novel signal conditions.

'What I want to do is get half a dozen of them and go and see Simon Cowell': Reflecting on participation and outcomes for people with dementia taking part in a creative musical project.

PubMed

McCabe, Louise; Greasley-Adams, Corinne; Goodson, Katy

2015-11-01

This paper presents the findings from an evaluation of a creative musical project led by Scottish Opera. The project included people with dementia and their carers in the development, writing, design and performance of a musical production about their experiences of love. The project involved professional singers, artists and choreographers from the opera company. Activities involved practice sessions and performances. People with dementia and their carers reflected on positive outcomes from the project including improved confidence; being part of a group; improved physical strength and people seeing them in a new way. Within the evaluation framework they also reported on how the project had been run and gave ideas for future development. Key elements in the success of this project were the involvement of professionals, the kudos of working with a national organisation and the performances that, while daunting, provided unique and rewarding experiences. © The Author(s) 2013.

Performance of Low Temperature Electrolytes in Experimental and Prototype Li-Ion Cells

NASA Technical Reports Server (NTRS)

Smart, M. C.; Ratnakumar, B. V.; Whitcanack, L. D.

2007-01-01

Due to their attractive properties and proven success, Li-ion batteries have become identified as the battery chemistry of choice for a number of future NASA missions. A number of these applications would be greatly benefited by improved performance of Li-ion technology over a wider operating temperature range, especially at low temperatures, such as future ESMD missions. In many cases, these technology improvements may be mission enabling, and at the very least mission enhancing. In addition to aerospace applications, the DoE has interest in developing advanced Li-ion batteries that can operate over a wide temperature range to enable terrestrial HEV applications. Thus, our focus at JPL in recent years has been to extend the operating temperature range of Li-ion batteries, especially at low temperatures. To accomplish this, the main focus of the research has been devoted to developing improved lithium-ion conducting electrolytes. In the present paper, we would like to present some of the results we have obtained with ethylene carbonate-based electrolytes optimized for low temperature in experimental MCMB-LiNixCo1_x0 2 cells. In addition to obtaining discharge and charge rate performance data at various temperatures, electrochemical measurements were performed on individual electrodes (made possible by the incorporation of Li reference electrodes), including EIS, linear polarization and Tafel polarization measurements. The combination of techniques enables the elucidation of various trends associated with electrolyte composition. In addition to investigating the behavior in experimental cells, the performance of many promising low temperature electrolytes was demonstrated in large capacity, aerospace quality Li-ion prototype cells. These cells were subjected to a number of performance tests, including discharge rate characterization, charge rate characterization, cycle life performance at various temperatures, and power characterization tests.

Yttria-stabilized zirconia solid oxide electrolyte fuel cells: Monolithic solid oxide fuel cells

NASA Astrophysics Data System (ADS)

1990-10-01

The monolithic solid oxide fuel cell (MSOFC) is currently under development for a variety of applications including coal-based power generation. The MSOFC is a design concept that places the thin components of a solid oxide fuel cell in lightweight, compact, corrugated structure, and so achieves high efficiency and excellent performance simultaneously with high power density. The MSOFC can be integrated with coal gasification plants and is expected to have high overall efficiency in the conversion of the chemical energy of coal to electrical energy. This report describes work aimed at: (1) assessing manufacturing costs for the MSOFC and system costs for a coal-based plant; (2) modifying electrodes and electrode/electrolyte interfaces to improve the electrochemical performance of the MSOFC; and (3) testing the performance of the MSOFC on hydrogen and simulated coal gas. Manufacturing costs for both the coflow and crossflow MSOFC's were assessed based on the fabrication flow charts developed by direct scaleup of tape calendering and other laboratory processes. Integrated coal-based MSOFC systems were investigated to determine capital costs and costs of electricity. Design criteria were established for a coal-fueled 200-Mw power plant. Four plant arrangements were evaluated, and plant performance was analyzed. Interfacial modification involved modification of electrodes and electrode/electrolyte interfaces to improve the MSOFC electrochemical performance. Work in the cathode and cathode/electrolyte interface was concentrated on modification of electrode porosity, electrode morphology, electrode material, and interfacial bonding. Modifications of the anode and anode/electrolyte interface included the use of additives and improvement of nickel distribution. Single cells have been tested for their electrochemical performance. Performance data were typically obtained with humidified H2 or simulated coal gas and air or oxygen.

Improving Trends in Gender Disparities in the Department of Veterans Affairs: 2008–2013

PubMed Central

Czarnogorski, Maggie; Wright, Steve M.; Hayes, Patricia M.; Haskell, Sally G.

2014-01-01

Increasing numbers of women veterans using Department of Veterans Affairs (VA) services has contributed to the need for equitable, high-quality care for women. The VA has evaluated performance measure data by gender since 2006. In 2008, the VA launched a 5-year women’s health redesign, and, in 2011, gender disparity improvement was included on leadership performance plans. We examined data from VA Office of Analytics and Business Intelligence quarterly gender reports for trends in gender disparities in gender-neutral performance measures from 2008 to 2013. Through reporting of data by gender, leadership involvement, electronic reminders, and population management dashboards, VA has seen a decreasing trend in gender inequities on most Health Effectiveness Data and Information Set performance measures. PMID:25100416

An evaluation of performance by older persons on a simulated telecommuting task.

PubMed

Sharit, Joseph; Czaja, Sara J; Hernandez, Mario; Yang, Yulong; Perdomo, Dolores; Lewis, John E; Lee, Chin Chin; Nair, Sankaran

2004-11-01

Telecommuting work represents a strategy for managing the growing number of older people in the workforce. This study involved a simulated customer service telecommuting task that used e-mail to answer customer queries about media-related products and company policies. Participants included 27 "younger" older adults (50-65 years) and 25 "older" older adults (66-80 years). The participants performed the task for two 2-hr sessions a day over 4 consecutive days. Although both age groups showed significant improvement across sessions on many of the performance criteria, in general the improvements were more marked for the older age-group participants. However, the participants from both age groups had difficulty meeting some of the task performance requirements. These results are discussed in terms of training strategies for older workers.

Spectromicroscopy and coherent diffraction imaging: focus on energy materials applications.

PubMed

Hitchcock, Adam P; Toney, Michael F

2014-09-01

Current and future capabilities of X-ray spectromicroscopy are discussed based on coherence-limited imaging methods which will benefit from the dramatic increase in brightness expected from a diffraction-limited storage ring (DLSR). The methods discussed include advanced coherent diffraction techniques and nanoprobe-based real-space imaging using Fresnel zone plates or other diffractive optics whose performance is affected by the degree of coherence. The capabilities of current systems, improvements which can be expected, and some of the important scientific themes which will be impacted are described, with focus on energy materials applications. Potential performance improvements of these techniques based on anticipated DLSR performance are estimated. Several examples of energy sciences research problems which are out of reach of current instrumentation, but which might be solved with the enhanced DLSR performance, are discussed.

CPE--A New Perspective: The Impact of the Technology Revolution. Proceedings of the Computer Performance Evaluation Users Group Meeting (19th, San Francisco, California, October 25-28, 1983). Final Report. Reports on Computer Science and Technology.

ERIC Educational Resources Information Center

Mobray, Deborah, Ed.

Papers on local area networks (LANs), modelling techniques, software improvement, capacity planning, software engineering, microcomputers and end user computing, cost accounting and chargeback, configuration and performance management, and benchmarking presented at this conference include: (1) "Theoretical Performance Analysis of Virtual…

Implementation and Performance of Factorized Back projection on Low-Cost Commercial-Off-the-Shelf Hardware

DTIC Science & Technology

performance on a low cost, low size, weight, and power (SWAP) computer : a Raspberry Pi Model B. For a comparison of performance, a baseline implementation...improvement factor of 2-3 compared to filtered backprojection. Execution on a single Raspberry Pi is too slow for real-time imaging. However, factorized...backprojection is easily parallelized, and we include a discussion of parallel implementation across multiple Pis .

Engineering performance metrics

NASA Astrophysics Data System (ADS)

Delozier, R.; Snyder, N.

1993-03-01

Implementation of a Total Quality Management (TQM) approach to engineering work required the development of a system of metrics which would serve as a meaningful management tool for evaluating effectiveness in accomplishing project objectives and in achieving improved customer satisfaction. A team effort was chartered with the goal of developing a system of engineering performance metrics which would measure customer satisfaction, quality, cost effectiveness, and timeliness. The approach to developing this system involved normal systems design phases including, conceptual design, detailed design, implementation, and integration. The lessons teamed from this effort will be explored in this paper. These lessons learned may provide a starting point for other large engineering organizations seeking to institute a performance measurement system accomplishing project objectives and in achieving improved customer satisfaction. To facilitate this effort, a team was chartered to assist in the development of the metrics system. This team, consisting of customers and Engineering staff members, was utilized to ensure that the needs and views of the customers were considered in the development of performance measurements. The development of a system of metrics is no different than the development of any type of system. It includes the steps of defining performance measurement requirements, measurement process conceptual design, performance measurement and reporting system detailed design, and system implementation and integration.

Performance measurement in cancer care: uses and challenges.

PubMed

Lazar, G S; Desch, C E

1998-05-15

Unnecessary, inappropriate, and futile care are given in all areas of health care including cancer care. Not only does such care increase costs and waste precious resources, but patients may have adverse outcomes when the wrong care is given. One of the ways to address this issue is to measure performance with the use of administrative data sets. Through performance measurement, the best providers can be chosen, providers can be rewarded on the basis of the quality of their performance, opportunities for improvement can be identified, and variation in practice can be minimized. Purchasers should take leadership role in creating data sets that will enhance, clinical performance. Specifically, purchasers should require the following from payers: 1) staging information; 2) requirements and/or incentives for proper International Classification of Diseases coding, including other important (comorbid) conditions; 3) incentives or requirements for proper data collection if the payer is using a reimbursement strategy that places the risk on the provider; and 4) a willingness to collect and report information to providers of care, with a view toward increasing quality and decreasing the costs of cancer care. Demanding better clinical performance can lead to better outcomes. Once good data is presented to patients and providers, better clinical behavior and improved cancer care systems will quickly follow.

Case study evaluating Just-In-Time Teaching and Peer Instruction using clickers in a quantum mechanics course

NASA Astrophysics Data System (ADS)

Sayer, Ryan; Marshman, Emily; Singh, Chandralekha

2016-12-01

Just-in-Time Teaching (JiTT) is an instructional strategy involving feedback from students on prelecture activities in order to design in-class activities to build on the continuing feedback from students. We investigate the effectiveness of a JiTT approach, which included in-class concept tests using clickers in an upper-division quantum mechanics course. We analyze student performance on prelecture reading quizzes, in-class clicker questions answered individually, and clicker questions answered after group discussion, and compare those performances with open-ended retention quizzes administered after all instructional activities on the same concepts. In general, compared to the reading quizzes, student performance improved when individual clicker questions were posed after lectures that focused on student difficulties found via electronic feedback. The performance on the clicker questions after group discussion following individual clicker question responses also showed improvement. We discuss some possible reasons for the improved performance at various stages, e.g., from prelecture reading quizzes to postlecture clicker questions, and from individual to group clicker questions.

The Effects of Low-Vision Rehabilitation on Reading Speed and Depression in Age Related Macular Degeneration: A Meta-Analysis.

PubMed

Hamade, Noura; Hodge, William G; Rakibuz-Zaman, Muhammad; Malvankar-Mehta, Monali S

2016-01-01

Age related macular degeneration (AMD) is a progressive eye disease that, as of 2015, has affected 11 million people in the U.S. and 1.5 million in Canada causing central vision blindness. By 2050, this number is expected to double to 22 million. Eccentric vision is the target of low-vision rehabilitation aids and programs for patients with AMD, which are thought to improve functional performance by improving reading speed and depression. This study evaluates the effect of various low-vision rehabilitation strategies on reading speed and depression in patients 55 and older with AMD. Computer databases including MEDLINE (OVID), EMBASE (OVID), BIOSIS Previews (Thomson-Reuters), CINAHL (EBSCO), Health Economic Evaluations Database (HEED), ISI Web of Science (Thomson-Reuters) and the Cochrane Library (Wiley) were searched from the year 2000 to January 2015. Included papers were research studies with a sample size of 20 eyes or greater focused on AMD in adults aged 55 or older with low vision (20/60 or lower). Two independent reviewers screened and extracted relevant data from the included articles. Standardized mean difference (SMD) was chosen as an effect size to perform meta-analysis using STATA. Fixed- and random-effect models were developed based on heterogeneity. Reading Speed and Depression Scores. A total of 9 studies (885 subjects) were included. Overall, a significant improvement in reading speed was found with a SMD of 1.01 [95% CI: 0.05 to 1.97]. Low-vision rehabilitation strategies including micro-perimetric biofeedback, microscopes teaching program significantly improved reading speed. Eccentric viewing training showed the maximum improvement in reading speed. In addition, a non-significant improvement in depression scores was found with a SMD of -0.44 [95% CI: -0.96 to 0.09]. A considerable amount of research is required in the area of low-vision rehabilitation strategies for patients with AMD. Based on current research, low-vision rehabilitation aids improve reading speed. However, they do not have a significant effect on depression scores in those 55 and older with AMD.