Managing in-hospital quality improvement: An importance-performance analysis to set priorities for ST-elevation myocardial infarction care.

PubMed

Aeyels, Daan; Seys, Deborah; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Bruyneel, Luk; Vanhaecht, Kris

2018-02-01

A focus on specific priorities increases the success rate of quality improvement efforts for broad and complex-care processes. Importance-performance analysis presents a possible approach to set priorities around which to design and implement effective quality improvement initiatives. Persistent variation in hospital performance makes ST-elevation myocardial infarction care relevant to consider for importance-performance analysis. The purpose of this study was to identify quality improvement priorities in ST-elevation myocardial infarction care. Importance and performance levels of ST-elevation myocardial infarction key interventions were combined in an importance-performance analysis. Content validity indexes on 23 ST-elevation myocardial infarction key interventions of a multidisciplinary RAND Delphi Survey defined importance levels. Structured review of 300 patient records in 15 acute hospitals determined performance levels. The significance of between-hospital variation was determined by a Kruskal-Wallis test. A performance heat-map allowed for hospital-specific priority setting. Seven key interventions were each rated as an overall improvement priority. Priority key interventions related to risk assessment, timely reperfusion by percutaneous coronary intervention and secondary prevention. Between-hospital performance varied significantly for the majority of key interventions. The type and number of priorities varied strongly across hospitals. Guideline adherence in ST-elevation myocardial infarction care is low and improvement priorities vary between hospitals. Importance-performance analysis helps clinicians and management in demarcation of the nature, number and order of improvement priorities. By offering a tailored improvement focus, this methodology makes improvement efforts more specific and achievable.

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.

A Novel Feed-Forward Modeling System Leads to Sustained Improvements in Attention and Academic Performance.

PubMed

McDermott, Ashley F; Rose, Maya; Norris, Troy; Gordon, Eric

2016-01-28

This study tested a novel feed-forward modeling (FFM) system as a nonpharmacological intervention for the treatment of ADHD children and the training of cognitive skills that improve academic performance. This study implemented a randomized, controlled, parallel design comparing this FFM with a nonpharmacological community care intervention. Improvements were measured on parent- and clinician-rated scales of ADHD symptomatology and on academic performance tests completed by the participant. Participants were followed for 3 months after training. Participants in the FFM training group showed significant improvements in ADHD symptomatology and academic performance, while the control group did not. Improvements from FFM were sustained 3 months later. The FFM appeared to be an effective intervention for the treatment of ADHD and improving academic performance. This FFM training intervention shows promise as a first-line treatment for ADHD while improving academic performance. © The Author(s) 2016.

Partnering through Training and Practice to Achieve Performance Improvement

ERIC Educational Resources Information Center

Lyons, Paul R.

2010-01-01

This article presents a partnership effort among managers, trainers, and employees to spring to life performance improvement using the performance templates (P-T) approach. P-T represents a process model as well as a method of training leading to performance improvement. Not only does it add to our repertoire of training and performance management…

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

Performance improvement in the JCAHO environment of care.

PubMed

Hill, Scott A

2002-01-01

Using security management to demonstrate performance improvement for JCAHO can be a viable option. The article illustrates how a program for reducing theft became the basis for demonstrating performance improvement.

Examining the Relationship between Employee Satisfaction and Organizational Performance in Higher Education

ERIC Educational Resources Information Center

Dusing, Roger P.

2017-01-01

Organizations, regardless of industry/sector, should consistently evaluate and improve organizational performance. Higher education institutions have come under increasing pressures to control costs while improving outcomes and would benefit from strategies that improve the performance of their employees leading to improved organizational…

The Prevalence of Performance Improvement as a Central Topic in the Professional Literature

ERIC Educational Resources Information Center

Guerra-Lopez, Ingrid

2012-01-01

The performance improvement field has evolved from the work of professionals seeking to improve performance in the workplace. Each time the field has evolved, it has done so by consistently expanding its scope and incorporating a broader performance context in line with its systems-theory roots. But just how much has performance improvement…

Embarking on performance improvement.

PubMed

Brown, Bobbi; Falk, Leslie Hough

2014-06-01

Healthcare organizations should approach performance improvement as a program, not a project. The program should be led by a guidance team that identifies goals, prioritizes work, and removes barriers to enable clinical improvement teams and work groups to realize performance improvements. A healthcare enterprise data warehouse can provide the initial foundation for the program analytics. Evidence-based best practices can help achieve improved outcomes and reduced costs.

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.

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/

42 CFR 460.136 - Internal quality assessment and performance improvement activities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... in quality assessment and performance improvement activities, including providing information about... 42 Public Health 4 2014-10-01 2014-10-01 false Internal quality assessment and performance...) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460...

42 CFR 460.136 - Internal quality assessment and performance improvement activities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... in quality assessment and performance improvement activities, including providing information about... 42 Public Health 4 2012-10-01 2012-10-01 false Internal quality assessment and performance...) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460...

42 CFR 460.136 - Internal quality assessment and performance improvement activities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... in quality assessment and performance improvement activities, including providing information about... 42 Public Health 4 2013-10-01 2013-10-01 false Internal quality assessment and performance...) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460...

Deodorants, value, and performance.

PubMed

Newcomer, L N

1997-11-01

For the health-care market, like the deodorant market, the message is clear: Add value or your product will not be competitive. For physicians of all specialties, the best way to add value is to measure and improve performance. Performance measurement is critical to improvement in health care. Without measurement, there can be no improvement in quality. Without improvement in quality, there is no added value. Oncologists can take at least two actions to add value for their health plans: (1) measure practice performance and demonstrate a quality improvement; and (2) become the personal-care physician for cancer patients.

Uncertain behaviours of integrated circuits improve computational performance.

PubMed

Yoshimura, Chihiro; Yamaoka, Masanao; Hayashi, Masato; Okuyama, Takuya; Aoki, Hidetaka; Kawarabayashi, Ken-ichi; Mizuno, Hiroyuki

2015-11-20

Improvements to the performance of conventional computers have mainly been achieved through semiconductor scaling; however, scaling is reaching its limitations. Natural phenomena, such as quantum superposition and stochastic resonance, have been introduced into new computing paradigms to improve performance beyond these limitations. Here, we explain that the uncertain behaviours of devices due to semiconductor scaling can improve the performance of computers. We prototyped an integrated circuit by performing a ground-state search of the Ising model. The bit errors of memory cell devices holding the current state of search occur probabilistically by inserting fluctuations into dynamic device characteristics, which will be actualised in the future to the chip. As a result, we observed more improvements in solution accuracy than that without fluctuations. Although the uncertain behaviours of devices had been intended to be eliminated in conventional devices, we demonstrate that uncertain behaviours has become the key to improving computational performance.

Measuring, managing and maximizing refinery performance

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

Bascur, O.A.; Kennedy, J.P.

1996-01-01

Implementing continuous quality improvement is a confluence of total quality management, people empowerment, performance indicators and information engineering. Supporting information technologies allow a refiner to narrow the gap between management objectives and the process control level. Dynamic performance monitoring benefits come from production cost savings, improved communications and enhanced decision making. A refinery workgroup information flow model helps automate continuous improvement of processes, performance and the organization. The paper discusses the rethinking of refinery operations, dynamic performance monitoring, continuous process improvement, the knowledge coordinator and repository manager, an integrated plant operations workflow, and successful implementation.

Improving Test-Taking Performance of Secondary At-Risk Youth and Students with Disabilities

ERIC Educational Resources Information Center

Banks, Tachelle; Eaton, India

2014-01-01

Preparing at-risk youth and students with mild disabilities for state and district tests is important for improving their test performance, and basic instruction in test preparation can significantly improve student test performance. The article defines noncognitive variables that adversely affect test-taker performance. The article also describes…

Using TSP to Improve Performance

DTIC Science & Technology

2008-11-13

Carnegie Mellon University Using TSP to Improve Performance 46 Work - Life Balance People are your most important resource. Finding and retaining good people...is critical to long-term success. Intuit found that TSP improved work - life balance , a key factor in job satisfaction. Source: Intuit © 2008 Carnegie...Mellon University Using TSP to Improve Performance 47 Intuit TSP Survey Results Improved work - life balance with TSP is reflected in job satisfaction

Creatine supplementation and swim performance: a brief review.

PubMed

Hopwood, Melissa J; Graham, Kenneth; Rooney, Kieron B

2006-03-01

Nutritional supplements are popular among athletes participating in a wide variety of sports. Creatine is one of the most commonly used dietary supplements, as it has been shown to be beneficial in improving performance during repeated bouts of high-intensity anaerobic activity. This review examines the specific effects of creatine supplementation on swimming performance, and considers the effects of creatine supplementation on various measures of power development in this population. Research performed on the effect of creatine supplementation on swimming performance indicates that whilst creatine supplementation is ineffective in improving performance during a single sprint swim, dietary creatine supplementation may benefit repeated interval swim set performance. Considering the relationship between sprint swimming performance and measurements of power, the effect of creatine supplementation on power development in swimmers has also been examined. When measured on a swim bench ergometer, power development does show some improvement following a creatine supplementation regime. How this improvement in power output transfers to performance in the pool is uncertain. Although some evidence exists to suggest a gender effect on the performance improvements seen in swimmers following creatine supplementation, the majority of research indicates that male and female swimmers respond equally to supplementation. A major limitation to previous research is the lack of consideration given to the possible stroke dependant effect of creatine supplementation on swimming performance. The majority of the research conducted to date has involved examination of the freestyle swimming stroke only. The potential for performance improvements in the breaststroke and butterfly swimming strokes is discussed, with regards to the biomechanical differences and differences in efficiency between these strokes and freestyle. Key PointsCreatine supplementation does not improve single sprint swimming performance.Creatine supplementation does improve repeated interval swim set performance.Creatine supplementation does improve power development in swimmers when measured on a swim bench ergometer.As a result of the high energy demands of the butterfly and breaststroke competitive swimming styles, potentially, the benefits associated with creatine supplementation and swimming performance could be greater when swimming butterfly or breaststroke, compared to the commonly examined freestyle swimming stroke.

Five training sessions improves 3000 meter running performance.

PubMed

Riiser, A; Ripe, S; Aadland, E

2015-12-01

The primary aim of the present study was to evaluate the effect of two weeks of endurance training on 3000-meter running performance. Secondary we wanted to assess the relationship between baseline running performance and change in running performance over the intervention period. We assigned 36 military recruits to a training group (N.=28) and a control group. The training group was randomly allocated to one of three sub-groups: 1) a 3000 meter group (test race); 2) a 4x4-minutes high-intensity interval group; 3) a continuous training group. The training group exercised five times over a two-week period. The training group improved its 3000 meter running performance with 50 seconds (6%) compared to the control group (P=0.003). Moreover, all sub-groups improved their performance by 37 to 73 seconds (4-8%) compared to the control group (P<0.037). There was a significant relationship between pretest performance and improvement from pre- to post-test (ρ=-0.65, P<0.001) in the training group. We conclude that five endurance training sessions improved 3000 meter running performance and the slowest runners achieved the greatest improvement in running performance.

The Reliability of In-Training Assessment when Performance Improvement Is Taken into Account

ERIC Educational Resources Information Center

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

2010-01-01

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…

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

PubMed

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

2010-11-01

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

Training Attentional Control Improves Cognitive and Motor Task Performance.

PubMed

Ducrocq, Emmanuel; Wilson, Mark; Vine, Sam; Derakshan, Nazanin

2016-10-01

Attentional control is a necessary function for the regulation of goal-directed behavior. In three experiments we investigated whether training inhibitory control using a visual search task could improve task-specific measures of attentional control and performance. In Experiment 1 results revealed that training elicited a near-transfer effect, improving performance on a cognitive (antisaccade) task assessing inhibitory control. In Experiment 2 an initial far-transfer effect of training was observed on an index of attentional control validated for tennis. The principal aim of Experiment 3 was to expand on these findings by assessing objective gaze measures of inhibitory control during the performance of a tennis task. Training improved inhibitory control and performance when pressure was elevated, confirming the mechanisms by which cognitive anxiety impacts performance. These results suggest that attentional control training can improve inhibition and reduce taskspecific distractibility with promise of transfer to more efficient sporting performance in competitive contexts.

48 CFR 970.5203-2 - Performance improvement and collaboration.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ENERGY AGENCY SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Solicitation Provisions and Contract Clauses for Management and Operating Contracts 970.5203-2 Performance improvement and... practices, where appropriate, that will improve performance in the areas of environmental and health, safety...

Plotting performance improvement progress through the development of a trauma dashboard.

PubMed

Hochstuhl, Diane C; Elwell, Sean

2014-01-01

Performance improvement processes are the core of a pediatric trauma program. The ability to identify, resolve, and trend specific indicators related to patient care and to show effective loop closure can be especially challenging. Using the hospital's overall quality process as a template, the trauma program built its own electronic dashboard. Our maturing trauma PI program now guides the overall trauma care. All departments own at least one performance indicator and must provide action plans for improvement. Utilization of an electronic dashboard for trauma performance improvement has provided a highly visible scorecard, which highlights successes and tracks areas needing improvement.

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.

Performance Measurement and Target-Setting in California's Safety Net Health Systems.

PubMed

Hemmat, Shirin; Schillinger, Dean; Lyles, Courtney; Ackerman, Sara; Gourley, Gato; Vittinghoff, Eric; Handley, Margaret; Sarkar, Urmimala

Health policies encourage implementing quality measurement with performance targets. The 2010-2015 California Medicaid waiver mandated quality measurement and reporting. In 2013, California safety net hospitals participating in the waiver set a voluntary performance target (the 90th percentile for Medicare preferred provider organization plans) for mammography screening and cholesterol control in diabetes. They did not reach the target, and the difference-in-differences analysis suggested that there was no difference for mammography ( P = .39) and low-density lipoprotein control ( P = .11) performance compared to measures for which no statewide quality improvement initiative existed. California's Medicaid waiver was associated with improved performance on a number of metrics, but this performance was not attributable to target setting on specific health conditions. Performance may have improved because of secular trends or systems improvements related to waiver funding. Relying on condition-specific targets to measure performance may underestimate improvements and disadvantage certain health systems. Achieving ambitious targets likely requires sustained fiscal, management, and workforce investments.

Improve compliance and financial performance at the same time.

PubMed

Sinaiko, Jeff

2002-01-01

Contrary to conventional wisdom, which holds that compliance is often a net negative to a practice's financial performance, the fact is that compliance, operations, and the financial performance of a medical practice can all be simultaneously improved. This article will illustrate that the basic drivers of effective compliance are often the same fundamental business principles that lead to outstanding operations and enhanced financial performance. The lesson for medical practice managers is that if you improve compliance, you should actually improve your bottom line, not harm it.

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.

Design Alternatives to Improve Access Time Performance of Disk Drives Under DOS and UNIX

NASA Astrophysics Data System (ADS)

Hospodor, Andy

For the past 25 years, improvements in CPU performance have overshadowed improvements in the access time performance of disk drives. CPU performance has been slanted towards greater instruction execution rates, measured in millions of instructions per second (MIPS). However, the slant for performance of disk storage has been towards capacity and corresponding increased storage densities. The IBM PC, introduced in 1982, processed only a fraction of a MIP. Follow-on CPUs, such as the 80486 and 80586, sported 5-10 MIPS by 1992. Single user PCs and workstations, with one CPU and one disk drive, became the dominant application, as implied by their production volumes. However, disk drives did not enjoy a corresponding improvement in access time performance, although the potential still exists. The time to access a disk drive improves (decreases) in two ways: by altering the mechanical properties of the drive or by adding cache to the drive. This paper explores the improvement to access time performance of disk drives using cache, prefetch, faster rotation rates, and faster seek acceleration.

42 CFR 460.136 - Internal quality assessment and performance improvement activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Internal quality assessment and performance improvement activities. 460.136 Section 460.136 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES....136 Internal quality assessment and performance improvement activities. (a) Quality assessment and...

Restoring Executive Confidence in Performance Improvement

ERIC Educational Resources Information Center

Seidman, William; McCauley, Michael

2012-01-01

Many organizations have significantly decreased their investment in performance improvement initiatives because they believe they are too risky. In fact, organizations should invest in performance improvements to build cash reserves and gain market share. Recent scientific breakthroughs have led to the development of methodologies and technologies…

Sense of agency in continuous action: Assistance-induced performance improvement is self-attributed even with knowledge of assistance.

PubMed

Inoue, Kazuya; Takeda, Yuji; Kimura, Motohiro

2017-02-01

In a task involving continuous action to achieve a goal, the sense of agency increases with an improvement in task performance that is induced by unnoticed computer assistance. This study investigated how explicit instruction about the existence of computer assistance affects the increase of sense of agency that accompanies performance improvement. Participants performed a continuous action task in which they controlled the direction of motion of a dot to a goal by pressing keys. When instructions indicated the absence of assistance, the sense of agency increased with performance improvement induced by computer assistance, replicating previous findings. Interestingly, this increase of sense of agency was also observed even when instructions indicated the presence of assistance. These results suggest that even when a plausible cause of performance improvement other than one's own action exists, the improvement can be misattributed to one's own control of action, resulting in an increased sense of agency. Copyright © 2016 Elsevier Inc. All rights reserved.

Implementing a Motivational Program Using Musical Skit Development as a Technique To Improve Performance Skills of Middle School Students.

ERIC Educational Resources Information Center

Roi, Christine S.

A pilot program was developed and implemented to improve the music performance of middle school choral students. A target group of 27 low performing students in grade seven and eight participated in the program. The program utilized four strategies for improving performance skills. Lectures were given by inspirational leaders. Small groups were…

Effects of methylphenidate on acute math performance in children with attention-deficit hyperactivity disorder.

PubMed

Grizenko, Natalie; Cai, Emmy; Jolicoeur, Claude; Ter-Stepanian, Mariam; Joober, Ridha

2013-11-01

Examine the short-term (acute) effects of methylphenidate (MPH) on math performance in children with attention-deficit hyperactivity disorder (ADHD) and what factors predict improvement in math performance. One hundred ninety-eight children with ADHD participated in a double-blind, placebo-controlled, randomized crossover MPH trial. Math response to MPH was determined through administration of math problems adjusted to their academic level during the Restricted Academic Situation Scale (RASS). Student t tests were conducted to assess change in math performance with psychostimulants. Correlation between change on the RASS and change on the math performance was also examined. Linear regression was performed to determine predictor variables. Children with ADHD improved significantly in their math with MPH (P < 0.001). The degree of improvement on the RASS (which evaluates motor activity and orientation to task) and on math performance on MPH was highly correlated. A child's age at baseline and Wechsler Individual Achievement Test (WIAT)-Numerical Operations standard scores at baseline accounted for 15% of variances for acute math improvement. MPH improves acute math performance in children with ADHD. Younger children with lower math scores (as assessed by the WIAT) improved most on math scores when given psychostimulants. NCT00483106.

Health professionals' perceptions about their clinical performance and the influence of audit and feedback on their intentions to improve practice: a theory-based study in Dutch intensive care units.

PubMed

Gude, Wouter T; Roos-Blom, Marie-José; van der Veer, Sabine N; Dongelmans, Dave A; de Jonge, Evert; Francis, Jill J; Peek, Niels; de Keizer, Nicolette F

2018-02-17

Audit and feedback aims to guide health professionals in improving aspects of their practice that need it most. Evidence suggests that feedback fails to increase accuracy of professional perceptions about clinical performance, which likely reduces audit and feedback effectiveness. This study investigates health professionals' perceptions about their clinical performance and the influence of feedback on their intentions to change practice. We conducted an online laboratory experiment guided by Control Theory with 72 intensive care professionals from 21 units. For each of four new pain management indicators, we collected professionals' perceptions about their clinical performance; peer performance; targets; and improvement intentions before and after receiving first-time feedback. An electronic audit and feedback dashboard provided ICU's own performance, median and top 10% peer performance, and improvement recommendations. The experiment took place approximately 1 month before units enrolled into a cluster-randomised trial assessing the impact of adding a toolbox with suggested actions and materials to improve intensive care pain management. During the experiment, the toolbox was inaccessible; all participants accessed the same version of the dashboard. We analysed 288 observations. In 53.8%, intensive care professionals overestimated their clinical performance; but in only 13.5%, they underestimated it. On average, performance was overestimated by 22.9% (on a 0-100% scale). Professionals similarly overestimated peer performance, and set targets 20.3% higher than the top performance benchmarks. In 68.4% of cases, intentions to improve practice were consistent with actual gaps in performance, even before professionals had received feedback; which increased to 79.9% after receiving feedback (odds ratio, 2.41; 95% CI, 1.53 to 3.78). However, in 56.3% of cases, professionals still wanted to improve care aspects at which they were already top performers. Alternatively, in 8.3% of cases, they lacked improvement intentions because they did not consider indicators important; did not trust the data; or deemed benchmarks unrealistic. Audit and feedback helps health professionals to work on aspects for which improvement is recommended. Given the abundance of professionals' prior good improvement intentions, the limited effects typically found by audit and feedback studies are likely predominantly caused by barriers to translation of intentions into actual change in clinical practice. ClinicalTrials.gov NCT02922101 . Registered 26 September 2016.

Continuing education for performance improvement: a creative approach.

PubMed

Collins, Patti-Ann; Hardesty, Ilana; White, Julie L; Zisblatt, Lara

2012-10-01

In an effort to improve patient safety and health care outcomes, continuing medical education has begun to focus on performance improvement initiatives for physician practices. Boston University School of Medicine's (BUSM) Continuing Nursing Education Accredited Provider Unit has begun a creative project to award nursing contact hours for nurses' participation in performance improvement activities. This column highlights its initial efforts. Copyright 2012, SLACK Incorporated.

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.

Evaluation of an institutional project to improve venous thromboembolism prevention.

PubMed

Minami, Christina A; Yang, Anthony D; Ju, Mila; Culver, Eckford; Seifert, Kathryn; Kreutzer, Lindsey; Halverson, Terri; O'Leary, Kevin J; Bilimoria, Karl Y

2016-12-01

Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures. A retrospective observational study. NMH, an 885-bed academic medical center in Chicago, Illinois PATIENTS: Inpatients admitted to NMH from January 1, 2013 to May 1, 2013 and from October 1, 2014 to April 1, 2015 were eligible for evaluation. Using the define-measure-analyze-improve-control (DMAIC) process-improvement methodology, a multidisciplinary team implemented and iteratively improved 15 data-driven interventions in 4 broad areas: (1) electronic medical record (EMR) alerts, (2) education initiatives, (3) new EMR order sets, and (4) other EMR changes. The Joint Commission's 6 core measures and the Surgical Care Improvement Project (SCIP) SCIP-VTE-2 measure. Based on 3103 observations (1679 from January 1, 2013 to May 1, 2013, and 1424 from October 1, 2014 to April 1, 2015), performance on the core measures improved. Performance on measure 1 (chemoprophylaxis) improved from 82.5% to 90.2% on medicine services, and from 94.4% to 97.6% on surgical services. The largest improvements were seen in measure 4 (platelet monitoring), with a performance increase from 76.7% adherence to 100%, and measure 5 (warfarin discharge instructions), with a performance increase from 27.4% to 88.8%. A systematic hospital-wide DMAIC project improved VTE prophylaxis measure performance. Sustained performance has been observed, and novel control mechanisms for continued performance surveillance have been embedded in the hospital system. Journal of Hospital Medicine 2016;11:S29-S37. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Electronic Performance Support Systems: Comparison of Types of Integration Levels on Performance Outcomes

ERIC Educational Resources Information Center

Phillips, Sharon A.

2013-01-01

Selecting appropriate performance improvement interventions is a critical component of a comprehensive model of performance improvement. Intervention selection is an interconnected process involving analysis of an organization's environment, definition of the performance problem, and identification of a performance gap and identification of causal…

42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... projects, develop and implement an information technology system explicitly designed to improve patient... program that shows measurable improvement in indicators for which there is evidence that it will improve... learning throughout the hospital. (3) The hospital must take actions aimed at performance improvement and...

Short-Term Effects of Methylphenidate on Math Productivity in Children With Attention-Deficit/Hyperactivity Disorder are Mediated by Symptom Improvements: Evidence From a Placebo-Controlled Trial.

PubMed

Kortekaas-Rijlaarsdam, Anne Fleur; Luman, Marjolein; Sonuga-Barke, Edmund; Bet, Pierre M; Oosterlaan, Jaap

2017-04-01

Although numerous studies report positive effects of methylphenidate on academic performance, the mechanism behind these improvements remains unclear. This study investigates the effects of methylphenidate on academic performance in children with attention-deficit/hyperactivity disorder (ADHD) and the mediating and moderating influence of ADHD severity, academic performance, and ADHD symptom improvement. Sixty-three children with ADHD participated in a double-blind placebo-controlled crossover study comparing the effects of long-acting methylphenidate and placebo. Dependent variables were math, reading, and spelling performance. The ADHD group performance was compared with a group of 67 typically developing children. Methylphenidate improved math productivity and accuracy in children with ADHD. The effect of methylphenidate on math productivity was partly explained by parent-rated symptom improvement, with greater efficacy for children showing more symptom improvement. Further, children showing below-average math performance while on placebo profited more from methylphenidate than children showing above-average math performance. The results from this study indicate positive effects of methylphenidate on academic performance, although these were limited to math abilities. In light of these results, expectations of parents, teachers, and treating physicians about the immediate effects of methylphenidate on academic improvement should be tempered. Moreover, our results implicate that positive effects of methylphenidate on math performance are in part due directly to effects on math ability and in part due to reductions in ADHD symptoms.

Reverse alignment "mirror image" visualization as a laparoscopic training tool improves task performance.

PubMed

Dunnican, Ward J; Singh, T Paul; Ata, Ashar; Bendana, Emma E; Conlee, Thomas D; Dolce, Charles J; Ramakrishnan, Rakesh

2010-06-01

Reverse alignment (mirror image) visualization is a disconcerting situation occasionally faced during laparoscopic operations. This occurs when the camera faces back at the surgeon in the opposite direction from which the surgeon's body and instruments are facing. Most surgeons will attempt to optimize trocar and camera placement to avoid this situation. The authors' objective was to determine whether the intentional use of reverse alignment visualization during laparoscopic training would improve performance. A standard box trainer was configured for reverse alignment, and 34 medical students and junior surgical residents were randomized to train with either forward alignment (DIRECT) or reverse alignment (MIRROR) visualization. Enrollees were tested on both modalities before and after a 4-week structured training program specific to their modality. Student's t test was used to determine differences in task performance between the 2 groups. Twenty-one participants completed the study (10 DIRECT, 11 MIRROR). There were no significant differences in performance time between DIRECT or MIRROR participants during forward or reverse alignment initial testing. At final testing, DIRECT participants had improved times only in forward alignment performance; they demonstrated no significant improvement in reverse alignment performance. MIRROR participants had significant time improvement in both forward and reverse alignment performance at final testing. Reverse alignment imaging for laparoscopic training improves task performance for both reverse alignment and forward alignment tasks. This may be translated into improved performance in the operating room when faced with reverse alignment situations. Minimal lab training can account for drastic adaptation to this environment.

Quality of Care Improves for Patients with Diabetes in Medicare Shared Savings Accountable Care Organizations: Organizational Characteristics Associated with Performance.

PubMed

Fraze, Taressa K; Lewis, Valerie A; Tierney, Emily; Colla, Carrie H

2017-12-06

Accountable care organizations (ACOs), a primary care-centric delivery and payment model, aim to promote integrated population health, which may improve care for those with chronic conditions such as diabetes. Research has shown that, overall, the ACO model is effective at reducing costs, but there is substantial variation in how effective different types of ACOs are at impacting costs and improving care delivery. This study examines how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes. Secondary data were analyzed retrospectively to examine Medicare Shared Savings Program (MSSP) ACOs' performance on diabetes metrics in the first 2 years of ACO contracts. Ordinary least squares was used to analyze 162 MSSP ACOs with publicly available performance data and the National Survey of ACOs. ACOs improved performance significantly for patients with diabetes between contract years 1 and 2. In year 1, also having a private payer contract and an increased number of services within the ACO were positively associated with performance, while having a community health center or a hospital were negatively associated with performance. Better performance in year 1 was negatively associated with improved performance in year 2. This study found that ACOs substantively improved diabetes management within initial contract years. ACOs may need different types of support throughout their contracts to ensure continued improvements in performance.

Li Anode Technology for Improved Performance

NASA Technical Reports Server (NTRS)

Chen, Tuqiang

2011-01-01

A novel, low-cost approach to stabilization of Li metal anodes for high-performance rechargeable batteries was developed. Electrolyte additives are selected and used in Li cell electrolyte systems, promoting formation of a protective coating on Li metal anodes for improved cycle and safety performance. Li batteries developed from the new system will show significantly improved battery performance characteristics, including energy/power density, cycle/ calendar life, cost, and safety.

Improvement of Organizational Performance and Instructional Design: An Analogy Based on General Principles of Natural Information Processing Systems

ERIC Educational Resources Information Center

Darabi, Aubteen; Kalyuga, Slava

2012-01-01

The process of improving organizational performance through designing systemic interventions has remarkable similarities to designing instruction for improving learners' performance. Both processes deal with subjects (learners and organizations correspondingly) with certain capabilities that are exposed to novel information designed for producing…

Improving Student Naval Aviator Aircraft Carrier Landing Performance

ERIC Educational Resources Information Center

Sheppard, Thomas H.; Foster, T. Chris

2008-01-01

This article discusses the use of human performance technology (HPT) to improve qualification rates for learning to land onboard aircraft carriers. This project started as a request for a business case analysis and evolved into a full-fledged performance improvement project, from mission analysis through evaluation. The result was a significant…

Surviving Performance Improvement "Solutions": Aligning Performance Improvement Interventions

ERIC Educational Resources Information Center

Bernardez, Mariano L.

2009-01-01

How can organizations avoid the negative, sometimes chaotic, effects of multiple, poorly coordinated performance improvement interventions? How can we avoid punishing our external clients or staff with the side effects of solutions that might benefit our bottom line or internal efficiency at the expense of the value received or perceived by…

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... patient safety by using quality indicators or performance measures associated with improved health... that includes care and services furnished in the ASC. (b) Standard: Program data. (1) The program must...

Performance improvement: the organization's quest.

PubMed

McKinley, C O; Parmer, D E; Saint-Amand, R A; Harbin, C B; Roulston, J C; Ellis, R A; Buchanan, J R; Leonard, R B

1999-01-01

In today's health care marketplace, quality has become an expectation. Stakeholders are demanding quality clinical outcomes, and accrediting bodies are requiring clinical performance data. The Roosevelt Institute's quest was to define and quantify quality outcomes, develop an organizational culture of performance improvement, and ensure customer satisfaction. Several of the organization's leaders volunteered to work as a team to develop a specific performance improvement approach tailored to the organization. To date, over 200 employees have received an orientation to the model and its philosophy and nine problem action and process improvement teams have been formed.

Piloted studies of Enhanced or Synthetic Vision display parameters

NASA Technical Reports Server (NTRS)

Harris, Randall L., Sr.; Parrish, Russell V.

1992-01-01

This paper summarizes the results of several studies conducted at Langley Research Center over the past few years. The purposes of these studies were to investigate parameters of pictorial displays and imaging sensors that affect pilot approach and landing performance. Pictorial displays have demonstrated exceptional tracking performance and improved the pilots' spatial awareness. Stereopsis cueing improved pilot flight performance and reduced pilot stress. Sensor image parameters such as increased field-of-view. faster image update rate, and aiding symbology improved flare initiation. Finer image resolution and magnification improved attitude control performance parameters.

Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering.

PubMed

Mrazek, Michael D; Franklin, Michael S; Phillips, Dawa Tarchin; Baird, Benjamin; Schooler, Jonathan W

2013-05-01

Given that the ability to attend to a task without distraction underlies performance in a wide variety of contexts, training one's ability to stay on task should result in a similarly broad enhancement of performance. In a randomized controlled investigation, we examined whether a 2-week mindfulness-training course would decrease mind wandering and improve cognitive performance. Mindfulness training improved both GRE reading-comprehension scores and working memory capacity while simultaneously reducing the occurrence of distracting thoughts during completion of the GRE and the measure of working memory. Improvements in performance following mindfulness training were mediated by reduced mind wandering among participants who were prone to distraction at pretesting. Our results suggest that cultivating mindfulness is an effective and efficient technique for improving cognitive function, with wide-reaching consequences.

Does Iron Supplementation Improve Performance in Iron-Deficient Nonanemic Athletes?

PubMed

Rubeor, Amity; Goojha, Carmen; Manning, Jeffrey; White, Jordan

2018-05-01

Supplementing iron-deficient nonanemic (IDNA) athletes with iron to improve performance is a trend in endurance sports. To investigate the benefits of iron on performance, identify a ferritin level cutoff in IDNA athletes, and determine which iron supplementation regimens are most effective. A search of the PubMed, CINAHL, Embase, ERIC, and Cochrane databases was performed in 2014 including all articles. Citations of pertinent review articles were also searched. In 2017, the search was repeated. Inclusion criteria comprised studies of level 1 to 3 evidence, written in the English language, that researched iron supplementation in nonanemic athletes and reported performance outcomes. Systematic review. Level 3. The search terms used included athletic performance, resistance training, athletes, physical endurance, iron, iron deficiency, supplement, non-anemic, low ferritin, ferritin, ferritin blood level, athletes, and sports. A total of 1884 studies were identified through the initial database search, and 13 were identified through searching references of relevant review articles. A subsequent database search identified 46 studies. Following exclusions, 12 studies with a total of 283 participants were included. Supplementing IDNA athletes with iron improved performance in 6 studies (146 participants) and did not improve performance in the other 6 studies (137 participants). In the 6 studies that showed improved performance with iron supplementation, all used a ferritin level cutoff of ≤20 μg/L for treatment. Additionally, all studies that showed improved performance used oral iron as a supplement. The evidence is equivocal as to whether iron supplementation in IDNA athletes improves athletic performance. Supplementing athletes with ferritin levels <20 μg/L may be more beneficial than supplementing athletes with higher baseline ferritin levels.

Improving performance of Zambia Defence Force antiretroviral therapy providers: evaluation of a standards-based approach

PubMed Central

Kim, Young Mi; Banda, Joseph; Kanjipite, Webby; Sarkar, Supriya; Bazant, Eva; Hiner, Cyndi; Tholandi, Maya; Reinhardt, Stephanie; Njobvu, Panganani Dalisani; Kols, Adrienne; Benavides, Bruno

2013-01-01

ABSTRACT Background: The Zambia Defence Force (ZDF) has applied the Standards-Based Management and Recognition (SBM-R®) approach, which uses detailed performance standards, at some health facilities to improve HIV-related services offered to military personnel and surrounding civilian communities. This study examines the effectiveness of the SBM-R approach in improving facility readiness and provider performance at ZDF facilities. Methods: We collected data on facility readiness and provider performance before and after the 2010–2012 intervention at 4 intervention sites selected for their relatively poor performance and 4 comparison sites. Assessors observed whether each facility met 16 readiness standards and whether providers met 9 performance standards during consultations with 354 returning antiretroviral therapy (ART) clients. We then calculated the percentages of criteria achieved for each readiness and performance standard and conducted bivariate and multivariate analyses of provider performance data. Results: Facilities' ART readiness scores exceeded 80% before the intervention at both intervention and comparison sites. At endline, scores improved on 4 facility readiness standards in the intervention group but on only 1 standard in the comparison group. Multivariate analysis found that the overall provider performance score increased significantly in the intervention group (from 58% to 84%; P<.01) but not in the comparison group (from 62% to 70%). The before-and-after improvement in scores was significantly greater among intervention sites than among comparison sites for 2 standards—initial assessment of the client's condition and nutrition counseling. Conclusion: The standards-based approach, which involved intensive and mutually reinforcing intervention activities, showed modest improvements in some aspects of providers' performance during ART consultations. Further research is needed to determine whether improvements in provider performance affect client outcomes such as adherence to ART. PMID:25276534

Kinematic and kinetic improvements associated with action observation facilitated learning of the power clean in Australian footballers.

PubMed

Sakadjian, Alex; Panchuk, Derek; Pearce, Alan J

2014-06-01

This study investigated the effectiveness of action observation (AO) on facilitating learning of the power clean technique (kinematics) compared with traditional strength coaching methods and whether improvements in performance (kinetics) were associated with an improvement in lifting technique. Fifteen subjects (age, 20.9 ± 2.3 years) with no experience in performing the power clean exercise attended 12 training and testing sessions over a 4-week period. Subjects were assigned to 2 matched groups, based on preintervention power clean performance and performed 3 sets of 5 repetitions of the power clean exercise at each training session. Subjects in the traditional coaching group (TC; n = 7) received the standard coaching feedback (verbal cues and physical practice), whereas subjects in the AO group (n = 8) received similar verbal coaching cues and physical practice but also observed a video of a skilled model before performing each set. Kinematic data were collected from video recordings of subjects who were fitted with joint center markings during testing, whereas kinetic data were collected from a weightlifting analyzer attached to the barbell. Subjects were tested before intervention, at the end of weeks 2 and 3, and at after intervention at the end of week 4. Faster improvements (3%) were observed in power clean technique with AO-facilitated learning in the first week and performance improvements (mean peak power of the subject's 15 repetitions) over time were significant (p < 0.001). In addition, performance improvement was significantly associated (R = 0.215) with technique improvements. In conclusion, AO combined with verbal coaching and physical practice of the power clean exercise resulted in significantly faster technique improvements and improvement in performance compared with traditional coaching methods.

Off-Design Performance of a Streamline-Traced, External-Compression Supersonic Inlet

NASA Technical Reports Server (NTRS)

Slater, John W.

2017-01-01

A computational study was performed to explore the aerodynamic performance of a streamline-traced, external-compression inlet designed for Mach 1.664 at off-design conditions of freestream Mach number, angle-of-attack, and angle-of-sideslip. Serious degradation of the inlet performance occurred for negative angles-of-attack and angles-of-sideslip greater than 3 degrees. At low subsonic speeds, the swept leading edges of the inlet created a pair of vortices that propagated to the engine face. Increasing the bluntness of the cowl lip showed no real improvement in the inlet performance at the low speeds, but did improve the inlet performance at the design conditions. Reducing the inlet flow rate improved the inlet performance, but at the likely expense of reduced thrust of the propulsion system. Deforming the cowl lip for low-speed operation of the inlet increased the inlet capture area and improved the inlet performance.

Modified Thermoresponsive Hyperbranched Polymers for Improved Viscosity and Enhanced Lubricity of Engine Oils

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

Cosimbescu, Lelia; Robinson, Joshua W.; Bays, John Timothy

The manuscript captures the chronological succession of the molecular design progression through multiple architectures and topologies of the polymeric viscosity index improvers and their rheology bench test performance. Tribology testing was also performed on selected analogs and their friction and wear was evaluated. Finally, a top performing polymer was selected for engine testing, scaled-up, and its rheological performance in a complete formulation was assessed. The engine performance of the viscosity index improver was examined against an industry-established baseline.

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... time. (c) Standard: Prioritizing improvement activities. The dialysis facility must set priorities for performance improvement, considering prevalence and severity of identified problems and giving priority to...

12 CFR Appendix A to Part 228 - Ratings

Code of Federal Regulations, 2011 CFR

2011-01-01

... loans. (iv) Needs to improve. The Board rates a bank's lending performance “needs to improve” if, in... to improve. The Board rates a bank's investment performance “needs to improve” if, in general, it... to improve. The Board rates a bank's service performance “needs to improve” if, in general, the bank...

Defense Logistics: Improved Performance Measures and Information Needed for Assessing Asset Visibility Initiatives

DTIC Science & Technology

2017-03-01

Accountability Office Highlights of GAO-17-183, a report to congressional committees March 2017 DEFENSE LOGISTICS Improved Performance Measures ...DEFENSE LOGISTICS Improved Performance Measures and Information Needed for Assessing Asset Visibility Initiatives...Report to Congressional Committees March 2017 GAO-17-183 United States Government Accountability Office United States Government

Performance tests of a two phase ejector

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

Harrell, G.S.; Kornhauser, A.A.

1995-12-31

The ejector expansion refrigeration cycle is a modified vapor compression cycle in which a two phase ejector is used to recover a portion of the work otherwise lost in the expansion valve. The ejector improves cycle performance by increasing compressor inlet pressure and by lowering the quality of liquid entering the evaporator. Theoretically, a cooling COP improvement of approximately 23% is achievable for a typical refrigerating cycle and an ideal ejector. If the ejector performed as well as typical single phase ejectors an improvement of 12% could be achieved. Previous tests have demonstrated a smaller 3.7% improvement; the difference ismore » in the poor performance of the two phase ejector. The purpose of this research is to understand the operating characteristics of the two phase ejector and to devise design improvements. A two phase ejector test rig has been constructed and tested. Preliminary data show performance superior to previously tested two phase ejectors, but still inferior to single phase ejectors. Ejector performance corresponds to refrigeration cycle COP improvements ranging from 3.9% to 7.6%.« less

Improved MIMO radar GMTI via cyclic-shift transmission of orthogonal frequency division signals

NASA Astrophysics Data System (ADS)

Li, Fuyou; He, Feng; Dong, Zhen; Wu, Manqing

2018-05-01

Minimum detectable velocity (MDV) and maximum detectable velocity are both important in ground moving target indication (GMTI) systems. Smaller MDV can be achieved by longer baseline via multiple-input multiple-output (MIMO) radar. Maximum detectable velocity is decided by blind velocities associated with carrier frequencies, and blind velocities can be mitigated by orthogonal frequency division signals. However, the scattering echoes from different carrier frequencies are independent, which is not good for improving MDV performance. An improved cyclic-shift transmission is applied in MIMO GMTI system in this paper. MDV performance is improved due to the longer baseline, and maximum detectable velocity performance is improved due to the mitigation of blind velocities via multiple carrier frequencies. The signal model for this mode is established, the principle of mitigating blind velocities with orthogonal frequency division signals is presented; the performance of different MIMO GMTI waveforms is analysed; and the performance of different array configurations is analysed. Simulation results by space-time-frequency adaptive processing proves that our proposed method is a valid way to improve GMTI performance.

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.

CF6 Jet Engine Performance Improvement Program: High Pressure Turbine Aerodynamic Performance Improvement

NASA Technical Reports Server (NTRS)

Fasching, W. A.

1980-01-01

The improved single shank high pressure turbine design was evaluated in component tests consisting of performance, heat transfer and mechanical tests, and in core engine tests. The instrumented core engine test verified the thermal, mechanical, and aeromechanical characteristics of the improved turbine design. An endurance test subjected the improved single shank turbine to 1000 simulated flight cycles, the equivalent of approximately 3000 hours of typical airline service. Initial back-to-back engine tests demonstrated an improvement in cruise sfc of 1.3% and a reduction in exhaust gas temperature of 10 C. An additional improvement of 0.3% in cruise sfc and 6 C in EGT is projected for long service engines.

Independent Coactors May Improve Performance and Lower Workload: Viewing Vigilance Under Social Facilitation.

PubMed

Claypoole, Victoria L; Szalma, James L

2018-04-01

The purpose of the present study was to examine the effects of an independent coactor on vigilance task performance. It was hypothesized that the presence of an independent coactor would improve performance in terms of the proportion of false alarms while also increasing perceived workload and stress. Vigilance, or the ability to maintain attention for extended periods, is of great interest to human factors psychologists. Substantial work has focused on improving vigilance task performance, typically through motivational interventions. Of interest to vigilance researchers is the application of social facilitation as a means of enhancing vigilance. Social facilitation seeks to explain how social presence may improve performance. A total of 100 participants completed a 24-min vigil either alone or in the presence of an independent (confederate) coactor. Participants completed measures of perceived workload and stress. The results indicated that performance (i.e., proportion of false alarms) was improved for those who completed the vigil in the presence of an independent coactor. Interestingly, perceived workload was actually lower for those who completed the vigil in the presence of an independent coactor, although perceived stress was not affected by the manipulation. Authors of future research should extend these findings to other forms of social facilitation and examine vigilance task performance in social contexts in order to determine the utility of social presence for improving vigilance. The use of coactors may be an avenue for organizations to consider utilizing to improve performance because of its relative cost-effectiveness and easy implementation.

Paravertebral Spinal Injection for the Treatment of Patients with Degenerative Facet Osteoarthropathy: Evidence of Motor Performance Improvements based on Objective Assessments

PubMed Central

Toosizadeh, Nima; Harati, Homayoon; Yen, Tzu-Chuan; Fastje, Cindy; Mohler, Jane; Najafi, Bijan; Dohm, Michael

2016-01-01

Background This study examined short- and long-term improvements in motor performance, quantified using wearable sensors, in response to facet spine injection in degenerative facet osteoarthropathy patients. Methods Adults with confirmed degenerative facet osteoarthropathy were recruited and were treated with medial or intermediate branch block injection. Self-report pain, health condition, and disability (Oswestry), as well as objective motor performance measures (gait, balance, and timed-up-and-go) were obtained in five sessions: pre-surgery (baseline), immediately after the injection, one-month, three-month, and 12-month follow-ups. Baseline motor performance parameters were compared with 10 healthy controls. Findings Thirty patients (age=50(14) years) and 10 controls (age=46(15) years) were recruited. All motor performance parameters were significantly different between groups. Results showed that average pain and Oswestry scores improved by 51% and 24%, respectively among patients, only one month after injection. Similarly, improvement in motor performance was most noticeable in one-month post-injection measurements; most improvements were observed in gait speed (14% normal walking, P<0.02), hip sway within balance tests (63% eyes-open P<0.01), and turning velocity within the timed-up-and-go test (28%, P<0.02). Better baseline motor performance led to better outcomes in terms of pain relief; baseline turning velocity was 18% faster among the responsive compared to the non-responsive patients. Interpretations Spinal injection can temporarily (one to three months) improve motor performance in degenerative facet osteoarthropathy patients. Successful pain relief in response to treatment is independent of demographic characteristics and initial pain but dependent on baseline motor performance. Immediate self-reported pain relief is unrelated to magnitude of gradual improvement in motor performance. PMID:27744005

Does Mandatory Attendance Improve Student Performance?

ERIC Educational Resources Information Center

Marburger, Daniel R.

2006-01-01

Previous empirical literature indicates that student performance is inversely correlated with absenteeism. The author investigates the impact of enforcing an attendance policy on absenteeism and student performance. The evidence suggests that an enforced mandatory attendance policy significantly reduces absenteeism and improves exam performance.

Designing a Large-Scale Multilevel Improvement Initiative: The Improving Performance in Practice Program

ERIC Educational Resources Information Center

Margolis, Peter A.; DeWalt, Darren A.; Simon, Janet E.; Horowitz, Sheldon; Scoville, Richard; Kahn, Norman; Perelman, Robert; Bagley, Bruce; Miles, Paul

2010-01-01

Improving Performance in Practice (IPIP) is a large system intervention designed to align efforts and motivate the creation of a tiered system of improvement at the national, state, practice, and patient levels, assisting primary-care physicians and their practice teams to assess and measurably improve the quality of care for chronic illness and…

Performance improvements of binary diffractive structures via optimization of the photolithography and dry etch processes

NASA Astrophysics Data System (ADS)

Welch, Kevin; Leonard, Jerry; Jones, Richard D.

2010-08-01

Increasingly stringent requirements on the performance of diffractive optical elements (DOEs) used in wafer scanner illumination systems are driving continuous improvements in their associated manufacturing processes. Specifically, these processes are designed to improve the output pattern uniformity of off-axis illumination systems to minimize degradation in the ultimate imaging performance of a lithographic tool. In this paper, we discuss performance improvements in both photolithographic patterning and RIE etching of fused silica diffractive optical structures. In summary, optimized photolithographic processes were developed to increase critical dimension uniformity and featuresize linearity across the substrate. The photoresist film thickness was also optimized for integration with an improved etch process. This etch process was itself optimized for pattern transfer fidelity, sidewall profile (wall angle, trench bottom flatness), and across-wafer etch depth uniformity. Improvements observed with these processes on idealized test structures (for ease of analysis) led to their implementation in product flows, with comparable increases in performance and yield on customer designs.

Teaching Performance Improvement: An Opportunity for Continuing Medical Education

ERIC Educational Resources Information Center

Staker, Larry V.

2003-01-01

Practicing physicians generally are not engaged in either the methods of performance improvement for health care or the measurement and reporting of clinical outcomes. The principal reasons are lack of compensation for such work, the perception that the work of performance improvement adds no value and is a waste of time, the lack of knowledge and…

[Acceptance and commitment therapy (ACT) and improving chess performance in promising young chess-players].

PubMed

Ruiz, Francisco J; Luciano, Carmen

2009-08-01

Acceptance and Commitment Therapy (ACT) is shown to be effective in relatively distant fields from the so-called psychological disorders. One of these areas is sport performance improvement. The aim of the current study is to expand the application of brief ACT protocols to improve chess-players' performance. In a previous study, a brief protocol was applied to international-level adult chess-players that was effective. The current study aims to apply an equivalent brief ACT protocol, but in this case, applied in a group format to promising young chess-players. In addition, this brief protocol is compared to a non-intervention control condition. Results show that the ACT brief protocol improved the performance in 5 out of 7 participants, and that none of the chess-players in the control condition reached the established change criterion. The differences between the conditions in chess performance were statistically significant. The results are discussed, emphasizing the replicated impact of a brief ACT protocol on the improvement of chess-players' performance.

Measuring, managing and maximizing performance of mineral processing plants

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

Bascur, O.A.; Kennedy, J.P.

1995-12-31

The implementation of continuous quality improvement is the confluence of Total Quality Management, People Empowerment, Performance Indicators and Information Engineering. The supporting information technologies allow a mineral processor to narrow the gap between management business objectives and the process control level. One of the most important contributors is the user friendliness and flexibility of the personal computer in a client/server environment. This synergistic combination when used for real time performance monitoring translates into production cost savings, improved communications and enhanced decision support. Other savings come from reduced time to collect data and perform tedious calculations, act quickly with fresh newmore » data, generate and validate data to be used by others. This paper presents an integrated view of plant management. The selection of the proper tools for continuous quality improvement are described. The process of selecting critical performance monitoring indices for improved plant performance are discussed. The importance of a well balanced technological improvement, personnel empowerment, total quality management and organizational assets are stressed.« less

Audit and feedback interventions to improve endoscopist performance: Principles and effectiveness.

PubMed

Tinmouth, Jill; Patel, Jigisha; Hilsden, Robert J; Ivers, Noah; Llovet, Diego

2016-06-01

There is considerable variation in the quality of colonoscopy, attributable in part to endoscopist performance. Audit and feedback (A&F) provides health professionals with a summary of their performance over a period of time and is a common strategy used to improve provider performance. In this review, we discuss current understanding of the mechanism of A&F and describe specific features of effective A&F. To date, trials of A&F to improve colonoscopy performance report heterogeneous results, in part because colonoscopy is a complex procedural skill but also because the quality improvement interventions were sub-optimally implemented or inadequately evaluated. Nonetheless, evidence from a wide range of literature suggests that A&F has the potential to improve endoscopist performance. We discuss future directions for research in this area and provide guidance for providers or health system planners wishing to implement A&F to address quality of colonoscopy in their practice and/or jurisdiction. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

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.

Effects of the performance management information system in improving performance: an empirical study in Shanghai Ninth People's Hospital.

PubMed

Cui, Yinghui; Wu, Zhengyi; Lu, Yao; Jin, Wenzhong; Dai, Xing; Bai, Jinxi

2016-01-01

Improving the performance of clinical departments is not only the significant content of the healthcare system reform in China, but also the essential approach to better satisfying the Chinese growing demand for medical services. Performance management is vital and meaningful to public hospitals in China. Several studies are conducted in hospital internal performance management, but almost none of them consider the effects of informational tools. Therefore, we carried out an empirical study on effects of using performance management information system in Shanghai Ninth People's Hospital. The main feature of the system is that it provides a real-time query platform for users to analyze and dynamically monitor the key performance indexes, timely detect problems and make adjustments. We collected pivotal medical data on 35 clinical departments of this hospital from January 2013 until December 2014, 1 year before and after applying the performance management information system. Comparative analysis was conducted by statistical methods. The results show that the system is beneficial to improve performance scores of clinical departments and lower the proportion of drug expenses, meanwhile, shorten the average hospitalized days and increase the bed turnover rate. That is to say, with the increasing medical services, the quality and efficiency is greatly improved. In a word, application of the performance management information system has a positive effect on improving performance of clinical departments.

How to achieve and prove performance improvement - 15 years of experience in German wastewater benchmarking.

PubMed

Bertzbach, F; Franz, T; Möller, K

2012-01-01

This paper shows the results of performance improvement, which have been achieved in benchmarking projects in the wastewater industry in Germany over the last 15 years. A huge number of changes in operational practice and also in achieved annual savings can be shown, induced in particular by benchmarking at process level. Investigation of this question produces some general findings for the inclusion of performance improvement in a benchmarking project and for the communication of its results. Thus, we elaborate on the concept of benchmarking at both utility and process level, which is still a necessary distinction for the integration of performance improvement into our benchmarking approach. To achieve performance improvement via benchmarking it should be made quite clear that this outcome depends, on one hand, on a well conducted benchmarking programme and, on the other, on the individual situation within each participating utility.

Co-culture of channel catfish with hybrid catfish facilitates 'herd effect' to improve production performance

USDA-ARS?s Scientific Manuscript database

Herd effect is an epidemiological phenomenon, where the presence or proximity of a certain proportion of improved (superior) individuals improve the performance of less improved (normal) individuals. Channel catfish, Ictalurus puntatus is the single largest aquaculture species cultured in US. Ho...

Meeting the Challenge: Providing High-Quality School Environments through Energy Performance Contracting.

ERIC Educational Resources Information Center

Birr, David

2000-01-01

Energy performance contracting allows schools to pay for needed new energy equipment and modernization improvements with savings from reduced utility and maintenance costs. Improved energy efficiency reduces demand for burning fossil fuels, which reduces air pollution, leading to improved learning environments and budgets (through improved average…

Early Exercise in the Burn Intensive Care Unit Decreases Hospital Stay, Improves Mental Health, and Physical Performance

DTIC Science & Technology

2017-10-01

Decreases Hospital Stay, Improves Mental Health , and Physical Performance 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Oscar E. Suman, PhD...Multicenter Study of the Effect of In-Patient Exercise Training on Length of Hospitalization, Mental Health , and Physical Performance in Burned...Intensive Care Unit Decreases Hospital Stay, Improves Mental Health , and Physical Performance,” Proposal Log Number 13214039, Award Number W81XWH-14

Recent progress towards predicting aircraft ground handling performance

NASA Technical Reports Server (NTRS)

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

1981-01-01

Capability implemented in simulating aircraft ground handling performance is reviewed and areas for further expansion and improvement are identified. Problems associated with providing necessary simulator input data for adequate modeling of aircraft tire/runway friction behavior are discussed and efforts to improve tire/runway friction definition, and simulator fidelity are described. Aircraft braking performance data obtained on several wet runway surfaces are compared to ground vehicle friction measurements. Research to improve methods of predicting tire friction performance are discussed.

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, embeded system, are knowing which components are the low performers, and knowing what can be done to improve their performance.

Train the brain: immediate sensorimotor effects of mentally performed flexor exercises in patients with neck pain. A pilot study.

PubMed

Beinert, Konstantin; Sofsky, Marc; Trojan, Jörg

2018-05-09

Sensorimotor tests, like cranio- cervical flexion and cervical joint position sense tests, share a strong cognitive component during their execution. However, cognitive training for those tests has not been investigated so far. To compare mental and physical exercises for improving the sensorimotor function of the cervical spine. A within-subject design with 16 participants. Outpatient physiotherapy centre. Patients with chronic neck pain. Participants were instructed to perform specific active or mental exercises for the deep and superficial neck flexor muscles. The primary outcomes were cranio-cervical flexion test performance, postural sway, cervical joint position sense and pressure pain threshold. A mixed model analysis was used. The interventions improved cranio-cervical flexion performance (p < 0.001), with no difference between actively or mentally performed exercises. Postural sway increased after actively (p < 0.01) and mentally (p < 0.05) performed deep cervical neck flexor exercises, but not after superficial neck flexor exercises. Mentally performed superficial neck flexor exercises improved cervical joint position sense when compared to mentally performed deep cervical flexor exercises (p < 0.05), and actively performed superficial neck flexor exercises were effective in improving cervical joint position sense acuity compared to mentally performed deep cervical flexor exercises (p < 0.05) for relocation tasks in the transverse plane. The pressure pain threshold at the cervical spine increased after active deep cervical flexor exercises (p < 0.05) and after mental superficial neck flexor exercise (p < 0.05). Mentally performed deep cervical flexor exercises improved cranio-cervical flexion test performance, postural sway and pressure pain threshold at the cervical spine. Mentally performed superficial neck flexor exercises improved cervical joint position sense acuity more than mentally performed deep cervical flexor exercises. Mentally performed exercises are recommended in the early stages of rehabilitation to counteract extensive muscle impairment, and these can be incorporated into daily routine.

Motor intensive anti-gravity training improves performance in dynamic balance related tasks in persons with Parkinson's disease.

PubMed

Malling, Anne Sofie B; Jensen, Bente R

2016-01-01

Recent studies indicate that the effect of training on motor performance in persons with Parkinson's disease (PDP) is dependent on motor intensity. However, training of high motor intensity can be hard to apply in PDP due to e.g. bradykinesia, rigidity, tremor and postural instability. Therefore, the aim was to study the effect of motor intensive training performed in a safe anti-gravity environment using lower-body positive pressure (LBPP) technology on performance during dynamic balance related tasks. Thirteen male PDP went through an 8-week control period followed by 8 weeks of motor intensive antigravity training. Seventeen healthy males constituted a control group (CON). Performance during a five repetition sit-to-stand test (STS; sagittal plane) and a dynamic postural balance test (DPB; transversal plane) was evaluated. Effect measures were completion time, functional rates of force development, directional changes and force variance. STS completion time improved by 24% to the level of CON which was explained by shorter sitting-time and standing-time and larger numeric rate of force change during lowering to the chair, indicating faster vertical directional change and improved relaxation. DPB completion time tended to improve and was accompanied by improvements of functional medial and lateral rates of force development and higher vertical force variance during DPB. Our results suggest that the performance improvements may relate to improved inter-limb coordination. It is concluded that 8 weeks of motor intensive training in a safe LBPP environment improved performance during dynamic balance related tasks in PDP. Copyright © 2015 Elsevier B.V. All rights reserved.

Locked-wrap fuel rod

DOEpatents

Kaplan, Samuel; Chertock, Alan J.; Punches, James R.

1977-01-01

A method for spacing fast reactor fuel rods using a wire wrapper improved by orienting the wire-wrapped fuel rods in a unique manner which introduces desirable performance characteristics not attainable by previous wire-wrapped designs. Use of this method in a liquid metal fast breeder reactor results in: (a) improved mechanical performance, (b) improved rod-to-rod contact, (c) reduced steel volume, and (d) improved thermal-hydraulic performance. The method produces a "locked wrap" design which tends to lock the rods together at each of the wire cluster locations.

Propulsion system-flight control integration and optimization: Flight evaluation and technology transition

NASA Technical Reports Server (NTRS)

Burcham, Frank W., Jr.; Gilyard, Glenn B.; Myers, Lawrence P.

1990-01-01

Integration of propulsion and flight control systems and their optimization offers significant performance improvements. Research programs were conducted which have developed new propulsion and flight control integration concepts, implemented designs on high-performance airplanes, demonstrated these designs in flight, and measured the performance improvements. These programs, first on the YF-12 airplane, and later on the F-15, demonstrated increased thrust, reduced fuel consumption, increased engine life, and improved airplane performance; with improvements in the 5 to 10 percent range achieved with integration and with no changes to hardware. The design, software and hardware developments, and testing requirements were shown to be practical.

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.

Implementation of Turnaround Strategies in Chronically Low-Performing Schools

ERIC Educational Resources Information Center

Turnbull, Brenda J.; Arcaira, Erikson R.

2012-01-01

There is some evidence to indicate that chronically low-performing schools, whether improving student performance or not, often report pursuing substantially similar policies, programs, and practices. However, while chronically low-performing schools may pursue similar school improvement strategies, there is some evidence that the level and…

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.

Relative health performance in BRICS over the past 20 years: the winners and losers.

PubMed

Petrie, Dennis; Tang, Kam Ki

2014-06-01

To determine whether the health performance of Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--has kept in step with their economic development. Reductions in age- and sex-specific mortality seen in each BRICS country between 1990 and 2011 were measured. These results were compared with those of the best-performing countries in the world and the best-performing countries with similar income levels. We estimated each country's progress in reducing mortality and compared changes in that country's mortality rates against other countries with similar mean incomes to examine changes in avoidable mortality. The relative health performance of the five study countries differed markedly over the study period. Brazil demonstrated fairly even improvement in relative health performance across the different age and sex subgroups that we assessed. India's improvement was more modest and more varied across the subgroups. South Africa and the Russian Federation exhibited large declines in health performance as well as large sex-specific inequalities in health. Although China's levels of avoidable mortality decreased in absolute terms, the level of improvement appeared low in the context of China's economic growth. When evaluating a country's health performance in terms of avoidable mortality, it is useful to compare that performance against the performance of other countries. Such comparison allows any country-specific improvements to be distinguished from general global improvements.

Indonesian Private University Lecturer Performance Improvement Model to Improve a Sustainable Organization Performance

ERIC Educational Resources Information Center

Suryaman

2018-01-01

Lecturer performance will affect the quality and carrying capacity of the sustainability of an organization, in this case the university. There are many models developed to measure the performance of teachers, but not much to discuss the influence of faculty performance itself towards sustainability of an organization. This study was conducted in…

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

ERIC Educational Resources Information Center

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

2014-01-01

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

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

PubMed

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

2016-12-01

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

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.

Solid polymer electrolyte (SPE) fuel cell technology program, phase 2/2A. [testing and evaluations

NASA Technical Reports Server (NTRS)

1976-01-01

Test evaluations were performed on a fabricated single solid polymer electrolyte cell unit. The cell operated at increased current density and at higher performance levels. This improved performance was obtained through a combination of increased temperature, increased reactant pressures, improved activation techniques and improved thermal control over the baseline cell configuration. The cell demonstrated a higher acid content membrane which resulted in increased performance. Reduced catalyst loading and low cost membrane development showed encouraging results.

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.

School Faculty as a High-Performing Learning Community: Normative Data from 132 Schools.

ERIC Educational Resources Information Center

Meehan, Merrill L.; Wiersma, William; Cowley, Kimberly S.; Craig, James R.; Orletsky, Sandra R.; Childers, Robert D.

A faculty's commitment to continuous learning and improvement is a critical dimension in defining schools as high-performing learning communities. When planning an improvement effort, a school's staff needs a conceptual framework that outlines the dimensions of school improvement. The AEL Continuous School Improvement Questionnaire (CSIQ) is a…

Physician groups' use of data from patient experience surveys.

PubMed

Friedberg, Mark W; SteelFisher, Gillian K; Karp, Melinda; Schneider, Eric C

2011-05-01

In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. To examine whether and how physician groups are using patient experience data to improve patient care. During 2008, we conducted semi-structured interviews with the leaders of 72 participating physician groups (out of 117 groups receiving patient experience reports). Based on leaders' responses, we identified three levels of engagement with patient experience reporting: no efforts to improve (level 1), efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and efforts to improve group-wide performance (level 3). Groups' level of engagement and specific efforts to improve patient care. Forty-four group leaders (61%) reported group-wide improvement efforts (level 3), 16 (22%) reported efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and 12 (17%) reported no performance improvement efforts (level 1). Level 3 groups were more likely than others to have an integrated medical group organizational model (84% vs. 31% at level 2 and 33% at level 1; P < 0.005) and to employ the majority of their physicians (69% vs. 25% and 20%; P < 0.05). Among level 3 groups, the most common targets for improvement were access, communication with patients, and customer service. The most commonly reported improvement initiatives were changing office workflow, providing additional training for nonclinical staff, and adopting or enhancing an electronic health record. Despite statewide public reporting, physician groups' use of patient experience data varied widely. Integrated organizational models were associated with greater engagement, and efforts to enhance clinicians' interpersonal skills were uncommon, with groups predominantly focusing on office workflow and support staff.

Improving a Bimanual Motor Skill Through Unimanual Training

PubMed Central

Hayashi, Takuji; Nozaki, Daichi

2016-01-01

When we learn a bimanual motor skill (e.g., rowing a boat), we often break it down into unimanual practices (e.g., a rowing drill with the left or right arm). Such unimanual practice is thought to be useful for learning bimanual motor skills efficiently because the learner can concentrate on learning to perform a simpler component. However, it is not so straightforward to assume that unimanual training (UT) improves bimanual performance. We have previously demonstrated that motor memories for reaching movements consist of three different parts: unimanual-specific, bimanual-specific, and overlapping parts. According to this scheme, UT appears to be less effective, as its training effect is only partially transferred to the same limb for bimanual movement. In the present study, counter-intuitively, we demonstrate that, even after the bimanual skill is almost fully learned by means of bimanual training (BT), additional UT could further improve bimanual skill. We hypothesized that this effect occurs because UT increases the memory content in the overlapping part, which might contribute to an increase in the memory for bimanual movement. To test this hypothesis, we examined whether the UT performed after sufficient BT could improve the bimanual performance. Participants practiced performing bimanual reaching movements (BM) in the presence of a novel force-field imposed only on their left arm. As an index for the motor performance, we used the error-clamp method (i.e., after-effect of the left arm) to evaluate the force output to compensate for the force-field during the reaching movement. After sufficient BT, the training effect reached a plateau. However, UT performed subsequently improved the bimanual performance significantly. In contrast, when the same amount of BT was continued, the bimanual performance remained unchanged, highlighting the beneficial effect of UT on bimanual performance. Considering memory structure, we also expected that BT could improve unimanual performance, which was confirmed by another experiment. These results provide a new interpretation of why UT was useful for improving a bimanual skill, and propose a practical strategy for enhancing performance by performing training in various contexts. PMID:27471452

The Social Responsibility Performance Outcomes Model: Building Socially Responsible Companies through Performance Improvement Outcomes.

ERIC Educational Resources Information Center

Hatcher, Tim

2000-01-01

Considers the role of performance improvement professionals and human resources development professionals in helping organizations realize the ethical and financial power of corporate social responsibility. Explains the social responsibility performance outcomes model, which incorporates the concepts of societal needs and outcomes. (LRW)

Research and Theory as Necessary Tools for Organizational Training and Performance Improvement Practitioners

ERIC Educational Resources Information Center

Abaci, Serdar; Pershing, James A.

2017-01-01

Human Performance Technology (HPT) is the applied study and practice of improving organizational performance through training and non-training interventions. For practitioners working in this area that identify themselves as an HPT practitioner, organizational training and performance (OTP) specialist, or instructional designer--offering the right…

Tracking Environmental Sustainability Performance of Public Universities in Kenya

ERIC Educational Resources Information Center

Mungai, David N.

2017-01-01

Environmental Sustainability Performance Contract (PC) targets were introduced in the 2012/13 financial year as part of the broader public sector reforms and a strategy for performance improvement in the public service that includes Kenyan public universities. However, no evaluation has been conducted to assess performance improvement and impact.…

Using Performance-Based Pay to Improve the Quality of Teachers

ERIC Educational Resources Information Center

Lavy, Victor

2007-01-01

Tying teachers' pay to their classroom performance should, says Victor Lavy, improve the current educational system both by clarifying teaching goals and by attracting and retaining the most productive teachers. But implementing pay for performance poses many practical challenges, because measuring individual teachers' performance is difficult.…

Effect of respiratory muscle training on exercise performance in healthy individuals: a systematic review and meta-analysis.

PubMed

Illi, Sabine K; Held, Ulrike; Frank, Irène; Spengler, Christina M

2012-08-01

Two distinct types of specific respiratory muscle training (RMT), i.e. respiratory muscle strength (resistive/threshold) and endurance (hyperpnoea) training, have been established to improve the endurance performance of healthy individuals. We performed a systematic review and meta-analysis in order to determine the factors that affect the change in endurance performance after RMT in healthy subjects. A computerized search was performed without language restriction in MEDLINE, EMBASE and CINAHL and references of original studies and reviews were searched for further relevant studies. RMT studies with healthy individuals assessing changes in endurance exercise performance by maximal tests (constant load, time trial, intermittent incremental, conventional [non-intermittent] incremental) were screened and abstracted by two independent investigators. A multiple linear regression model was used to identify effects of subjects' fitness, type of RMT (inspiratory or combined inspiratory/expiratory muscle strength training, respiratory muscle endurance training), type of exercise test, test duration and type of sport (rowing, running, swimming, cycling) on changes in performance after RMT. In addition, a meta-analysis was performed to determine the effect of RMT on endurance performance in those studies providing the necessary data. The multiple linear regression analysis including 46 original studies revealed that less fit subjects benefit more from RMT than highly trained athletes (6.0% per 10 mL · kg⁻¹ · min⁻¹ decrease in maximal oxygen uptake, 95% confidence interval [CI] 1.8, 10.2%; p = 0.005) and that improvements do not differ significantly between inspiratory muscle strength and respiratory muscle endurance training (p = 0.208), while combined inspiratory and expiratory muscle strength training seems to be superior in improving performance, although based on only 6 studies (+12.8% compared with inspiratory muscle strength training, 95% CI 3.6, 22.0%; p = 0.006). Furthermore, constant load tests (+16%, 95% CI 10.2, 22.9%) and intermittent incremental tests (+18.5%, 95% CI 10.8, 26.3%) detect changes in endurance performance better than conventional incremental tests (both p < 0.001) with no difference between time trials and conventional incremental tests (p = 0.286). With increasing test duration, improvements in performance are greater (+0.4% per minute test duration, 95% CI 0.1, 0.6%; p = 0.011) and the type of sport does not influence the magnitude of improvements (all p > 0.05). The meta-analysis, performed on eight controlled trials revealed a significant improvement in performance after RMT, which was detected by constant load tests, time trials and intermittent incremental tests, but not by conventional incremental tests. RMT improves endurance exercise performance in healthy individuals with greater improvements in less fit individuals and in sports of longer durations. The two most common types of RMT (inspiratory muscle strength and respiratory muscle endurance training) do not differ significantly in their effect, while combined inspiratory/expiratory strength training might be superior. Improvements are similar between different types of sports. Changes in performance can be detected by constant load tests, time trials and intermittent incremental tests only. Thus, all types of RMT can be used to improve exercise performance in healthy subjects but care must be taken regarding the test used to investigate the improvements.

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.

RTC simulations on large branched sewer systems with SmaRTControl.

PubMed

de Korte, Kees; van Beest, Dick; van der Plaat, Marcel; de Graaf, Erno; Schaart, Niels

2009-01-01

In The Netherlands many large branched sewer systems exist. RTC can improve the performance of these systems. The objective of the universal algorithm of SmaRTControl is to improve the performance of the sewer system and the WWTP. The effect of RTC under rain weather flow conditions is simulated using a hydrological model with 19 drainage districts. The system related inefficiency coefficient (SIC) is introduced for assessment of the performance of sewer systems. The performance can be improved by RTC in combination with increased pumping capacities in the drainage districts, but without increasing the flow to the WWTP. Under dry weather flow conditions the flow to the WWTP can be equalized by storage of wastewater in the sewer system. It is concluded that SmaRTControl can improve the performance, that simulations are necessary and that SIC is an excellent parameter for assessment of the performance.

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

Diagnostic colonoscopy: performance measurement study.

PubMed

Kuznets, Naomi

2002-07-01

This is the fifth of a series of best practices studies undertaken by the Performance Measurement Initiative (PMI), the centerpiece of the Institute for Quality Improvement (IQI), a not-for-profit quality improvement subsidiary of the Accreditation Association for Ambulatory Health Care (AAAHC) (Performance Measurement Initiative, 1999a, 1999b, 2000a, 2000b). The IQI was created to offer clinical performance measurement and improvement opportunities to ambulatory health care organizations and others interested in quality patient care. The purpose of the study was to provide opportunities to initiate clinical performance measurement on key processes and outcomes for this procedure and use this information for clinical quality improvement. This article provides performance measurement information on how organizations that have demonstrated and validated differences in clinical practice can have similar outcomes, but at a dramatically lower cost. The intent of the article is to provide organizations with alternatives in practice to provide a better value to their patients.

Improved rate control for electron-beam evaporation and evaluation of optical performance improvements.

PubMed

Gevelber, Michael; Xu, Bing; Smith, Douglas

2006-03-01

A new deposition-rate-control and electron-beam-gun (e-gun) strategy was developed that significantly reduces the growth-rate variations for e-beam-deposited SiO2 coatings. The resulting improvements in optical performance are evaluated for multilayer bandpass filters. The adverse effect of uneven silica-source depletion on coating spectral performances during long deposition runs is discussed.

Progress Toward Adaptive Integration and Optimization of Automated and Neural Processing Systems: Establishing Neural and Behavioral Benchmarks of Optimized Performance

DTIC Science & Technology

2014-11-01

Paradigm ............................................................................19 3.4 Collaborative BCI for Improving Overall Performance...interfaces ( BCIs ) provide the biggest improvement in performance? Can we demonstrate clear advantages with BCIs ? 2 2. Simulator Development and...stimuli in real time. Fig. 18 ROC curves for each subject after the combination of 2 trials 3.4 Collaborative BCI for Improving Overall

CF6 Jet Engine Performance Improvement: High Pressure Turbine Active Clearance Control

NASA Technical Reports Server (NTRS)

Rich, S. E.; Fasching, W. A.

1982-01-01

An active clearance control system was developed which reduces fuel consumption and performance degradation. This system utilizes compressor discharge air during takeoff and fan discharge air during cruise to impinge on the shroud structure to improve the thermal response. The system was evaluated in component and engine tests. The test results demonstrated a performance improvement of 0.7 percent in cruise SFC.

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.

Constructing an adaptive care model for the management of disease-related symptoms throughout the course of multiple sclerosis--performance improvement CME.

PubMed

Miller, Aaron E; Cohen, Bruce A; Krieger, Stephen C; Markowitz, Clyde E; Mattson, David H; Tselentis, Helen N

2014-01-01

Symptom management remains a challenging clinical aspect of MS. To design a performance improvement continuing medical education (PI CME) activity for better clinical management of multiple sclerosis (MS)-related depression, fatigue, mobility impairment/falls, and spasticity. Ten volunteer MS centers participated in a three-stage PI CME model: A) baseline assessment; B) practice improvement CME intervention; C) reassessment. Expert faculty developed performance measures and activity intervention tools. Designated MS center champions reviewed patient charts and entered data into an online database. Stage C data were collected eight weeks after implementation of the intervention and compared with Stage A baseline data to measure change in performance. Aggregate data from the 10 participating MS centers (405 patient charts) revealed performance improvements in the assessment of all four MS-related symptoms. Statistically significant improvements were found in the documented assessment of mobility impairment/falls (p=0.003) and spasticity (p<0.001). For documentation of care plans, statistically significant improvements were reported for fatigue (p=0.007) and mobility impairment/falls (p=0.040); non-significant changes were noted for depression and spasticity. Our PI CME interventions demonstrated performance improvement in the management of MS-related symptoms. This PI CME model (available at www.achlpicme.org/ms/toolkit) offers a new perspective on enhancing symptom management in patients with MS.

Performing Well on Nursing Home Report Cards: Does It Pay Off?

PubMed Central

Park, Jeongyoung; Konetzka, R Tamara; Werner, Rachel M

2011-01-01

Objective To examine whether high performance or improvement on quality measures leads to economic rewards for nursing homes in the presence of public reporting. Data Sources Data from 6,286 freestanding Medicare-certified nursing homes between 1999 and 2005 were identified in Medicare Cost Reports, Minimum Data Set, and Online Survey and Certification Reporting System. Study Design Using a facility-level fixed-effects model, the effect of public reporting on financial performance was measured by comparing each of four financial outcomes (revenues, expenses, operating, and total profit margins) before (1999–2002) to after (2003–2005) public reporting was initiated. The effects were estimated separately by level of performance and improvement over time. Principal Findings Facilities that improved on publicly reported performance had increased revenues and higher profit margins after public reporting, mainly through increased Medicare admissions. High-scoring facilities showed similar patterns, though differences were not statistically significant. Conclusions Providers that improve their performance under public reporting may receive a return on their investment in quality improvement. This supports the business case for public reporting. PMID:21029093

Melodic contour identification by cochlear implant listeners.

PubMed

Galvin, John J; Fu, Qian-Jie; Nogaki, Geraldine

2007-06-01

While the cochlear implant provides many deaf patients with good speech understanding in quiet, music perception and appreciation with the cochlear implant remains a major challenge for most cochlear implant users. The present study investigated whether a closed-set melodic contour identification (MCI) task could be used to quantify cochlear implant users' ability to recognize musical melodies and whether MCI performance could be improved with moderate auditory training. The present study also compared MCI performance with familiar melody identification (FMI) performance, with and without MCI training. For the MCI task, test stimuli were melodic contours composed of 5 notes of equal duration whose frequencies corresponded to musical intervals. The interval between successive notes in each contour was varied between 1 and 5 semitones; the "root note" of the contours was also varied (A3, A4, and A5). Nine distinct musical patterns were generated for each interval and root note condition, resulting in a total of 135 musical contours. The identification of these melodic contours was measured in 11 cochlear implant users. FMI was also evaluated in the same subjects; recognition of 12 familiar melodies was tested with and without rhythm cues. MCI was also trained in 6 subjects, using custom software and melodic contours presented in a different frequency range from that used for testing. Results showed that MCI recognition performance was highly variable among cochlear implant users, ranging from 14% to 91% correct. For most subjects, MCI performance improved as the number of semitones between successive notes was increased; performance was slightly lower for the A3 root note condition. Mean FMI performance was 58% correct when rhythm cues were preserved and 29% correct when rhythm cues were removed. Statistical analyses revealed no significant correlation between MCI performance and FMI performance (with or without rhythmic cues). However, MCI performance was significantly correlated with vowel recognition performance; FMI performance was not correlated with cochlear implant subjects' phoneme recognition performance. Preliminary results also showed that the MCI training improved all subjects' MCI performance; the improved MCI performance also generalized to improved FMI performance. Preliminary data indicate that the closed-set MCI task is a viable approach toward quantifying an important component of cochlear implant users' music perception. The improvement in MCI performance and generalization to FMI performance with training suggests that MCI training may be useful for improving cochlear implant users' music perception and appreciation; such training may be necessary to properly evaluate patient performance, as acute measures may underestimate the amount of musical information transmitted by the cochlear implant device and received by cochlear implant listeners.

Methylphenidate Reduces State Anxiety During a Continuous Performance Test That Distinguishes Adult ADHD Patients From Controls.

PubMed

Bloch, Yuval; Aviram, Shai; Segev, Aviv; Nitzan, Uri; Levkovitz, Yechiel; Braw, Yoram; Mimouni Bloch, Aviva

2017-01-01

We hypothesized that patients with ADHD were typified by distress more than by functional difficulties. Thus, a decline in state anxiety while performing a cognitive task when taking methylphenidate would discriminate between ADHD patients and controls. State anxiety and cognitive performance on a continuous performance test were assessed in ADHD patients and controls with and without taking methylphenidate. State anxiety and cognitive performance improved from baseline in 36 ADHD adults after taking methylphenidate. In 25 controls, cognitive performance improved, but state anxiety did not abate after a recess. In two additional studies, 5 controls were evaluated at baseline and after receiving methylphenidate, and showed improvement in cognitive assessment but not in state anxiety. Five ADHD adults were assessed at baseline and after a recess, and showed no improvement. Our results support the hypothesis that adult ADHD patients are characterized by distress and the relief of this distress under effective therapy as expressed by a decline in state anxiety while they perform a cognitive task.

Effects of selective activation of M1 and M4 muscarinic receptors on object recognition memory performance in rats.

PubMed

Galloway, Claire R; Lebois, Evan P; Shagarabi, Shezza L; Hernandez, Norma A; Manns, Joseph R

2014-01-01

Acetylcholine signaling through muscarinic receptors has been shown to benefit memory performance in some conditions, but pan-muscarinic activation also frequently leads to peripheral side effects. Drug therapies that selectively target M1 or M4 muscarinic receptors could potentially improve memory while minimizing side effects mediated by the other muscarinic receptor subtypes. The ability of three recently developed drugs that selectively activate M1 or M4 receptors to improve recognition memory was tested by giving Long-Evans rats subcutaneous injections of three different doses of the M1 agonist VU0364572, the M1 positive allosteric modulator BQCA or the M4 positive allosteric modulator VU0152100 before performing an object recognition memory task. VU0364572 at 0.1 mg/kg, BQCA at 1.0 mg/kg and VU0152100 at 3.0 and 30.0 mg/kg improved the memory performance of rats that performed poorly at baseline, yet the improvements in memory performance were the most statistically robust for VU0152100 at 3.0 mg/kg. The results suggested that selective M1 and M4 receptor activation each improved memory but that the likelihood of obtaining behavioral efficacy at a given dose might vary between subjects even in healthy groups depending on baseline performance. These results also highlighted the potential of drug therapies that selectively target M1 or M4 receptors to improve memory performance in individuals with impaired memory.

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.

The Effect of Concurrent Plyometric Training Versus Submaximal Aerobic Cycling on Rowing Economy, Peak Power, and Performance in Male High School Rowers.

PubMed

Egan-Shuttler, Julian D; Edmonds, Rohan; Eddy, Cassandra; O'Neill, Veronica; Ives, Stephen J

2017-12-01

Plyometric training has been shown to increase muscle power, running economy, and performance in athletes. Despite its use by rowing coaches, it is unknown whether plyometrics might improve rowing economy or performance. The purpose was to determine if plyometric training, in conjunction with training on the water, would lead to improved rowing economy and performance. Eighteen male high school rowers were assigned to perform 4 weeks of either plyometric training (PLYO, n = 9) or steady-state cycling below ventilatory threshold (endurance, E, n = 9), for 30 min prior to practice on the water (matched for training volume) 3 days per week. Rowing performance was assessed through a 500-m rowing time trial (TT) and peak rowing power (RP), while rowing economy (RE) was assessed by measuring the oxygen cost over four work rates (90, 120, 150, and 180 W). Rowing economy was improved in both PLYO and E (p < 0.05). The 500-m TT performance improved significantly for PLYO (from 99.8 ± 9 s to 94.6 ± 2 s, p < 0.05) but not for E (from 98.8 ± 6 s to 98.7 ± 5 s, p > 0.05). Finally, RP was moderately higher in the PLYO group post-training (E 569 ± 75 W, PLYO 629 ± 51 W, ES = 0.66) CONCLUSIONS: In a season when the athletes performed no rowing sprint training, 4 weeks of plyometric training improved the 500-m rowing performance and moderately improved peak power. This increase in performance may have been mediated by moderate improvements in rowing power, but not economy, and warrants further investigation.

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.

Liquid Nitrogen Temperature Operation of a Switching Power Converter

NASA Technical Reports Server (NTRS)

Ray, Biswajit; Gerber, Scott S.; Patterson, Richard L.; Myers, Ira T.

1995-01-01

The performance of a 42/28 V, 175 W, 50 kHz pulse-width modulated buck dc/dc switching power converter at liquid nitrogen temperature (LNT) is compared with room temperature operation. The power circuit as well as the control circuit of the converter, designed with commercially available components, were operated at LNT and resulted in a slight improvement in converter efficiency. The improvement in power MOSFET operation was offset by deteriorating performance of the output diode rectifier at LNT. Performance of the converter could be further improved at low temperatures by using only power MOSFET's as switches. The use of a resonant topology will further improve the circuit performance by reducing the switching noise and loss.

Performance monitoring for safe and livable communities : fusing data, to improve arterial operations for all users.

DOT National Transportation Integrated Search

2014-10-01

Measuring or analyzing transportation system performance occupies a large transportation professionals time. So, improving performance : measurement methods in terms of accuracy and cost are important contributions. This research documents develop...

Performance, Productivity and Continuous Improvement. Symposium.

ERIC Educational Resources Information Center

2002

This document contains four papers from a symposium on performance, productivity, and continuous improvement. "Investigating the Association between Productivity and Quality Performance in Two Manufacturing Settings" (Constantine Kontoghiorghes, Robert Gudgel) summarizes a study that identified the following quality management variables…

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

Turner, Tom; Watson, Stuart

This paper describes how the level of environmental sustainability at the Solid Waste Processing plant at Research Sites Restoration Ltd (RSRL) Harwell was measured and improved. It provides reasons to improve environmental performance in an organisation, states best practice on how improvement should be conducted, and gives first-hand experience on how changes were implemented. In this paper sustainability is defined as 'meeting the needs of the present without compromising the ability of future generations to meet their own needs'. A baseline for environmental sustainability was created, by looking at multiple attributes. From this, a matrix was created to show howmore » the baseline environmental performance compared to best practice, and a gap analysis was performed. Results from this analysis showed areas for potential systematic improvement, and actions were created. Nearly all actions were implemented within one year, and environmental sustainability improved significantly. Most improvements cost no money to implement, and the few that did had to pass criteria in a business case. Results from a company-wide survey showed that the vast majority of employees felt that environmental issues were important, and that they were willing to help improve performance. Environmental awareness training was given to everyone in the department, and individuals were given measurable improvement targets. A focus group was set up and met regularly to agree improvements and monitor results. Environmental performance was publicised regularly to highlight successes and seek further engagement and improvement. Improvement ideas were encouraged and managed in a transparent way which showed clear prioritisation and accountability. The culture of environmental improvement changed visibly and results at the end of the first year showed that electricity consumption had reduced by 12.5%, and gas consumption had reduced by 7.3%. In less than two years over UK Pound 60,000 was saved on utility bills in the Waste Processing Plant. (authors)« less

Nicotinic agonist-induced improvement of vigilance in mice in the 5-choice continuous performance test

PubMed Central

YOUNG, Jared W; MEVES, Jessica M; GEYER, Mark A

2012-01-01

Impaired attentional processing is prevalent in numerous neuropsychiatric disorders and may negatively impact other cognitive and functional domains. Nicotine – a nonspecific nicotinic acetylcholine receptor (nAChR) agonist – improves vigilance in healthy subjects and schizophrenia patients as measured by continuous performance tests (CPTs), but the nAChR mediating this effect remains unclear. Here we examine the effects of: a) nicotine; b) the selective α7 nAChR agonist PNU 282987; and c) the selective α4β2 nAChR agonist ABT-418 alone and in combination with scopolamine-induced disruption of mouse 5-choice (5C-)CPT performance. This task requires the inhibition of responses to non-target stimuli as well as active responses to target stimuli, consistent with human CPTs. C57BL/6N mice were trained to perform the 5C-CPT. Drug effects were examined in extended session and variable stimulus-duration challenges of performance. Acute drug effects on scopolamine-induced disruption in performance were also investigated. Nicotine and ABT-418 subtly but significantly improved performance of normal mice and attenuated scopolamine-induced disruptions in the 5C-CPT. PNU 282–987 had no effects on performance. The similarity of nicotine and ABT-418 effects provides support for an α4β2 nAChR mechanism of action for nicotine-induced improvement in attention/vigilance. Moreover, the data provide pharmacological predictive validation for the 5C-CPT because nicotine improved and scopolamine disrupted normal performance of the task, consistent with healthy humans in the CPT. Future studies using more selective agonists may result in more robust improvements in performance. PMID:23201359

Relationship between hospital financial performance and publicly reported outcomes.

PubMed

Nguyen, Oanh Kieu; Halm, Ethan A; Makam, Anil N

2016-07-01

Hospitals that have robust financial performance may have improved publicly reported outcomes. To assess the relationship between hospital financial performance and publicly reported outcomes of care, and to assess whether improved outcome metrics affect subsequent hospital financial performance. Observational cohort study. Hospital financial data from the Office of Statewide Health Planning and Development in California in 2008 and 2012 were linked to data from the Centers for Medicare and Medicaid Services Hospital Compare website. Hospital financial performance was measured by net revenue by operations, operating margin, and total margin. Outcomes were 30-day risk-standardized mortality and readmission rates for acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia (PNA). Among 279 hospitals, there was no consistent relationship between measures of financial performance in 2008 and publicly reported outcomes from 2008 to 2011 for AMI and PNA. However, improved hospital financial performance (by any of the 3 measures) was associated with a modest increase in CHF mortality rates (ie, 0.26% increase in CHF mortality rate for every 10% increase in operating margin [95% confidence interval: 0.07%-0.45%]). Conversely, there were no significant associations between outcomes from 2008 to 2011 and subsequent financial performance in 2012 (P > 0.05 for all). Robust financial performance is not associated with improved publicly reported outcomes for AMI, CHF, and PNA. Financial incentives in addition to public reporting, such as readmissions penalties, may help motivate hospitals with robust financial performance to further improve publicly reported outcomes. Reassuringly, improved mortality and readmission rates do not necessarily lead to loss of revenue. Journal of Hospital Medicine 2016;11:481-488. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Properties of PMR polyimide composites made with improved high strength graphite fibers

NASA Technical Reports Server (NTRS)

Vannucci, R. D.

1980-01-01

Recent graphite fiber developments have resulted in high strength, intermediate modulus graphite fibers having improved thermo-oxidative resistance. These improved fibers, obtained from various commercial suppliers, were used to fabricate PMR-15 and PMR-11 polyimide composites. Studies were performed to investigate the effects of the improved high strength graphite fibers on composite properties after exposure in air at 600 F. The use of the more oxidatively resistant fibers did not result in improved performance at 600 F. Two of the improved fibers were found to have an adverse effect on the long-term performance of PMR composites. The influence of various factors such as fiber physical properties, surface morphology and chemical composition are also discussed.

The CF6 engine performance improvement

NASA Technical Reports Server (NTRS)

Fasching, W. A.

1982-01-01

As part of the NASA-sponsored Engine Component Improvement (ECI) Program, a feasibility analysis of performance improvement and retention concepts for the CF6-6 and CF6-50 engines was conducted and seven concepts were identified for development and ground testing: new fan, new front mount, high pressure turbine aerodynamic performance improvement, high pressure turbine roundness, high pressure turbine active clearance control, low pressure turbine active clearance control, and short core exhaust nozzle. The development work and ground testing are summarized, and the major test results and an enomic analysis for each concept are presented.

Business intelligence: using insight to improve the value and performance of your practice.

PubMed

Coan, Tim

2007-01-01

Using information to improve the value of your practice can be a great way to create leverage and improve the performance of your practice. Business intelligence (BI) is the result of a complete system that produces meaningful insights by providing the information necessary to make business decisions. Changes made from these insights improve both the performance and value of your practice. It is important to identify the key elements required of a good BI system and the areas within a practice that can directly benefit from an effective BI system.

Pre-irradiation testing and analysis to support the LWRS Hybrid SiC-CMC-Zircaloy-04 unfueled rodlet irradiation

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

Isabella J van Rooyen

2012-09-01

Nuclear fuel performance is a significant driver of nuclear power plant operational performance, safety, economics and waste disposal requirements. The Advanced Light Water Reactor (LWR) Nuclear Fuel Development Pathway focuses on improving the scientific knowledge basis to enable the development of high-performance, high burn-up fuels with improved safety and cladding integrity and improved nuclear fuel cycle economics. To achieve significant improvements, fundamental changes are required in the areas of nuclear fuel composition, cladding integrity, and fuel/cladding interaction.

Pre-irradiation testing and analysis to support the LWRS Hybrid SiC-CMC-Zircaloy-04 unfueled rodlet irradiation

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

Isabella J van Rooyen

2013-01-01

Nuclear fuel performance is a significant driver of nuclear power plant operational performance, safety, economics and waste disposal requirements. The Advanced Light Water Reactor (LWR) Nuclear Fuel Development Pathway focuses on improving the scientific knowledge basis to enable the development of high-performance, high burn-up fuels with improved safety and cladding integrity and improved nuclear fuel cycle economics. To achieve significant improvements, fundamental changes are required in the areas of nuclear fuel composition, cladding integrity, and fuel/cladding interaction.

Improving HIV outcomes in resource-limited countries: the importance of quality indicators.

PubMed

Ahonkhai, Aima A; Bassett, Ingrid V; Ferris, Timothy G; Freedberg, Kenneth A

2012-11-24

Resource-limited countries increasingly depend on quality indicators to improve outcomes within HIV treatment programs, but indicators of program performance suitable for use at the local program level remain underdeveloped. Using the existing literature as a guide, we applied standard quality improvement (QI) concepts to the continuum of HIV care from HIV diagnosis, to enrollment and retention in care, and highlighted critical service delivery process steps to identify opportunities for performance indicator development. We then identified existing indicators to measure program performance, citing examples used by pivotal donor agencies, and assessed their feasibility for use in surveying local program performance. Clinical delivery steps without existing performance measures were identified as opportunities for measure development. Using National Quality Forum (NQF) criteria as a guide, we developed measurement concepts suitable for use at the local program level that address existing gaps in program performance assessment. This analysis of the HIV continuum of care identified seven critical process steps providing numerous opportunities for performance measurement. Analysis of care delivery process steps and the application of NQF criteria identified 24 new measure concepts that are potentially useful for improving operational performance in HIV care at the local level. An evidence-based set of program-level quality indicators is critical for the improvement of HIV care in resource-limited settings. These performance indicators should be utilized as treatment programs continue to grow.

The relationship between quality management practices and organisational performance: A structural equation modelling approach

NASA Astrophysics Data System (ADS)

Jamaluddin, Z.; Razali, A. M.; Mustafa, Z.

2015-02-01

The purpose of this paper is to examine the relationship between the quality management practices (QMPs) and organisational performance for the manufacturing industry in Malaysia. In this study, a QMPs and organisational performance framework is developed according to a comprehensive literature review which cover aspects of hard and soft quality factors in manufacturing process environment. A total of 11 hypotheses have been put forward to test the relationship amongst the six constructs, which are management commitment, training, process management, quality tools, continuous improvement and organisational performance. The model is analysed using Structural Equation Modeling (SEM) with AMOS software version 18.0 using Maximum Likelihood (ML) estimation. A total of 480 questionnaires were distributed, and 210 questionnaires were valid for analysis. The results of the modeling analysis using ML estimation indicate that the fits statistics of QMPs and organisational performance model for manufacturing industry is admissible. From the results, it found that the management commitment have significant impact on the training and process management. Similarly, the training had significant effect to the quality tools, process management and continuous improvement. Furthermore, the quality tools have significant influence on the process management and continuous improvement. Likewise, the process management also has a significant impact to the continuous improvement. In addition the continuous improvement has significant influence the organisational performance. However, the results of the study also found that there is no significant relationship between management commitment and quality tools, and between the management commitment and continuous improvement. The results of the study can be used by managers to prioritize the implementation of QMPs. For instances, those practices that are found to have positive impact on organisational performance can be recommended to managers so that they can allocate resources to improve these practices to get better performance.

A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional

PubMed Central

Karsh, B‐T; Holden, R J; Alper, S J; Or, C K L

2006-01-01

The goal of improving patient safety has led to a number of paradigms for directing improvement efforts. The main paradigms to date have focused on reducing injuries, reducing errors, or improving evidence based practice. In this paper a human factors engineering paradigm is proposed that focuses on designing systems to improve the performance of healthcare professionals and to reduce hazards. Both goals are necessary, but neither is sufficient to improve safety. We suggest that the road to patient and employee safety runs through the healthcare professional who delivers care. To that end, several arguments are provided to show that designing healthcare delivery systems to support healthcare professional performance and hazard reduction should yield significant patient safety benefits. The concepts of human performance and hazard reduction are explained. PMID:17142611

Attention Training in Autism as a Potential Approach to Improving Academic Performance: A School-Based Pilot Study.

PubMed

Spaniol, Mayra Muller; Shalev, Lilach; Kossyvaki, Lila; Mevorach, Carmel

2018-02-01

This study assessed the effectiveness of an attention intervention program (Computerized Progressive Attentional Training; CPAT) in improving academic performance of children with ASD. Fifteen 6-10 year olds with ASD attending a mainstream and a special school were assigned to an experimental (CPAT; n = 8) and active control (computer games; n = 7) group. Children were assessed pre- and post-intervention on measures of behavioural symptoms, cognitive skills and academic performance. The intervention was conducted in school twice a week for 8 weeks. Children in the CPAT group showed cognitive and academic improvements over and above the active control group, while children in both groups showed improvements in behaviour. Results suggest that attention training is a feasible approach to improving academic performance in this population.

Multi-input multioutput orthogonal frequency division multiplexing radar waveform design for improving the detection performance of space-time adaptive processing

NASA Astrophysics Data System (ADS)

Wang, Hongyan

2017-04-01

This paper addresses the waveform optimization problem for improving the detection performance of multi-input multioutput (MIMO) orthogonal frequency division multiplexing (OFDM) radar-based space-time adaptive processing (STAP) in the complex environment. By maximizing the output signal-to-interference-and-noise-ratio (SINR) criterion, the waveform optimization problem for improving the detection performance of STAP, which is subjected to the constant modulus constraint, is derived. To tackle the resultant nonlinear and complicated optimization issue, a diagonal loading-based method is proposed to reformulate the issue as a semidefinite programming one; thereby, this problem can be solved very efficiently. In what follows, the optimized waveform can be obtained to maximize the output SINR of MIMO-OFDM such that the detection performance of STAP can be improved. The simulation results show that the proposed method can improve the output SINR detection performance considerably as compared with that of uncorrelated waveforms and the existing MIMO-based STAP method.

Bingo! Externally-Supported Performance Intervention for Deficient Visual Search in Normal Aging, Parkinson’s Disease and Alzheimer’s Disease

PubMed Central

Laudate, Thomas M.; Neargarder, Sandy; Dunne, Tracy E.; Sullivan, Karen D.; Joshi, Pallavi; Gilmore, Grover C.; Riedel, Tatiana M.; Cronin-Golomb, Alice

2011-01-01

External support may improve task performance regardless of an individual’s ability to compensate for cognitive deficits through internally-generated mechanisms. We investigated if performance of a complex, familiar visual search task (the game of bingo) could be enhanced in groups with suboptimal vision by providing external support through manipulation of task stimuli. Participants were 19 younger adults, 14 individuals with probable Alzheimer’s disease (AD), 13 AD-matched healthy adults, 17 non-demented individuals with Parkinson’s disease (PD), and 20 PD-matched healthy adults. We varied stimulus contrast, size, and visual complexity during game play. The externally-supported performance interventions of increased stimulus size and decreased complexity resulted in improvements in performance by all groups. Performance improvement through increased stimulus size and decreased complexity was demonstrated by all groups. AD also obtained benefit from increasing contrast, presumably by compensating for their contrast sensitivity deficit. The general finding of improved performance across healthy and afflicted groups suggests the value of visual support as an easy-to-apply intervention to enhance cognitive performance. PMID:22066941

Specialty treatments

Treesearch

Rebecca E. Ibach

2010-01-01

Many specialty treatments can be applied to wood to either improve its performance or change its properties. Treatments addressed in this chapter are those that make permanent changes in the shape of a wood product, improvements in dimensional stability, or improvements in performance through combinations with nonwood resources

Biochar Improves Performance of Plants for Mine Soil Revegetation

EPA Science Inventory

Biochar (the solid by-product of pyrolysis of biomass), has the potential to improve plant performance for revegetation of mine soils by improving soil chemistry, fertility, moisture holding capacity and by binding heavy metals. We investigated the effect of gasified conifer sof...

Inventive Performance Improvement of Integrated Optical Rate Sensor Using TIPS/TRIZ

NASA Technical Reports Server (NTRS)

Blosiu, Julian O.; Youmans, Bruce R.; Kowalick, Jim

1996-01-01

The Theory of Inventive Problem Solving (TIPS or also known as TRIZ) is a new scientific approach to innovative improvements of products and processes. This methodology was applied to inventively improve performance of an Integrated Optic Rate Sensor (IORS).

Specialty treatments

Treesearch

Roger M. Rowell

1999-01-01

Many specialty treatments can be applied to wood to either improve its performance or change its properties. Treatments addressed in this chapter are those that make permanent changes in the shape of a wood product, improvements in dimensional stability, or improvements in performance through combinations with nonwood resources.

Does external evaluation of laboratories improve patient safety?

PubMed

Noble, Michael A

2007-01-01

Laboratory accreditation and External Quality Assessment (also called proficiency testing) are mainstays of laboratory quality assessment and performance. Both practices are associated with examples of improved laboratory performance. The relationship between laboratory performance and improved patient safety is more difficult to assess because of the many variables that are involved with patient outcome. Despite this difficulty, the argument to continue external evaluation of laboratories is too compelling to consider the alternative.

Do clinical safety charts improve paramedic key performance indicator results? (A clinical improvement programme evaluation).

PubMed

Ebbs, Phillip; Middleton, Paul M; Bonner, Ann; Loudfoot, Allan; Elliott, Peter

2012-07-01

Is the Clinical Safety Chart clinical improvement programme (CIP) effective at improving paramedic key performance indicator (KPI) results within the Ambulance Service of New South Wales? The CIP intervention area was compared with the non-intervention area in order to determine whether there was a statistically significant improvement in KPI results. The CIP was associated with a statistically significant improvement in paramedic KPI results within the intervention area. The strategies used within this CIP are recommended for further consideration.

Relative health performance in BRICS over the past 20 years: the winners and losers

PubMed Central

Petrie, Dennis

2014-01-01

Abstract Objective To determine whether the health performance of Brazil, the Russian Federation, India, China and South Africa – the countries known as BRICS – has kept in step with their economic development. Methods Reductions in age- and sex-specific mortality seen in each BRICS country between 1990 and 2011 were measured. These results were compared with those of the best-performing countries in the world and the best-performing countries with similar income levels. We estimated each country’s progress in reducing mortality and compared changes in that country’s mortality rates against other countries with similar mean incomes to examine changes in avoidable mortality. Findings The relative health performance of the five study countries differed markedly over the study period. Brazil demonstrated fairly even improvement in relative health performance across the different age and sex subgroups that we assessed. India’s improvement was more modest and more varied across the subgroups. South Africa and the Russian Federation exhibited large declines in health performance as well as large sex-specific inequalities in health. Although China’s levels of avoidable mortality decreased in absolute terms, the level of improvement appeared low in the context of China’s economic growth. Conclusion When evaluating a country’s health performance in terms of avoidable mortality, it is useful to compare that performance against the performance of other countries. Such comparison allows any country-specific improvements to be distinguished from general global improvements. PMID:24940013

Efforts to improve aviation medical examiner performance through continuing medical education and annual performance reports.

DOT National Transportation Integrated Search

1984-01-01

Continuing medical education (CME) serves to maintain or increase the knowledge, interpretive proficiencies, and technical skills that a physician uses in his/her practice of medicine. Resulting improvement in professional performance is frequently d...

ISPI's Value Proposition: Two Examples.

ERIC Educational Resources Information Center

Swinney, John

2003-01-01

Describes two experiences that illustrate the value of the International Society for Performance Improvement (ISPI). Highlights include measuring organizational results; identifying opportunities to improve performance; training as part of the solution; the role of ISD (instructional systems design); HPT (human performance technology) issues; and…

Improving Pediatric Rapid Response Team Performance Through Crew Resource Management Training of Team Leaders.

PubMed

Siems, Ashley; Cartron, Alexander; Watson, Anne; McCarter, Robert; Levin, Amanda

2017-02-01

Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively. Multiple quartile (median) and logistic regression models were developed to evaluate change in performance scores or completion of specific tasks. Team leader and team introductions (40% to 90%, P = .004; 7% to 45%, P = .03), floor team presentations in Situation Background Assessment Recommendation format (20% to 65%, P = .01), and confirmation of the plan (7% to 70%, P = .002) improved after training in patients transferred to the ICU (n = 35). The Team Emergency Assessment Measure metric was improved in all 4 categories: leadership (2.5 to 3.5, P < .001), teamwork (2.7 to 3.7, P < .001), task management (2.9 to 3.8, P < .001), and global scores (6.0 to 9.0, P < .001) for teams caring for patients who required transfer to the ICU. Targeted crew resource management training of the team leader resulted in improved team performance and dynamics for patients requiring transfer to the ICU. The intervention demonstrated that training the team leader improved behavior in RRT members who were not trained. Copyright © 2017 by the American Academy of Pediatrics.

Individualised Expert Feedback is Not Essential for Improving Basic Clinical Skills Performance in Novice Learners: A Randomized Trial.

PubMed

Phillips, Alexander W; Matthan, Joanna; Bookless, Lucy R; Whitehead, Ian J; Madhavan, Anantha; Rodham, Paul; Porter, Anna L R; Nesbitt, Craig I; Stansby, Gerard

To determine whether unsupervised video feedback (UVF) is as effective as direct expert feedback (DEF) in improving clinical skills performance for medical students learning basic surgical skills-intravenous cannulation, catheterization, and suturing. Feedback is a vital component of the learning process, yet great variation persists in its quality, quantity, and methods of delivery. The use of video technology to assist in the provision of feedback has been adopted increasingly. A prospective, blinded randomized trial comparing DEF, an expert reviewing students' performances with subsequent improvement suggestions, and UVF, students reviewing their own performance with an expert teaching video, was carried out. Medical students received an initial teaching lecture on intravenous cannulation, catheterization, and suturing and were then recorded performing the task. They subsequently received either DEF or UVF before reperforming the task. Students' recordings were additionally scored by 2 blinded experts using a validated proforma. A total of 71 medical students were recruited. Cannulation scores improved 4.3% with DEF and 9.5% with UVF (p = 0.044), catheterization scores improved 8.7% with DEF and 8.9% with UVF (p = 0.96), and suturing improved 15.6% with DEF and 13.2% with UVF (p = 0.54). Improvement from baseline scores was significant in all cases (p < 0.05). Video-assisted feedback allows a significant improvement in clinical skills for novices. No significant additional benefit was demonstrated from DEF, and a similar improvement can be obtained using a generic expert video and allowing students to review their own performance. This could have significant implications for the design and delivery of such training. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Using technology-enhanced, cooperative, group-project learning for student comprehension and academic performance

NASA Astrophysics Data System (ADS)

Tlhoaele, Malefyane; Suhre, Cor; Hofman, Adriaan

2016-05-01

Cooperative learning may improve students' motivation, understanding of course concepts, and academic performance. This study therefore enhanced a cooperative, group-project learning technique with technology resources to determine whether doing so improved students' deep learning and performance. A sample of 118 engineering students, randomly divided into two groups, participated in this study and provided data through questionnaires issued before and after the experiment. The results, obtained through analyses of variance and structural equation modelling, reveal that technology-enhanced, cooperative, group-project learning improves students' comprehension and academic performance.

Performance improvement of PEFC modules with cell containing low amount of platinum

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

Miyake, Y.; Kadowaki, M.; Hamada, A.

1996-12-31

Cell components of the PEFC module were studied to improve the module performance. The cell performance in a high air utilization region was improved by selecting an air channel design of the separator in which high air flow speed was obtained. Optimization of Teflon{reg_sign} amount on the cathode backing carbon paper also contributed the cell performance. Modifications of the gas channel design and the backing carbon paper were carried out in a 200 cm{sup 2} x 20-cell module and 36-cell module. Dependence of air utilization on module performance was remarkably improved and power density of more than 0.3 W/cm{sup 2}more » was achieved in spite of the platinum amount in the cells was decreased to 1.1 Mg/cm{sup 2}.« less

Methylphenidate improves performance on the radial arm maze in periadolescent rats

PubMed Central

Dow-Edwards, Diana L.; Weedon, Jeremy C.; Hellmann, Esther

2008-01-01

Methylphenidate (Ritalin; MPD) is one of the most commonly prescribed drugs in childhood and adolescence and many clinical studies have documented its efficacy. Due to the limitations of conducting invasive research in humans, animal models can be beneficial for studying drug effects. However, few animal studies have demonstrated the effects of methylphenidate on cognitive processes. The objective of this study was to find a dose of methylphenidate that was effective in improving performance on a spatial working memory cognitive task when administered orally to periadolescent rats. Therefore, we dosed subjects with methylphenidate at 1 or 3 mg/kg/day via gastric intubation from postnatal day 22 to 59 and assessed the effects of the drug on performance on the radial arm maze each day. To enhance performance overall, a second experiment was conducted where the subjects were moderately food restricted (to 90% of the free-feeding weight). Results of Experiment 1 show that during the first week of testing only the 3mg/kg MPD-treated males showed improved performance (entries prior to repeated entry) when ad-lib fed and housed in pairs while the same dose significantly improved performance in both males and females under conditions of food-restriction and individual housing in Experiment 2. MPD also produced a pattern of increased errors and arms entered during the first week, especially in Experiment 2. MPD increased locomotor activity when tested at postnatal day 60 in both experiments. The data suggest that 3mg/kg oral methylphenidate improves performance on a spatial cognitive task only early in treatment in the rat. While males show improvement under conditions of both high and low motivation, females only show MPD effects when highly motivated. Hypothetically, methylphenidate may improve radial arm maze performance through increased attention and improved spatial working memory and/or alterations in locomotion, reactivity to novelty or anxiety. Regardless, the study supports the utility of the rat as a suitable model to examine the effects of low dose oral MPD. PMID:18538539

Simulation and rubrics: technology and grading student performance in nurse anesthesia education.

PubMed

Overstreet, Maria; McCarver, Lewis; Shields, John; Patterson, Jordan

2015-06-01

The use of simulation technology has introduced a challenge for simulation nurse educators: evaluation of student performance. The subjectivity of student performance evaluation has been in need of improvement. It is imperative to provide clear and consistent information to the learner of expectations for their performance. Educators use objectives to define for the learner what the primary focus will be in the learning activities. Creation of rubrics to replace checklists to evaluate learner performance is a team task. Improved rubrics assist instructors in providing valuable, immediate, and postactivity feedback and consistency among instructors, and improved inter-rater reliability. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Impact of Contextual Factors on the Effect of Interventions to Improve Health Worker Performance in Sub-Saharan Africa: Review of Randomised Clinical Trials.

PubMed

Blacklock, Claire; Gonçalves Bradley, Daniela C; Mickan, Sharon; Willcox, Merlin; Roberts, Nia; Bergström, Anna; Mant, David

2016-01-01

Africa bears 24% of the global burden of disease but has only 3% of the world's health workers. Substantial variation in health worker performance adds to the negative impact of this significant shortfall. We therefore sought to identify interventions implemented in sub-Saharan African aiming to improve health worker performance and the contextual factors likely to influence local effectiveness. A systematic search for randomised controlled trials of interventions to improve health worker performance undertaken in sub-Saharan Africa identified 41 eligible trials. Data were extracted to define the interventions' components, calculate the absolute improvement in performance achieved, and document the likelihood of bias. Within-study variability in effect was extracted where reported. Statements about contextual factors likely to have modified effect were subjected to thematic analysis. Interventions to improve health worker performance can be very effective. Two of the three trials assessing mortality impact showed significant reductions in death rates (age<5 case fatality 5% versus 10%, p<0.01; maternal in-hospital mortality 6.8/1000 versus 10.3/1000; p<0.05). Eight of twelve trials focusing on prescribing had a statistically significant positive effect, achieving an absolute improvement varying from 9% to 48%. However, reported range of improvement between centres within trials varied substantially, in many cases exceeding the mean effect. Nine contextual themes were identified as modifiers of intervention effect across studies; most frequently cited were supply-line failures, inadequate supervision or management, and failure to follow-up training interventions with ongoing support, in addition to staff turnover. Interventions to improve performance of existing staff and service quality have the potential to improve patient care in underserved settings. But in order to implement interventions effectively, policy makers need to understand and address the contextual factors which can contribute to differences in local effect. Researchers therefore must recognise the importance of reporting how context may modify effect size.

Impact of Contextual Factors on the Effect of Interventions to Improve Health Worker Performance in Sub-Saharan Africa: Review of Randomised Clinical Trials

PubMed Central

Mickan, Sharon; Willcox, Merlin; Roberts, Nia; Bergström, Anna; Mant, David

2016-01-01

Background Africa bears 24% of the global burden of disease but has only 3% of the world’s health workers. Substantial variation in health worker performance adds to the negative impact of this significant shortfall. We therefore sought to identify interventions implemented in sub-Saharan African aiming to improve health worker performance and the contextual factors likely to influence local effectiveness. Methods and Findings A systematic search for randomised controlled trials of interventions to improve health worker performance undertaken in sub-Saharan Africa identified 41 eligible trials. Data were extracted to define the interventions’ components, calculate the absolute improvement in performance achieved, and document the likelihood of bias. Within-study variability in effect was extracted where reported. Statements about contextual factors likely to have modified effect were subjected to thematic analysis. Interventions to improve health worker performance can be very effective. Two of the three trials assessing mortality impact showed significant reductions in death rates (age<5 case fatality 5% versus 10%, p<0.01; maternal in-hospital mortality 6.8/1000 versus 10.3/1000; p<0.05). Eight of twelve trials focusing on prescribing had a statistically significant positive effect, achieving an absolute improvement varying from 9% to 48%. However, reported range of improvement between centres within trials varied substantially, in many cases exceeding the mean effect. Nine contextual themes were identified as modifiers of intervention effect across studies; most frequently cited were supply-line failures, inadequate supervision or management, and failure to follow-up training interventions with ongoing support, in addition to staff turnover. Conclusions Interventions to improve performance of existing staff and service quality have the potential to improve patient care in underserved settings. But in order to implement interventions effectively, policy makers need to understand and address the contextual factors which can contribute to differences in local effect. Researchers therefore must recognise the importance of reporting how context may modify effect size. PMID:26731097

Education Criteria for Performance Excellence, 2002.

ERIC Educational Resources Information Center

National Inst. of Standards and Technology, Gaithersburg, MD.

The education criteria presented in this guide are designed to help organizations use an integrated approach to organizational performance management that results in delivery of ever-improving value to students and stakeholders. Implementation of the criteria will contribute to improvement of education quality, improvement of overall…

Thriving and Not Just Surviving: New Directions for Tomorrow's Performance-Improvement Managers.

ERIC Educational Resources Information Center

Kaufman, Roger

2000-01-01

Examines popular approaches to performance and organizational improvement to see what flaws they contain and how continued practice will impede progress. Discusses benchmarking; quality management/continuous improvement; needs assessment; training; downsizing; reengineering; system(s) approach; and strategic planning. Describes the Organizational…

5 CFR 410.101 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... supports agency goals by improving organizational performance at any appropriate level in the agency, as... and performance objectives; (2) Improves an employee's current job performance; (3) Allows for..., United States Code. (i) Established contact hours are the number of academic credit hours assigned to a...

Improvements in motor tasks through the use of smartphone technology for individuals with Duchenne muscular dystrophy.

PubMed

Capelini, Camila Miliani; da Silva, Talita Dias; Tonks, James; Watson, Suzanna; Alvarez, Mayra Priscila Boscolo; de Menezes, Lilian Del Ciello; Favero, Francis Meire; Caromano, Fátima Aparecida; Massetti, Thais; de Mello Monteiro, Carlos Bandeira

2017-01-01

In individuals severely affected with Duchenne muscular dystrophy (DMD), virtual reality has recently been used as a tool to enhance community interaction. Smartphones offer the exciting potential to improve communication, access, and participation, and present the unique opportunity to directly deliver functionality to people with disabilities. To verify whether individuals with DMD improve their motor performance when undertaking a visual motor task using a smartphone game. Fifty individuals with DMD and 50 healthy, typically developing (TD) controls, aged 10-34 years participated in the study. The functional characterization of the sample was determined through Vignos, Egen Klassifikation, and the Motor Function Measure scales. To complete the task, individuals moved a virtual ball around a virtual maze and the time in seconds was measured after every attempt in order to analyze improvement of performance after the practice trials. Motor performance (time to finish each maze) was measured in phases of acquisition, short-term retention, and transfer. Use of the smartphone maze game promoted improvement in performance during acquisition in both groups, which remained in the retention phase. At the transfer phases, with alternative maze tasks, the performance in DMD group was similar to the performance of TD group, with the exception of the transfer to the contralateral hand (nondominant). However, the group with DMD demonstrated longer movement time at all stages of learning, compared with the TD group. The practice of a visual motor task delivered via smartphone game promoted an improvement in performance with similar patterns of learning in both groups. Performance can be influenced by task difficulty, and for people with DMD, motor deficits are responsible for the lower speed of execution. This study indicates that individuals with DMD showed improved performance in a short-term motor learning protocol using a smartphone. We advocate that this technology could be used to promote function in this population.

Improvements in motor tasks through the use of smartphone technology for individuals with Duchenne muscular dystrophy

PubMed Central

Capelini, Camila Miliani; da Silva, Talita Dias; Tonks, James; Watson, Suzanna; Alvarez, Mayra Priscila Boscolo; de Menezes, Lilian Del Ciello; Favero, Francis Meire; Caromano, Fátima Aparecida; Massetti, Thais; de Mello Monteiro, Carlos Bandeira

2017-01-01

Background In individuals severely affected with Duchenne muscular dystrophy (DMD), virtual reality has recently been used as a tool to enhance community interaction. Smartphones offer the exciting potential to improve communication, access, and participation, and present the unique opportunity to directly deliver functionality to people with disabilities. Objective To verify whether individuals with DMD improve their motor performance when undertaking a visual motor task using a smartphone game. Patients and methods Fifty individuals with DMD and 50 healthy, typically developing (TD) controls, aged 10–34 years participated in the study. The functional characterization of the sample was determined through Vignos, Egen Klassifikation, and the Motor Function Measure scales. To complete the task, individuals moved a virtual ball around a virtual maze and the time in seconds was measured after every attempt in order to analyze improvement of performance after the practice trials. Motor performance (time to finish each maze) was measured in phases of acquisition, short-term retention, and transfer. Results Use of the smartphone maze game promoted improvement in performance during acquisition in both groups, which remained in the retention phase. At the transfer phases, with alternative maze tasks, the performance in DMD group was similar to the performance of TD group, with the exception of the transfer to the contralateral hand (nondominant). However, the group with DMD demonstrated longer movement time at all stages of learning, compared with the TD group. Conclusion The practice of a visual motor task delivered via smartphone game promoted an improvement in performance with similar patterns of learning in both groups. Performance can be influenced by task difficulty, and for people with DMD, motor deficits are responsible for the lower speed of execution. This study indicates that individuals with DMD showed improved performance in a short-term motor learning protocol using a smartphone. We advocate that this technology could be used to promote function in this population. PMID:28860778

A High Intensity Interval Training (HIIT)-Based Running Plan Improves Athletic Performance by Improving Muscle Power.

PubMed

García-Pinillos, Felipe; Cámara-Pérez, Jose C; Soto-Hermoso, Víctor M; Latorre-Román, Pedro Á

2017-01-01

García-Pinillos, F, Cámara-Pérez, JC, Soto-Hermoso, VM, and Latorre-Román, PÁ. A High Intensity Interval Training (HIIT)-based running plan improves athletic performance by improving muscle power. J Strength Cond Res 31(1): 146-153, 2017-This study aimed to examine the effect of a 5-week high-intensity intermittent training (HIIT)-based running plan on athletic performance and to compare the physiological and neuromuscular responses during a sprint-distance triathlon before and after the HIIT period. Thirteen triathletes were matched into 2 groups: the experimental group (EG) and the control group (CG). The CG was asked to maintain their normal training routines, whereas the EG maintained only their swimming and cycling routines and modified their running routine. Participants completed a sprint-distance triathlon before (pretest) and after (posttest) the intervention period. In both pretest and posttest, the participants performed 4 jumping tests: before the race (baseline), postswim, postcycling, and postrun. Additionally, heart rate was monitored (HRmean), whereas rate of perceived exertion (RPE) and blood lactate accumulation (BLa) were registered after the race. No significant differences (p ≥ 0.05) between groups were found before HIIT intervention (at pretest). Significant group-by-training interactions were found in vertical jumping ability and athletic performance: the EG improved jumping performance (∼6-9%, p ≤ 0.05, effect size (ES) > 0.7), swimming performance (p = 0.013, ES = 0.438), and running time (p = 0.001, ES = 0.667) during the competition, whereas the CG remained unchanged (p ≥ 0.05, ES < 0.4). No changes (p ≥ 0.05, ES < 0.4) were observed in RPE, HRmean, and BLa. A linear regression analysis showed that ΔCMJ predicted both the ΔRu_time (R = 0.559; p = 0.008) and the ΔOverall_time (R = 0.391; p = 0.048). This low-volume, HIIT-based running plan combined with the high training volumes of these triathletes in swimming and cycling improved athletic performance during a sprint-distance triathlon. This improvement may be due to improved neuromuscular characteristics that were transferred into improved muscle power and work economy.

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.

Balanced scorecard as a framework for driving performance in managed care organizations.

PubMed

Sahney, V K

1998-01-01

Managed care organizations in a highly competitive environment constantly face the pressure of improving their financial performance. At the same time, customers of the organization expect the organization to deliver high-quality outcomes and improve customer service. Payers expect the organization to develop innovative new products to meet their needs. This article presents an approach called "Balanced Scorecard" for measurement, development of strategy, and performance improvement in a managed care organization.

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.

Does having a drink help you think? 6-7-Year-old children show improvements in cognitive performance from baseline to test after having a drink of water.

PubMed

Edmonds, Caroline J; Jeffes, Ben

2009-12-01

Little research has examined the effect of water consumption on cognition in children. We examined whether drinking water improves performance from baseline to test in twenty-three 6-7-year-old children. There were significant interactions between time of test and water group (water/no water), with improvements in the water group on thirst and happiness ratings, visual attention and visual search, but not visual memory or visuomotor performance. These results indicate that even under conditions of mild dehydration, not as a result of exercise, intentional water deprivation or heat exposure, children's cognitive performance can be improved by having a drink of water.

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.

Practice-based learning can improve osteoporosis care.

PubMed

Hess, Brian J; Johnston, Mary M; Iobst, William F; Lipner, Rebecca S

2013-10-01

To examine physician engagement in practice-based learning using a self-evaluation module to assess and improve their care of individuals with or at risk of osteoporosis. Retrospective cohort study. Internal medicine and subspecialty clinics. Eight hundred fifty U.S. physicians with time-limited certification in general internal medicine or a subspecialty. Performance rates on 23 process measures and seven practice system domain scores were obtained from the American Board of Internal Medicine (ABIM) Osteoporosis Practice Improvement Module (PIM), an Internet-based self-assessment module that physicians use to improve performance on one targeted measure. Physicians remeasured performance on their targeted measures by conducting another medical chart review. Variability in performance on measures was found, with observed differences between general internists, geriatricians, and rheumatologists. Some practice system elements were modestly associated with measure performance; the largest association was between providing patient-centered self-care support and documentation of calcium intake and vitamin D estimation and counseling (correlation coefficients from 0.20 to 0.28, Ps < .002). For all practice types, the most commonly selected measure targeted for improvement was documentation of vitamin D level (38% of physicians). On average, physicians reported significant and large increases in performance on measures targeted for improvement. Gaps exist in the quality of osteoporosis care, and physicians can apply practice-based learning using the ABIM PIM to take action to improve the quality of care. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

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.

Bacillus subtilis strain specificity affects performance improvement in broilers.

PubMed

Rhayat, L; Jacquier, V; Brinch, K S; Nielsen, P; Nelson, A; Geraert, P-A; Devillard, E

2017-07-01

The study reports the effects on broiler performance of a newly isolated Bacillus subtilis strain, which is phylogenetically not closely related to already well-described strains of B. subtilis. In the first experiment, birds were reared in battery cages and exposed to C. perfringens. An increase in growth performance was observed with the strain when compared to the challenged animals. Three additional growth trials were conducted to 35 d of age, in different rearing conditions (genetic breeds, corn-soybean meal-based diet with or without animal proteins, in presence or absence of phytase, on fresh or used litter) to investigate the efficacy and the specificity of this new B. subtilis strain on the improvement of BWG and FCR of broilers in comparison with a B. subtilis-based DFM already used in the field. Whatever the rearing conditions tested, the new B. subtilis strain led to an average 3.2% improvement in feed conversion ratio or bodyweight. Comparatively, the commercial Bacillus strain significantly improved broiler performance in only one trial out of 3 with an average improvement reaching 2%. All these results indicate that this new B. subtilis strain consistently improves broiler performances. © 2017 Poultry Science Association Inc.

Videotape review leads to rapid and sustained learning.

PubMed

Scherer, Lynette A; Chang, Michael C; Meredith, J Wayne; Battistella, Felix D

2003-06-01

Performance review using videotapes is a strategy employed to improve future performance. We postulated that videotape review of trauma resuscitations would improve compliance with a treatment algorithm. Trauma resuscitations were taped and reviewed during a 6-month period. For 3 months, team members were given verbal feedback regarding performance. During the next 3 months, new teams attended videotape reviews of their performance. Data on targeted behaviors were compared between the two groups. Behavior did not change after 3 months of verbal feedback; however, behavior improved after 1 month of videotape feedback (P <0.05) and total time to disposition was reduced by 50% (P <0.01). This response was sustained for the remainder of the study. Videotape review can be an important learning tool as it was more effective than verbal feedback in achieving behavioral changes and algorithm compliance. Videotape review can be an important quality assurance adjunct, as improved algorithm compliance should be associated with improved patient care.

Improving creativity performance by short-term meditation.

PubMed

Ding, Xiaoqian; Tang, Yi-Yuan; Tang, Rongxiang; Posner, Michael I

2014-03-19

One form of meditation intervention, the integrative body-mind training (IBMT) has been shown to improve attention, reduce stress and change self-reports of mood. In this paper we examine whether short-term IBMT can improve performance related to creativity and determine the role that mood may play in such improvement. Forty Chinese undergraduates were randomly assigned to short-term IBMT group or a relaxation training (RT) control group. Mood and creativity performance were assessed by the Positive and Negative Affect Schedule (PANAS) and Torrance Tests of Creative Thinking (TTCT) questionnaire respectively. As predicted, the results indicated that short-term (30 min per day for 7 days) IBMT improved creativity performance on the divergent thinking task, and yielded better emotional regulation than RT. In addition, cross-lagged analysis indicated that both positive and negative affect may influence creativity in IBMT group (not RT group). Our results suggested that emotion-related creativity-promoting mechanism may be attributed to short-term meditation.

Brainwave Monitoring Software Improves Distracted Minds

NASA Technical Reports Server (NTRS)

2014-01-01

Neurofeedback technology developed at Langley Research Center to monitor pilot awareness inspired Peter Freer to develop software for improving student performance. His company, Fletcher, North Carolina-based Unique Logic and Technology Inc., has gone on to develop technology for improving workplace and sports performance, monitoring drowsiness, and encouraging relaxation.

Flight assessment of the onboard propulsion system model for the Performance Seeking Control algorithm on an F-15 aircraft

NASA Technical Reports Server (NTRS)

Orme, John S.; Schkolnik, Gerard S.

1995-01-01

Performance Seeking Control (PSC), an onboard, adaptive, real-time optimization algorithm, relies upon an onboard propulsion system model. Flight results illustrated propulsion system performance improvements as calculated by the model. These improvements were subject to uncertainty arising from modeling error. Thus to quantify uncertainty in the PSC performance improvements, modeling accuracy must be assessed. A flight test approach to verify PSC-predicted increases in thrust (FNP) and absolute levels of fan stall margin is developed and applied to flight test data. Application of the excess thrust technique shows that increases of FNP agree to within 3 percent of full-scale measurements for most conditions. Accuracy to these levels is significant because uncertainty bands may now be applied to the performance improvements provided by PSC. Assessment of PSC fan stall margin modeling accuracy was completed with analysis of in-flight stall tests. Results indicate that the model overestimates the stall margin by between 5 to 10 percent. Because PSC achieves performance gains by using available stall margin, this overestimation may represent performance improvements to be recovered with increased modeling accuracy. Assessment of thrust and stall margin modeling accuracy provides a critical piece for a comprehensive understanding of PSC's capabilities and limitations.

Whole-Body Vibration Training and Its Application to Age-Related Performance Decrements: An Exploratory Analysis.

PubMed

Hawkey, Adam; Griffiths, Katie; Babraj, John; Cobley, James N

2016-02-01

Middle age is associated with a pronounced decline in power and flexibility. Whilst whole-body vibration training (WBVT) improves performance in a range of populations, whether WBVT can improve muscle power and flexibility in a middle-aged population is not known. The present study aimed to determine the influence of 5 weeks progressive WBVT in middle-aged (45-55 years) and younger (20-30 years) recreationally active females. Participants in each age group were randomly allocated to an intervention (WBVT) or control group. The WBVT groups trained for 5 weeks on a vibration platform, while the control groups performed identical exercises, with no vibration. Prior to, and after, the 5-week study vertical countermovement jump (VCMJ) and range of motion (ROM) performance were measured. WBVT significantly (p = 0.001) improved VCMJ performance when compared to the control groups. This improvement was significantly (p = 0.001) greater in the middle-aged compared with the younger WBVT group. WBVT significantly (p = 0.001) improved ROM irrespective of age. Taken together, these results suggest that WBVT can off-set age related performance decrements, which has therapeutic implications for musculoskeletal aging. Therefore, WBVT could be undertaken to minimise age-related performance deterioration in middle-aged female populations.

The feasibility of meta-cognitive strategy training in acute inpatient stroke rehabilitation: case report.

PubMed

Skidmore, Elizabeth R; Holm, Margo B; Whyte, Ellen M; Dew, Mary Amanda; Dawson, Deirdre; Becker, James T

2011-04-01

Meta-cognitive strategy training may be used to augment inpatient rehabilitation to promote active engagement and subsequent benefit for individuals with cognitive impairments after stroke. We examined the feasibility of administering a form of meta-cognitive strategy training, Cognitive Orientation to daily Occupational Performance (CO-OP), during inpatient rehabilitation. We trained an individual with cognitive impairments after right hemisphere stroke to identify performance problems, set self-selected goals, develop plans to address goals, and evaluate performance improvements. To assess feasibility, we examined the number of meta-cognitive training sessions attended, the number of self-selected goals, and changes in goal-related performance. We also examined changes in rehabilitation engagement and disability. The participant used the meta-cognitive strategy to set eight goals addressing physically oriented, instrumental, and work-related activities. Mean improvement in Canadian Occupational Performance Measure Performance Scale scores was 6.1. Pittsburgh Rehabilitation Participation Scale scores (measuring rehabilitation engagement) improved from 3.2 at admission to 4.9 at discharge. Functional Independence Measure scores (measuring disability) improved from 68 at admission, to 97 at discharge. Performance Assessment of Self-Care Skills scores improved from 1.1 at admission to 2.9 at discharge. The results indicate that meta-cognitive strategy training was feasible during inpatient rehabilitation and warrants further evaluation to determine its effectiveness.

The effect of filmed versus personal after-event reviews on task performance: the mediating and moderating role of self-efficacy.

PubMed

Ellis, Shmuel; Ganzach, Yoav; Castle, Evan; Sekely, Gal

2010-01-01

In the current study, we compared the effect of personal and filmed after-event reviews (AERs) on performance, and the role that self-efficacy plays in moderating and mediating the effects of these 2 types of AER on performance. The setting was one in which 49 men and 63 women participated twice in a simulated business decision-making task. In between, participants received a personal AER, watched a filmed AER, or had a break. We found that individuals who participated in an AER, whether personal or filmed, improved their performance significantly more than those who did not participate in a review. Furthermore, there was no significant difference in performance improvement between the personal and the filmed AER, which suggests that the 2 are quite similar in their effect. We also found that the differences in performance improvement between the personal AER group and the control group were somewhat greater than those found in the filmed AER group. Self-efficacy mediated the effect of AER on performance improvement in both types of AER. In addition, the effect of AER on performance improvement was moderated by initial self-efficacy in the personal but not in the filmed AER: The personal AER was more effective, the higher the initial self-efficacy. Copyright 2009 APA, all rights reserved.

LPV Controller Interpolation for Improved Gain-Scheduling Control Performance

NASA Technical Reports Server (NTRS)

Wu, Fen; Kim, SungWan

2002-01-01

In this paper, a new gain-scheduling control design approach is proposed by combining LPV (linear parameter-varying) control theory with interpolation techniques. The improvement of gain-scheduled controllers can be achieved from local synthesis of Lyapunov functions and continuous construction of a global Lyapunov function by interpolation. It has been shown that this combined LPV control design scheme is capable of improving closed-loop performance derived from local performance improvement. The gain of the LPV controller will also change continuously across parameter space. The advantages of the newly proposed LPV control is demonstrated through a detailed AMB controller design example.

Recovery interventions and strategies for improved tennis performance

PubMed Central

Kovacs, Mark S; Baker, Lindsay B

2014-01-01

Improving the recovery capabilities of the tennis athlete is receiving more emphasis in the research communities, and also by practitioners (coaches, physical trainers, tennis performance specialists, physical therapists, etc). The purpose of this article was to review areas of recovery to limit the severity of fatigue and/or speed recovery from fatigue. This review will cover four broad recovery techniques commonly used in tennis with the belief that the interventions may improve athlete recovery and therefore improve adaptation and future performance. The four areas covered are: (1) temperature-based interventions, (2) compressive clothing, (3) electronic interventions and (4) nutritional interventions. PMID:24668374

PCR thermocycler

DOEpatents

Benett, William J.; Richards, James B.

2003-01-01

A sleeve-type silicon polymerase chain reaction (PCR) chamber or thermocycler having improved thermal performance. The silicon sleeve reaction chamber is improved in thermal performance by etched features therein that reduce thermal mass and increase the surface area of the sleeve for cooling. This improved thermal performance of the thermocycler enables an increase in speed and efficiency of the reaction chamber. The improvement is accomplished by providing grooves in the faces of the sleeve and a series of grooves on the interior surfaces that connect with grooves on the faces of the sleeve. The grooves can be anisotropically etched in the silicon sleeve simultaneously with formation of the chamber.

PCR thermocycler

DOEpatents

Benett, William J.; Richards, James B.

2005-05-17

A sleeve-type silicon polymerase chain reaction (PCR) chamber or thermocycler having improved thermal performance. The silicon sleeve reaction chamber is improved in thermal performance by etched features therein that reduce thermal mass and increase the surface area of the sleeve for cooling. This improved thermal performance of the thermocycler enables an increase in speed and efficiency of the reaction chamber. The improvement is accomplished by providing grooves in the faces of the sleeve and a series of grooves on the interior surfaces that connect with grooves on the faces of the sleeve. The grooves can be anisotropically etched in the silicon sleeve simultaneously with formation of the chamber.

Preschoolers' Cognitive Performance Improves Following Massage.

ERIC Educational Resources Information Center

Hart, Sybil; Field, Tiffany; Hernandez-Reif, Maria; Lundy, Brenda

1998-01-01

Effects of massage on preschoolers' cognitive performance were assessed. Preschoolers were given Wechsler Preschool and Primary Scale of Intelligence-Revised subtests before and after receiving 15-minute massage or spending 15 minutes reading stories with the experimenter. Children's performance on Block Design improved following massage, and…

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.

Improving the 'how' and 'what' decisions of elite table tennis players.

PubMed

Raab, Markus; Masters, Rich S W; Maxwell, Jonathan P

2005-06-01

Training methods in sport usually focus on improving either technical or tactical aspects of performance, ignoring the fact that successful performance requires the athlete to simultaneously decide what movement to perform and how it should be executed. Young elite table tennis players were trained, in a first phase, to improve their forehand and backhand movements and, in a second phase, to make a tactical switch between forehand and backhand movements. Half of the players took part in behavioral training focusing on how to perform the required movements, whereas half received additional video feedback about their technical and tactical performance (decision training). The results indicate that improvements of how decisions (techniques) and what decisions (tactics) can occur as a consequence of combining technical and tactical training. These results were stable in delayed Post-test analyses of competitive matches. It was concluded that a combination of both technical and tactical training is beneficial to elite table tennis performers, particularly during early seasonal training programs.

Improvement of cutting performance for thick stainless steel plates by step-like cutting speed increase in high-power fiber laser cutting

NASA Astrophysics Data System (ADS)

Seon, Sangwoo; Shin, Jae Sung; Oh, Seong Yong; Park, Hyunmin; Chung, Chin-Man; Kim, Taek-Soo; Lee, Lim; Lee, Jonghwan

2018-07-01

A study was conducted to improve the cutting performance of a 60-mm thick stainless steel plate using a 6-kW fiber laser. Two techniques for improving the initial cutting performance were evaluated by preheating the work piece with a waiting time and step-like cutting speed increase. Both techniques showed improved cutting results compared to constant speed cutting. Among them, the method with a step-like cutting speed increase showed the better result in terms of cutting performance. As a result, a 60-mm thick stainless steel plate was cut at a maximum cutting speed of 72 mm/min with a preheating cutting speed of 24 mm/min. In order to confirm the effect of preheating, an additional experiment was performed to measure the temperature variation during the cutting process. Through this experiment, preheating temperature conditions were found to allow the specimen to be cut. It is expected that the results of this work will contribute to improving the cutting performance of thick metal structures in various industrial fields, as well as the dismantling of nuclear facilities using lasers in the future.

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.

Improving resident performance on standardized assessments of medical knowledge: a retrospective analysis of interventions correlated to American Board of Surgery In-Service Training Examination performance.

PubMed

Buckley, Elaine Jayne; Markwell, Stephen; Farr, Debb; Sanfey, Hilary; Mellinger, John

2015-10-01

American Board of Surgery In-Service Training Examination (ABSITE) scores are used to assess individual progress and predict board pass rates. We reviewed strategies to enhance ABSITE performance and their impact within a surgery residency. Several interventions were introduced from 2010 to 2014. A retrospective review was undertaken evaluating these and correlating them to ABSITE performance. Analyses of variance and linear trends were performed for ABSITE, United States Medical Licensing Examination (USMLEs), mock oral, and mock ABSITE scores followed by post hoc analyses if significant. Results were correlated with core curricular changes. ABSITE mean percentile increased 34% in 4 years with significant performance improvement and increasing linear trends in postgraduate year (PGY)1 and PGY4 ABSITE scores. Mock ABSITE introduction correlated to significant improvement in ABSITE scores for PGY4 and PGY5. Mock oral introduction correlated with significant improvement in PGY1 and PGY3. Our study demonstrates an improvement in mean program ABSITE percentiles correlating with multiple interventions. Similar strategies may be useful for other programs. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving the quality of primary care by allocating performance-based targets, in a diverse insured population.

PubMed

Peled, Ronit; Porath, Avi; Wilf-Miron, Rachel

2016-11-21

Primary Care Health organizations, operating under universal coverage and a regulated package of benefits, compete mainly over quality of care. Monitoring, primary care clinical performance, has been repeatedly proven effective in improving the quality of care. In 2004, Maccabi Healthcare Services (MHS), the second largest Israeli HMO, launched its Performance Measurement System (PMS) based on clinical quality indicators. A unique module was built in the PMS to adjust for case mix while tailoring targets to the local units. This article presents the concept and formulas developed to adjust targets to the units' current performance, and analyze change in clinical indicators over a six year period, between sub-population groups. Six process and intermediate outcome indicators, representing screening for breast and colorectal cancer and care for patients with diabetes and cardiovascular disease, were selected and analyzed for change over time (2003-2009) in overall performance, as well as the difference between the lowest and the highest socio-economic ranks (SERs) and Arab and non-Arab members. MHS demonstrated a significant improvement in the selected indicators over the years. Performance of members from low SERs and Arabs improved to a greater extent, as compared to members from high ranks and non-Arabs, respectively. The performance measurement system, with its module for tailoring of units' targets, served as a managerial vehicle for bridging existing gaps by allocating more resources to lower performing units. This concept was proven effective in improving performance while reducing disparities between diverse population groups.

In vitro cavity and crown preparations and direct restorations: A comparison of performance at the start and end of the FD programme.

PubMed

Burke, F J T; Ravaghi, V; Mackenzie, L; Priest, N; Falcon, H C

2017-04-21

Aim To assess the performance and thereby the progress of the FDs when they carried out a number of simulated clinical exercises at the start and at the end of their FD year.Methods A standardised simulated clinical restorative dentistry training exercise was carried out by a group of 61 recently qualified dental graduates undertaking a 12 months' duration foundation training programme in England, at both the start and end of the programme. Participants completed a Class II cavity preparation and amalgam restoration, a Class IV composite resin restoration and two preparations for a porcelain-metal full crown. The completed preparations and restorations were independently assessed by an experienced consultant in restorative dentistry, using a scoring system based on previously validated criteria. The data were subjected to statistical analysis.Results There was wide variation in individual performance. Overall, there was a small but not statistically significant improvement in performance by the end of the programme. A statistically significant improvement was observed for the amalgam preparation and restoration, and, overall, for one of the five geographical sub-groups in the study. Possible reasons for the variable performance and improvement are discussed.Conclusions There was variability in the performance of the FDs. The operative performance of FDs at the commencement and end of their FD year indicated an overall moderately improved performance over the year and a statistically significant improvement in their performance with regard to amalgam restoration.

Improving balance by performing a secondary cognitive task.

PubMed

Swan, Laurie; Otani, Hajime; Loubert, Peter V; Sheffert, Sonya M; Dunbar, Gary L

2004-02-01

Contrary to general findings in the attention and memory literature, some studies have shown that performing a secondary cognitive task produces an improvement in balance performance. The purpose of the present experiment was to investigate under what condition such an improvement would occur. Young and older adults were asked to hold as still as possible on a platform that measured sway while performing or not performing the encoding phase of the Brooks' (1967) spatial or non-spatial memory task. The difficulty of maintaining balance was manipulated by varying the availability of visual input and sway-referenced motion of the platform. Sway scores were computed based on the distance between the individual pressure centres and the average centre of pressure during each 20-s trial. The results indicated that both the spatial and non-spatial memory tasks improved balance for older adults under the most difficult balance condition.

Can tutoring improve performance on a reasoning task under deadline conditions?

PubMed

Osman, Magda

2007-03-01

The present study examined the effectiveness of a tutoring technique that has been used to identify and address participants' misunderstandings in Wason's selection task. In particular, the study investigated whether the technique would lead to improvements in performance when the task was presented in a deadline format (a condition in which time restrictions are imposed). In Experiment 1, the effects of tutoring on performance were compared in free time (conditions in which no time restrictions are imposed) and deadline task formats. In Experiment 2, improvements in performance were studied in deadline task formats, in which the tutoring and test phases were separated by an interval of 1 day. The results suggested that tutoring improved performance on the selection task under deadline and in free time conditions. Additionally, the study showed that participants made errors because they had misinterpreted the task. With tutoring, they were able to modify their initial misunderstandings.

National Aeronautics and Space Administration FY 02 Revised Final Annual Performance Plan

NASA Technical Reports Server (NTRS)

2002-01-01

The Government Performance and Results Act (GPRA) was passed by Congress and signed by the President in 1993. GPRA was enacted to improve the efficiency of all Federal agencies, with the following specific goals: (1) Improve Federal program management, effectiveness, and public accountability; (2) Improve Congressional decision making on where to commit the Nation's financial and human resources; and (3) Improve citizen confidence in government performance. GPRA directs Executive Branch agencies to develop a customer-focused strategic plan that aligns activities with concrete missions and goals. The Act directs agencies to manage and measure results to justify Congressional appropriations and authorizations. The Report Consolidation Act of 2000 directs agencies to provide a report on the degree of success in achieving the goals and performance measures defined in the strategic and performance plans one hundred and fifty days after the completion of the fiscal year.

Autophagy Is a Promoter for Aerobic Exercise Performance during High Altitude Training

PubMed Central

Zhang, Ying

2018-01-01

High altitude training is one of the effective strategies for improving aerobic exercise performance at sea level via altitude acclimatization, thereby improving oxygen transport and/or utilization. But its underlying molecular mechanisms on physiological functions and exercise performance of athletes are still vague. More recent evidence suggests that the recycling of cellular components by autophagy is an important process of the body involved in the adaptive responses to exercise. Whether high altitude training can activate autophagy or whether high altitude training can improve exercise performance through exercise-induced autophagy is still unclear. In this narrative review article, we will summarize current research advances in the improvement of exercise performance through high altitude training and its reasonable molecular mechanisms associated with autophagy, which will provide a new field to explore the molecular mechanisms of adaptive response to high altitude training. PMID:29849885

Market and plan characteristics related to HMO quality and improvement.

PubMed

Scanlon, Dennis P; Swaminathan, Shailender; Chernew, Michael; Lee, Woolton

2006-12-01

Existing research on health plan performance examines whether variation in plans' scores is related to enrollee and health plan traits, primarily using cross-sectional research designs. This study extends that literature by incorporating data on market characteristics using a longitudinal framework. We estimate multivariate growth models that relate plan performance on standard measures to market and HMO characteristics using an unbalanced panel of data for 1998 to 2002. We find that HMO competition is not associated with better performance or greater rates of improvement in performance on the HEDIS chronic care measures. HMO penetration, on the other hand, is positively associated with HEDIS performance in several of the chronic care process-and-outcomes measures but not with a greater rate of improvement through time. Our analysis indicates that a significant percentage of the unexplained variation in quality improvement is because of permanent, unobserved plan-level characteristics that future research should strive to identify.

Caffeine Enhances Memory Performance in Young Adults during Their Non-optimal Time of Day

PubMed Central

Sherman, Stephanie M.; Buckley, Timothy P.; Baena, Elsa; Ryan, Lee

2016-01-01

Many college students struggle to perform well on exams in the early morning. Although students drink caffeinated beverages to feel more awake, it is unclear whether these actually improve performance. After consuming coffee (caffeinated or decaffeinated), college-age adults completed implicit and explicit memory tasks in the early morning and late afternoon (Experiment 1). During the morning, participants ingesting caffeine demonstrated a striking improvement in explicit memory, but not implicit memory. Caffeine did not alter memory performance in the afternoon. In Experiment 2, participants engaged in cardiovascular exercise in order to examine whether increases in physiological arousal similarly improved memory. Despite clear increases in physiological arousal, exercise did not improve memory performance compared to a stretching control condition. These results suggest that caffeine has a specific benefit for memory during students’ non-optimal time of day – early morning. These findings have real-world implications for students taking morning exams. PMID:27895607

Changes in cerebro-cerebellar interaction during response inhibition after performance improvement.

PubMed

Hirose, Satoshi; Jimura, Koji; Kunimatsu, Akira; Abe, Osamu; Ohtomo, Kuni; Miyashita, Yasushi; Konishi, Seiki

2014-10-01

It has been demonstrated that motor learning is supported by the cerebellum and the cerebro-cerebellar interaction. Response inhibition involves motor responses and the higher-order inhibition that controls the motor responses. In this functional MRI study, we measured the cerebro-cerebellar interaction during response inhibition in two separate days of task performance, and detected the changes in the interaction following performance improvement. Behaviorally, performance improved in the second day, compared to the first day. The psycho-physiological interaction (PPI) analysis revealed the interaction decrease from the right inferior frontal cortex (rIFC) to the cerebellum (lobule VII or VI). It was also revealed that the interaction increased from the same cerebellar region to the primary motor area. These results suggest the involvement of the cerebellum in response inhibition, and raise the possibility that the performance improvement was supported by the changes in the cerebro-cerebellar interaction. Copyright © 2014 Elsevier Inc. All rights reserved.

Testing the Limits of Optimizing Dual-Task Performance in Younger and Older Adults

PubMed Central

Strobach, Tilo; Frensch, Peter; Müller, Herrmann Josef; Schubert, Torsten

2012-01-01

Impaired dual-task performance in younger and older adults can be improved with practice. Optimal conditions even allow for a (near) elimination of this impairment in younger adults. However, it is unknown whether such (near) elimination is the limit of performance improvements in older adults. The present study tests this limit in older adults under conditions of (a) a high amount of dual-task training and (b) training with simplified component tasks in dual-task situations. The data showed that a high amount of dual-task training in older adults provided no evidence for an improvement of dual-task performance to the optimal dual-task performance level achieved by younger adults. However, training with simplified component tasks in dual-task situations exclusively in older adults provided a similar level of optimal dual-task performance in both age groups. Therefore through applying a testing the limits approach, we demonstrated that older adults improved dual-task performance to the same level as younger adults at the end of training under very specific conditions. PMID:22408613

Countermeasures to Improve the Driving Performance of Older Drivers.

ERIC Educational Resources Information Center

Ashman, Richard D.; And Others

1994-01-01

In a 2-year project, 105 older drivers were given physical therapy (flexibility exercises), perceptual therapy (to improve visual discrimination), and driver education; traffic engineering modifications were also made. All four interventions improved performance an average of 7.9%. Engineering was most cost effective on high-volume roads, the…

Improving Examination Performance through the Clenched Fist Technique.

ERIC Educational Resources Information Center

Stanton, Harry E.

1988-01-01

The literature on the use of hypnosis in an educational setting is briefly reviewed, and a hypnotic approach involving the use of the clenched fist as a conditioned trigger to improve examination performance is described. A study of 60 high school students indicates that the approach can improve test outcomes. (TJH)

Sharing Collaborative Designs of Tobacco Cessation Performance Improvement CME Projects

ERIC Educational Resources Information Center

Mullikin, Elizabeth A.; Ales, Mary W.; Cho, Jane; Nelson, Teena M.; Rodrigues, Shelly B.; Speight, Mike

2011-01-01

Introduction: Performance Improvement Continuing Medical Education (PI CME) provides an important opportunity for CME providers to combine educational and quality health care improvement methodologies. Very few CME providers take on the challenges of planning this type of intervention because it is still a new practice and there are limited…

Learning to Collaborate: A Case Study of Performance Improvement CME

ERIC Educational Resources Information Center

Shershneva, Marianna B.; Mullikin, Elizabeth A.; Loose, Anne-Sophie; Olson, Curtis A.

2008-01-01

Introduction: Performance Improvement Continuing Medical Education (PI CME) is a mechanism for joining quality improvement (QI) in health care to continuing medical education (CME) systems together. Although QI practices and CME approaches have been recognized for years, what emerges from their integration is largely unfamiliar, because it…

JT8D-15/17 High Pressure Turbine Root Discharged Blade Performance Improvement. [engine design

NASA Technical Reports Server (NTRS)

Janus, A. S.

1981-01-01

The JT8D high pressure turbine blade and seal were modified, using a more efficient blade cooling system, improved airfoil aerodynamics, more effective control of secondary flows, and improved blade tip sealing. Engine testing was conducted to determine the effect of these improvements on performance. The modified turbine package demonstrated significant thrust specific fuel consumption and exhaust gas temperature improvements in sea level and altitude engine tests. Inspection of the improved blade and seal hardware after testing revealed no unusual wear or degradation.

A virtual pointer to support the adoption of professional vision in laparoscopic training.

PubMed

Feng, Yuanyuan; McGowan, Hannah; Semsar, Azin; Zahiri, Hamid R; George, Ivan M; Turner, Timothy; Park, Adrian; Kleinsmith, Andrea; Mentis, Helena M

2018-05-23

To assess a virtual pointer in supporting surgical trainees' development of professional vision in laparoscopic surgery. We developed a virtual pointing and telestration system utilizing the Microsoft Kinect movement sensor as an overlay for any imagine system. Training with the application was compared to a standard condition, i.e., verbal instruction with un-mediated gestures, in a laparoscopic training environment. Seven trainees performed four simulated laparoscopic tasks guided by an experienced surgeon as the trainer. Trainee performance was subjectively assessed by the trainee and trainer, and objectively measured by number of errors, time to task completion, and economy of movement. No significant differences in errors and time to task completion were obtained between virtual pointer and standard conditions. Economy of movement in the non-dominant hand was significantly improved when using virtual pointer ([Formula: see text]). The trainers perceived a significant improvement in trainee performance in virtual pointer condition ([Formula: see text]), while the trainees perceived no difference. The trainers' perception of economy of movement was similar between the two conditions in the initial three runs and became significantly improved in virtual pointer condition in the fourth run ([Formula: see text]). Results show that the virtual pointer system improves the trainer's perception of trainee's performance and this is reflected in the objective performance measures in the third and fourth training runs. The benefit of a virtual pointing and telestration system may be perceived by the trainers early on in training, but this is not evident in objective trainee performance until further mastery has been attained. In addition, the performance improvement of economy of motion specifically shows that the virtual pointer improves the adoption of professional vision- improved ability to see and use laparoscopic video results in more direct instrument movement.

Inhibitory Mechanisms in Primary Somatosensory Cortex Mediate the Effects of Peripheral Electrical Stimulation on Tactile Spatial Discrimination.

PubMed

Saito, Kei; Otsuru, Naofumi; Inukai, Yasuto; Kojima, Sho; Miyaguchi, Shota; Tsuiki, Shota; Sasaki, Ryoki; Onishi, Hideaki

2018-06-01

Selective afferent activation can be used to improve somatosensory function, possibly by altering cortical inhibitory circuit activity. Peripheral electrical stimulation (PES) is widely used to induce selective afferent activation, and its effect may depend on PES intensity. Therefore, we investigated the effects of high- and low-intensity PES applied to the right index finger on tactile discrimination performance and cortical sensory-evoked potential paired-pulse depression (SEP-PPD) in 25 neurologically healthy subjects. In Experiment 1, a grating orientation task (GOT) was performed before and immediately after local high- and low-intensity PES (both delivered as 1-s, 20-Hz trains of 0.2-ms electrical pulses at 5-s intervals). In Experiment 2, PPD of SEP components N20/P25_SEP-PPD and N20_SEP-PPD, respectively, were assessed before and immediately after high- and low-intensity PES. Improved GOT discrimination performance after high-intensity PES (reduced discrimination threshold) was associated with lower baseline performance (higher baseline discrimination threshold). Subjects were classified into low and high (baseline) GOT performance groups. Improved GOT discrimination performance in the low GOT performance group was significantly associated with a greater N20_SEP-PPD decrease (weaker PPD). Subjects were also classified into GOT improvement and GOT decrement groups. High-intensity PES decreased N20_SEP-PPD in the GOT improvement group but increased N20_SEP-PPD in the GOT decrement group. Furthermore, a greater decrease in GOT discrimination threshold was significantly associated with a greater N20_SEP-PPD decrease in the GOT improvement group. These results suggest that high-intensity PES can improve sensory perception in subjects with low baseline function by modulating cortical inhibitory circuits in primary somatosensory cortex. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Adaptations Associated With an After-School Strength and Conditioning Program in Middle-School-Aged Boys: A Quasi-Experimental Design.

PubMed

Thompson, Brennan J; Stock, Matt S; Mota, Jacob A; Drusch, Alexander S; DeFranco, Ryan N; Cook, Tyler R; Hamm, Matthew A

2017-10-01

High-intensity strength and conditioning programs aimed at improving youth performance are becoming increasingly prevalent. The purpose of this study was to investigate the effects of a 16-week after-school strength and conditioning program on performance and body composition in middle-school-aged boys. Subjects in the training group (n = 16, mean age = 11.8 years) performed 90 minutes of supervised plyometric and resistance training twice weekly for 16 weeks. A group of control subjects (n = 9, age = 12.1 years) maintained their current activity levels. Sprint speed, 5-10-5 proagility, jump height, isometric peak torque of the leg extensors and flexors, and dual energy x-ray absorptiometry-derived body composition were examined during pretesting and posttesting. Data were analyzed by performing independent samples t-tests on the absolute change scores between groups. The primary findings were that the training intervention elicited significant improvements in 20-m sprint times (p = 0.03; mean change for training group = -0.17 seconds) and body-fat percentage (p = 0.03; 2.5% absolute improvement), the latter of which was a function of reduced fat mass (p = 0.06; -0.84 kg). Between-group differences were not noted for agility, jump height, lean mass, or strength measures; however, effect sizes generally showed greater improvements for the training group. In contrast to findings in longitudinal studies performed in collegiate athletes, sprint speed may be particularly adaptable during adolescence. In addition to potentially improving sport performance, high-intensity plyometric and resistance training programs offer the added benefit of improved body composition. These programs appear less effective for agility and jump performance and do not elicit substantial improvements in muscle mass above maturation.

Educational interventions to improve screening mammography interpretation: a randomized controlled trial.

PubMed

Geller, Berta M; Bogart, Andy; Carney, Patricia A; Sickles, Edward A; Smith, Robert; Monsees, Barbara; Bassett, Lawrence W; Buist, Diana M; Kerlikowske, Karla; Onega, Tracy; Yankaskas, Bonnie C; Haneuse, Sebastien; Hill, Deirdre; Wallis, Matthew G; Miglioretti, Diana

2014-06-01

The objective of our study was to conduct a randomized controlled trial of educational interventions that were created to improve performance of screening mammography interpretation. We randomly assigned physicians who interpret mammography to one of three groups: self-paced DVD, live expert-led educational seminar, or control. The DVD and seminar interventions used mammography cases of varying difficulty and provided associated teaching points. Interpretive performance was compared using a pretest-posttest design. Sensitivity, specificity, and positive predictive value (PPV) were calculated relative to two outcomes: cancer status and consensus of three experts about recall. The performance measures for each group were compared using logistic regression adjusting for pretest performance. One hundred two radiologists completed all aspects of the trial. After adjustment for preintervention performance, the odds of improved sensitivity for correctly identifying a lesion relative to expert recall were 1.34 times higher for DVD participants than for control subjects (95% CI, 1.00-1.81; p = 0.050). The odds of an improved PPV for correctly identifying a lesion relative to both expert recall (odds ratio [OR] = 1.94; 95% CI, 1.24-3.05; p = 0.004) and cancer status (OR = 1.81; 95% CI, 1.01-3.23; p = 0.045) were significantly improved for DVD participants compared with control subjects, with no significant change in specificity. For the seminar group, specificity was significantly lower than the control group (OR relative to expert recall = 0.80; 95% CI, 0.64-1.00; p = 0.048; OR relative to cancer status = 0.79; 95% CI, 0.65-0.95; p = 0.015). In this randomized controlled trial, the DVD educational intervention resulted in a significant improvement in screening mammography interpretive performance on a test set, which could translate into improved interpretative performance in clinical practice.

Aerodynamic Performance of Hand Launch Glider

NASA Astrophysics Data System (ADS)

Koike, Masaru; Ishii, Mitsuru

In recent years Micro Air Vehicles (MAV) for disaster aerial video are developed vigorously. In order to improve aerodynamic performance of MAV wing performance in low Reynolds numbers (Re) need to be improved, but research on the theme are very rare. In category of Hand Launch Glider, a kind of model aircraft, glide performance are competed, as a result high performance airfoils in Re is around 20,000 are developed. Therefore for MAV's aerodynamic performance improvement airfoils of Hand Launch Gliders should be referred and aerodynamic characteristics of the airfoils desired to be studied. So in this research, aerodynamic characteristics of the gliders are measured in wind tunnel. And also consistency between wind tunnel test and glide test in calm air is examined to confirm reliability of wind tunnel test. Comparison of different airfoils and flow visualization are also performed.

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

Supplementation with macular carotenoids improves visual performance of transgenic mice.

PubMed

Li, Binxing; Rognon, Gregory T; Mattinson, Ty; Vachali, Preejith P; Gorusupudi, Aruna; Chang, Fu-Yen; Ranganathan, Arunkumar; Nelson, Kelly; George, Evan W; Frederick, Jeanne M; Bernstein, Paul S

2018-07-01

Carotenoid supplementation can improve human visual performance, but there is still no validated rodent model to test their effects on visual function in laboratory animals. We recently showed that mice deficient in β-carotene oxygenase 2 (BCO2) and/or β-carotene oxygenase 1 (BCO1) enzymes can accumulate carotenoids in their retinas, allowing us to investigate the effects of carotenoids on the visual performance of mice. Using OptoMotry, a device to measure visual function in rodents, we examined the effect of zeaxanthin, lutein, and β-carotene on visual performance of various BCO knockout mice. We then transgenically expressed the human zeaxanthin-binding protein GSTP1 (hGSTP1) in the rods of bco2 -/- mice to examine if delivering more zeaxanthin to retina will improve their visual function further. The visual performance of bco2 -/- mice fed with zeaxanthin or lutein was significantly improved relative to control mice fed with placebo beadlets. β-Carotene had no significant effect in bco2 -/- mice but modestly improved cone visual function of bco1 -/- mice. Expression of hGSTP1 in the rods of bco2 -/- mice resulted in a 40% increase of retinal zeaxanthin and further improvement of visual performance. This work demonstrates that these "macular pigment mice" may serve as animal models to study carotenoid function in the retina. Copyright © 2018 Elsevier Inc. All rights reserved.

Visuospatial Training Improves Elementary Students' Mathematics Performance

ERIC Educational Resources Information Center

Lowrie, Tom; Logan, Tracy; Ramful, Ajay

2017-01-01

Background: Although spatial ability and mathematics performance are highly correlated, there is scant research on the extent to which spatial ability training can improve mathematics performance. Aims: This study evaluated the efficacy of a visuospatial intervention programme within classrooms to determine the effect on students' (1) spatial…

42 CFR 403.732 - Condition of participation: Quality assessment and performance improvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Access to care. (ii) Patient satisfaction. (iii) Staff performance. (iv) Complaints and grievances. (v... following: (i) Define quality assessment and performance improvement measures. (ii) Describe and outline...) Inform all patients, in writing, of the scope and responsibilities of the quality assessment and...

42 CFR 403.732 - Condition of participation: Quality assessment and performance improvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Access to care. (ii) Patient satisfaction. (iii) Staff performance. (iv) Complaints and grievances. (v... following: (i) Define quality assessment and performance improvement measures. (ii) Describe and outline...) Inform all patients, in writing, of the scope and responsibilities of the quality assessment and...

42 CFR 403.732 - Condition of participation: Quality assessment and performance improvement.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Access to care. (ii) Patient satisfaction. (iii) Staff performance. (iv) Complaints and grievances. (v... following: (i) Define quality assessment and performance improvement measures. (ii) Describe and outline...) Inform all patients, in writing, of the scope and responsibilities of the quality assessment and...

42 CFR 403.732 - Condition of participation: Quality assessment and performance improvement.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Access to care. (ii) Patient satisfaction. (iii) Staff performance. (iv) Complaints and grievances. (v... following: (i) Define quality assessment and performance improvement measures. (ii) Describe and outline...) Inform all patients, in writing, of the scope and responsibilities of the quality assessment and...

Performance Improvement Processes.

ERIC Educational Resources Information Center

1997

This document contains four papers from a symposium on performance improvement processes. In "Never the Twain Shall Meet?: A Glimpse into High Performance Work Practices and Downsizing" (Laurie J. Bassi, Mark E. Van Buren) evidence from a national cross-industry of more than 200 establishments is used to demonstrate that high-performance…

Improving Reading Performance through Hypnosis.

ERIC Educational Resources Information Center

Fillmer, H. Thompson; And Others

1981-01-01

Describes a study investigating the effects of group hypnosis on the reading performance of university students in a reading and writing center. Discusses study procedures and presents data on pretest scores and gains in vocabulary and comprehension scores. Concludes that regular use of self-hypnosis significantly improved performance. (DMM)

Improving TCP Performance over Mobile Satellite Channels: The ACKPrime Approach

NASA Technical Reports Server (NTRS)

Scott, Keith; Czetty, Stephen

1998-01-01

Various issues associated with "Improving TCP Performance over Mobile Satellite Channels: The ACKPrime Approach" are presented in viewgraph form. Specific topics include: 1) TCP over mobile satellite links; 2) ways of breaking the control loop at the groundstation; 3) ACK implementation; and 4) ACK performance.

Instructors' Evaluation as an Instrument to Improve Performance and Determine Competence

ERIC Educational Resources Information Center

Laei, Soosan; Abdi, Ali; Karamaerouz, Mohamad Javad; Shirkhani, Nassim

2014-01-01

Experts in human resources management have suggested common objectives for evaluating performance of all organizations, including motivation and improvement of staff performance, identification of competence and skills, identification of educational needs and developmental contexts, etc. Achievement to these objectives is -a responsibility of…

The HPT Value Proposition in the Larger Improvement Arena.

ERIC Educational Resources Information Center

Wallace, Guy W.

2003-01-01

Discussion of human performance technology (HPT) emphasizes the key variable, which is the human variable. Highlights include the Ishikawa Diagram; human performance as one variable of process performance; collaborating with other improvement approaches; value propositions; and benefits to stakeholders, including real return on investments. (LRW)

Throughput of Coded Optical CDMA Systems with AND Detectors

NASA Astrophysics Data System (ADS)

Memon, Kehkashan A.; Umrani, Fahim A.; Umrani, A. W.; Umrani, Naveed A.

2012-09-01

Conventional detection techniques used in optical code-division multiple access (OCDMA) systems are not optimal and result in poor bit error rate performance. This paper analyzes the coded performance of optical CDMA systems with AND detectors for enhanced throughput efficiencies and improved error rate performance. The results show that the use of AND detectors significantly improve the performance of an optical channel.

Integrated Physiological Mechanisms of Exercise Performance, Adaptation, and Maladaptation to Heat Stress

DTIC Science & Technology

2011-10-01

performance. We discuss novel systemic (heat acclimation) and cellular ( acquired thermal tolerance) adaptations that improve performance in hot and...cellular ( acquired thermal tolerance) adaptations that improve perfor- mance in hot and temperate environments and protect organs from heat stroke as...performance; (iii) newly identified adaptations associated with heat accli- mation/ acquired thermal tolerance that impact exercise-heat tolerance; (iv

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.

Process safety improvement--quality and target zero.

PubMed

Van Scyoc, Karl

2008-11-15

Process safety practitioners have adopted quality management principles in design of process safety management systems with positive effect, yet achieving safety objectives sometimes remain a distant target. Companies regularly apply tools and methods which have roots in quality and productivity improvement. The "plan, do, check, act" improvement loop, statistical analysis of incidents (non-conformities), and performance trending popularized by Dr. Deming are now commonly used in the context of process safety. Significant advancements in HSE performance are reported after applying methods viewed as fundamental for quality management. In pursuit of continual process safety improvement, the paper examines various quality improvement methods, and explores how methods intended for product quality can be additionally applied to continual improvement of process safety. Methods such as Kaizen, Poke yoke, and TRIZ, while long established for quality improvement, are quite unfamiliar in the process safety arena. These methods are discussed for application in improving both process safety leadership and field work team performance. Practical ways to advance process safety, based on the methods, are given.

Performance in physiology evaluation: possible improvement by active learning strategies.

PubMed

Montrezor, Luís H

2016-12-01

The evaluation process is complex and extremely important in the teaching/learning process. Evaluations are constantly employed in the classroom to assist students in the learning process and to help teachers improve the teaching process. The use of active methodologies encourages students to participate in the learning process, encourages interaction with their peers, and stimulates thinking about physiological mechanisms. This study examined the performance of medical students on physiology over four semesters with and without active engagement methodologies. Four activities were used: a puzzle, a board game, a debate, and a video. The results show that engaging in activities with active methodologies before a physiology cognitive monitoring test significantly improved student performance compared with not performing the activities. We integrate the use of these methodologies with classic lectures, and this integration appears to improve the teaching/learning process in the discipline of physiology and improves the integration of physiology with cardiology and neurology. In addition, students enjoy the activities and perform better on their evaluations when they use them. Copyright © 2016 The American Physiological Society.

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.

Meta-analysis of the efficacy of psychological and educational interventions to improve academic performance of students with learning disabilities in Iran

PubMed Central

Faramarzi, Salar; Shamsi, Abdolhossein; Samadi, Maryam; Ahmadzade, Maryam

2015-01-01

Introduction: with due attention to the importance of learning disabilities and necessity of presenting interventions for improvement of these disorders in order to prevent future problems, this study used meta-analysis of the research model on the impact of psychological and educational interventions to improve academic performance of students with learning disabilities. Methods: with the use of meta-analysis method by integrating the results of various researches, this study specifies the effect of psychological and educational interventions. In this order, 57 studies, which their methodology was accepted, were selected and meta-analysis was performed on them. The research instrument was a meta-analysis checklist. Results: The effect size for the effectiveness of psychological-educational interventions on improving the academic performance of students with mathematics disorder (0.57), impaired writing (0.50) and dyslexia (0.55) were reported. Conclusions: The result of meta-analysis showed that according to Cohen's table, the effect size is above average, and it can be said that educational and psychological interventions improve the academic performance of students with learning disabilities. PMID:26430685

Interacting multiple model forward filtering and backward smoothing for maneuvering target tracking

NASA Astrophysics Data System (ADS)

Nandakumaran, N.; Sutharsan, S.; Tharmarasa, R.; Lang, Tom; McDonald, Mike; Kirubarajan, T.

2009-08-01

The Interacting Multiple Model (IMM) estimator has been proven to be effective in tracking agile targets. Smoothing or retrodiction, which uses measurements beyond the current estimation time, provides better estimates of target states. Various methods have been proposed for multiple model smoothing in the literature. In this paper, a new smoothing method, which involves forward filtering followed by backward smoothing while maintaining the fundamental spirit of the IMM, is proposed. The forward filtering is performed using the standard IMM recursion, while the backward smoothing is performed using a novel interacting smoothing recursion. This backward recursion mimics the IMM estimator in the backward direction, where each mode conditioned smoother uses standard Kalman smoothing recursion. Resulting algorithm provides improved but delayed estimates of target states. Simulation studies are performed to demonstrate the improved performance with a maneuvering target scenario. The comparison with existing methods confirms the improved smoothing accuracy. This improvement results from avoiding the augmented state vector used by other algorithms. In addition, the new technique to account for model switching in smoothing is a key in improving the performance.

Fighting Against Disuse of the Masticatory System in Duchenne Muscular Dystrophy: A Pilot Study Using Chewing Gum.

PubMed

van Bruggen, H Willemijn; van den Engel-Hoek, Lenie; Steenks, Michel H; van der Bilt, Andries; Bronkhorst, Ewald M; Creugers, Nico H J; de Groot, Imelda J M; Kalaykova, Stanimira I

2015-10-01

Duchenne muscular dystrophy patients report masticatory problems. The aim was to determine the efficacy of mastication training in Duchenne muscular dystrophy using chewing gum for 4 weeks. In all, 17 patients and 17 healthy age-matched males participated. The masticatory performance was assessed using a mixing ability test and measuring anterior bite force before, shortly after and 1 month after the training. In the patient group the masticatory performance improved and remained after 1-month follow-up, no significant changes in anterior maximum bite force was observed after mastication training. In the healthy subject the bite force increased and remained at the 1-month follow-up; no significant differences in masticatory performance were observed. Mastication training by using sugar-free chewing gum in Duchenne muscular dystrophy patients improved their masticatory performance. Since bite force did not improve, the working mechanism of the improvement in chewing may relate to changes of the neuromuscular function and coordination, resulting in improvement of skills in performing mastication. © The Author(s) 2015.

Meta-analysis of the efficacy of psychological and educational interventions to improve academic performance of students with learning disabilities in Iran.

PubMed

Faramarzi, Salar; Shamsi, Abdolhossein; Samadi, Maryam; Ahmadzade, Maryam

2015-01-01

with due attention to the importance of learning disabilities and necessity of presenting interventions for improvement of these disorders in order to prevent future problems, this study used meta-analysis of the research model on the impact of psychological and educational interventions to improve academic performance of students with learning disabilities. with the use of meta-analysis method by integrating the results of various researches, this study specifies the effect of psychological and educational interventions. In this order, 57 studies, which their methodology was accepted, were selected and meta-analysis was performed on them. The research instrument was a meta-analysis checklist. The effect size for the effectiveness of psychological-educational interventions on improving the academic performance of students with mathematics disorder (0.57), impaired writing (0.50) and dyslexia (0.55) were reported. The result of meta-analysis showed that according to Cohen's table, the effect size is above average, and it can be said that educational and psychological interventions improve the academic performance of students with learning disabilities.

Performance improvement CME for quality: challenges inherent to the process.

PubMed

Vakani, Farhan Saeed; O'Beirne, Ronan

2015-01-01

The purpose of this paper is to discuss the perspective debates upon the real-time challenges for a three-staged Performance Improvement Continuing Medical Education (PI-CME) model, an innovative and potential approach for future CME, to inform providers to think, prepare and to act proactively. In this discussion, the challenges associated for adopting the American Medical Association's three-staged PI-CME model are reported. Not many institutions in USA are using a three-staged performance improvement model and then customizing it to their own healthcare context for the specific targeted audience. They integrate traditional CME methods with performance and quality initiatives, and linking with CME credits. Overall the US health system is interested in a structured PI-CME model with the potential to improve physicians practicing behaviors. Knowing the dearth of evidence for applying this structured performance improvement methodology into the design of CME activities, and the lack of clarity on challenges inherent to the process that learners and providers encounter. This paper establishes all-important first step to render the set of challenges for a three-staged PI-CME model.

Training children aged 5-10 years in manual compliance control to improve drawing and handwriting.

PubMed

Bingham, Geoffrey P; Snapp-Childs, Winona

2018-04-12

A large proportion of school-aged children exhibit poor drawing and handwriting. This prevalence limits the availability of therapy. We developed an automated method for training improved manual compliance control and relatedly, prospective control of a stylus. The approach included a difficult training task, while providing parametrically modifiable support that enables the children to perform successfully while developing good compliance control. The task was to use a stylus to push a bead along a 3D wire path. Support was provided by making the wire magnetically attractive to the stylus. Support was progressively reduced as 3D tracing performance improved. We report studies that (1) compared performance of Typically Developing (TD) children and children with Developmental Coordination Disorder (DCD), (2) tested training with active versus passive movement, (3) tested progressively reduced versus constant or no support during training, (4) tested children of different ages, (5) tested the transfer of training to a drawing task, (6) tested the specificity of training in respect to the size, shape and dimensionality of figures, and (7) investigated the relevance of the training task to the Beery VMI, an inventory used to diagnose DCD. The findings were as follows. (1) Pre-training performance of TD and DCD children was the same and good with high support but distinct and poor with low support. Support yielded good self-efficacy that motivated training. Post training performance with no support was improved and the same for TD and DCD children. (2) Actively controlled movements were required for improved performance. (3) Progressively reduced support was required for good performance during and after training. (4) Age differences in performance during pre-training were eliminated post-training. (5) Improvements transferred to drawing. (6) There was no evidence of specificity of training in transfer. (7) Disparate Beery scores were reflected in pre-training but not post-training performance. We conclude that the method improves manual compliance control, and more generally, prospective control of movements used in drawing performance. Copyright © 2018. Published by Elsevier B.V.

Dutch healthcare reform: did it result in performance improvement of health plans? A comparison of consumer experiences over time.

PubMed

Hendriks, Michelle; Spreeuwenberg, Peter; Rademakers, Jany; Delnoij, Diana M J

2009-09-17

Many countries have introduced elements of managed competition in their healthcare system with the aim to accomplish more efficient and demand-driven health care. Simultaneously, generating and reporting of comparative healthcare information has become an important quality-improvement instrument. We examined whether the introduction of managed competition in the Dutch healthcare system along with public reporting of quality information was associated with performance improvement in health plans. Experiences of consumers with their health plan were measured in four consecutive years (2005-2008) using the CQI(R) health plan instrument 'Experiences with Healthcare and Health Insurer'. Data were available of 13,819 respondents (response = 45%) of 30 health plans in 2005, of 8,266 respondents (response = 39%) of 32 health plans in 2006, of 8,088 respondents (response = 34%) of 32 health plans in 2007, and of 7,183 respondents (response = 31%) of 32 health plans in 2008. We performed multilevel regression analyses with three levels: respondent, health plan and year of measurement. Per year and per quality aspect, we estimated health plan means while adjusting for consumers' age, education and self-reported health status. We tested for linear and quadratic time effects using chi-squares. The overall performance of health plans increased significantly from 2005 to 2008 on four quality aspects. For three other aspects, we found that the overall performance first declined and then increased from 2006 to 2008, but the performance in 2008 was not better than in 2005. The overall performance of health plans did not improve more often for quality aspects that were identified as important areas of improvement in the first year of measurement. On six out of seven aspects, the performance of health plans that scored below average in 2005 increased more than the performance of health plans that scored average and/or above average in that year. We found mixed results concerning the effects of managed competition on the performance of health plans. To determine whether managed competition in the healthcare system leads to quality improvement in health plans, it is important to examine whether and for what reasons health plans initiate improvement efforts.

Effects of chewing gum on mood, learning, memory and performance of an intelligence test.

PubMed

Smith, Andrew

2009-04-01

Recent research suggests that chewing gum may increase alertness and lead to changes in cognitive performance. The present study examined effects of chewing gum on these functions within the context of a single study. This study had four main aims. The first was to examine whether chewing gum improved learning and memory of information in a story. The second aim was to determine whether chewing gum improved test performance on a validated intellectual task (the Alice Heim task). A third aim was to determine whether chewing gum improved performance on short memory tasks (immediate and delayed recall of a list of words, delayed recognition memory, retrieval from semantic memory, and a working memory task). The final aim was to determine whether chewing gum improved mood (alertness, calm and hedonic tone). A cross-over design was used with gum and no-gum sessions being on consecutive weeks. In each week, volunteers attended for two sessions, two days apart. The first session assessed mood, immediate recall of information from a story and performance on short memory tasks. The second session assessed mood, delayed recall of information from a story and performance of an intelligence test (the Alice Heim test). There were no significant effects of chewing gum on any aspect of recall of the story. Chewing gum improved the accuracy of performing the Alice Heim test which confirms the benefits of gum on test performance seen in an earlier study. Chewing gum had no significant effect on the short memory tasks. Chewing gum increased alertness at the end of the test session in both parts of the study. This effect was in the region of a 10% increase and was highly significant (P < 0.001). The results of this study showed that chewing gum increases alertness. In contrast, no significant effects of chewing gum were observed in the memory tasks. Intellectual performance was improved in the gum condition. Overall, the results suggest further research on the alerting effects of chewing gum and possible improved test performance in these situations.

Managing hospital doctors and their practice: what can we learn about human resource management from non-healthcare organisations?

PubMed

Trebble, Timothy M; Heyworth, Nicola; Clarke, Nicholas; Powell, Timothy; Hockey, Peter M

2014-11-21

Improved management of clinicians' time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual clinicians. This may reflect the absence of effective and transferrable models. The current systems of managing the performance of individual clinicians in a secondary healthcare organisation were reviewed through the study of practice in 10 successful partnership organisations, including knowledge worker predominant, within commercial, public and voluntary sector operating environments. Reciprocal visits to the secondary healthcare environment were undertaken. Six themes in performance related HRM were identified across the external organisations representing best practice and considered transferrable to managing clinicians in secondary care organisations. These included: performance measurement through defined outcomes at the team level with decision making through local data interpretation; performance improvement through empowered formal leadership with organisational support; individual performance review (IPR); and reward, recognition and talent management. The role of the executive was considered essential to support and implement effective HRM, with management of staff performance, behaviour and development integrated into organisational strategy, including through the use of universally applied values and effective communication. These approaches reflected many of the key aspects of high performance work systems and strategic HRM. There is the potential to develop systems of HRM of individual clinicians in secondary healthcare to improve practice. This should include both performance measurement and performance improvement but also engagement at an organisational level. This suggests that effective HRM and performance management of individual clinicians may be possible but requires an alternative approach for the NHS.

The Effect of Cerebellar Transcranial Direct Current Stimulation on A Throwing Task Depends on Individual Level of Task Performance.

PubMed

Mizuguchi, Nobuaki; Katayama, Takashi; Kanosue, Kazuyuki

2018-02-10

The effect of cerebellar transcranial direct current stimulation (tDCS) on motor performance remains controversial. Some studies suggest that the effect of tDCS depends upon task-difficulty and individual level of task performance. Here, we investigated whether the effect of cerebellar tDCS on the motor performance depends upon the individual's level of performance. Twenty-four naïve participants practiced dart throwing while receiving a 2-mA cerebellar tDCS for 20 min under three stimulus conditions (anodal-, cathodal-, and sham-tDCS) on separate days with a double-blind, counter-balanced cross-over design. Task performance was assessed by measuring the distance between the center of the bull's eye and the dart's position. Although task performance tended to improve throughout the practice under all stimulus conditions, improvement within a given day was not significant as compared to the first no-stimulus block. In addition, improvement did not differ among stimulation conditions. However, the magnitude of improvement was associated with an individual's level of task performance only under cathodal tDCS condition (p < 0.05). This resulted in a significant performance improvement only for the sub-group of participants with lower performance levels as compared to that with sham-tDCS (p < 0.05). These findings suggest that the facilitation effect of cerebellar cathodal tDCS on motor skill learning of complex whole-body movements depends on the level of an individual's task performance. Thus, cerebellar tDCS would facilitate learning of a complex motor skill task only in a subset of individuals. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Acute, low-dose methamphetamine administration improves attention/information processing speed and working memory in methamphetamine-dependent individuals displaying poorer cognitive performance at baseline

PubMed Central

Mahoney, James J.; Jackson, Brian J.; Kalechstein, Ari D.; De La Garza, Richard; Newton, Thomas F.

2012-01-01

Abstinent methamphetamine (Meth) dependent individuals demonstrate poorer performance on tests sensitive to attention/information processing speed, learning and memory, and working memory when compared to non-Meth dependent individuals. The poorer performance on these tests may contribute to the morbidity associated with Meth-dependence. In light of this, we sought to determine the effects of acute, low-dose Meth administration on attention, working memory, and verbal learning and memory in 19 non-treatment seeking, Meth-dependent individuals. Participants were predominantly male (89%), Caucasian (63%), and cigarette smokers (63%). Following a four day, drug-free washout period, participants were given a single-blind intravenous infusion of saline, followed the next day by 30 mg of Meth. A battery of neurocognitive tasks was administered before and after each infusion, and performance on measures of accuracy and reaction time were compared between conditions. While acute Meth exposure did not affect test performance for the entire sample, participants who demonstrated relatively poor performance on these tests at baseline, identified using a median split on each test, showed significant improvement on measures of attention/information processing speed and working memory when administered Meth. Improved performance was seen on the following measures of working memory: choice reaction time task (p≤0.04), a 1-back task (p≤0.01), and a 2-back task (p≤0.04). In addition, those participants demonstrating high neurocognitive performance at baseline experienced similar or decreased performance following Meth exposure. These findings suggest that acute administration of Meth may temporarily improve Meth-associated neurocognitive performance in those individuals experiencing lower cognitive performance at baseline. As a result, stimulants may serve as a successful treatment for improving cognitive functioning in those Meth-dependent individuals experiencing neurocognitive impairment. PMID:21122811

Improved reading performance using individualized compensation filters for observers with losses in central vision

NASA Technical Reports Server (NTRS)

Lawton, Teri B.

1989-01-01

A method to improve the reading performance of subjects with losses in central vision is proposed in which the amplitudes of the intermediate spatial frequencies are boosted relative to the lower spatial frequencies. In the method, words are filtered using an image enhancement function which is based on a subject's losses in visual function relative to a normal subject. It was found that 30-70 percent less magnification was necessary, and that reading rates were improved 2-3 times, using the method. The individualized compensation filters improved the clarity and visibility of words. The shape of the enhancement function was shown to be important in determining the optimum compensation filter for improving reading performance.

Modifying the Toyota Production System for continuous performance improvement in an academic children's hospital.

PubMed

Stapleton, F Bruder; Hendricks, James; Hagan, Patrick; DelBeccaro, Mark

2009-08-01

The Toyota Production System (TPS) has become a successful model for improving efficiency and eliminating errors in manufacturing processes. In an effort to provide patients and families with the highest quality clinical care, our academic children's hospital has modified the techniques of the TPS for a program in continuous performance improvement (CPI) and has expanded its application to educational and research programs. Over a period of years, physicians, nurses, residents, administrators, and hospital staff have become actively engaged in a culture of continuous performance improvement. This article provides background into the methods of CPI and describes examples of how we have applied these methods for improvement in clinical care, resident teaching, and research administration.

Do repeated assessments of performance status improve predictions for risk of death among patients with cancer? A population-based cohort study.

PubMed

Su, Jiandong; Barbera, Lisa; Sutradhar, Rinku

2015-06-01

Prior work has utilized longitudinal information on performance status to demonstrate its association with risk of death among cancer patients; however, no study has assessed whether such longitudinal information improves the predictions for risk of death. To examine whether the use of repeated performance status assessments improve predictions for risk of death compared to using only performance status assessment at the time of cancer diagnosis. This was a population-based longitudinal study of adult outpatients who had a cancer diagnosis and had at least one assessment of performance status. To account for each patient's changing performance status over time, we implemented a Cox model with a time-varying covariate for performance status. This model was compared to a Cox model using only a time-fixed (baseline) covariate for performance status. The regression coefficients of each model were derived based on a randomly selected 60% of patients, and then, the predictive ability of each model was assessed via concordance probabilities when applied to the remaining 40% of patients. Our study consisted of 15,487 cancer patients with over 53,000 performance status assessments. The utilization of repeated performance status assessments improved predictions for risk of death compared to using only the performance status assessment taken at diagnosis. When studying the hazard of death among patients with cancer, if available, researchers should incorporate changing information on performance status scores, instead of simply baseline information on performance status. © The Author(s) 2015.

Evolution of magnetic disk subsystems

NASA Astrophysics Data System (ADS)

Kaneko, Satoru

1994-06-01

The higher recording density of magnetic disk realized today has brought larger storage capacity per unit and smaller form factors. If the required access performance per MB is constant, the performance of large subsystems has to be several times better. This article describes mainly the technology for improving the performance of the magnetic disk subsystems and the prospects of their future evolution. Also considered are 'crosscall pathing' which makes the data transfer channel more effective, 'disk cache' which improves performance coupling with solid state memory technology, and 'RAID' which improves the availability and integrity of disk subsystems by organizing multiple disk drives in a subsystem. As a result, it is concluded that since the performance of the subsystem is dominated by that of the disk cache, maximation of the performance of the disk cache subsystems is very important.

MSR performance enhancements and modifications at St. Lucie Power Plant

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

Rubano, V.F.; Ugelow, A.G.; Menocal, A.G.

1989-01-01

The St. Lucie Power Plant provides an excellent historical prospective on various moisture separator/reheater improvements. Between the two essentially identical units there is a total of 14 years of operating experience with various moisture separator/reheater configurations, with a combination of four different heat transfer surfaces and three moisture removal configurations. Through various modifications and enhancements, the performance and the reliability of the moisture separator/reheaters at the St. Lucie Power Plant and consequently the overall plant performance has been improved. This improvement has taken place over several years and involves changes in both the heat transfer and moisture removal areas. Thismore » paper provides an overview of the history and description of moisture separator/reheater modifications at the St. Lucie Power Plant with the resulting performance improvements.« less

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.

Working Memory Training Improves Dual-Task Performance on Motor Tasks.

PubMed

Kimura, Takehide; Kaneko, Fuminari; Nagahata, Keita; Shibata, Eriko; Aoki, Nobuhiro

2017-01-01

The authors investigated whether working memory training improves motor-motor dual-task performance consisted of upper and lower limb tasks. The upper limb task was a simple reaction task and the lower limb task was an isometric knee extension task. 45 participants (age = 21.8 ± 1.6 years) were classified into a working memory training group (WM-TRG), dual-task training group, or control group. The training duration was 2 weeks (15 min, 4 times/week). Our results indicated that working memory capacity increased significantly only in the WM-TRG. Dual-task performance improved in the WM-TRG and dual-task training group. Our study provides the novel insight that working memory training improves dual-task performance without specific training on the target motor task.

Research on the drag reduction performance induced by the counterflowing jet for waverider with variable blunt radii

NASA Astrophysics Data System (ADS)

Li, Shi-bin; Wang, Zhen-guo; Barakos, George N.; Huang, Wei; Steijl, Rene

2016-10-01

Waverider will endure the huge aero-heating in the hypersonic flow, thus, it need be blunt for the leading edge. However, the aerodynamic performance will decrease for the blunt waverider because of the drag hoik. How to improve the aerodynamic performance and reduce the drag and aero-heating is very important. The variable blunt radii method will improve the aerodynamic performance, however, the huge aero-heating and bow shock wave at the head is still serious. In the current study, opposing jet is used in the waverider with variable blunt radii to improve its performance. The three-dimensional coupled implicit Reynolds-averaged Navier-Stokes(RANS) equation and the two equation SST k-ω turbulence model have been utilized to obtain the flow field properties. The numerical method has been validated against the available experimental data in the open literature. The obtained results show that the L/D will drop 7-8% when R changes from 2 to 8. The lift coefficient will increase, and the drag coefficient almost keeps the same when the variable blunt radii method is adopted, and the L/D will increase. The variable blunt radii method is very useful to improve the whole characteristics of blunt waverider and the L/D can improve 3%. The combination of the variable blunt radii method and opposing jet is a novel way to improve the whole performance of blunt waverider, and L/D can improve 4-5%. The aperture as a novel way of opposing jet is suitable for blunt waverider and also useful to improve the aerodynamic and aerothermodynamic characteristics of waverider in the hypersonic flow. There is the optimal P0in/P0 that can make the detached shock wave reattach the lower surface again so that the blunt waverider can get the better aerodynamic performance.

Using Technology-Enhanced, Cooperative, Group-Project Learning for Student Comprehension and Academic Performance

ERIC Educational Resources Information Center

Tlhoaele, Malefyane; Suhre, Cor; Hofman, Adriaan

2016-01-01

Cooperative learning may improve students' motivation, understanding of course concepts, and academic performance. This study therefore enhanced a cooperative, group-project learning technique with technology resources to determine whether doing so improved students' deep learning and performance. A sample of 118 engineering students, randomly…

Analyzing the Interaction of Performance Appraisal Factors Using Interpretive Structural Modeling

ERIC Educational Resources Information Center

Manoharan, T. R.; Muralidharan, C.; Deshmukh, S. G.

2010-01-01

In today's changed environment where the economy and industry are driven by customers, business is open to worldwide competition. Manufacturing firms have looked at employee performance improvement as a means to succeed. These findings advocate setting up priorities for employee performance improvement. This requires a continuous improvement…

Improved Performance via the Inverted Classroom

ERIC Educational Resources Information Center

Weinstein, Randy D.

2015-01-01

This study examined student performance in an inverted thermodynamics course (lectures provided by video outside of class) compared to a traditional lecture class. Students in the inverted class performed better on their exams. Students in the bottom third of the inverted course showed the greatest improvement. These bottom third students had a C…

A Performance Appraisal System for School Principals.

ERIC Educational Resources Information Center

Knoop, Robert; Common, Ronald W.

The Performance Review, Analysis, and Improvement System for Educators (PRAISE) is a formative evaluation instrument designed to improve the performance of school principals. The system appears to be reliable and valid and is flexible enough to accommodate the needs of a variety of schools. Sample items and categories of the instrument include…

Engine Performance Improvement for the 378-Foot High Endurance Cutter

DOT National Transportation Integrated Search

1978-06-01

Methods for improving the performance of the main diesel engines : of the 378-foot Coast Guard High Endurance Cutter have been investgated. : These engines are models FM3W8-l-/8 rated for 3600hp at : 90QrDM. Present engine performance was evaluated t...

Play for Performance: Using Computer Games to Improve Motivation and Test-Taking Performance

ERIC Educational Resources Information Center

Dennis, Alan R.; Bhagwatwar, Akshay; Minas, Randall K.

2013-01-01

The importance of testing, especially certification and high-stakes testing, has increased substantially over the past decade. Building on the "serious gaming" literature and the psychology "priming" literature, we developed a computer game designed to improve test-taking performance using psychological priming. The game primed…

The Relationship between Optimism and Engagement: The Impact on Student Performance

ERIC Educational Resources Information Center

Medlin, Bobby; Faulk, Larry

2011-01-01

The concepts of optimism and employee engagement as mechanisms to improving individual performance have been discussed in the management literature. Though studies concerning optimism in the workplace are relatively limited, evidence certainly exists that links the concept to improvement in individual academic and workplace performance.…

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…

Peer Mentors Can Improve Academic Performance

ERIC Educational Resources Information Center

Asgari, Shaki; Carter, Frederick, Jr.

2016-01-01

The present study examined the relationship between peer mentoring and academic performance. Students from two introductory psychology classes either received (n = 37) or did not receive (n = 36) peer mentoring. The data indicated a consistent improvement in the performance (i.e., grades on scheduled exams) of the mentored group. A similar pattern…

Poststimulation time interval-dependent effects of motor cortex anodal tDCS on reaction-time task performance.

PubMed

Molero-Chamizo, Andrés; Alameda Bailén, José R; Garrido Béjar, Tamara; García López, Macarena; Jaén Rodríguez, Inmaculada; Gutiérrez Lérida, Carolina; Pérez Panal, Silvia; González Ángel, Gloria; Lemus Corchero, Laura; Ruiz Vega, María J; Nitsche, Michael A; Rivera-Urbina, Guadalupe N

2018-02-01

Anodal transcranial direct current stimulation (tDCS) induces long-term potentiation-like plasticity, which is associated with long-lasting effects on different cognitive, emotional, and motor performances. Specifically, tDCS applied over the motor cortex is considered to improve reaction time in simple and complex tasks. The timing of tDCS relative to task performance could determine the efficacy of tDCS to modulate performance. The aim of this study was to compare the effects of a single session of anodal tDCS (1.5 mA, for 15 min) applied over the left primary motor cortex (M1) versus sham stimulation on performance of a go/no-go simple reaction-time task carried out at three different time points after tDCS-namely, 0, 30, or 60 min after stimulation. Performance zero min after anodal tDCS was improved during the whole course of the task. Performance 30 min after anodal tDCS was improved only in the last block of the reaction-time task. Performance 60 min after anodal tDCS was not significantly different throughout the entire task. These findings suggest that the motor cortex excitability changes induced by tDCS can improve motor responses, and these effects critically depend on the time interval between stimulation and task 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

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.

Does feedback matter? Practice-based learning for medical students after a multi-institutional clinical performance examination.

PubMed

Srinivasan, Malathi; Hauer, Karen E; Der-Martirosian, Claudia; Wilkes, Michael; Gesundheit, Neil

2007-09-01

Achieving competence in 'practice-based learning' implies that doctors can accurately self- assess their clinical skills to identify behaviours that need improvement. This study examines the impact of receiving feedback via performance benchmarks on medical students' self-assessment after a clinical performance examination (CPX). The authors developed a practice-based learning exercise at 3 institutions following a required 8-station CPX for medical students at the end of Year 3. Standardised patients (SPs) scored students after each station using checklists developed by experts. Students assessed their own performance immediately after the CPX (Phase 1). One month later, students watched their videotaped performance and reassessed (Phase 2). Some students received performance benchmarks (their scores, plus normative class data) before the video review. Pearson's correlations between self-ratings and SP ratings were calculated for overall performance and specific skill areas (history taking, physical examination, doctor-patient communication) for Phase 1 and Phase 2. The 2 correlations were then compared for each student group (i.e. those who received and those who did not receive feedback). A total of 280 students completed both study phases. Mean CPX scores ranged from 51% to 71% of items correct overall and for each skill area. Phase 1 self-assessment correlated weakly with SP ratings of student performance (r = 0.01-0.16). Without feedback, Phase 2 correlations remained weak (r = 0.13-0.18; n = 109). With feedback, Phase 2 correlations improved significantly (r = 0.26-0.47; n = 171). Low-performing students showed the greatest improvement after receiving feedback. The accuracy of student self-assessment was poor after a CPX, but improved significantly with performance feedback (scores and benchmarks). Videotape review alone (without feedback) did not improve self-assessment accuracy. Practice-based learning exercises that incorporate feedback to medical students hold promise to improve self-assessment skills.

Parameter Optimization and Electrode Improvement of Rotary Stepper Micromotor

NASA Astrophysics Data System (ADS)

Sone, Junji; Mizuma, Toshinari; Mochizuki, Shunsuke; Sarajlic, Edin; Yamahata, Christophe; Fujita, Hiroyuki

We developed a three-phase electrostatic stepper micromotor and performed a numerical simulation to improve its performance for practical use and to optimize its design. We conducted its circuit simulation by simplifying its structure, and the effect of springback force generated by supported mechanism using flexures was considered. And we considered new improvement method for electrodes. This improvement and other parameter optimizations achieved the low voltage drive of micromotor.

Well-Being and the Social Environment of Work: A Systematic Review of Intervention Studies.

PubMed

Daniels, Kevin; Watson, David; Gedikli, Cigdem

2017-08-16

There is consistent evidence that a good social environment in the workplace is associated with employee well-being. However, there has been no specific review of interventions to improve well-being through improving social environments at work. We conducted a systematic review of such interventions, and also considered performance as an outcome. We found eight studies of interventions. Six studies were of interventions that were based on introducing shared social activities into workgroups. Six out of the six studies demonstrated improvements in well-being across the sample (five studies), or for an identifiable sub-group (one study). Four out of the five studies demonstrated improvements in social environments, and four out of the five studies demonstrated improvements in indicators of performance. Analysis of implementation factors indicated that the interventions based on shared activities require some external facilitation, favorable worker attitudes prior to the intervention, and several different components. We found two studies that focused on improving fairness perceptions in the workplace. There were no consistent effects of these interventions on well-being or performance. We conclude that there is some evidence that interventions that increase the frequency of shared activities between workers can improve worker well-being and performance. We offer suggestions for improving the evidence base.

Well-Being and the Social Environment of Work: A Systematic Review of Intervention Studies

PubMed Central

Gedikli, Cigdem

2017-01-01

There is consistent evidence that a good social environment in the workplace is associated with employee well-being. However, there has been no specific review of interventions to improve well-being through improving social environments at work. We conducted a systematic review of such interventions, and also considered performance as an outcome. We found eight studies of interventions. Six studies were of interventions that were based on introducing shared social activities into workgroups. Six out of the six studies demonstrated improvements in well-being across the sample (five studies), or for an identifiable sub-group (one study). Four out of the five studies demonstrated improvements in social environments, and four out of the five studies demonstrated improvements in indicators of performance. Analysis of implementation factors indicated that the interventions based on shared activities require some external facilitation, favorable worker attitudes prior to the intervention, and several different components. We found two studies that focused on improving fairness perceptions in the workplace. There were no consistent effects of these interventions on well-being or performance. We conclude that there is some evidence that interventions that increase the frequency of shared activities between workers can improve worker well-being and performance. We offer suggestions for improving the evidence base. PMID:28813009

Target recognition of ladar range images using slice image: comparison of four improved algorithms

NASA Astrophysics Data System (ADS)

Xia, Wenze; Han, Shaokun; Cao, Jingya; Wang, Liang; Zhai, Yu; Cheng, Yang

2017-07-01

Compared with traditional 3-D shape data, ladar range images possess properties of strong noise, shape degeneracy, and sparsity, which make feature extraction and representation difficult. The slice image is an effective feature descriptor to resolve this problem. We propose four improved algorithms on target recognition of ladar range images using slice image. In order to improve resolution invariance of the slice image, mean value detection instead of maximum value detection is applied in these four improved algorithms. In order to improve rotation invariance of the slice image, three new improved feature descriptors-which are feature slice image, slice-Zernike moments, and slice-Fourier moments-are applied to the last three improved algorithms, respectively. Backpropagation neural networks are used as feature classifiers in the last two improved algorithms. The performance of these four improved recognition systems is analyzed comprehensively in the aspects of the three invariances, recognition rate, and execution time. The final experiment results show that the improvements for these four algorithms reach the desired effect, the three invariances of feature descriptors are not directly related to the final recognition performance of recognition systems, and these four improved recognition systems have different performances under different conditions.

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.

On the tip of the tongue: learning typing and pointing with an intra-oral computer interface.

PubMed

Caltenco, Héctor A; Breidegard, Björn; Struijk, Lotte N S Andreasen

2014-07-01

To evaluate typing and pointing performance and improvement over time of four able-bodied participants using an intra-oral tongue-computer interface for computer control. A physically disabled individual may lack the ability to efficiently control standard computer input devices. There have been several efforts to produce and evaluate interfaces that provide individuals with physical disabilities the possibility to control personal computers. Training with the intra-oral tongue-computer interface was performed by playing games over 18 sessions. Skill improvement was measured through typing and pointing exercises at the end of each training session. Typing throughput improved from averages of 2.36 to 5.43 correct words per minute. Pointing throughput improved from averages of 0.47 to 0.85 bits/s. Target tracking performance, measured as relative time on target, improved from averages of 36% to 47%. Path following throughput improved from averages of 0.31 to 0.83 bits/s and decreased to 0.53 bits/s with more difficult tasks. Learning curves support the notion that the tongue can rapidly learn novel motor tasks. Typing and pointing performance of the tongue-computer interface is comparable to performances of other proficient assistive devices, which makes the tongue a feasible input organ for computer control. Intra-oral computer interfaces could provide individuals with severe upper-limb mobility impairments the opportunity to control computers and automatic equipment. Typing and pointing performance of the tongue-computer interface is comparable to performances of other proficient assistive devices, but does not cause fatigue easily and might be invisible to other people, which is highly prioritized by assistive device users. Combination of visual and auditory feedback is vital for a good performance of an intra-oral computer interface and helps to reduce involuntary or erroneous activations.

Rifaximin Improves Driving Simulator Performance in a Randomized Trial of Patients with Minimal Hepatic Encephalopathy

PubMed Central

Bajaj, Jasmohan S; Heuman, Douglas M; Wade, James B; Gibson, Douglas P; Saeian, Kia; Wegelin, Jacob A; Hafeezullah, Muhammad; Bell, Debulon E; Sterling, Richard K; Stravitz, R. Todd; Fuchs, Michael; Luketic, Velimir; Sanyal, Arun J

2010-01-01

Background & Aims Patients with cirrhosis and minimal hepatic encephalopathy (MHE) have driving difficulties but the effects of therapy on driving performance have not been assessed. We evaluated whether performance on a driving simulator improves in patients with MHE following treatment with rifaximin. Methods Patients with MHE who were current drivers were randomly assigned to placebo or rifaximin groups and followed for 8 weeks (n=42). Patients underwent driving simulation (driving and navigation tasks) at the start (baseline) and end of the study. We evaluated patients’ cognitive abilities, quality-of-life (using the Sickness Impact Profile [SIP]), serum levels of ammonia, levels of inflammatory cytokines, and MELD scores. The primary outcome was percent who improved in driving performance, calculated by: total driving errors=speeding + illegal turns + collisions. Results Over the 8-week study period, patients given rifaximin made significantly greater improvements than those given placebo in avoiding total driving errors (76% vs. 31%, P=0.013), speeding (81% vs. 33%, P=0.005), and illegal turns (62% vs. 19%, P=0.01). Of patients given rifaximin, 91% improved their cognitive performance, compared with 61% of patients given placebo (P=0.01); they also made improvements in the psycho-social dimension of the SIP, compared with the placebo group (P=0.04). Adherence to the assigned drug averaged 92%. Neither group had changes in ammonia levels or MELD scores, but patients in the rifaximin group had increased levels of the anti-inflammatory cytokine interleukin-10. Conclusions Patients with MHE significantly improve driving simulator performance following treatment with rifaximin, compared with placebo. PMID:20849805

An improved method to detect correct protein folds using partial clustering.

PubMed

Zhou, Jianjun; Wishart, David S

2013-01-16

Structure-based clustering is commonly used to identify correct protein folds among candidate folds (also called decoys) generated by protein structure prediction programs. However, traditional clustering methods exhibit a poor runtime performance on large decoy sets. We hypothesized that a more efficient "partial" clustering approach in combination with an improved scoring scheme could significantly improve both the speed and performance of existing candidate selection methods. We propose a new scheme that performs rapid but incomplete clustering on protein decoys. Our method detects structurally similar decoys (measured using either C(α) RMSD or GDT-TS score) and extracts representatives from them without assigning every decoy to a cluster. We integrated our new clustering strategy with several different scoring functions to assess both the performance and speed in identifying correct or near-correct folds. Experimental results on 35 Rosetta decoy sets and 40 I-TASSER decoy sets show that our method can improve the correct fold detection rate as assessed by two different quality criteria. This improvement is significantly better than two recently published clustering methods, Durandal and Calibur-lite. Speed and efficiency testing shows that our method can handle much larger decoy sets and is up to 22 times faster than Durandal and Calibur-lite. The new method, named HS-Forest, avoids the computationally expensive task of clustering every decoy, yet still allows superior correct-fold selection. Its improved speed, efficiency and decoy-selection performance should enable structure prediction researchers to work with larger decoy sets and significantly improve their ab initio structure prediction performance.

An improved method to detect correct protein folds using partial clustering

PubMed Central

2013-01-01

Background Structure-based clustering is commonly used to identify correct protein folds among candidate folds (also called decoys) generated by protein structure prediction programs. However, traditional clustering methods exhibit a poor runtime performance on large decoy sets. We hypothesized that a more efficient “partial“ clustering approach in combination with an improved scoring scheme could significantly improve both the speed and performance of existing candidate selection methods. Results We propose a new scheme that performs rapid but incomplete clustering on protein decoys. Our method detects structurally similar decoys (measured using either Cα RMSD or GDT-TS score) and extracts representatives from them without assigning every decoy to a cluster. We integrated our new clustering strategy with several different scoring functions to assess both the performance and speed in identifying correct or near-correct folds. Experimental results on 35 Rosetta decoy sets and 40 I-TASSER decoy sets show that our method can improve the correct fold detection rate as assessed by two different quality criteria. This improvement is significantly better than two recently published clustering methods, Durandal and Calibur-lite. Speed and efficiency testing shows that our method can handle much larger decoy sets and is up to 22 times faster than Durandal and Calibur-lite. Conclusions The new method, named HS-Forest, avoids the computationally expensive task of clustering every decoy, yet still allows superior correct-fold selection. Its improved speed, efficiency and decoy-selection performance should enable structure prediction researchers to work with larger decoy sets and significantly improve their ab initio structure prediction performance. PMID:23323835

Activity gains after reconstructions of elbow extension in patients with tetraplegia.

PubMed

Wangdell, Johanna; Fridén, Jan

2012-05-01

Reconstruction of triceps function in persons with tetraplegia is an established surgical intervention. The purpose of this study was to investigate and evaluate patient perspective of gains in activity and satisfaction after surgical reconstruction of triceps function and subsequent rehabilitation. We studied the effects of surgery and rehabilitation in 14 persons (19 arms) treated with deltoid-to-triceps transfer. We used Canadian Occupational Performance Measurement standards to capture the performance and satisfaction of patient-identified activity goals. Follow-up was performed at 6 and 12 months postoperatively. To make group analyses, we classified activity goals according to the International Classification of Function, Disability, and Health categories of activities and participation, as well as relative to the position of the arm in space. Patients reported improvement in performance after surgery, and satisfaction was rated even higher. Improvement was seen in all types of activities that patients had prioritized. No single goal was rated lower at 12 months' follow-up than before surgery. The most common activity gains were related to "driving a wheelchair" and the ability to "reach out," each of which represented 20% of expressed goals. Although "driving a wheelchair" and "moving the body" (transfers) were common goals, the smallest improvements for both performance and satisfaction after 12 months were seen in these areas. We observed the highest performance improvement in the category of "writing" and the ability to "stretch out the arm when lying down." Improvement in activity continues over the first year after triceps reconstruction. Complex activities continue to improve over a longer period than simpler activities. We saw the highest improvement in activities performed without the aid of gravity and activities highly dependent on coordination. Such actions are difficult to compensate for by technique or skills, and therefore elbow extension is essential for performance. Therapeutic IV. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Using the balanced scorecard to measure Chinese and Japanese hospital performance.

PubMed

Chen, Xiao-yun; Yamauchi, Kazunobu; Kato, Ken; Nishimura, Akio; Ito, Katuski

2006-01-01

The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries. One hospital from China and another from Japan were chosen and key indicators were selected according to the BSC framework. A comparative hospital performance measurement model was set up using the BSC framework to comprehensively compare hospital performance in two countries. The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the hospitals' contribution to performance improvement of each country's total health system. Hospital performance comparisons between countries using the BSC depend on the selection of feasible and appropriate key performance indicators, which is occasionally limited by data collection problems. The first use of the BSC to compare hospital performance between China and Japan shows benefits that not only suggests performance improvements in individual hospitals but also reveals effective health factors allowing implementation of valid national health policies.

Training for Template Creation: A Performance Improvement Method

ERIC Educational Resources Information Center

Lyons, Paul

2008-01-01

Purpose: There are three purposes to this article: first, to offer a training approach to employee learning and performance improvement that makes use of a step-by-step process of skill/knowledge creation. The process offers follow-up opportunities for skill maintenance and improvement; second, to explain the conceptual bases of the approach; and…

Adoption and Perceived Effectiveness of Financial Improvement Strategies in Critical Access Hospitals

ERIC Educational Resources Information Center

Holmes, George M.; Pink, George H.

2012-01-01

Purpose: To ascertain the use and perceived success of strategies to improve the financial performance of Critical Access Hospitals (CAHs). Methods: Information about the use and perceived effectiveness of 44 specific strategies to improve financial performance was collected from an online survey of 291 CAH Chief Executive Officers and Chief…

Sex Differences in Learned Helplessness: I. Differential Debilitation with Peer and Adult Evaluators

ERIC Educational Resources Information Center

Bush, Ellen S.; Dweck, Carol S.

1976-01-01

Peer and adult evaluators were used to examine sex differences in responses of 108 fifth graders to failure feedback. Performance in boys improved with feedback from adult agents but did not change with peer feedback. Performance in girls improved with peer feedback but showed little improvement with adult feedback. (GO)

Using an Intelligent Tutor and Math Fluency Training to Improve Math Performance

ERIC Educational Resources Information Center

Arroyo, Ivon; Royer, James M.; Woolf, Beverly P.

2011-01-01

This article integrates research in intelligent tutors with psychology studies of memory and math fluency (the speed to retrieve or calculate answers to basic math operations). It describes the impact of computer software designed to improve either strategic behavior or math fluency. Both competencies are key to improved performance and both…

Winning performance improvement strategies--linking documentation and accounts receivable.

PubMed

Braden, J H; Swadley, D

1996-01-01

When the HIM department at The University of Texas Medical Branch set out to improve documentation and accounts receivable management, it established a plan that encompassed a broad spectrum of data management process changes. The department examined and acknowledged the deficiencies in data management processes and used performance improvement tools to achieve successful results.

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…

Channels for Improved Performance from Living on Campus

ERIC Educational Resources Information Center

de Araujo, Pedro; Murray, James

2010-01-01

In a recent study, de Araujo and Murray (2010) find empirical evidence that living on campus leads to improved student performance, finding both immediate effects (GPA improves while the student lives on campus) and permanent effects (GPA remains higher even after moving off campus). Using the same dataset, we extend the analysis to explain why…

42 CFR 418.58 - Condition of participation: Quality assessment and performance improvement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... collected to do the following: (i) Monitor the effectiveness and safety of services and quality of care. (ii..., patient safety, and quality of care. (2) Performance improvement activities must track adverse patient... care and patient safety, and that all improvement actions are evaluated for effectiveness. (3) That one...

Self-Assessment of Practice Performance: Development of the ABIM Practice Improvement Module (PIM[superscript SM])

ERIC Educational Resources Information Center

Duffy, F. Daniel; Lynn, Lorna A.; Didura, Halyna; Hess, Brian; Caverzagie, Kelly; Grosso, Louis; Lipner, Rebecca A.; Holmboe, Eric S.

2008-01-01

Background: Quality measurement and improvement in practice are requirements for Maintenance of Certification by the American Board of Medical Specialties boards and a component of many pay for performance programs. Objective: To describe the development of the American Board of Internal Medicine (ABIM) Practice Improvement Module (PIM[superscript…

Construction Project Performance Improvement through Radio Frequency Identification Technology Application on a Project Supply Chain

ERIC Educational Resources Information Center

Wang, Heng

2017-01-01

Construction project productivity typically lags other industries and it has been the focus of numerous studies in order to improve the project performance. This research investigated the application of Radio Frequency Identification (RFID) technology on construction projects' supply chain and determined that RFID technology can improve the…

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…

The CF6 Jet Engine Performance Improvement - Low Pressure Turbine Active Clearance Control

NASA Technical Reports Server (NTRS)

Beck, B. D.; Fasching, W. A.

1982-01-01

A low pressure turbine (LPT) active clearance control (ACC) cooling system was developed to reduce the fuel consumption of current CF6-50 turbofan engines for wide bodied commercial aircraft. The program performance improvement goal of 0.3% delta sfc was determined to be achievable with an improved impingement cooling system. The technology enables the design of an optimized manifold and piping system which is capable of a performance gain of 0.45% delta sfc.

Performance Variability as a Predictor of Response to Aphasia Treatment.

PubMed

Duncan, E Susan; Schmah, Tanya; Small, Steven L

2016-10-01

Performance variability in individuals with aphasia is typically regarded as a nuisance factor complicating assessment and treatment. We present the alternative hypothesis that intraindividual variability represents a fundamental characteristic of an individual's functioning and an important biomarker for therapeutic selection and prognosis. A total of 19 individuals with chronic aphasia participated in a 6-week trial of imitation-based speech therapy. We assessed improvement both on overall language functioning and repetition ability. Furthermore, we determined which pretreatment variables best predicted improvement on the repetition test. Significant gains were made on the Western Aphasia Battery-Revised (WAB) Aphasia Quotient, Cortical Quotient, and 2 subtests as well as on a separate repetition test. Using stepwise regression, we found that pretreatment intraindividual variability was the only predictor of improvement in performance on the repetition test, with greater pretreatment variability predicting greater improvement. Furthermore, the degree of reduction in this variability over the course of treatment was positively correlated with the degree of improvement. Intraindividual variability may be indicative of potential for improvement on a given task, with more uniform performance suggesting functioning at or near peak potential. © The Author(s) 2016.

Combining instruction prefetching with partial cache locking to improve WCET in real-time systems.

PubMed

Ni, Fan; Long, Xiang; Wan, Han; Gao, Xiaopeng

2013-01-01

Caches play an important role in embedded systems to bridge the performance gap between fast processor and slow memory. And prefetching mechanisms are proposed to further improve the cache performance. While in real-time systems, the application of caches complicates the Worst-Case Execution Time (WCET) analysis due to its unpredictable behavior. Modern embedded processors often equip locking mechanism to improve timing predictability of the instruction cache. However, locking the whole cache may degrade the cache performance and increase the WCET of the real-time application. In this paper, we proposed an instruction-prefetching combined partial cache locking mechanism, which combines an instruction prefetching mechanism (termed as BBIP) with partial cache locking to improve the WCET estimates of real-time applications. BBIP is an instruction prefetching mechanism we have already proposed to improve the worst-case cache performance and in turn the worst-case execution time. The estimations on typical real-time applications show that the partial cache locking mechanism shows remarkable WCET improvement over static analysis and full cache locking.

Combining Instruction Prefetching with Partial Cache Locking to Improve WCET in Real-Time Systems

PubMed Central

Ni, Fan; Long, Xiang; Wan, Han; Gao, Xiaopeng

2013-01-01

Caches play an important role in embedded systems to bridge the performance gap between fast processor and slow memory. And prefetching mechanisms are proposed to further improve the cache performance. While in real-time systems, the application of caches complicates the Worst-Case Execution Time (WCET) analysis due to its unpredictable behavior. Modern embedded processors often equip locking mechanism to improve timing predictability of the instruction cache. However, locking the whole cache may degrade the cache performance and increase the WCET of the real-time application. In this paper, we proposed an instruction-prefetching combined partial cache locking mechanism, which combines an instruction prefetching mechanism (termed as BBIP) with partial cache locking to improve the WCET estimates of real-time applications. BBIP is an instruction prefetching mechanism we have already proposed to improve the worst-case cache performance and in turn the worst-case execution time. The estimations on typical real-time applications show that the partial cache locking mechanism shows remarkable WCET improvement over static analysis and full cache locking. PMID:24386133

Measuring the value of process improvement initiatives in a preoperative assessment center using time-driven activity-based costing.

PubMed

French, Katy E; Albright, Heidi W; Frenzel, John C; Incalcaterra, James R; Rubio, Augustin C; Jones, Jessica F; Feeley, Thomas W

2013-12-01

The value and impact of process improvement initiatives are difficult to quantify. We describe the use of time-driven activity-based costing (TDABC) in a clinical setting to quantify the value of process improvements in terms of cost, time and personnel resources. Difficulty in identifying and measuring the cost savings of process improvement initiatives in a Preoperative Assessment Center (PAC). Use TDABC to measure the value of process improvement initiatives that reduce the costs of performing a preoperative assessment while maintaining the quality of the assessment. Apply the principles of TDABC in a PAC to measure the value, from baseline, of two phases of performance improvement initiatives and determine the impact of each implementation in terms of cost, time and efficiency. Through two rounds of performance improvements, we quantified an overall reduction in time spent by patient and personnel of 33% that resulted in a 46% reduction in the costs of providing care in the center. The performance improvements resulted in a 17% decrease in the total number of full time equivalents (FTE's) needed to staff the center and a 19% increase in the numbers of patients assessed in the center. Quality of care, as assessed by the rate of cancellations on the day of surgery, was not adversely impacted by the process improvements. © 2013 Published by Elsevier Inc.

How Changes in White Matter Might Underlie Improved Reaction Time Due to Practice1

PubMed Central

Voelker, Pascale; Piscopo, Denise; Weible, Aldis; Lynch, Gary; Rothbart, Mary K.; Posner, Michael I.; Niell, Cristopher M.

2017-01-01

Why does training on a task reduce the reaction time for performing it? New research points to changes in white matter pathways as one likely mechanism. These pathways connect remote brain areas involved in performing the task. Genetic variations may be involved in individual differences in the extent of this improvement. If white matter change is involved in improved reaction time with training, it may point the way toward understanding where and how generalization occurs. We examine the hypothesis that brain pathways shared by different tasks may result in improved performance of cognitive tasks remote from the training. PMID:27064751

Improvement of the Performance of a Turbo-Ramjet Engine for UAV and Missile Applications

DTIC Science & Technology

2003-12-01

Improvement of the Performance of a Turbo-Ramjet Engine for UAV and Missile Applications 5. FUNDING NUMBERS 6. AUTHOR ( S ) Dimitrios...Krikellas 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Naval Postgraduate School Monterey, CA 93943-5000 8. PERFORMING ORGANIZATION REPORT...NUMBER 9. SPONSORING / MONITORING AGENCY NAME( S ) AND ADDRESS(ES) N/A 10. SPONSORING/MONITORING AGENCY REPORT NUMBER 11

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.

A Case Report Examining the Feasibility of Meta-Cognitive Strategy Training in Acute Inpatient Stroke Rehabilitation

PubMed Central

Skidmore, Elizabeth R.; Holm, Margo B.; Whyte, Ellen M.; Dew, Mary Amanda; Dawson, Deirdre; Becker, James T.

2011-01-01

Meta-cognitive strategy training may be used to augment inpatient rehabilitation to promote active engagement and subsequent benefit for individuals with cognitive impairments after stroke. We examined the feasibility of administering a form of meta-cognitive strategy training, Cognitive Orientation to daily Occupational Performance, during inpatient rehabilitation. We trained an individual with cognitive impairments after right hemisphere stroke to identify performance problems, set self-selected goals, develop plans to address goals, and evaluate performance improvements. To assess feasibility, we examined the number of meta-cognitive training sessions attended, the number of self-selected goals, and changes in goal-related performance. We also examined changes in rehabilitation engagement and disability. The participant used the meta-cognitive strategy to set 8 goals addressing physically-oriented, instrumental, and work-related activities. Mean improvement in Canadian Occupational Performance Measure Performance Scale scores was 6.1. Pittsburgh Rehabilitation Participation Scale scores (measuring rehabilitation engagement) improved from 3.2 at admission to 4.9 at discharge. Functional Independence Measure scores (measuring disability) improved from 68 at admission, to 97 at discharge. Performance Assessment of Self-care Skills scores improved from 1.1 at admission to 2.9 at discharge. The results indicate that meta-cognitive strategy training was feasible during inpatient rehabilitation and warrants further evaluation to determine its effectiveness. PMID:21391121

Intensive client-centred occupational therapy in the home improves older adults' occupational performance. Results from a Danish randomized controlled trial.

PubMed

Nielsen, Tove Lise; Andersen, Niels Trolle; Petersen, Kirsten Schultz; Polatajko, Helene; Nielsen, Claus Vinther

2018-01-12

There is growing interest in enabling older adults' occupational performance. We tested whether 11 weeks of intensive client-centred occupational therapy (ICC-OT) was superior to usual practice in improving the occupational performance of home-dwelling older adults. An assessor-masked randomized controlled trial among adults 60 + with chronic health issues, who received or applied for homecare services. Recruitment took place September 2012 to April 2014. All participants received practical and personal assistance and meal delivery as needed. In addition, they were randomized to receive either a maximum 22 sessions of occupation-based ICC-OT (N = 59) or to receive usual practice with a maximum three sessions of occupational therapy (N = 60). The primary outcome was self-rated occupational performance assessed with the Canadian Occupational Performance Measure (COPM). No important adverse events occurred. ICC-OT was accepted by 46 participants (88%), usual practice by 60 (100%). After 3 months, the ICC-OT-group had improved 1.86 points on COPM performance; the Usual-Practice group had improved 0.61 points. The between-group difference was statistically significant (95% confidence interval 0.50 to 2.02), t-test: p = 0.001. ICC-OT improved older adults' occupational performance more effectively than usual practice. This result may benefit older adults and support programmatic changes.

Effects of a minimalist shoe on running economy and 5-km running performance.

PubMed

Fuller, Joel T; Thewlis, Dominic; Tsiros, Margarita D; Brown, Nicholas A T; Buckley, Jonathan D

2016-09-01

The purpose of this study was to determine if minimalist shoes improve time trial performance of trained distance runners and if changes in running economy, shoe mass, stride length, stride rate and footfall pattern were related to any difference in performance. Twenty-six trained runners performed three 6-min sub-maximal treadmill runs at 11, 13 and 15 km·h(-1) in minimalist and conventional shoes while running economy, stride length, stride rate and footfall pattern were assessed. They then performed a 5-km time trial. In the minimalist shoe, runners completed the trial in less time (effect size 0.20 ± 0.12), were more economical during sub-maximal running (effect size 0.33 ± 0.14) and decreased stride length (effect size 0.22 ± 0.10) and increased stride rate (effect size 0.22 ± 0.11). All but one runner ran with a rearfoot footfall in the minimalist shoe. Improvements in time trial performance were associated with improvements in running economy at 15 km·h(-1) (r = 0.58), with 79% of the improved economy accounted for by reduced shoe mass (P < 0.05). The results suggest that running in minimalist shoes improves running economy and 5-km running performance.

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.

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.

Self-regulation workshop and Occupational Performance Coaching with teachers: A pilot study.

PubMed

Hui, Caroline; Snider, Laurie; Couture, Mélanie

2016-04-01

Teachers' occupational role and performance can be undermined when working with students with disruptive classroom behaviours. This pilot study aimed to explore the impact of school-based occupational therapy intervention on teachers' classroom management self-efficacy and perceived performance/satisfaction in their management of students with disruptive behaviours. This pilot study used a multiple-case replication study design. A cohort of regular classroom elementary school teachers (n = 11) participated in a 1-day workshop on sensorimotor strategies for supporting student self-regulation followed by eight individual sessions of Occupational Performance Coaching (OPC). Measurement tools were the Canadian Occupational Performance Measure, Goal Attainment Scaling (GAS), and Teachers' Self-Efficacy Scale-Classroom Management. Improvement in teachers' perception of performance, satisfaction, and classroom management was seen. GAS showed clinically significant improvement. Improvements were sustained at 7 weeks follow-up. Preliminary results support the use of sensorimotor education combined with OPC to enable teachers' occupational performance. © CAOT 2016.

Physician Perceptions of Performance Feedback in a Quality Improvement Activity.

PubMed

Eden, Aimee R; Hansen, Elizabeth; Hagen, Michael D; Peterson, Lars E

Physician performance and peer comparison feedback can affect physician care quality and patient outcomes. This study aimed to understand family physician perspectives of the value of performance feedback in quality improvement (QI) activities. This study analyzed American Board of Family Medicine open-ended survey data collected between 2004 and 2014 from physicians who completed a QI module that provided pre- and post-QI project individual performance data and peer comparisons. Physicians made 3480 comments in response to a question about this performance feedback, which were generally positive in nature (86%). Main themes that emerged were importance of accurate feedback data, enhanced detail in the content of feedback, and ability to customize peer comparison groups to compare performance to peers with similar patient populations or practice characteristics. Meaningful and tailored performance feedback may be an important tool for physicians to improve their care quality and should be considered an integral part of QI project design.

Practical session assessments in human anatomy: Weightings and performance.

PubMed

McDonald, Aaron C; Chan, Siew-Pang; Schuijers, Johannes A

2016-07-08

Assessment weighting within a given module can be a motivating factor for students when deciding on their commitment level and time given to study a specific topic. In this study, an analysis of assessment performances of second year anatomy students was performed over four years to determine if (1) students performed better when a higher weighting was given to a set of practical session assessments and (2) whether an improved performance in the practical session assessments had a carry-over effect on other assessment tasks within that anatomy module and/or other anatomy modules that follow. Results showed that increasing the weighting of practical session assessments improved the average mark in that assessment and also improved the percentage of students passing that assessment. Further, it significantly improved performance in the written end-semester examination within the same module and had a carry-over effect on the anatomy module taught in the next teaching period, as students performed better in subsequent practical session assessments as well as subsequent end-semester examinations. It was concluded that the weighting of assessments had significant influences on a student's performance in that, and subsequent, assessments. It is postulated that practical session assessments, designed to develop deep learning skills in anatomy, improved efficacy in student performance in assessments undertaken in that and subsequent anatomy modules when the weighting of these assessments was greater. These deep learning skills were also transferable to other methods of assessing anatomy. Anat Sci Educ 9: 330-336. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

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.

Physical Therapist Students' Perceptions from Performing Strength and Conditioning Training: Academic, Professional, and Clinical Benefits.

PubMed

Meiners, Kelly M; Wisdom, Christina M

2017-01-01

The purpose of this qualitative study was to assess the perceptions of Doctor of Physical Therapy (DPT) students in performing collegiate athletes' strength and conditioning training. Four DPT students with the Certified Strength and Conditioning Specialist (CSCS) credential voluntarily provided collegiate athletes strength and conditioning training. Students were interviewed to obtain their perceptions of how the experience impacted performance in DPT school and perceptions of anticipated future benefits. Seven themes emerged from interviews: improved communication skills, movement analysis experience, improved time management/organization, increased understanding of exercises, attention to psychosocial aspects, interprofessional experience, and improved performance in coursework. DPT students with the CSCS credential perceived benefits from performing strength and conditioning training outside the standard DPT curriculum.

Computational Fluid Dynamics Simulation Study of Active Power Control in Wind Plants

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

Fleming, Paul; Aho, Jake; Gebraad, Pieter

2016-08-01

This paper presents an analysis performed on a wind plant's ability to provide active power control services using a high-fidelity computational fluid dynamics-based wind plant simulator. This approach allows examination of the impact on wind turbine wake interactions within a wind plant on performance of the wind plant controller. The paper investigates several control methods for improving performance in waked conditions. One method uses wind plant wake controls, an active field of research in which wind turbine control systems are coordinated to account for their wakes, to improve the overall performance. Results demonstrate the challenge of providing active power controlmore » in waked conditions but also the potential methods for improving this performance.« less

Recent developments in photodetection for medical applications

NASA Astrophysics Data System (ADS)

Llosá, Gabriela

2015-07-01

The use of the most advanced technology in medical imaging results in the development of high performance detectors that can significantly improve the performance of the medical devices employed in hospitals. Scintillator crystals coupled to photodetectors remain to be essential detectors in terms of performance and cost for medical imaging applications in different imaging modalities. Recent advances in photodetectors result in an increase of the performance of the medical scanners. Solid state detectors can provide substantial performance improvement, but are more complex to integrate into clinical detectors due mainly to their higher cost. Solid state photodetectors (APDs, SiPMs) have made new detector concepts possible and have led to improvements in different imaging modalities. Recent advances in detectors for medical imaging are revised.

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.

Simulation-based Randomized Comparative Assessment of Out-of-Hospital Cardiac Arrest Resuscitation Bundle Completion by Emergency Medical Service Teams Using Standard Life Support or an Experimental Automation-assisted Approach.

PubMed

Choi, Bryan; Asselin, Nicholas; Pettit, Catherine C; Dannecker, Max; Machan, Jason T; Merck, Derek L; Merck, Lisa H; Suner, Selim; Williams, Kenneth A; Jay, Gregory D; Kobayashi, Leo

2016-12-01

Effective resuscitation of out-of-hospital cardiac arrest (OHCA) patients is challenging. Alternative resuscitative approaches using electromechanical adjuncts may improve provider performance. Investigators applied simulation to study the effect of an experimental automation-assisted, goal-directed OHCA management protocol on EMS providers' resuscitation performance relative to standard protocols and equipment. Two-provider (emergency medical technicians (EMT)-B and EMT-I/C/P) teams were randomized to control or experimental group. Each team engaged in 3 simulations: baseline simulation (standard roles); repeat simulation (standard roles); and abbreviated repeat simulation (reversed roles, i.e., basic life support provider performing ALS tasks). Control teams used standard OHCA protocols and equipment (with high-performance cardiopulmonary resuscitation training intervention); for second and third simulations, experimental teams performed chest compression, defibrillation, airway, pulmonary ventilation, vascular access, medication, and transport tasks with goal-directed protocol and resuscitation-automating devices. Videorecorders and simulator logs collected resuscitation data. Ten control and 10 experimental teams comprised 20 EMT-B's; 1 EMT-I, 8 EMT-C's, and 11 EMT-P's; study groups were not fully matched. Both groups suboptimally performed chest compressions and ventilations at baseline. For their second simulations, control teams performed similarly except for reduced on-scene time, and experimental teams improved their chest compressions (P=0.03), pulmonary ventilations (P<0.01), and medication administration (P=0.02); changes in their performance of chest compression, defibrillation, airway, and transport tasks did not attain significance against control teams' changes. Experimental teams maintained performance improvements during reversed-role simulations. Simulation-based investigation into OHCA resuscitation revealed considerable variability and improvable deficiencies in small EMS teams. Goal-directed, automation-assisted OHCA management augmented select resuscitation bundle element performance without comprehensive improvement.

Decline in physical performance among women with a recent transient ischemic attack or ischemic stroke: opportunities for functional preservation a report of the Women's Estrogen Stroke Trial.

PubMed

Kernan, Walter N; Viscoli, Catherine M; Brass, Lawrence M; Gill, Thomas M; Sarrel, Philip M; Horwitz, Ralph I

2005-03-01

Physical performance for walking, reaching, turning, and other common tasks is a major determinant of functional independence after stroke. Current strategies to preserve physical performance focus on prevention of recurrent stroke. Loss of physical performance, however, may occur in the absence of recurrence. To examine this possibility, we measured change in physical performance, independent of subsequent stroke, among women with a recent ischemic stroke or transient ischemic attack (TIA). Among 664 postmenopausal women who participated in a clinical trial of estrogen therapy after stroke or TIA, we administered the Physical Performance Test (PPT) at baseline (mean 58 days from the cerebrovascular event) and annually. Women who died or had a stroke during follow-up were censored. Decline or improvement in physical performance was defined as a change in the PPT score from baseline of at least 3 points. Sustained decline or improvement was defined as 2 consecutive years during which the score had declined or improved, respectively, relative to the baseline score. With each year of follow-up, a smaller proportion of the cohort demonstrated improvement (16% in year 1, 6% in year 5) and a larger proportion demonstrated decline (15% in year 1, 35% in year 5). In an analysis restricted to 259 women with 3 years of follow-up, 46 (18%) experienced a nonsustained decline in physical performance, and 39 (15%) experienced a sustained decline. Decline in physical performance is common after an ischemic stroke or TIA even in the absence of a recurrent neurological event. Our findings suggest that specific interventions to maintain and improve physical performance may be important for reducing long-term disability.

Use of Provider-Level Dashboards and Pay-for-Performance in Venous Thromboembolism Prophylaxis*

PubMed Central

Michtalik, Henry J.; Carolan, Howard T.; Haut, Elliott R.; Lau, Brandyn D.; Streiff, Michael B.; Finkelstein, Joseph; Pronovost, Peter J.; Durkin, Nowella; Brotman, Daniel J.

2014-01-01

Background Despite safe and cost-effective venous thromboembolism (VTE) prevention measures, VTE prophylaxis rates are often suboptimal. Healthcare reform efforts emphasize transparency through programs to report performance, and payment incentives through programs to pay-for-performance. Objective To sequentially examine an individualized physician dashboard and pay-for-performance program to improve VTE prophylaxis rates amongst hospitalists. Design Retrospective analysis of 3144 inpatient admissions. After a baseline observation period, VTE prophylaxis compliance was compared during both interventions. Setting 1060-bed tertiary care medical center. Participants 38 part- and full-time academic hospitalists. Interventions A Web-based hospitalist dashboard provided VTE prophylaxis feedback. After 6 months of feedback only, a pay-for-performance program was incorporated, with graduated payouts for compliance rates of 80-100%. Measurements Prescription of American College of Chest Physicians guideline-compliant VTE prophylaxis and subsequent pay-for-performance payments. Results Monthly VTE prophylaxis compliance rates were 86% (95% CI: 85, 88), 90% (95% CI: 88, 93), and 94% (95% CI: 93, 96) during the baseline, dashboard, and combined dashboard/pay-for-performance periods, respectively. Compliance significantly improved with the use of the dashboard (p=0.01) and addition of the pay-for-performance program (p=0.01). The highest rate of improvement occurred with the dashboard (1.58%/month; p=0.01). Annual individual physician performance payments ranged from $53 to $1244 (mean $633; SD ±350). Conclusions Direct feedback using dashboards was associated with significantly improved compliance, with further improvement after incorporating an individual physician pay-for-performance program. Real-time dashboards and physician-level incentives may assist hospitals in achieving higher safety and quality benchmarks. PMID:25545690

Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.

PubMed

Michtalik, Henry J; Carolan, Howard T; Haut, Elliott R; Lau, Brandyn D; Streiff, Michael B; Finkelstein, Joseph; Pronovost, Peter J; Durkin, Nowella; Brotman, Daniel J

2015-03-01

Despite safe and cost-effective venous thromboembolism (VTE) prevention measures, VTE prophylaxis rates are often suboptimal. Healthcare reform efforts emphasize transparency through programs to report performance and payment incentives through pay-for-performance programs. To sequentially examine an individualized physician dashboard and pay-for-performance program to improve VTE prophylaxis rates among hospitalists. Retrospective analysis of 3144 inpatient admissions. After a baseline observation period, VTE prophylaxis compliance was compared during both interventions. A 1060-bed tertiary care medical center. Thirty-eight part-time and full-time academic hospitalists. A Web-based hospitalist dashboard provided VTE prophylaxis feedback. After 6 months of feedback only, a pay-for-performance program was incorporated, with graduated payouts for compliance rates of 80% to 100%. Prescription of American College of Chest Physicians' guideline-compliant VTE prophylaxis and subsequent pay-for-performance payments. Monthly VTE prophylaxis compliance rates were 86% (95% confidence interval [CI]: 85-88), 90% (95% CI: 88-93), and 94% (95% CI: 93-96) during the baseline, dashboard, and combined dashboard/pay-for-performance periods, respectively. Compliance significantly improved with the use of the dashboard (P = 0.01) and addition of the pay-for-performance program (P = 0.01). The highest rate of improvement occurred with the dashboard (1.58%/month; P = 0.01). Annual individual physician performance payments ranged from $53 to $1244 (mean $633; standard deviation ±$350). Direct feedback using dashboards was associated with significantly improved compliance, with further improvement after incorporating an individual physician pay-for-performance program. Real-time dashboards and physician-level incentives may assist hospitals in achieving higher safety and quality benchmarks. © 2014 Society of Hospital Medicine.

Infrequent dream recall associated with low performance but high overnight improvement on mirror-tracing.

PubMed

Dumel, Gaëlle; Carr, Michelle; Marquis, Louis-Philippe; Blanchette-Carrière, Cloé; Paquette, Tyna; Nielsen, Tore

2015-08-01

Although sleep facilitates learning and memory, the roles of dreaming and habitual levels of recalling dreams remain unknown. This study examined if performance and overnight improvement on a rapid eye movement sleep-sensitive visuomotor task is associated differentially with habitually high or low dream recall frequency. As a relation between dream production and visuospatial skills has been demonstrated previously, one possibility is that frequency of dream recall will be linked to performance on visuomotor tasks such as the Mirror Tracing Task. We expected that habitually low dream recallers would perform more poorly on the Mirror Tracing Task than would high recallers and would show less task improvement following a night of sleep. Fifteen low and 20 high dream recallers slept one night each in the laboratory and performed the Mirror Tracing Task before and after sleep. Low recallers had overall worse baseline performance but a greater evening-to-morning improvement than did high recallers. Greater improvements in completion time in low recallers were associated with Stage 2 rather than rapid eye movement sleep. Findings support the separate notions that dreaming is related to visuomotor processes and that different levels of visuomotor skill engage different sleep- and dream-related consolidation mechanisms. © 2015 European Sleep Research Society.

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.

Exploring inter-task transfer following a CO-OP approach with four children with DCD: A single subject multiple baseline design.

PubMed

Capistran, Julie; Martini, Rose

2016-10-01

Cognitive Orientation to daily Occupational Performance (CO-OP) approach has been shown to be effective for improving the performance of tasks worked on in therapy and the use of cognitive strategies. No study to date seems to have explored its effectiveness for improving performance of untrained tasks (inter-task transfer) in children with Developmental Coordination Disorder (DCD). This study aimed to determine whether CO-OP leads to improved performance in an untrained task. A single-subject design with multiple baselines across skills was adopted, with three replications. Four children with DCD (7-12years) received 10 sessions of CO-OP intervention where each child worked on three tasks during therapy sessions and a fourth task was identified, but not worked on, to verify inter-task transfer. Task performance was rated over four phases (baseline, intervention, post-intervention, follow-up) using the Performance Quality Rating Scale (PQRS-OD). Graphed data was statistically analyzed using a two or three standard deviation band method. Significant improvement was obtained for 11 of 12 tasks worked on during therapy and for two of the four untrained tasks. These results indicate that the effectiveness of CO-OP to improve untrained tasks in children merit further exploration. Copyright © 2016 Elsevier B.V. All rights reserved.

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

Randomized Controlled Trial Investigating the Role of Exercise in the Workplace to Improve Work Ability, Performance, and Patient-Reported Symptoms Among Older Workers With Osteoarthritis.

PubMed

Chopp-Hurley, Jaclyn N; Brenneman, Elora C; Wiebenga, Emily G; Bulbrook, Brittany; Keir, Peter J; Maly, Monica R

2017-06-01

The aim of this study was to evaluate the effectiveness of a 12-week workplace exercise program on work ability, performance, and patient-reported symptoms in older university employees with knee and/or hip osteoarthritis. Twenty-four participants with clinical hip and/or knee osteoarthritis were randomized to exercise or no exercise. At baseline and follow-up, several work (work ability, resilience), patient-reported (pain, physical function, depressive symptoms, self-efficacy), and performance outcomes (hip and knee strength, mobility performance) were measured. Significant improvements in work ability (P < 0.049) and patient-reported outcomes (pain, function, depressive symptoms) existed in the exercise group. No improvements were demonstrated in the no exercise group. Exercise in the workplace improved work ability and patient-reported symptoms in older workers with osteoarthritis. The benefits of workplace exercise programs should be studied in a larger sample in which attention is given to improving exercise adherence.

Improving creativity performance by short-term meditation

PubMed Central

2014-01-01

Background One form of meditation intervention, the integrative body-mind training (IBMT) has been shown to improve attention, reduce stress and change self-reports of mood. In this paper we examine whether short-term IBMT can improve performance related to creativity and determine the role that mood may play in such improvement. Methods Forty Chinese undergraduates were randomly assigned to short-term IBMT group or a relaxation training (RT) control group. Mood and creativity performance were assessed by the Positive and Negative Affect Schedule (PANAS) and Torrance Tests of Creative Thinking (TTCT) questionnaire respectively. Results As predicted, the results indicated that short-term (30 min per day for 7 days) IBMT improved creativity performance on the divergent thinking task, and yielded better emotional regulation than RT. In addition, cross-lagged analysis indicated that both positive and negative affect may influence creativity in IBMT group (not RT group). Conclusions Our results suggested that emotion-related creativity-promoting mechanism may be attributed to short-term meditation. PMID:24645871

(Too) optimistic about optimism: the belief that optimism improves performance.

PubMed

Tenney, Elizabeth R; Logg, Jennifer M; Moore, Don A

2015-03-01

A series of experiments investigated why people value optimism and whether they are right to do so. In Experiments 1A and 1B, participants prescribed more optimism for someone implementing decisions than for someone deliberating, indicating that people prescribe optimism selectively, when it can affect performance. Furthermore, participants believed optimism improved outcomes when a person's actions had considerable, rather than little, influence over the outcome (Experiment 2). Experiments 3 and 4 tested the accuracy of this belief; optimism improved persistence, but it did not improve performance as much as participants expected. Experiments 5A and 5B found that participants overestimated the relationship between optimism and performance even when their focus was not on optimism exclusively. In summary, people prescribe optimism when they believe it has the opportunity to improve the chance of success-unfortunately, people may be overly optimistic about just how much optimism can do. PsycINFO Database Record (c) 2015 APA, all rights reserved.

A surgical skills laboratory improves residents' knowledge and performance of episiotomy repair.

PubMed

Banks, Erika; Pardanani, Setul; King, Mary; Chudnoff, Scott; Damus, Karla; Freda, Margaret Comerford

2006-11-01

This study was undertaken to assess whether a surgical skills laboratory improves residents' knowledge and performance of episiotomy repair. Twenty-four first- and second-year residents were randomly assigned to either a surgical skills laboratory on episiotomy repair or traditional teaching alone. Pre- and posttests assessed basic knowledge. Blinded attending physicians assessed performance, evaluating residents on second-degree laceration/episiotomy repairs in the clinical setting with 3 validated tools: a task-specific checklist, global rating scale, and a pass-fail grade. Postgraduate year 1 (PGY-1) residents participating in the laboratory scored significantly better on all 3 surgical assessment tools: the checklist, the global score, and the pass/fail analysis. All the residents who had the teaching laboratory demonstrated significant improvements on knowledge and the skills checklist. PGY-2 residents did not benefit as much as PGY-1 residents. A surgical skills laboratory improved residents' knowledge and performance in the clinical setting. Improvement was greatest for PGY-1 residents.

Motorized mobility scooters – The use of training/intervention and technology for improving driving skills in aging adults - A Mini-Review

PubMed Central

Toosizadeh, Nima; Bunting, Matthew; Howe, Carol; Mohler, Jane; Sprinkle, Jonathan; Najafi, Bijan

2014-01-01

Background Motorized mobility scooters (MMS) have become the most acceptable powered assistive device for those with impaired mobility, who have sufficient upper body strength and dexterity, and postural stability. Although several benefits have been attributed to MMS usage, there are likewise risks of use, including injuries and even deaths. Objective The aim of the current review was to summarize results from clinical studies regarding the enhancement of MMS driver safety with a primary focus on improving driving skills/performance using clinical approaches. We addressed three main objectives: 1) to identify and summarize any available evidence (strong, moderate, or weak evidence based on the quality of studies) regarding improved driving skills/performance following training/intervention; 2) to identify types of driving skills/performance that might be improved by training/intervention; and 3) to identify the use of technology in improving MMS performance or training procedure. Methods Articles were searched for in the following medical and engineering electronic databases: PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov, PsycINFO, CINAHL, ERIC, EI Compendix, IEEE Explore, and REHABDATA. Inclusion criteria included: aging adults or those with ambulatory problems; intervention or targeted training; and clinical trial. Outcomes included: MMS skills/performance. Results Six articles met the inclusion criteria and are analyzed in this review. Four of the six articles contained training approaches for MMS drivers including skill trainings using real MMS inside and outside (i.e., in community) and in a 3D virtual environment. The other two studies contain infrastructural assessments (i.e., the minimum space required for safe maneuverability of MMS users) and additional mobility assistance tools to improve maneuverability and to enhance driving performance. Conclusions Results from the current review showed improved driving skills/performance by training, infrastructural assessments, and incorporating mobility assistance tools. MMS driving skills that can be improved through driver training include: weaving, negotiating with and avoiding pedestrian interference, simultaneous reading of signs and obstacle avoidance in path, level driving, forward and reverse driving, figure 8s, turning in place, crossing left slope, maneuvering down a 2-inch curb, and driving up and down inclines. However, several limitations exist in the available literature regarding evidence of improved driving skills/performance following training/intervention, such as small sample sizes, lack of control groups and statistical analysis. PMID:24481257

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.

Effects of Mindfulness-Based Intervention to Improve Task Performance for Children with Intellectual Disabilities

ERIC Educational Resources Information Center

Kim, Jeongil; Kwon, Miyoung

2018-01-01

Background: 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). Methods: Three elementary school children with ID participated in the study. A multiple baseline…

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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

ERIC Educational Resources Information Center

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

2017-01-01

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

12 CFR Appendix A to Part 345 - Ratings

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (iv) Needs to improve. The FDIC rates a bank's lending performance “needs to improve” if, in general... FDIC rates a bank's investment performance “needs to improve” if, in general, it demonstrates: (A) A... to improve. The FDIC rates a bank's service performance “needs to improve” if, in general, the bank...

12 CFR Appendix A to Part 25 - Ratings

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (iv) Needs to improve. The OCC rates a bank's lending performance “needs to improve” if, in general... OCC rates a bank's investment performance “needs to improve” if, in general, it demonstrates: (A) A... to improve. The OCC rates a bank's service performance “needs to improve” if, in general, the bank...

Priming Ability-Relevant Social Categories Improves Intellectual Test Performance

ERIC Educational Resources Information Center

Lin, Phoebe S.; Kennette, Lynne N.; Van Havermaet, Lisa R.; Frank, Nichole M.; McIntyre, Rusty B.

2012-01-01

Research shows that priming affects behavioral tasks; fewer studies, however, have been conducted on how social category primes affect cognitive tasks. The present study aimed to examine the effects of social category primes on math performance and word recall. It was hypothesized that Asian prime words would improve math performance and word…

The SEA of the Future: Leveraging Performance Management to Support School Improvement. Volume 1

ERIC Educational Resources Information Center

Gross, Betheny, Ed.; Jochim, Ashley, Ed.

2013-01-01

"The SEA of the Future" is an education publication series examining how state education agencies can shift from a compliance to a performance-oriented organization through strategic planning and performance management tools to meet growing demands to support education reform while improving productivity. This inaugural edition of…

Evaluating the Implementation of Performance Improvement Training: The E[superscript 3] Process for Success

ERIC Educational Resources Information Center

Larbi-Apau, Josephine A.; Moseley, James L.

2008-01-01

This article provides a comprehensive approach to careful review and evaluation of the implementation of performance training intervention. It discusses the E[superscript 3] process for success, a basic framework for evaluating the implementation phase of a training program implemented as a broad-based performance improvement strategy. The intent…

Influence of Integration of Information Communication Technology in Teaching on Students' Academic Performance

ERIC Educational Resources Information Center

Mbugua, Stephen Ngugi; Kiboss, Joel; Tanui, Edward

2015-01-01

Teachers must understand the context within which students' performance improvement takes place. Operational effectiveness and strategy are both essential to superior performance and strategy execution is crucial for quality and better students' academic result. ICT can be a catalyst by providing tools which teachers use to improve teaching and…

Improving Student Performance through Computer-Based Assessment: Insights from Recent Research.

ERIC Educational Resources Information Center

Ricketts, C.; Wilks, S. J.

2002-01-01

Compared student performance on computer-based assessment to machine-graded multiple choice tests. Found that performance improved dramatically on the computer-based assessment when students were not required to scroll through the question paper. Concluded that students may be disadvantaged by the introduction of online assessment unless care is…

Improved Fuzzy Modelling to Predict the Academic Performance of Distance Education Students

ERIC Educational Resources Information Center

Yildiz, Osman; Bal, Abdullah; Gulsecen, Sevinc

2013-01-01

It is essential to predict distance education students' year-end academic performance early during the course of the semester and to take precautions using such prediction-based information. This will, in particular, help enhance their academic performance and, therefore, improve the overall educational quality. The present study was on the…

Goal Setting and Task Performance: 1969-1980

DTIC Science & Technology

1980-06-01

self - esteem showed greater performance improvement than individuals with low self - esteem ...There was no self - esteem effect when instrumentality was high. When self - esteem was low , typists who perceived high goal instrumentality showed greater...performance improvement than M. 49 those with low goal instrumentality; when self - esteem was high, there was no instrumentality effect.

Two-well terahertz quantum cascade lasers with suppressed carrier leakage

DOE PAGES

Albo, Asaf; Flores, Yuri V.; Hu, Qing; ...

2017-09-11

The mechanisms that limit the temperature performance of diagonal GaAs/Al 0.15GaAs 0.85-based terahertz quantum cascade lasers (THz-QCLs) have been identified as thermally activated leakage of charge carriers through excited states into the continuum. THz-QCLs with energetically higher-laying excited states supported by sufficiently high barriers aim to eliminate these leakage mechanisms and lead to improved temperature performance. Although suppression of thermally activated carrier leakage was realized in a three-well THz-QCL based on a resonant-phonon scheme, no improvement in the temperature performance was reported thus far. Here, we report a major improvement in the temperature performance of a two-quantum-well direct-phonon THz-QCL structure.more » We show that the improved laser performance is due to the suppression of the thermally activated carrier leakage into the continuum with the increase in the injection barrier height. Furthermore, we demonstrate that high-barrier two-well structures can support a clean three-level laser system at elevated temperatures, which opens the opportunity to achieve temperature performance beyond the state-of-the-art.« less

Two-well terahertz quantum cascade lasers with suppressed carrier leakage

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

Albo, Asaf; Flores, Yuri V.; Hu, Qing

The mechanisms that limit the temperature performance of diagonal GaAs/Al 0.15GaAs 0.85-based terahertz quantum cascade lasers (THz-QCLs) have been identified as thermally activated leakage of charge carriers through excited states into the continuum. THz-QCLs with energetically higher-laying excited states supported by sufficiently high barriers aim to eliminate these leakage mechanisms and lead to improved temperature performance. Although suppression of thermally activated carrier leakage was realized in a three-well THz-QCL based on a resonant-phonon scheme, no improvement in the temperature performance was reported thus far. Here, we report a major improvement in the temperature performance of a two-quantum-well direct-phonon THz-QCL structure.more » We show that the improved laser performance is due to the suppression of the thermally activated carrier leakage into the continuum with the increase in the injection barrier height. Furthermore, we demonstrate that high-barrier two-well structures can support a clean three-level laser system at elevated temperatures, which opens the opportunity to achieve temperature performance beyond the state-of-the-art.« less

Modeling and investigation of refrigeration system performance with two-phase fluid injection in a scroll compressor

NASA Astrophysics Data System (ADS)

Gu, Rui

Vapor compression cycles are widely used in heating, refrigerating and air-conditioning. A slight performance improvement in the components of a vapor compression cycle, such as the compressor, can play a significant role in saving energy use. However, the complexity and cost of these improvements can block their application in the market. Modifying the conventional cycle configuration can offer a less complex and less costly alternative approach. Economizing is a common modification for improving the performance of the refrigeration cycle, resulting in decreasing the work required to compress the gas per unit mass. Traditionally, economizing requires multi-stage compressors, the cost of which has restrained the scope for practical implementation. Compressors with injection ports, which can be used to inject economized refrigerant during the compression process, introduce new possibilities for economization with less cost. This work focuses on computationally investigating a refrigeration system performance with two-phase fluid injection, developing a better understanding of the impact of injected refrigerant quality on refrigeration system performance as well as evaluating the potential COP improvement that injection provides based on refrigeration system performance provided by Copeland.

Two-well terahertz quantum cascade lasers with suppressed carrier leakage

NASA Astrophysics Data System (ADS)

Albo, Asaf; Flores, Yuri V.; Hu, Qing; Reno, John L.

2017-09-01

The mechanisms that limit the temperature performance of diagonal GaAs/Al0.15GaAs0.85-based terahertz quantum cascade lasers (THz-QCLs) have been identified as thermally activated leakage of charge carriers through excited states into the continuum. THz-QCLs with energetically higher-laying excited states supported by sufficiently high barriers aim to eliminate these leakage mechanisms and lead to improved temperature performance. Although suppression of thermally activated carrier leakage was realized in a three-well THz-QCL based on a resonant-phonon scheme, no improvement in the temperature performance was reported thus far. Here, we report a major improvement in the temperature performance of a two-quantum-well direct-phonon THz-QCL structure. We show that the improved laser performance is due to the suppression of the thermally activated carrier leakage into the continuum with the increase in the injection barrier height. Moreover, we demonstrate that high-barrier two-well structures can support a clean three-level laser system at elevated temperatures, which opens the opportunity to achieve temperature performance beyond the state-of-the-art.

Visuospatial training improves elementary students' mathematics performance.

PubMed

Lowrie, Tom; Logan, Tracy; Ramful, Ajay

2017-06-01

Although spatial ability and mathematics performance are highly correlated, there is scant research on the extent to which spatial ability training can improve mathematics performance. This study evaluated the efficacy of a visuospatial intervention programme within classrooms to determine the effect on students' (1) spatial reasoning and (2) mathematics performance as a result of the intervention. The study involved grade six students (ages 10-12) in eight classes. There were five intervention classes (n = 120) and three non-intervention control classes (n = 66). A specifically designed 10-week spatial reasoning programme was developed collaboratively with the participating teachers, with the intervention replacing the standard mathematics curriculum. The five classroom teachers in the intervention programme presented 20 hr of activities aimed at enhancing students' spatial visualization, mental rotation, and spatial orientation skills. The spatial reasoning programme led to improvements in both spatial ability and mathematics performance relative to the control group who received standard mathematics instruction. Our study is the first to show that a classroom-based spatial reasoning intervention improves elementary school students' mathematics performance. © 2017 The British Psychological Society.

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.

Development of a Scintillation Detector and the Influence on Clinical Imaging

NASA Astrophysics Data System (ADS)

Panetta, Joseph Vincent

The detector is the functional unit within a Positron Emission Tomography (PET) scanner, serving to convert the energy of radiation emitted from a patient into positional information, and as such contributes significantly to the performance of the scanner. Excellent spatial resolution in continuous detectors that are thick has proven difficult to achieve using simple positioning algorithms, leading to research in the field to improve performance. This thesis aims to investigate the effect of modifications to the scintillation light spread within the bulk of the scintillator to improve performance, focusing on the use of laser induced optical barriers (LIOBs) etched within thick continuous crystals, and furthermore aims to translate the effect on detector performance to scanner quantitation in patient studies. The conventional continuous detector is first investigated by analyzing the various components of the detector as well as its limitations. It is seen that the performance of the detector is affected by a number of variables that either cannot be improved or may be improved only at the expense of greater complexity or computing time; these include the photodetector, the positioning algorithm, and Compton scatter in the detector. The performance of the detectors, however, is fundamentally determined by the light spread within the detector, and limited by the depth-dependence of the light spread and poor performance in the entrance region, motivating efforts to modify this aspect of the detector. The feasibility and potential of LIOBs to fine-tune this light spread and improve these limitations is then studied using both experiments and simulations. The behavior of the LIOBs in response to optical light is investigated, and the opacity of the etchings is shown to be dependent on the parameters of the etching procedure. Thick crystals were also etched with LIOBs in their entrance region in a grid pattern in order to improve the resolution in the entrance region. Measurements show an overall improvement in spatial resolution: the resolution in the etched region of the crystals is slightly improved (e.g., 0.8mm for a 25mm thick crystal), though in the unetched region, it is slightly degraded (e.g., 0.4mm for a 25mm thick crystal). While the depth-dependence of the response of the crystal is decreased, the depth-of-interaction (DOI) performance is degraded as well. Simulation studies informed by these measurements show that the properties of the LIOBs strongly affect the performance of the crystal, and ultimately further illustrate that trade-offs in spatial resolution, position sampling, and DOI resolution are inherent in varying the light spread using LIOBs in this manner; these may be used as a guide for future experiments. System Monte Carlo simulations were used to investigate the added benefit of improved detector spatial resolution and position sampling to the imaging performance of a whole-body scanner. These simulations compared the performance of scanners composed of conventional pixelated detectors to that of scanners using continuous crystals. Results showed that the improved performance (relative to that of 4-mm pixelated detectors) of continuous crystals with a 2-mm resolution, pertinent to both the etched 14mm thick crystal studied as well as potential designs with the etched 25mm thick crystal, increased the mean contrast recovery coefficient (CRC) of images by 22% for 5.5mm spheres. Last, a set of experiments aimed to test the correspondence between quantification in phantom and patient images using a lesion embedding methodology, so that any improvements determined using phantom studies may be understood clinically. The results show that the average CRC values for lesions embedded in the lung and liver agree well with those for lesions embedded in the phantom for all lesion sizes. In addition, the relative changes in CRC resulting from application of post-filters on the subject and phantom images are consistent within measurement uncertainty. This study shows that the improvements in CRC resulting from improved spatial resolution, measured using phantom studies in the simulations, are representative of improvements in quantitative accuracy in patient studies. While unmodified thick continuous detectors hold promise for both improved image quality and quantitation in whole-body imaging, excellent performance requires intensive hardware and computational solutions. Laser induced optical barriers offer the ability to modify the light spread within the scintillator to improve the intrinsic performance of the detector: while measurements with crystals etched with relatively transmissive etchings show a slight improvement in resolution, simulations show that the LIOBs may be fine-tuned to result in improved performance using relatively simple positioning algorithms. For systems in which DOI information is less important, and transverse resolution and sensitivity are paramount, etching thick detectors with this design, fine-tuned to the particular thickness of the crystal and application, is an interesting alternative to the standard detector design. (Abstract shortened by ProQuest.).

42 CFR 460.132 - Quality assessment and performance improvement plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132 Quality...

42 CFR 460.132 - Quality assessment and performance improvement plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132 Quality...

42 CFR 418.58 - Condition of participation: Quality assessment and performance improvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

.... The hospice must develop, implement, and maintain an effective, ongoing, hospice-wide data-driven... learning throughout the hospice. (3) The hospice must take actions aimed at performance improvement and...

42 CFR 418.58 - Condition of participation: Quality assessment and performance improvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

.... The hospice must develop, implement, and maintain an effective, ongoing, hospice-wide data-driven... learning throughout the hospice. (3) The hospice must take actions aimed at performance improvement and...

42 CFR 418.58 - Condition of participation: Quality assessment and performance improvement.

Code of Federal Regulations, 2012 CFR

2012-10-01

.... The hospice must develop, implement, and maintain an effective, ongoing, hospice-wide data-driven... learning throughout the hospice. (3) The hospice must take actions aimed at performance improvement and...

RETROFITTING POTW

EPA Science Inventory

This manual is intended as a source document for individuals responsible for improving the performance of an existing, non-complying wastewater treatment facility. Described are: 1) methods to evaluate an existing facility's capability to achieve improved performance, 2) a ...

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.

Use Deflected Trailing Edge to Improve the Aerodynamic Performance and Develop Low Solidity LPT Cascade

NASA Astrophysics Data System (ADS)

Chao, Li; Peigang, Yan; Xiangfeng, Wang; Wanjin, Han; Qingchao, Wang

2017-08-01

This paper investigates the feasibility of improving the aerodynamic performance of low pressure turbine (LPT) blade cascades and developing low solidity LPT blade cascades through deflected trailing edge. A deflected trailing edge improved aerodynamic performance of both LPT blade cascades and low solidity LPT blade cascades. For standard solidity LPT cascades, deflecting the trailing edge can decrease the energy loss coefficient by 20.61 % for a Reynolds number (Re) of 25,000 and freestream turbulence intensities (FSTI) of 1 %. For a low solidity LPT cascade, aerodynamic performance was also improved by deflecting the trailing edge. Solidity of the LPT cascade can be reduced by 12.5 % for blades with a deflected trailing edge without a drop in efficiency. Here, the flow control mechanism surrounding a deflected trailing edge was also revealed.

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.

Low thrust chemical rocket technology

NASA Technical Reports Server (NTRS)

Schneider, Steven J.

1992-01-01

An on-going technology program to improve the performance of low thrust chemical rockets for spacecraft on-board propulsion applications is reviewed. Improved performance and lifetime is sought by the development of new predictive tools to understand the combustion and flow physics, introduction of high temperature materials and improved component designs to optimize performance, and use of higher performance propellants. Improved predictive technology is sought through the comparison of both local and global predictions with experimental data. Predictions are based on both the RPLUS Navier-Stokes code with finite rate kinetics and the JANNAF methodology. Data were obtained with laser-based diagnostics along with global performance measurements. Results indicate that the modeling of the injector and the combustion process needs improvement in these codes and flow visualization with a technique such as 2-D laser induced fluorescence (LIF) would aid in resolving issues of flow symmetry and shear layer combustion processes. High temperature material fabrication processes are under development and small rockets are being designed, fabricated, and tested using these new materials. Rhenium coated with iridium for oxidation protection was produced by the Chemical Vapor Deposition (CVD) process and enabled an 800 K increase in rocket operating temperature. Performance gains with this material in rockets using Earth storable propellants (nitrogen tetroxide and monomethylhydrazine or hydrazine) were obtained through component redesign to eliminate fuel film cooling and its associated combustion inefficiency while managing head end thermal soakback. Material interdiffusion and oxidation characteristics indicated that the requisite lifetimes of tens of hours were available for thruster applications. Rockets were designed, fabricated, and tested with thrusts of 22, 62, 440 and 550 N. Performance improvements of 10 to 20 seconds specific impulse were demonstrated. Higher performance propellants were evaluated: Space storable propellants, including liquid oxygen (LOX) as the oxidizer with nitrogen hydrides or hydrocarbon as fuels. Specifically, a LOX/hydrazine engine was designed, fabricated, and shown to have a 95 pct theoretical c-star which translates into a projected vacuum specific impulse of 345 seconds at an area ratio of 204:1. Further performance improvment can be obtained by the use of LOX/hydrogen propellants, especially for manned spacecraft applications, and specific designs must be developed and advanced through flight qualification.

Does real-time objective feedback and competition improve performance and quality in manikin CPR training--a prospective observational study from several European EMS.

PubMed

Smart, J R; Kranz, K; Carmona, F; Lindner, T W; Newton, A

2015-10-15

Previous studies have reported that the quality of cardiopulmonary resuscitation (CPR) is important for patient survival. Real time objective feedback during manikin training has been shown to improve CPR performance. Objective measurement could facilitate competition and help motivate participants to improve their CPR performance. The aims of this study were to investigate whether real time objective feedback on manikins helps improve CPR performance and whether competition between separate European Emergency Medical Services (EMS) and between participants at each EMS helps motivation to train. Ten European EMS took part in the study and was carried out in two stages. At Stage 1, each EMS provided 20 pre-hospital professionals. A questionnaire was completed and standardised assessment scenarios were performed for adult and infant out of hospital cardiac arrest (OHCA). CPR performance was objectively measured and recorded but no feedback given. Between Stage 1 and 2, each EMS was given access to manikins for 6 months and instructed on how to use with objective real-time CPR feedback available. Stage 2 was undertaken and was a repeat of Stage 1 with a questionnaire with additional questions relating to usefulness of feedback and the competition nature of the study (using a 10 point Likert score). The EMS that improved the most from Stage 1 to Stage 2 was declared the winner. An independent samples Student t-test was used to analyse the objective CPR metrics with the significance level taken as p < 0.05. Overall mean Improvement of CPR performance from Stage 1 to Stage 2 was significant. The improvement was greater for the infant assessment. The participants thought the real-time feedback very useful (mean score of 8.5) and very easy to use (mean score of 8.2). Competition between EMS organisations recorded a mean score of 5.8 and competition between participants recorded a mean score of 6.0. The results suggest that the use of real time objective feedback can significantly help improve CPR performance. Competition, especially between participants, appeared to encourage staff to practice and this study suggests that competition might have a useful role to help motivate staff to perform CPR training.

Importance of Indigenous Breeds of Chicken for Rural Economy and Their Improvements for Higher Production Performance

PubMed Central

Padhi, Mahendra Kumar

2016-01-01

Indigenous/native breeds of chickens are playing an important role in rural economies in most of the developing and underdeveloped countries. They play a major role for the rural poor and marginalised section of the people with respect to their subsidiary income and also provide them with nutritious chicken egg and meat for their own consumption. Performance of native fowl can be improved by change in husbandry, feeding, and better health cover. However, genetic improvement may be made either through selection and crossbreeding or by utilisation of both selection and crossbreeding. Improvement through selection may be time consuming but the improvement will be permanent. Through crossbreeding improvement may be faster but research has to aim for the production of native-type birds with higher production potential. In the present review efforts have been made to present the importance of native fowl to rural economy and their improvement for higher production performance. PMID:27144053

Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs.

PubMed

Konetzka, R Tamara; Skira, Meghan M; Werner, Rachel M

2018-01-01

Pay-for-performance (P4P) programs have become a popular policy tool aimed at improving health care quality. We analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented P4P programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, we examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in those measures. We find larger weights on clinical outcomes often lead to larger improvements, but small weights can lead to no improvement or worsening of some clinical outcomes. We find a qualifier for P4P eligibility based on having few or no severe inspection deficiencies is more effective at decreasing inspection deficiencies than using weights, suggesting simple rules for participation may incent larger improvement.

Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs

PubMed Central

Konetzka, R. Tamara; Skira, Meghan M.; Werner, Rachel M.

2017-01-01

Pay-for-performance (P4P) programs have become a popular policy tool aimed at improving health care quality. We analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented P4P programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, we examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in those measures. We find larger weights on clinical outcomes often lead to larger improvements, but small weights can lead to no improvement or worsening of some clinical outcomes. We find a qualifier for P4P eligibility based on having few or no severe inspection deficiencies is more effective at decreasing inspection deficiencies than using weights, suggesting simple rules for participation may incent larger improvement. PMID:29594189

Measuring Performance Excellence: Key Performance Indicators for Institutions Accepted into the Academic Quality Improvement Program (AQIP)

ERIC Educational Resources Information Center

Ballard, Paul J.

2013-01-01

Given growing interest in accountability and outcomes, the North Central Association's Higher Learning Commission developed a new path for accreditation, the Academic Quality Improvement Program (AQIP). The goal is to infuse continuous improvement and quality in the culture of higher education, and to blend traditional accreditation with the…

Using Six Sigma for Performance Improvement in Business Curriculum: A Case Study

ERIC Educational Resources Information Center

Kukreja, Anil; Ricks, Joe M., Jr.; Meyer, Jean A.

2009-01-01

During the last few decades, a number of quality improvement methodologies have been used by organizations. This article provides a brief review of the quality improvement literature related to academia and a case study using Six Sigma methodology to analyze students' performance in a standardized examination. We found Six Sigma to be an effective…

The Empirical Relationship among Organisational Learning, Continuous Improvement and Performance Improvement

ERIC Educational Resources Information Center

Sun, Hongyi; Ho, Kario; Ni, Wenbin

2008-01-01

There are still many questions remain unanswered about the relationship between Organisational Learning (OL) and Continuous Improvement (CI). For example, how do OL and CI contribute to business performance? Are OL and CI equal? Do OL and CI support each other? Should OL and CI be implemented separately or together? If together, how to integrate…

Are Low-Performing Schools Adopting Practices Promoted by School Improvement Grants? NCEE Evaluation Brief. NCEE 2015-4001

ERIC Educational Resources Information Center

Herrmann, Mariesa; Dragoset, Lisa; James-Burdumy, Susanne

2014-01-01

The federal School Improvement Grants (SIG) program aims to improve student achievement by promoting the implementation of four school intervention models: transformation, turnaround, restart, and closure. Previous research provides evidence that low-performing schools adopt some practices promoted by the four models, but little is known about how…

Study Abroad Field Trip Improves Test Performance through Engagement and New Social Networks

ERIC Educational Resources Information Center

Houser, Chris; Brannstrom, Christian; Quiring, Steven M.; Lemmons, Kelly K.

2011-01-01

Although study abroad trips provide an opportunity for affective and cognitive learning, it is largely assumed that they improve learning outcomes. The purpose of this study is to determine whether a study abroad field trip improved cognitive learning by comparing test performance between the study abroad participants (n = 20) and their peers who…

Providing the Answers Does Not Improve Performance on a College Final Exam

ERIC Educational Resources Information Center

Glass, Arnold Lewis; Sinha, Neha

2013-01-01

In the context of an upper-level psychology course, even when students were given an opportunity to refer to text containing the answers and change their exam responses in order to improve their exam scores, their performance on these questions improved slightly or not at all. Four experiments evaluated competing explanations for the students'…

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.

A High Performance SOAP Engine for Grid Computing

NASA Astrophysics Data System (ADS)

Wang, Ning; Welzl, Michael; Zhang, Liang

Web Service technology still has many defects that make its usage for Grid computing problematic, most notably the low performance of the SOAP engine. In this paper, we develop a novel SOAP engine called SOAPExpress, which adopts two key techniques for improving processing performance: SCTP data transport and dynamic early binding based data mapping. Experimental results show a significant and consistent performance improvement of SOAPExpress over Apache Axis.

Evaluating brain-computer interface performance using color in the P300 checkerboard speller.

PubMed

Ryan, D B; Townsend, G; Gates, N A; Colwell, K; Sellers, E W

2017-10-01

Current Brain-Computer Interface (BCI) systems typically flash an array of items from grey to white (GW). The objective of this study was to evaluate BCI performance using uniquely colored stimuli. In addition to the GW stimuli, the current study tested two types of color stimuli (grey to color [GC] and color intensification [CI]). The main hypotheses were that in a checkboard paradigm, unique color stimuli will: (1) increase BCI performance over the standard GW paradigm; (2) elicit larger event-related potentials (ERPs); and, (3) improve offline performance with an electrode selection algorithm (i.e., Jumpwise). Online results (n=36) showed that GC provides higher accuracy and information transfer rate than the CI and GW conditions. Waveform analysis showed that GC produced higher amplitude ERPs than CI and GW. Information transfer rate was improved by the Jumpwise-selected channel locations in all conditions. Unique color stimuli (GC) improved BCI performance and enhanced ERPs. Jumpwise-selected electrode locations improved offline performance. These results show that in a checkerboard paradigm, unique color stimuli increase BCI performance, are preferred by participants, and are important to the design of end-user applications; thus, could lead to an increase in end-user performance and acceptance of BCI technology. Copyright © 2017 International Federation of Clinical Neurophysiology. All rights reserved.

Running with horizontal pulling forces: the benefits of towing.

PubMed

Grabowski, Alena M; Kram, Rodger

2008-10-01

Towing, or running with a horizontal pulling force, is a common technique used by adventure racing teams. During an adventure race, the slowest person on a team determines the team's overall performance. To improve overall performance, a faster runner tows a slower runner with an elastic cord attached to their waists. Our purpose was to create and validate a model that predicts the optimal towing force needed by two runners to achieve their best overall performance. We modeled the effects of towing forces between two runners that differ in solo 10-km performance time and/or body mass. We calculated the overall time that could be saved with towing for running distances of 10, 20, and 42.2-km based on equations from previous research. Then, we empirically tested our 10-km model on 15 runners. Towing improved overall running performance considerably and our model accurately predicted this performance improvement. For example, if two runners (a 70 kg runner with a 35 min solo 10-km time and a 70-kg runner with a 50-min solo 10-km time) maintain an optimal towing force throughout a 10-km race, they can improve overall performance by 15%, saving almost 8 min. Ultimately, the race performance time and body mass of each runner determine the optimal towing force.

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.

Improving performance in golf: current research and implications from a clinical perspective.

PubMed

Evans, Kerrie; Tuttle, Neil

2015-01-01

Golf, a global sport enjoyed by people of all ages and abilities, involves relatively long periods of low intensity exercise interspersed with short bursts of high intensity activity. To meet the physical demands of full swing shots and the mental and physical demands of putting and walking the course, it is frequently recommended that golfers undertake golf-specific exercise programs. Biomechanics, motor learning, and motor control research has increased the understanding of the physical requirements of the game, and using this knowledge, exercise programs aimed at improving golf performance have been developed. However, while it is generally accepted that an exercise program can improve a golfer's physical measurements and some golf performance variables, translating the findings from research into clinical practice to optimise an individual golfer's performance remains challenging. This paper discusses how biomechanical and motor control research has informed current practice and discusses how emerging sophisticated tools and research designs may better assist golfers improve their performance.

Improving performance in golf: current research and implications from a clinical perspective

PubMed Central

Evans, Kerrie; Tuttle, Neil

2015-01-01

Golf, a global sport enjoyed by people of all ages and abilities, involves relatively long periods of low intensity exercise interspersed with short bursts of high intensity activity. To meet the physical demands of full swing shots and the mental and physical demands of putting and walking the course, it is frequently recommended that golfers undertake golf-specific exercise programs. Biomechanics, motor learning, and motor control research has increased the understanding of the physical requirements of the game, and using this knowledge, exercise programs aimed at improving golf performance have been developed. However, while it is generally accepted that an exercise program can improve a golfer's physical measurements and some golf performance variables, translating the findings from research into clinical practice to optimise an individual golfer's performance remains challenging. This paper discusses how biomechanical and motor control research has informed current practice and discusses how emerging sophisticated tools and research designs may better assist golfers improve their performance. PMID:26537808

Motivation for documentation.

PubMed

Graham, Denise H

2004-11-01

The quality improvement plan relies on controlling quality of care through improving the process or system as a whole. Your ongoing data collection is paramount to the process of system-wide improvement and performance, enhancement of financial performance, operational performance and overall service performance and satisfaction. The threat of litigation and having to defend yourself from a claim of wrongdoing still looms every time your wheels turn. Your runsheet must serve and protect you. Look at the NFPA 1710 standard, which was enacted to serve and protect firefighters. This standard was enacted with their personal safety and well-being as the principle behind staffing requirements. At what stage of draft do you suppose the NFPA 1710 standard would be today if the relative data were collected sporadically or were not tracked for each service-related death? It may have taken many more service-related deaths to effect change for a system-wide improvement in operational performance. Every call merits documentation and data collection. Your data are catalysts for change.

Parametric studies of phase change thermal energy storage canisters for Space Station Freedom

NASA Technical Reports Server (NTRS)

Kerslake, Thomas W.

1991-01-01

Phase Change Materials (PCM) canister parametric studies are discussed wherein the thermal-structural effects of changing various canister dimensions and contained PCM mass values are examined. With the aim of improving performance, 11 modified canister designs are analyzed and judged relative to a baseline design using five quantitative performance indicators. Consideration is also given to qualitative factors such as fabrication/inspection, canister mass production, and PCM containment redundancy. Canister thermal analyses are performed using the finite-difference based computer program NUCAM-2DV. Thermal-stresses are calculated using closed-form solutions and simplifying assumptions. Canister wall thickness, outer radius, length, and contained PCM mass are the parameters considered for this study. Results show that singular canister design modifications can offer improvements on one or two performance indicators. Yet, improvement in one indicator is often realized at the expense of another. This confirms that the baseline canister is well designed. However, two alternative canister designs, which incorporate multiple modifications, are presented that offer modest improvements in mass or thermal performance, respectively.

Optimisation of active suspension control inputs for improved vehicle handling performance

NASA Astrophysics Data System (ADS)

Čorić, Mirko; Deur, Joško; Kasać, Josip; Tseng, H. Eric; Hrovat, Davor

2016-11-01

Active suspension is commonly considered under the framework of vertical vehicle dynamics control aimed at improvements in ride comfort. This paper uses a collocation-type control variable optimisation tool to investigate to which extent the fully active suspension (FAS) application can be broaden to the task of vehicle handling/cornering control. The optimisation approach is firstly applied to solely FAS actuator configurations and three types of double lane-change manoeuvres. The obtained optimisation results are used to gain insights into different control mechanisms that are used by FAS to improve the handling performance in terms of path following error reduction. For the same manoeuvres the FAS performance is compared with the performance of different active steering and active differential actuators. The optimisation study is finally extended to combined FAS and active front- and/or rear-steering configurations to investigate if they can use their complementary control authorities (over the vertical and lateral vehicle dynamics, respectively) to further improve the handling performance.

Delayed benefit of naps on motor learning in preschool children.

PubMed

Desrochers, Phillip C; Kurdziel, Laura B F; Spencer, Rebecca M C

2016-03-01

Sleep benefits memory consolidation across a variety of domains in young adults. However, while declarative memories benefit from sleep in young children, such improvements are not consistently seen for procedural skill learning. Here we examined whether performance improvements on a procedural task, although not immediately observed, are evident after a longer delay when augmented by overnight sleep (24 h after learning). We trained 47 children, aged 33-71 months, on a serial reaction time task and, using a within-subject design, evaluated performance at three time points: immediately after learning, after a daytime nap (nap condition) or equivalent wake opportunity (wake condition), and 24 h after learning. Consistent with previous studies, performance improvements following the nap did not differ from performance improvements following an equivalent interval spent awake. However, significant benefits of the nap were found when performance was assessed 24 h after learning. This research demonstrates that motor skill learning is benefited by sleep, but that this benefit is only evident after an extended period of time.

Improving motor performance without training: the effect of combining mirror visual feedback with transcranial direct current stimulation.

PubMed

von Rein, Erik; Hoff, Maike; Kaminski, Elisabeth; Sehm, Bernhard; Steele, Christopher J; Villringer, Arno; Ragert, Patrick

2015-04-01

Mirror visual feedback (MVF) during motor training has been shown to improve motor performance of the untrained hand. Here we thought to determine if MVF-induced performance improvements of the left hand can be augmented by upregulating plasticity in right primary motor cortex (M1) by means of anodal transcranial direct current stimulation (a-tDCS) while subjects trained with the right hand. Participants performed a ball-rotation task with either their left (untrained) or right (trained) hand on two consecutive days (days 1 and 2). During training with the right hand, MVF was provided concurrent with two tDCS conditions: group 1 received a-tDCS over right M1 (n = 10), whereas group 2 received sham tDCS (s-tDCS, n = 10). On day 2, performance was reevaluated under the same experimental conditions compared with day 1 but without tDCS. While baseline performance of the left hand (day 1) was not different between groups, a-tDCS exhibited stronger MVF-induced performance improvements compared with s-tDCS. Similar results were observed for day 2 (without tDCS application). A control experiment (n = 8) with a-tDCS over right M1 as outlined above but without MVF revealed that left hand improvement was significantly less pronounced than that induced by combined a-tDCS and MVF. Based on these results, we provide novel evidence that upregulating activity in the untrained M1 by means of a-tDCS is capable of augmenting MVF-induced performance improvements in young normal volunteers. Our findings suggest that concurrent MVF and tDCS might have synergistic and additive effects on motor performance of the untrained hand, a result of relevance for clinical approaches in neurorehabilitation and/or exercise science. Copyright © 2015 the American Physiological Society.

High-Performance, Multi-Node File Copies and Checksums for Clustered File Systems

NASA Technical Reports Server (NTRS)

Kolano, Paul Z.; Ciotti, Robert B.

2012-01-01

Modern parallel file systems achieve high performance using a variety of techniques, such as striping files across multiple disks to increase aggregate I/O bandwidth and spreading disks across multiple servers to increase aggregate interconnect bandwidth. To achieve peak performance from such systems, it is typically necessary to utilize multiple concurrent readers/writers from multiple systems to overcome various singlesystem limitations, such as number of processors and network bandwidth. The standard cp and md5sum tools of GNU coreutils found on every modern Unix/Linux system, however, utilize a single execution thread on a single CPU core of a single system, and hence cannot take full advantage of the increased performance of clustered file systems. Mcp and msum are drop-in replacements for the standard cp and md5sum programs that utilize multiple types of parallelism and other optimizations to achieve maximum copy and checksum performance on clustered file systems. Multi-threading is used to ensure that nodes are kept as busy as possible. Read/write parallelism allows individual operations of a single copy to be overlapped using asynchronous I/O. Multinode cooperation allows different nodes to take part in the same copy/checksum. Split-file processing allows multiple threads to operate concurrently on the same file. Finally, hash trees allow inherently serial checksums to be performed in parallel. Mcp and msum provide significant performance improvements over standard cp and md5sum using multiple types of parallelism and other optimizations. The total speed-ups from all improvements are significant. Mcp improves cp performance over 27x, msum improves md5sum performance almost 19x, and the combination of mcp and msum improves verified copies via cp and md5sum by almost 22x. These improvements come in the form of drop-in replacements for cp and md5sum, so are easily used and are available for download as open source software at http://mutil.sourceforge.net.

Feature engineering for MEDLINE citation categorization with MeSH.

PubMed

Jimeno Yepes, Antonio Jose; Plaza, Laura; Carrillo-de-Albornoz, Jorge; Mork, James G; Aronson, Alan R

2015-04-08

Research in biomedical text categorization has mostly used the bag-of-words representation. Other more sophisticated representations of text based on syntactic, semantic and argumentative properties have been less studied. In this paper, we evaluate the impact of different text representations of biomedical texts as features for reproducing the MeSH annotations of some of the most frequent MeSH headings. In addition to unigrams and bigrams, these features include noun phrases, citation meta-data, citation structure, and semantic annotation of the citations. Traditional features like unigrams and bigrams exhibit strong performance compared to other feature sets. Little or no improvement is obtained when using meta-data or citation structure. Noun phrases are too sparse and thus have lower performance compared to more traditional features. Conceptual annotation of the texts by MetaMap shows similar performance compared to unigrams, but adding concepts from the UMLS taxonomy does not improve the performance of using only mapped concepts. The combination of all the features performs largely better than any individual feature set considered. In addition, this combination improves the performance of a state-of-the-art MeSH indexer. Concerning the machine learning algorithms, we find that those that are more resilient to class imbalance largely obtain better performance. We conclude that even though traditional features such as unigrams and bigrams have strong performance compared to other features, it is possible to combine them to effectively improve the performance of the bag-of-words representation. We have also found that the combination of the learning algorithm and feature sets has an influence in the overall performance of the system. Moreover, using learning algorithms resilient to class imbalance largely improves performance. However, when using a large set of features, consideration needs to be taken with algorithms due to the risk of over-fitting. Specific combinations of learning algorithms and features for individual MeSH headings could further increase the performance of an indexing system.

Autogenic-feedback training improves pilot performance during emergency flying conditions

NASA Technical Reports Server (NTRS)

Kellar, Michael A.; Folen, Raymond A.; Cowings, Patricia S.; Toscano, William B.; Hisert, Glen L.

1994-01-01

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group comprised three pilots of HC-130 Hercules aircraft and four HH-65 Dolphin helicopter pilots; the control group comprised three pilots of HC-130's and six Dolphin helicopter pilots. During an initial flight, physiological data were recorded for each crew member and individual crew performance was rated by an instructor pilot. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training (AFT). The remaining subjects received no training. During a second flight, treatment subjects showed significant improvement in performance, while controls did not improve. The results indicate that AFT management of high states of physiological arousal may improve pilot performance during emergency flying conditions.

Autogenic-feedback training improves pilot performance during emergency flying conditions

NASA Technical Reports Server (NTRS)

Kellar, Michael A.; Folen, Raymond A.; Cowings, Patricia S.; Toscano, William B.; Hisert, Glen L.

1993-01-01

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. The effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance was examined. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group comprised four pilots of HC-130 Hercules aircraft and four HH-65 Dolphin helicopter pilots; the control group comprised three pilots of HC-130's and six Dolphin helicopter pilots. During an initial flight physiological data were recorded for each crewmember and individual crew performance and rated by an instructor pilot. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training (AFT). The remaining subjects received no training. During a second flight, treatment subjects showed significant improvement in performance, while controls did not improve. The results indicate that AFT management of high states of physiological arousal may improve pilot performance during emergency flying conditions.

Improving the signal subtle feature extraction performance based on dual improved fractal box dimension eigenvectors

NASA Astrophysics Data System (ADS)

Chen, Xiang; Li, Jingchao; Han, Hui; Ying, Yulong

2018-05-01

Because of the limitations of the traditional fractal box-counting dimension algorithm in subtle feature extraction of radiation source signals, a dual improved generalized fractal box-counting dimension eigenvector algorithm is proposed. First, the radiation source signal was preprocessed, and a Hilbert transform was performed to obtain the instantaneous amplitude of the signal. Then, the improved fractal box-counting dimension of the signal instantaneous amplitude was extracted as the first eigenvector. At the same time, the improved fractal box-counting dimension of the signal without the Hilbert transform was extracted as the second eigenvector. Finally, the dual improved fractal box-counting dimension eigenvectors formed the multi-dimensional eigenvectors as signal subtle features, which were used for radiation source signal recognition by the grey relation algorithm. The experimental results show that, compared with the traditional fractal box-counting dimension algorithm and the single improved fractal box-counting dimension algorithm, the proposed dual improved fractal box-counting dimension algorithm can better extract the signal subtle distribution characteristics under different reconstruction phase space, and has a better recognition effect with good real-time performance.

Educational interventions to improve screening mammography interpretation: a randomized, controlled trial

PubMed Central

BM, Geller; A, Bogart; PA, Carney; EA, Sickles; RA, Smith; B, Monsees; LW, Bassett; DM, Buist; K, Kerlikowske; T, Onega; B, Yankaskas; S, Haneuse; DA, Hill; M, Wallis; DL, Miglioretti

2014-01-01

Purpose Conduct a randomized controlled trial of educational interventions to improve performance of screening mammography interpretation. Materials and Methods We randomly assigned physicians who interpret mammography to one of three groups: (1) self-paced DVD; (2) live, expert-led educational session; or (3) control. The DVD and live interventions used mammography cases of varying difficulty and associated teaching points. Interpretive performance was compared using a pre-/post-test design. Sensitivity, specificity, and positive predictive value (PPV) were calculated relative to two outcomes: cancer status and consensus of three experts about recall, and each were compared using logistic regression adjusting for pre-test performance. Results 102 radiologists completed all aspects of the trial. After adjustment for pre-intervention performance, the odds of improved sensitivity for correctly identifying a lesion relative to expert recall were 1.34 times higher for DVD participants than controls (95% confidence interval [CI]: 1.00, 1.81; P=0.050). The odds of improved PPV for correctly identifying a lesion relative to both expert recall (odds ratio [OR]=1.94, 95% CI: 1.24, 3.05; P=0.004) and cancer status (OR=1.81, 95% CI: 1.01, 3.23; P=0.045) were significantly improved for DVD participants compared to controls with no significant change in specificity. For the live-intervention group, specificity was significantly lower than the control group (OR relative to expert recall=0.80; 95% CI: 0.64, 1.00; P=0.048; OR relative to cancer=0.79; 95% CI: 0.65, 0.95; P=0.015). Conclusion In this randomized controlled trial, the DVD educational intervention resulted in a significant improvement in mammography interpretive screening performance on a test-set, which could translate into improved clinical interpretative performance. PMID:24848854

Effect of Plyometric Training on Handspring Vault Performance and Functional Power in Youth Female Gymnasts

PubMed Central

Hall, Emma; Bishop, Daniel C.; Gee, Thomas I.

2016-01-01

This study aimed to determine the effect of plyometric training (PT) when added to habitual gymnastic training (HT) on handspring vault (HV) performance variables. Twenty youth female competitive gymnasts (Age: 12.5 ± 1.67 y) volunteered to participate and were randomly assigned to two independent groups. The experimental plyometric training group (PTG) undertook a six-week plyometric program, involving two additional 45 min PT sessions a week, alongside their HT, while the control group (CG) performed regular HT only. Videography was used (120 Hz) in the sagittal plane to record both groups performing three HVs for both the baseline and post-intervention trials. Furthermore, participants completed a countermovement jump test (CMJ) to assess the effect of PT on functional power. Through the use of Quintic biomechanics software, significant improvements (P < 0.05) were found for the PTG for run-up velocity, take-off velocity, hurdle to board distance, board contact time, table contact time and post-flight time and CMJ height. However, there were no significant improvements on pre-flight time, shoulder angle or hip angle on the vault for the PTG. The CG demonstrated no improvement for all HV measures. A sport-specific PT intervention improved handspring vault performance measures and functional power when added to the habitual training of youth female gymnasts. The additional two hours plyometric training seemingly improved the power generating capacity of movement-specific musculature, which consequently improved aspects of vaulting performance. Future research is required to examine the whether the improvements are as a consequence of the additional volume of sprinting and jumping activities, as a result of the specific PT method or a combination of these factors. PMID:26859381

Effect of Plyometric Training on Handspring Vault Performance and Functional Power in Youth Female Gymnasts.

PubMed

Hall, Emma; Bishop, Daniel C; Gee, Thomas I

2016-01-01

This study aimed to determine the effect of plyometric training (PT) when added to habitual gymnastic training (HT) on handspring vault (HV) performance variables. Twenty youth female competitive gymnasts (Age: 12.5 ± 1.67 y) volunteered to participate and were randomly assigned to two independent groups. The experimental plyometric training group (PTG) undertook a six-week plyometric program, involving two additional 45 min PT sessions a week, alongside their HT, while the control group (CG) performed regular HT only. Videography was used (120 Hz) in the sagittal plane to record both groups performing three HVs for both the baseline and post-intervention trials. Furthermore, participants completed a countermovement jump test (CMJ) to assess the effect of PT on functional power. Through the use of Quintic biomechanics software, significant improvements (P < 0.05) were found for the PTG for run-up velocity, take-off velocity, hurdle to board distance, board contact time, table contact time and post-flight time and CMJ height. However, there were no significant improvements on pre-flight time, shoulder angle or hip angle on the vault for the PTG. The CG demonstrated no improvement for all HV measures. A sport-specific PT intervention improved handspring vault performance measures and functional power when added to the habitual training of youth female gymnasts. The additional two hours plyometric training seemingly improved the power generating capacity of movement-specific musculature, which consequently improved aspects of vaulting performance. Future research is required to examine the whether the improvements are as a consequence of the additional volume of sprinting and jumping activities, as a result of the specific PT method or a combination of these factors.

Time Course of Improvements in Power Characteristics in Elite Development Netball Players Entering a Full-Time Training Program.

PubMed

McKeown, Ian; Chapman, Dale W; Taylor, Kristie Lee; Ball, Nick B

2016-05-01

We describe the time course of adaptation to structured resistance training on entering a full-time high-performance sport program. Twelve international caliber female netballers (aged 19.9 ± 0.4 years) were monitored for 18 weeks with countermovement (CMJ: performed with body weight and 15 kg) and drop jumps (0.35-m box at body weight) at the start of each training week. Performance did not improve linearly or concurrently with loaded CMJ power improving 11% by Week 5 (effect size [ES] 0.93 ± 0.72) in contrast, substantial positive changes were observed for unloaded CMJ power (12%; ES 0.78 ± 0.39), and CMJ velocity (unloaded: 7.1%; ES 0.66 ± 0.34; loaded: 7.5%; ES 0.90 ± 0.41) by week 7. Over the investigation duration, large improvements were observed in unloaded CMJ power (24%; ES 1.45 ± 1.11) and velocity (12%; ES 1.13 ± 0.76). Loaded CMJ power also showed a large improvement (19%; ES 1.49 ± 0.97) but only moderate changes were observed for loaded CMJ velocity (8.4%; ES 1.01 ± 0.67). Jump height changes in either unloaded or loaded CMJ were unclear over the 18-week period. Drop jump performance improved throughout the investigation period with moderate positive changes in reactive strength index observed (35%; ES 0.97 ± 0.69). The adaptation response to a structured resistance training program does not occur linearly in young female athletes. Caution should be taken if assessing jump height only, as this will provide a biased observation to a training response. Frequently assessing CMJ performance can aid program design coaching decisions to ensure improvements are seen past the initial neuromuscular learning phase in performance training.

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.

42 CFR 460.136 - Internal quality assessment and performance improvement activities.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460...

Valley Fill Design and Construction Alternatives to Improve Ecological Performance

EPA Pesticide Factsheets

This presentation discusses; current challenges, comprehensive approaches, BMPs, the Middlefork Development, the Guy Cove project, and a path forward when looking at construction alternatives to improve the ecological performance of valley fills.

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 ...

Carbohydrates, Muscle Glycogen, and Improved Performance.

ERIC Educational Resources Information Center

Sherman, W. Mike

1987-01-01

One way to improve athletic performance without harming the athlete's health is diet manipulation. This article explores the relationship between muscular endurance and muscle glycogen and discusses a diet and training approach to competition. (Author/MT)

Improved sidelobe suppression mode performance on ATCRBS with various antennas

DOT National Transportation Integrated Search

1975-02-01

The SLS mode performance of terminal and enroute ATCRBS using existing and various improved antennas in the presence of perfectly dielectric flat ground are investigated theoretically. Necessary analytical expressions for various quantities character...

A performance improvement plan to increase nurse adherence to use of medication safety software.

PubMed

Gavriloff, Carrie

2012-08-01

Nurses can protect patients receiving intravenous (IV) medication by using medication safety software to program "smart" pumps to administer IV medications. After a patient safety event identified inconsistent use of medication safety software by nurses, a performance improvement team implemented the Deming Cycle performance improvement methodology. The combined use of improved direct care nurse communication, programming strategies, staff education, medication safety champions, adherence monitoring, and technology acquisition resulted in a statistically significant (p < .001) increase in nurse adherence to using medication safety software from 28% to above 85%, exceeding national benchmark adherence rates (Cohen, Cooke, Husch & Woodley, 2007; Carefusion, 2011). Copyright © 2012 Elsevier Inc. All rights reserved.

Efficacy of Stochastic Vestibular Stimulation to Improve Locomotor Performance in a Discordant Sensory Environment

NASA Technical Reports Server (NTRS)

Temple, D. R.; De Dios, Y. E.; Layne, C. S.; Bloomberg, J. J.; Mulavara, A. P.

2016-01-01

Astronauts exposed to microgravity face sensorimotor challenges incurred when readapting to a gravitational environment. Sensorimotor Adaptability (SA) training has been proposed as a countermeasure to improve locomotor performance during re-adaptation, and it is suggested that the benefits of SA training may be further enhanced by improving detection of weak sensory signals via mechanisms such as stochastic resonance when a non-zero level of stochastic white noise based electrical stimulation is applied to the vestibular system (stochastic vestibular stimulation, SVS). The purpose of this study was to test the efficacy of using SVS to improve short-term adaptation in a sensory discordant environment during performance of a locomotor task.

Training to improve manual control in 7-8 and 10-12 year old children: Training eliminates performance differences between ages.

PubMed

Snapp-Childs, Winona; Fath, Aaron J; Watson, Carol A; Flatters, Ian; Mon-Williams, Mark; Bingham, Geoffrey P

2015-10-01

Many children have difficulty producing movements well enough to improve in perceptuo-motor learning. We have developed a training method that supports active movement generation to allow improvement in a 3D tracing task requiring good compliance control. We previously tested 7-8 year old children who exhibited poor performance and performance differences before training. After training, performance was significantly improved and performance differences were eliminated. According to the Dynamic Systems Theory of development, appropriate support can enable younger children to acquire the ability to perform like older children. In the present study, we compared 7-8 and 10-12 year old school children and predicted that younger children would show reduced performance that was nonetheless amenable to training. Indeed, the pre-training performance of the 7-8 year olds was worse than that of the 10-12 year olds, but post-training performance was equally good for both groups. This was similar to previous results found using this training method for children with DCD and age-matched typically developing children. We also found in a previous study of 7-8 year old school children that training in the 3D tracing task transferred to a 2D drawing task. We now found similar transfer for the 10-12 year olds. Copyright © 2015 Elsevier B.V. All rights reserved.

Combustion Characteristics Analysis of Improved Combustor Structure of Micro Turbine Engine

NASA Astrophysics Data System (ADS)

Chen, Hai

2018-05-01

In order to improve the performance of micro combustor, the 60 slots of the original combustor were modified into 120 slots for the MIT 6-wafer micro-combustor. The performance of the micro combustor with the improved and original design was compared through numerical simulation, and stable operating ranges was studied. It was found that the improved combustor can stabilize the flame under the condition of higher fuel/air mixture mass flow rate.

The power of Kawaii: viewing cute images promotes a careful behavior and narrows attentional focus.

PubMed

Nittono, Hiroshi; Fukushima, Michiko; Yano, Akihiro; Moriya, Hiroki

2012-01-01

Kawaii (a Japanese word meaning "cute") things are popular because they produce positive feelings. However, their effect on behavior remains unclear. In this study, three experiments were conducted to examine the effects of viewing cute images on subsequent task performance. In the first experiment, university students performed a fine motor dexterity task before and after viewing images of baby or adult animals. Performance indexed by the number of successful trials increased after viewing cute images (puppies and kittens; M ± SE=43.9 ± 10.3% improvement) more than after viewing images that were less cute (dogs and cats; 11.9 ± 5.5% improvement). In the second experiment, this finding was replicated by using a non-motor visual search task. Performance improved more after viewing cute images (15.7 ± 2.2% improvement) than after viewing less cute images (1.4 ± 2.1% improvement). Viewing images of pleasant foods was ineffective in improving performance (1.2 ± 2.1%). In the third experiment, participants performed a global-local letter task after viewing images of baby animals, adult animals, and neutral objects. In general, global features were processed faster than local features. However, this global precedence effect was reduced after viewing cute images. Results show that participants performed tasks requiring focused attention more carefully after viewing cute images. This is interpreted as the result of a narrowed attentional focus induced by the cuteness-triggered positive emotion that is associated with approach motivation and the tendency toward systematic processing. For future applications, cute objects may be used as an emotion elicitor to induce careful behavioral tendencies in specific situations, such as driving and office work.

Transcranial direct current stimulation versus user training on improving online myoelectric control for amputees

NASA Astrophysics Data System (ADS)

Pan, Lizhi; Zhang, Dingguo; Jiang, Ning; Sheng, Xinjun; Zhu, Xiangyang

2017-08-01

Objective. Transcranial direct current stimulation (tDCS) and user training (UT) are two types of methods to improve myoelectric control performance for amputees. In this study, we compared the independent effect between tDCS and UT, and investigated the combined effect of tDCS and UT. Approach. An online paradigm of simultaneous and proportional control (SPC) based on electromyography (EMG) was adopted. The proposed experiments were conducted on six naïve unilateral trans-radial amputees. The subjects each received three types of 20 min interventions: active tDCS with motor training (tDCS  +  UT), active tDCS with quiet sitting (tDCS), and sham tDCS with motor training (UT). The interventions were applied at one week intervals in a randomized order. The subjects performed online control of a feedback arrow with two degrees of freedom (DoFs) to accomplish target reaching motor tasks in pre-sessions and post-sessions. We compared the performance, measured by completion rate, completion time, and efficiency coefficient, between pre-sessions and post-sessions. Main results. The results showed that the intervention tDCS  +  UT and tDCS significantly improved the online SPC performance (i.e. improved the completion rate; reduced the completion time; and improved the efficiency coefficient), while intervention UT did not significantly change the performance. The results also showed that the online SPC performance after intervention tDCS  +  UT and tDCS was not significantly different, but both were significantly better than that after intervention UT. Significance. tDCS could be an effective intervention to improve the online SPC performance in a short time.

The Power of Kawaii: Viewing Cute Images Promotes a Careful Behavior and Narrows Attentional Focus

PubMed Central

Nittono, Hiroshi; Fukushima, Michiko; Yano, Akihiro; Moriya, Hiroki

2012-01-01

Kawaii (a Japanese word meaning “cute”) things are popular because they produce positive feelings. However, their effect on behavior remains unclear. In this study, three experiments were conducted to examine the effects of viewing cute images on subsequent task performance. In the first experiment, university students performed a fine motor dexterity task before and after viewing images of baby or adult animals. Performance indexed by the number of successful trials increased after viewing cute images (puppies and kittens; M ± SE = 43.9±10.3% improvement) more than after viewing images that were less cute (dogs and cats; 11.9±5.5% improvement). In the second experiment, this finding was replicated by using a non-motor visual search task. Performance improved more after viewing cute images (15.7±2.2% improvement) than after viewing less cute images (1.4±2.1% improvement). Viewing images of pleasant foods was ineffective in improving performance (1.2±2.1%). In the third experiment, participants performed a global–local letter task after viewing images of baby animals, adult animals, and neutral objects. In general, global features were processed faster than local features. However, this global precedence effect was reduced after viewing cute images. Results show that participants performed tasks requiring focused attention more carefully after viewing cute images. This is interpreted as the result of a narrowed attentional focus induced by the cuteness-triggered positive emotion that is associated with approach motivation and the tendency toward systematic processing. For future applications, cute objects may be used as an emotion elicitor to induce careful behavioral tendencies in specific situations, such as driving and office work. PMID:23050022

Improving older adults' memory performance using prior task success.

PubMed

Geraci, Lisa; Miller, Tyler M

2013-06-01

Holding negative aging stereotypes can lead older adults to perform poorly on memory tests. We attempted to improve older adults' memory performance by giving them task experience that would counter their negative performance expectations. Before participating in a memory experiment, younger and older adults were given a cognitive task that they could either successfully complete, not successfully complete, or they were given no prior task. For older adults, recall was significantly higher and self-reported anxiety was significantly lower for the prior task success group relative to the other groups. There was no effect of prior task experience on younger adults' memory performance. Results suggest that older adults' memory can be improved with a single successful prior task experience. PsycINFO Database Record (c) 2013 APA, all rights reserved.

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.

Improved Dental Implant Drill Durability and Performance Using Heat and Wear Resistant Protective Coatings.

PubMed

Er, Nilay; Alkan, Alper; Ilday, Serim; Bengu, Erman

2018-06-01

The dental implant drilling procedure is an essential step for implant surgery, and frictional heat in bone during drilling is a key factor affecting the success of an implant. The aim of this study was to increase the dental implant drill lifetime and performance by using heat- and wear-resistant protective coatings to decrease the alveolar bone temperature caused by the dental implant drilling procedure. Commercially obtained stainless steel drills were coated with titanium aluminum nitride, diamond-like carbon, titanium boron nitride, and boron nitride coatings via magnetron-sputter deposition. Drilling was performed on bovine femoral cortical bone under the conditions mimicking clinical practice. Tests were performed under water-assisted cooling and under the conditions when no cooling was applied. Coated drill performances and durabilities were compared with those of three commonly used commercial drills with surfaces made from zirconia, black diamond. and stainless steel. Protective coatings with boron nitride, titanium boron nitride, and diamond-like carbon have significantly improved drill performance and durability. In particular, boron nitride-coated drills have performed within safe bone temperature limits for 50 drillings even when no cooling is applied. Titanium aluminium nitride coated drills did not show any improvement over commercially obtained stainless steel drills. Surface modification using heat- and wear-resistant coatings is an easy and highly effective way to improve implant drill performance and durability, which can improve the surgical procedure and the postsurgical healing period. The noteworthy success of different types of coatings is novel and likely to be applicable to various other medical systems.

Chronic treadmill exercise in rats delicately alters the Purkinje cell structure to improve motor performance and toxin resistance in the cerebellum.

PubMed

Huang, Tung-Yi; Lin, Lung-Sheng; Cho, Keng-Chi; Chen, Shean-Jen; Kuo, Yu-Min; Yu, Lung; Wu, Fong-Sen; Chuang, Jih-Ing; Chen, Hsiun-Ing; Jen, Chauying J

2012-09-01

Although exercise usually improves motor performance, the underlying cellular changes in the cerebellum remain to be elucidated. This study aimed to investigate whether and how chronic treadmill exercise in young rats induced Purkinje cell changes to improve motor performance and rendered the cerebellum less vulnerable to toxin insults. After 1-wk familiarization of treadmill running, 6-wk-old male Wistar rats were divided into exercise and sedentary groups. The exercise group was then subjected to 8 wk of exercise training at moderate intensity. The rotarod test was carried out to evaluate motor performance. Purkinje cells in cerebellar slices were visualized by lucifer yellow labeling in single neurons and by calbindin immunostaining in groups of neurons. Compared with sedentary control rats, exercised rats not only performed better in the rotarod task, but also showed finer Purkinje cell structure (higher dendritic volume and spine density with the same dendritic field). The exercise-improved cerebellar functions were further evaluated by monitoring the long-lasting effects of intraventricular application of OX7-saporin. In the sedentary group, OX7-saporin treatment retarded the rotarod performance and induced ∼60% Purkinje cell loss in 3 wk. As a comparison, the exercise group showed much milder injuries in the cerebellum by the same toxin treatment. In conclusion, exercise training in young rats increased the dendritic density of Purkinje cells, which might play an important role in improving the motor performance. Furthermore, as Purkinje cells in the exercise group were relatively toxin resistant, the exercised rats showed good motor performance, even under toxin-treated conditions.

Experimental and analytical investigations to improve low-speed performance and stability and control characteristics of supersonic cruise fighter vehicles

NASA Technical Reports Server (NTRS)

Graham, A. B.

1977-01-01

Small- and large-scale models of supersonic cruise fighter vehicles were used to determine the effectiveness of airframe/propulsion integration concepts for improved low-speed performance and stability and control characteristics. Computer programs were used for engine/airframe sizing studies to yield optimum vehicle performance.

Influence of strain of sire on channel x blue F1 hybrid catfish embryo production and fingerling performance under commercial farm conditions.

USDA-ARS?s Scientific Manuscript database

Channel x blue hybrid catfish is presently the desired aquaculture species in US farm-raised catfish industry. Even though production and performance has improved over the last two decades, several production and performance parameters needs to be improved to maximize the genetic potential of this ...

Air Force Officials did not Consistently Comply with Requirements for Assessing Contractor Performance

DTIC Science & Technology

2016-01-29

31 Appendix B. Improvement in PAR Completion Statistics _________________________________ 33 vi...agencies must perform frequent evaluation of compliance with reporting requirements so they can readily identify delinquent past performance efforts...Reporting Program,” August 13, 2011 Appendixes DODIG-2016-043 │ 33 Appendix B Improvement in PAR Completion Statistics The Senate Armed Services Committee

Parent Tutoring for Students with Attention-Deficit/Hyperactivity Disorder: Effects on Reading at Home and School.

ERIC Educational Resources Information Center

Hook, Christine L.; DuPaul, George J.

1999-01-01

Examines the effects of a parent tutoring intervention on the reading performance of students with Attention-Deficit/Hyperactivity Disorder (ADHD), at home and at school. Results indicate that reading performance in the home setting improved for all students and reading performance in the school setting showed improvements, but data should be…

Improving Performance through HEI-Industry Engagements in the Built Environment

ERIC Educational Resources Information Center

Underwood, Jason; Williams, Aled; Thurairajah, Niraj

2009-01-01

The poor performance and inefficiencies of the construction industry are well recognized and documented. Through a variety of combined industry and government initiatives there has been a continual expression in the UK over the last decade of the urgent need to address the fragmented nature of the industry to improve its performance. A major…

State Strategies to Improve Low-Performing Schools: California's High Priority School Grants Program

ERIC Educational Resources Information Center

Timar, Thomas; Rodriguez, Gloria; Simon, Virginia Adams; Ferrario, Kim; Kim, Kris

2006-01-01

Central to California's school accountability system are programs to engage low-performing schools in improvement efforts. One of these is the High Priority Schools Program (HPSGP), created by Assembly Bill 961 (Chapter 747, "Statutes of 2001") to provide funds to the lowest performing schools in the state. To be eligible for funding,…

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…

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.

Seven Q-Tracks monitors of laboratory quality drive general performance improvement: experience from the College of American Pathologists Q-Tracks program 1999-2011.

PubMed

Meier, Frederick A; Souers, Rhona J; Howanitz, Peter J; Tworek, Joseph A; Perrotta, Peter L; Nakhleh, Raouf E; Karcher, Donald S; Bashleben, Christine; Darcy, Teresa P; Schifman, Ron B; Jones, Bruce A

2015-06-01

Many production systems employ standardized statistical monitors that measure defect rates and cycle times, as indices of performance quality. Clinical laboratory testing, a system that produces test results, is amenable to such monitoring. To demonstrate patterns in clinical laboratory testing defect rates and cycle time using 7 College of American Pathologists Q-Tracks program monitors. Subscribers measured monthly rates of outpatient order-entry errors, identification band defects, and specimen rejections; median troponin order-to-report cycle times and rates of STAT test receipt-to-report turnaround time outliers; and critical values reporting event defects, and corrected reports. From these submissions Q-Tracks program staff produced quarterly and annual reports. These charted each subscriber's performance relative to other participating laboratories and aggregate and subgroup performance over time, dividing participants into best and median performers and performers with the most room to improve. Each monitor's patterns of change present percentile distributions of subscribers' performance in relation to monitoring durations and numbers of participating subscribers. Changes over time in defect frequencies and the cycle duration quantify effects on performance of monitor participation. All monitors showed significant decreases in defect rates as the 7 monitors ran variously for 6, 6, 7, 11, 12, 13, and 13 years. The most striking decreases occurred among performers who initially had the most room to improve and among subscribers who participated the longest. All 7 monitors registered significant improvement. Participation effects improved between 0.85% and 5.1% per quarter of participation. Using statistical quality measures, collecting data monthly, and receiving reports quarterly and yearly, subscribers to a comparative monitoring program documented significant decreases in defect rates and shortening of a cycle time for 6 to 13 years in all 7 ongoing clinical laboratory quality monitors.

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.

Enhancing Self-Efficacy and Performance: An Experimental Comparison of Psychological Techniques.

PubMed

Wright, Bradley James; O'Halloran, Paul Daniel; Stukas, Arthur Anthony

2016-01-01

We assessed how 6 psychological performance enhancement techniques (PETs) differentially improved self-efficacy (SE) and skill performance. We also assessed whether vicarious experiences and verbal persuasion as posited sources of SE (Bandura, 1982 ) were supported and, further, if the effects of the 6 PETs remained after controlling for achievement motivation traits and self-esteem. A within-subject design assessed each individual across 2 trials for 3 disparate PETs. A between-groups design assessed differences between PETs paired against each other for 3 similar novel tasks. Participants (N = 96) performed 2 trials of 10 attempts at each of the tasks (kick, throw, golf putt) in a counterbalanced sequence using their nondominant limb. Participants completed the Sport Orientation Questionnaire, Rosenberg Self-Esteem Scale, and General Self-Efficacy Scale and were randomly allocated to either the modeling or imagery, goal-setting or instructional self-statement, or knowledge-of-results or motivational feedback conditions aligned with each task. An instructional self-statement improved performance better than imagery, modeling, goal setting, and motivational and knowledge-of-results augmented feedback. Motivational auditory feedback most improved SE. Increased SE change scores were related to increased performance difference scores on all tasks after controlling for age, sex, achievement motivation, and self-esteem. Some sources of SE may be more influential than others on both SE and performance improvements. We provide partial support for the sources of SE proposed by Bandura's social-cognitive theory with verbal persuasion but not vicarious experiences improving SE.

Complex relationship between seasonal streamflow forecast skill and value in reservoir operations

NASA Astrophysics Data System (ADS)

Turner, Sean W. D.; Bennett, James C.; Robertson, David E.; Galelli, Stefano

2017-09-01

Considerable research effort has recently been directed at improving and operationalising ensemble seasonal streamflow forecasts. Whilst this creates new opportunities for improving the performance of water resources systems, there may also be associated risks. Here, we explore these potential risks by examining the sensitivity of forecast value (improvement in system performance brought about by adopting forecasts) to changes in the forecast skill for a range of hypothetical reservoir designs with contrasting operating objectives. Forecast-informed operations are simulated using rolling horizon, adaptive control and then benchmarked against optimised control rules to assess performance improvements. Results show that there exists a strong relationship between forecast skill and value for systems operated to maintain a target water level. But this relationship breaks down when the reservoir is operated to satisfy a target demand for water; good forecast accuracy does not necessarily translate into performance improvement. We show that the primary cause of this behaviour is the buffering role played by storage in water supply reservoirs, which renders the forecast superfluous for long periods of the operation. System performance depends primarily on forecast accuracy when critical decisions are made - namely during severe drought. As it is not possible to know in advance if a forecast will perform well at such moments, we advocate measuring the consistency of forecast performance, through bootstrap resampling, to indicate potential usefulness in storage operations. Our results highlight the need for sensitivity assessment in value-of-forecast studies involving reservoirs with supply objectives.

Complex relationship between seasonal streamflow forecast skill and value in reservoir operations

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

Turner, Sean W. D.; Bennett, James C.; Robertson, David E.

Considerable research effort has recently been directed at improving and operationalising ensemble seasonal streamflow forecasts. Whilst this creates new opportunities for improving the performance of water resources systems, there may also be associated risks. Here, we explore these potential risks by examining the sensitivity of forecast value (improvement in system performance brought about by adopting forecasts) to changes in the forecast skill for a range of hypothetical reservoir designs with contrasting operating objectives. Forecast-informed operations are simulated using rolling horizon, adaptive control and then benchmarked against optimised control rules to assess performance improvements. Results show that there exists a strongmore » relationship between forecast skill and value for systems operated to maintain a target water level. But this relationship breaks down when the reservoir is operated to satisfy a target demand for water; good forecast accuracy does not necessarily translate into performance improvement. We show that the primary cause of this behaviour is the buffering role played by storage in water supply reservoirs, which renders the forecast superfluous for long periods of the operation. System performance depends primarily on forecast accuracy when critical decisions are made – namely during severe drought. As it is not possible to know in advance if a forecast will perform well at such moments, we advocate measuring the consistency of forecast performance, through bootstrap resampling, to indicate potential usefulness in storage operations. Our results highlight the need for sensitivity assessment in value-of-forecast studies involving reservoirs with supply objectives.« less

Performance Improvement Through Indexing of Turbine Airfoils. Part 2; Numerical Simulation

NASA Technical Reports Server (NTRS)

Griffin, Lisa W.; Huber, Frank W.; Sharma, Om P.

1996-01-01

An experimental/analytical study has been conducted to determine the performance improvements achievable by circumferentially indexing succeeding rows of turbine stator airfoils. A series of tests was conducted to experimentally investigate stator wake clocking effects on the performance of the space shuttle main engine (SSME) alternate turbopump development (ATD) fuel turbine test article (TTA). The results from this study indicate that significant increases in stage efficiency can be attained through application of this airfoil clocking concept. Details of the experiment and its results are documented in part 1 of this paper. In order to gain insight into the mechanisms of the performance improvement, extensive computational fluid dynamics (CFD) simulations were executed. The subject of the present paper is the initial results from the CFD investigation of the configurations and conditions detailed in part 1 of the paper. To characterize the aerodynamic environments in the experimental test series, two-dimensional (2D), time accurate, multistage, viscous analyses were performed at the TTA midspan. Computational analyses for five different circumferential positions of the first stage stator have been completed. Details of the computational procedure and the results are presented. The analytical results verify the experimentally demonstrated performance improvement and are compared with data whenever possible. Predictions of time-averaged turbine efficiencies as well as gas conditions throughout the flow field are presented. An initial understanding of the turbine performance improvement mechanism based on the results from this investigation is described.

Improvement of attention with amphetamine in low- and high-performing rats.

PubMed

Turner, Karly M; Burne, Thomas H J

2016-09-01

Attentional deficits occur in a range of neuropsychiatric disorders, such as schizophrenia and attention deficit hyperactivity disorder. Psychostimulants are one of the main treatments for attentional deficits, yet there are limited reports of procognitive effects of amphetamine in preclinical studies. Therefore, task development may be needed to improve predictive validity when measuring attention in rodents. This study aimed to use a modified signal detection task (SDT) to determine if and at what doses amphetamine could improve attention in rats. Sprague-Dawley rats were trained on the SDT prior to amphetamine challenge (0.1, 0.25, 0.75 and 1.25 mg/kg). This dose range was predicted to enhance and disrupt cognition with the effect differing between individuals depending on baseline performance. Acute low dose amphetamine (0.1 and 0.25 mg/kg) improved accuracy, while the highest dose (1.25 mg/kg) significantly disrupted performance. The effects differed for low- and high-performing groups across these doses. The effect of amphetamine on accuracy was found to significantly correlate with baseline performance in rats. This study demonstrates that improvement in attentional performance with systemic amphetamine is dependent on baseline accuracy in rats. Indicative of the inverted U-shaped relationship between dopamine and cognition, there was a baseline-dependent shift in performance with increasing doses of amphetamine. The SDT may be a useful tool for investigating individual differences in attention and response to psychostimulants in rodents.

Complex relationship between seasonal streamflow forecast skill and value in reservoir operations

DOE PAGES

Turner, Sean W. D.; Bennett, James C.; Robertson, David E.; ...

2017-09-28

Considerable research effort has recently been directed at improving and operationalising ensemble seasonal streamflow forecasts. Whilst this creates new opportunities for improving the performance of water resources systems, there may also be associated risks. Here, we explore these potential risks by examining the sensitivity of forecast value (improvement in system performance brought about by adopting forecasts) to changes in the forecast skill for a range of hypothetical reservoir designs with contrasting operating objectives. Forecast-informed operations are simulated using rolling horizon, adaptive control and then benchmarked against optimised control rules to assess performance improvements. Results show that there exists a strongmore » relationship between forecast skill and value for systems operated to maintain a target water level. But this relationship breaks down when the reservoir is operated to satisfy a target demand for water; good forecast accuracy does not necessarily translate into performance improvement. We show that the primary cause of this behaviour is the buffering role played by storage in water supply reservoirs, which renders the forecast superfluous for long periods of the operation. System performance depends primarily on forecast accuracy when critical decisions are made – namely during severe drought. As it is not possible to know in advance if a forecast will perform well at such moments, we advocate measuring the consistency of forecast performance, through bootstrap resampling, to indicate potential usefulness in storage operations. Our results highlight the need for sensitivity assessment in value-of-forecast studies involving reservoirs with supply objectives.« less

Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study.

PubMed

Eyre, Harris A; Acevedo, Bianca; Yang, Hongyu; Siddarth, Prabha; Van Dyk, Kathleen; Ercoli, Linda; Leaver, Amber M; Cyr, Natalie St; Narr, Katherine; Baune, Bernhard T; Khalsa, Dharma S; Lavretsky, Helen

2016-01-01

No study has explored the effect of yoga on cognitive decline and resting-state functional connectivity. This study explored the relationship between performance on memory tests and resting-state functional connectivity before and after a yoga intervention versus active control for subjects with mild cognitive impairment (MCI). Participants ( ≥ 55 y) with MCI were randomized to receive a yoga intervention or active "gold-standard" control (i.e., memory enhancement training (MET)) for 12 weeks. Resting-state functional magnetic resonance imaging was used to map correlations between brain networks and memory performance changes over time. Default mode networks (DMN), language and superior parietal networks were chosen as networks of interest to analyze the association with changes in verbal and visuospatial memory performance. Fourteen yoga and 11 MET participants completed the study. The yoga group demonstrated a statistically significant improvement in depression and visuospatial memory. We observed improved verbal memory performance correlated with increased connectivity between the DMN and frontal medial cortex, pregenual anterior cingulate cortex, right middle frontal cortex, posterior cingulate cortex, and left lateral occipital cortex. Improved verbal memory performance positively correlated with increased connectivity between the language processing network and the left inferior frontal gyrus. Improved visuospatial memory performance correlated inversely with connectivity between the superior parietal network and the medial parietal cortex. Yoga may be as effective as MET in improving functional connectivity in relation to verbal memory performance. These findings should be confirmed in larger prospective studies.

Experience measuring performance improvement in multiphase picture archiving and communications systems implementations.

PubMed

Reed, G; Reed, D H

1999-05-01

When planning a picture archiving and communications system (PACS) implementation and determining which equipment will be implemented in earlier and later phases, collection and analysis of selected data will aid in setting implementation priorities. If baseline data are acquired relative to performance objectives, the same information used for implementation planning can be used to measure performance improvement and outcomes. The main categories of data to choose from are: (1) financial data; (2) productivity data; (3) operational parameters; (4) clinical data; and (5) information about customer satisfaction. In the authors' experience, detailed workflow data have not proved valuable in measuring PACS performance and outcomes. Reviewing only one category of data in planning will not provide adequate basis for targeting operational improvements that will lead to the most significant gains. Quality improvement takes into account all factors in production: human capacity, materials, operating capital and assets. Once we have identified key areas of focus for quality improvement in each phase, we can translate objectives into implementation requirements and finally into detailed functional and performance requirements. Here, Integration Resources reports its experience measuring PACS performance relative to phased implementation strategies for three large medical centers. Each medical center had its own objectives for overcoming image management, physical/geographical, and functional/technical barriers. The report outlines (1) principal financial and nonfinancial measures used as performance indicators; (2) implementation strategies chosen by each of the three medical centers; and (3) the results of those strategies as compared with baseline data.

Preparing systems engineering and computing science students in disciplined methods, quantitative, and advanced statistical techniques to improve process performance

NASA Astrophysics Data System (ADS)

McCray, Wilmon Wil L., Jr.

The research was prompted by a need to conduct a study that assesses process improvement, quality management and analytical techniques taught to students in U.S. colleges and universities undergraduate and graduate systems engineering and the computing science discipline (e.g., software engineering, computer science, and information technology) degree programs during their academic training that can be applied to quantitatively manage processes for performance. Everyone involved in executing repeatable processes in the software and systems development lifecycle processes needs to become familiar with the concepts of quantitative management, statistical thinking, process improvement methods and how they relate to process-performance. Organizations are starting to embrace the de facto Software Engineering Institute (SEI) Capability Maturity Model Integration (CMMI RTM) Models as process improvement frameworks to improve business processes performance. High maturity process areas in the CMMI model imply the use of analytical, statistical, quantitative management techniques, and process performance modeling to identify and eliminate sources of variation, continually improve process-performance; reduce cost and predict future outcomes. The research study identifies and provides a detail discussion of the gap analysis findings of process improvement and quantitative analysis techniques taught in U.S. universities systems engineering and computing science degree programs, gaps that exist in the literature, and a comparison analysis which identifies the gaps that exist between the SEI's "healthy ingredients " of a process performance model and courses taught in U.S. universities degree program. The research also heightens awareness that academicians have conducted little research on applicable statistics and quantitative techniques that can be used to demonstrate high maturity as implied in the CMMI models. The research also includes a Monte Carlo simulation optimization model and dashboard that demonstrates the use of statistical methods, statistical process control, sensitivity analysis, quantitative and optimization techniques to establish a baseline and predict future customer satisfaction index scores (outcomes). The American Customer Satisfaction Index (ACSI) model and industry benchmarks were used as a framework for the simulation model.

Maximal Strength Training Improves Surfboard Sprint and Endurance Paddling Performance in Competitive and Recreational Surfers.

PubMed

Coyne, Joseph O C; Tran, Tai T; Secomb, Josh L; Lundgren, Lina E; Farley, Oliver R L; Newton, Robert U; Sheppard, Jeremy M

2017-01-01

Coyne, JOC, Tran, TT, Secomb, JL, Lundgren, LE, Farley, ORL, Newton, RU, and Sheppard, JM. Maximal strength training improves surfboard sprint and endurance paddling performance in competitive and recreational surfers. J Strength Cond Res 31(1): 244-253, 2017-Upper-body (UB) strength has very high correlations with faster surfboard paddling speeds. However, there is no research examining the effects of improving UB strength has on surfboard paddling ability. This study aimed to determine the influence that improvements in UB closed-kinetic chain maximal strength have on surfboard paddling in both competitive and recreational surfers. Seventeen competitive and recreational male surfers (29.7 ± 7.7 years, 177.4 ± 7.4 cm, 76.7 ± 9.9 kg) participated in a repeated-measures, parallel control study design. Anthropometry; 5-, 10-, and 15-m sprint; and 400-m endurance surfboard paddling tests along with pull-up and dip 1 repetition maximum strength tests were assessed pre- and postintervention. Subjects in the training group performed 5 weeks of maximal strength training in the pull-up and dip. Differences between the training and control groups were examined postintervention. The training group increased their speed over the 5-, 10-, and 15-m sprint, whereas the control group became slower (d = 0.71, 0.51, and 0.4, respectively). The training group also displayed faster endurance paddling performance compared with the control group (d = 0.72). Short-term exposure to maximal strength training elicits improvements in paddling performance measures. However, the magnitude of performance increases seems to be dependent on initial strength levels with differential responses between strong and weaker athletes. Although a longer maximal strength training period may have produced more significant paddling improvements in stronger subjects, practitioners are unlikely to have any more than 5 weeks in an uninterrupted block with competitive surfing athletes. This study reveals that a "threshold" level of maximal strength that if possessed, short-term maximal strength training may only provide little improvement in paddling performance.

Research in action: using positive deviance to improve quality of health care

PubMed Central

Bradley, Elizabeth H; Curry, Leslie A; Ramanadhan, Shoba; Rowe, Laura; Nembhard, Ingrid M; Krumholz, Harlan M

2009-01-01

Background Despite decades of efforts to improve quality of health care, poor performance persists in many aspects of care. Less than 1% of the enormous national investment in medical research is focused on improving health care delivery. Furthermore, when effective innovations in clinical care are discovered, uptake of these innovations is often delayed and incomplete. In this paper, we build on the established principle of 'positive deviance' to propose an approach to identifying practices that improve health care quality. Methods We synthesize existing literature on positive deviance, describe major alternative approaches, propose benefits and limitations of a positive deviance approach for research directed toward improving quality of health care, and describe an application of this approach in improving hospital care for patients with acute myocardial infarction. Results The positive deviance approach, as adapted for use in health care, presumes that the knowledge about 'what works' is available in existing organizations that demonstrate consistently exceptional performance. Steps in this approach: identify 'positive deviants,' i.e., organizations that consistently demonstrate exceptionally high performance in the area of interest (e.g., proper medication use, timeliness of care); study the organizations in-depth using qualitative methods to generate hypotheses about practices that allow organizations to achieve top performance; test hypotheses statistically in larger, representative samples of organizations; and work in partnership with key stakeholders, including potential adopters, to disseminate the evidence about newly characterized best practices. The approach is particularly appropriate in situations where organizations can be ranked reliably based on valid performance measures, where there is substantial natural variation in performance within an industry, when openness about practices to achieve exceptional performance exists, and where there is an engaged constituency to promote uptake of discovered practices. Conclusion The identification and examination of health care organizations that demonstrate positive deviance provides an opportunity to characterize and disseminate strategies for improving quality. PMID:19426507

Enhancing the performance of gastrointestinal tumour board by improving documentation.

PubMed

Alsuhaibani, Roaa Saleh; Alzahrani, Hajer; Algwaiz, Ghada; Alfarhan, Haneen; Alolayan, Ashwaq; Abdelhafiz, Nafisa; Ali, Yosra; Jazieh, Abdul Rahman

2018-01-01

Tumour board contributes to providing better patient care by using a multidisciplinary team approach. In the efforts of evaluating the performance of the gastrointestinal tumour board at our institution, it was difficult to assess past performance due to lack of proper use of standardised documentation tool. This project aimed at improving adherence to the documentation tool and its recommendations in order to obtain performance measures for the tumour board. A multidisciplinary team and a plan were developed to improve documentation. Four rapid improvement cycles, Plan-Do-Study-Act (PDSA) cycles, were conducted. The first cycle focused on updating the case discussion summary form (CDSF) based on experts' input and previous identified deficiencies to enhance documentation and improve performance. The second PDSA cycle aimed at incorporating the CDSF into the electronic medical records system and assessing its functionality. The third cycle was to orient and train staff on using the form and launching it. The fourth PDSA cycle aimed at assessing the ability to obtain tumour board performance measures. Adherence to completion of the CDSF improved from 82% (baseline) to 94% after the fourth PDSA cycle. Over 104 consecutive cases discussed in the tumour board between January and July 2016 and 76 cases discussed in 2015, results were as follows: adherence to National Comprehensive Cancer Network guidelines in 2016 was observed in 141 (95%) recommendations, while it was observed in 90 (92%) recommendations in 2015. Changes in the management plans were observed in 37 (36%) cases in 2016 and in 6 (8%) cases in 2015. Regarding tumour board recommendations, 87% were done within 3 months of tumour board discussion in 2016, while 69% were done in 2015. Implementing electronic standardised documentation tool improved communication among the team and enabled getting accurate data about performance measures of the tumour board with positive impact on healthcare process and outcomes.

Enhancing the performance of gastrointestinal tumour board by improving documentation

PubMed Central

Alsuhaibani, Roaa Saleh; Alzahrani, Hajer; Algwaiz, Ghada; Alfarhan, Haneen; Alolayan, Ashwaq; Abdelhafiz, Nafisa; Ali, Yosra; Jazieh, Abdul Rahman

2018-01-01

Tumour board contributes to providing better patient care by using a multidisciplinary team approach. In the efforts of evaluating the performance of the gastrointestinal tumour board at our institution, it was difficult to assess past performance due to lack of proper use of standardised documentation tool. This project aimed at improving adherence to the documentation tool and its recommendations in order to obtain performance measures for the tumour board. A multidisciplinary team and a plan were developed to improve documentation. Four rapid improvement cycles, Plan–Do–Study–Act (PDSA) cycles, were conducted. The first cycle focused on updating the case discussion summary form (CDSF) based on experts’ input and previous identified deficiencies to enhance documentation and improve performance. The second PDSA cycle aimed at incorporating the CDSF into the electronic medical records system and assessing its functionality. The third cycle was to orient and train staff on using the form and launching it. The fourth PDSA cycle aimed at assessing the ability to obtain tumour board performance measures. Adherence to completion of the CDSF improved from 82% (baseline) to 94% after the fourth PDSA cycle. Over 104 consecutive cases discussed in the tumour board between January and July 2016 and 76 cases discussed in 2015, results were as follows: adherence to National Comprehensive Cancer Network guidelines in 2016 was observed in 141 (95%) recommendations, while it was observed in 90 (92%) recommendations in 2015. Changes in the management plans were observed in 37 (36%) cases in 2016 and in 6 (8%) cases in 2015. Regarding tumour board recommendations, 87% were done within 3 months of tumour board discussion in 2016, while 69% were done in 2015. Implementing electronic standardised documentation tool improved communication among the team and enabled getting accurate data about performance measures of the tumour board with positive impact on healthcare process and outcomes. PMID:29610771

Building a Foundation of Continuous Improvement in a Rapidly Changing Environment: The Dartmouth-Hitchcock Value Institute Experience.

PubMed

McGrath, Susan P; Blike, George T

2015-10-01

A performance improvement competency development program, known as the Value Institute (VI), was established at Dartmouth-Hitchcock (D-H; Lebanon, New Hampshire) in 2011 to develop a performance improvement-focused workforce and systems capable of meeting the challenges of creating a sustainable health system. A tiered competency development program that provides patient safety, health care quality, and improvement science education, and an execution support infrastructure that enables access to performance improvement tools for all employees, comprise the core of the VI. At 20 months after the launch of the first VI classes, more than 10% of all employees were trained to the Yellow Belt level, and approximately 1.5% of all employees became advanced practitioners (Green Belts or Black Belts). Improvement projects have focused on both clinical and business process optimization, as well as regulatory and accreditation compliance and patient safety. Project savings during the two years of operation have exceeded the investment of resources to establish this long-term performance improvement capability by 2.5 times. The D-H VI model promotes multidisciplinary team-based learning, incremental skill development, and access to a common continuous improvement vocabulary and method for all employees-all key to building the teams and momentum needed for successful execution of improvement work and to maintain outcomes. Initial outcomes, represented by organizational spread, project execution status, participants' feedback scores, and return on investment estimates, suggest that robust team-based learning combined with coaching provides sufficient depth and breadth of learning and effective opportunities to gain practical experience in continuous improvement.

A Positive Deviance Approach to Understanding Key Features to Improving Diabetes Care in the Medical Home

PubMed Central

Gabbay, Robert A.; Friedberg, Mark W.; Miller-Day, Michelle; Cronholm, Peter F.; Adelman, Alan; Schneider, Eric C.

2013-01-01

PURPOSE The medical home has gained national attention as a model to reorganize primary care to improve health outcomes. Pennsylvania has undertaken one of the largest state-based, multipayer medical home pilot projects. We used a positive deviance approach to identify and compare factors driving the care models of practices showing the greatest and least improvement in diabetes care in a sample of 25 primary care practices in southeast Pennsylvania. METHODS We ranked practices into improvement quintiles on the basis of the average absolute percentage point improvement from baseline to 18 months in 3 registry-based measures of performance related to diabetes care: glycated hemoglobin concentration, blood pressure, and low-density lipoprotein cholesterol level. We then conducted surveys and key informant interviews with leaders and staff in the 5 most and least improved practices, and compared their responses. RESULTS The most improved/higher-performing practices tended to have greater structural capabilities (eg, electronic health records) than the least improved/lower-performing practices at baseline. Interviews revealed striking differences between the groups in terms of leadership styles and shared vision; sense, use, and development of teams; processes for monitoring progress and obtaining feedback; and presence of technologic and financial distractions. CONCLUSIONS Positive deviance analysis suggests that primary care practices’ baseline structural capabilities and abilities to buffer the stresses of change may be key facilitators of performance improvement in medical home transformations. Attention to the practices’ structural capabilities and factors shaping successful change, especially early in the process, will be necessary to improve the likelihood of successful medical home transformation and better care. PMID:23690393

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

DTIC Science & Technology

1985-09-01

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

[Course studies of spontaneous speech and graphic achievements in 175 aphasics].

PubMed

Leischner, A; Mattes, K

1982-01-01

In 175 aphasic patients with agraphia the course of the expressive oral and graphic performances was compared. Spontaneous speech and writing and the writing of dictated words and sentences were investigated and evaluated. In addition, several peculiarities of this syndrome were examined. The investigations showed that the relationship between the expressive oral and graphic performances changes in the course of improvement depending on the type of aphasia. In the first period of testing no difference was found in the performances of patients with total aphasia and motor-amnesic aphasia; in the group of mixed aphasics and sensory-amnesic aphasics, however, the oral performance predominated the writing. Investigations at later periods showed that in the cases of total aphasia the improvement of the oral performance was better whereas in the cases of motor-amnesic and sensory-amnesic aphasia the graphic performance was more improved.

Assessing students' performance in software requirements engineering education using scoring rubrics

NASA Astrophysics Data System (ADS)

Mkpojiogu, Emmanuel O. C.; Hussain, Azham

2017-10-01

The study investigates how helpful the use of scoring rubrics is, in the performance assessment of software requirements engineering students and whether its use can lead to students' performance improvement in the development of software requirements artifacts and models. Scoring rubrics were used by two instructors to assess the cognitive performance of a student in the design and development of software requirements artifacts. The study results indicate that the use of scoring rubrics is very helpful in objectively assessing the performance of software requirements or software engineering students. Furthermore, the results revealed that the use of scoring rubrics can also produce a good achievement assessments direction showing whether a student is either improving or not in a repeated or iterative assessment. In a nutshell, its use leads to the performance improvement of students. The results provided some insights for further investigation and will be beneficial to researchers, requirements engineers, system designers, developers and project managers.

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.

The Role of Social Media for Collaborative Learning to Improve Academic Performance of Students and Researchers in Malaysian Higher Education

ERIC Educational Resources Information Center

Al-Rahmi, Waleed Mugahed; Othman, Mohd Shahizan; Yusuf, Lizawati Mi

2015-01-01

Social media is widely considered to improve collaborative learning among students and researchers. However, there is a surprising lack of empirical research in Malaysian higher education to improve performance of students and researchers through the effective use of social media that facilitates desirable outcomes. Thus, this study offers a…

Achieving quality improvement in the nursing home: influence of nursing leadership on communication and teamwork.

PubMed

Vogelsmeier, Amy; Scott-Cawiezell, Jill

2011-01-01

Leadership, communication, and teamwork are essential elements of organizational capacity and are linked to organizational performance. How those organizations actually achieve improved performance, however, is not clearly understood. In this comparative case study, nursing leadership who facilitated open communication and teamwork achieved improvement while nursing leadership who impeded open communication and teamwork did not.

Implementation research to improve quality of maternal and newborn health care, Malawi.

PubMed

Brenner, Stephan; Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela

2017-07-01

To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities' essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants' adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care.

Different paths to high-quality care: three archetypes of top-performing practice sites.

PubMed

Feifer, Chris; Nemeth, Lynne; Nietert, Paul J; Wessell, Andrea M; Jenkins, Ruth G; Roylance, Loraine; Ornstein, Steven M

2007-01-01

Primary care practices use different approaches in their quest for high-quality care. Previous work in the Practice Partner Research Network (PPRNet) found that improved outcomes are associated with strategies to prioritize performance, involve staff, redesign elements of the delivery system, make patients active partners in guideline adherence, and use tools embedded in the electronic medical record. The aim of this study was to examine variations in the adoption of improvements among sites achieving the best outcomes. This study used an observational case study design. A practice-level measure of adherence to clinical guidelines was used to identify the highest performing practices in a network of internal and family medicine practices participating in a national demonstration project. We analyzed qualitative and quantitative information derived from project documents, field notes, and evaluation questionnaires to develop and compare case studies. Nine cases are described. All use many of the same improvement strategies. Differences in the way improvements are organized define 3 distinct archetypes: the Technophiles, the Motivated Team, and the Care Enterprise. There is no single approach that explains the superior performance of high-performing practices, though each has adopted variations of PPRNet's improvement model. Practices will vary in their path to high-quality care. The archetypes could prove to be a useful guide to other practices selecting an overall quality improvement approach.

Health-care process improvement decisions: a systems perspective.

PubMed

Walley, Paul; Silvester, Kate; Mountford, Shaun

2006-01-01

The paper seeks to investigate decision-making processes within hospital improvement activity, to understand how performance measurement systems influence decisions and potentially lead to unsuccessful or unsustainable process changes. A longitudinal study over a 33-month period investigates key events, decisions and outcomes at one medium-sized hospital in the UK. Process improvement events are monitored using process control methods and by direct observation. The authors took a systems perspective of the health-care processes, ensuring that the impacts of decisions across the health-care supply chain were appropriately interpreted. The research uncovers the ways in which measurement systems disguise failed decisions and encourage managers to take a low-risk approach of "symptomatic relief" when trying to improve performance metrics. This prevents many managers from trying higher risk, sustainable process improvement changes. The behaviour of the health-care system is not understood by many managers and this leads to poor analysis of problem situations. Measurement using time-series methodologies, such as statistical process control are vital for a better understanding of the systems impact of changes. Senior managers must also be aware of the behavioural influence of similar performance measurement systems that discourage sustainable improvement. There is a risk that such experiences will tarnish the reputation of performance management as a discipline. Recommends process control measures as a way of creating an organization memory of how decisions affect performance--something that is currently lacking.

Microwave photonic link with improved phase noise using a balanced detection scheme

NASA Astrophysics Data System (ADS)

Hu, Jingjing; Gu, Yiying; Tan, Wengang; Zhu, Wenwu; Wang, Linghua; Zhao, Mingshan

2016-07-01

A microwave photonic link (MPL) with improved phase noise performance using a dual output Mach-Zehnder modulator (DP-MZM) and balanced detection is proposed and experimentally demonstrated. The fundamental concept of the approach is based on the two complementary outputs of DP-MZM and the destructive combination of the photocurrent in balanced photodetector (BPD). Theoretical analysis is performed to numerical evaluate the additive phase noise performance and shows a good agreement with the experiment. Experimental results are presented for 4 GHz, 8 GHz and 12 GHz transmission link and an 11 dB improvement of phase noise performance at 10 MHz offset is achieved compared to the conventional intensity-modulation and direct-detection (IMDD) MPL.

Improving Motor and Drive System Performance – A Sourcebook for Industry

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

None

This sourcebook outlines opportunities to improve motor and drive systems performance. The sourcebook is divided into four main sections: (1) Motor and Drive System Basics: Summarizes important terms, relationships, and system design considerations relating to motor and drive systems. (2) Performance Opportunity Road Map: Details the key components of well-functioning motor and drive systems and opportunities for energy performance opportunities. (3) Motor System Economics: Offers recommendations on how to propose improvement projects based on corporate priorities, efficiency gains, and financial payback periods. (4) Where to Find Help: Provides a directory of organizations associated with motors and drives, as well asmore » resources for additional information, tools, software, videos, and training opportunities.« less

On improving the performance of nonphotochemical quenching in CP29 light-harvesting antenna complex

NASA Astrophysics Data System (ADS)

Berman, Gennady P.; Nesterov, Alexander I.; Sayre, Richard T.; Still, Susanne

2016-03-01

We model and simulate the performance of charge-transfer in nonphotochemical quenching (NPQ) in the CP29 light-harvesting antenna-complex associated with photosystem II (PSII). The model consists of five discrete excitonic energy states and two sinks, responsible for the potentially damaging processes and charge-transfer channels, respectively. We demonstrate that by varying (i) the parameters of the chlorophyll-based dimer, (ii) the resonant properties of the protein-solvent environment interaction, and (iii) the energy transfer rates to the sinks, one can significantly improve the performance of the NPQ. Our analysis suggests strategies for improving the performance of the NPQ in response to environmental changes, and may stimulate experimental verification.

Preliminary supersonic flight test evaluation of performance seeking control

NASA Technical Reports Server (NTRS)

Orme, John S.; Gilyard, Glenn B.

1993-01-01

Digital flight and engine control, powerful onboard computers, and sophisticated controls techniques may improve aircraft performance by maximizing fuel efficiency, maximizing thrust, and extending engine life. An adaptive performance seeking control system for optimizing the quasi-steady state performance of an F-15 aircraft was developed and flight tested. This system has three optimization modes: minimum fuel, maximum thrust, and minimum fan turbine inlet temperature. Tests of the minimum fuel and fan turbine inlet temperature modes were performed at a constant thrust. Supersonic single-engine flight tests of the three modes were conducted using varied after burning power settings. At supersonic conditions, the performance seeking control law optimizes the integrated airframe, inlet, and engine. At subsonic conditions, only the engine is optimized. Supersonic flight tests showed improvements in thrust of 9 percent, increases in fuel savings of 8 percent, and reductions of up to 85 deg R in turbine temperatures for all three modes. The supersonic performance seeking control structure is described and preliminary results of supersonic performance seeking control tests are given. These findings have implications for improving performance of civilian and military aircraft.

Gap analysis: assessing the value perception of consultant pharmacist services and the performance of consultant pharmacists.

PubMed

Clark, Thomas R

2008-09-01

To understand the importance of services provided by consultant pharmacists and to assess perception of their performance of services. Cross-sectional; nursing facility team. Random e-mail survey of consultant pharmacists; phone survey of team members. 233 consultant pharmacists (practicing in a nursing facility); 540 team members (practicing in a nursing facility, interacting with > or = 1 consultant pharmacist): 120 medical directors, 210 directors of nursing, 210 administrators. Consultant pharmacists, directors of nursing, medical directors, and administrators rating importance/performance of 21 services. Gap between teams' ratings of importance and consultant pharmacists' performance is assessed to categorize services. Importance/performance ranked on five-point scale. Mean scores used for gap analysis to cluster services into four categories. Per combined group, six services categorized as "Keep It Up" (important, good performance), consensus with individual groups, except discrepancy with medical directors, for one service. Six services each categorized as "Improve" (important, large gap) and "Improve Second" (lower importance, large gap), with varied responses by individual groups. Three different services were categorized into "Don't Worry," with consensus within individual groups. Consensus from all groups found 5 of 21 services are important and performed well by consultant pharmacists, indicating to maintain performance of services. For three services, consultant pharmacists do not need to worry about their performance. Thirteen services require improvement in consultant pharmacists' performance; various groups differ on extent of improvement needed. Results can serve as benchmark comparisons with results obtained by consultant pharmacists in their own facilities.

An evaluation of improved structural materials in marine piling.

DOT National Transportation Integrated Search

1980-11-01

A study to evaluate the production and field performance of marine piling fabricated with improved structural materials is currently being performed by the Oregon State Highway Division under the sponsorship of the Federal Highway Administration. In ...

Improved prediction models for PCC pavement performance-related specifications

DOT National Transportation Integrated Search

2000-01-01

Performance-related specifications (PRS) for the acceptance of newly constructed jointed plain concrete pavements (JPCP) have been developed over the past decade. The main objectives of this study were to improve the distress and smoothness predictio...

42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... learning throughout the hospital. (3) The hospital must take actions aimed at performance improvement and... QIO cooperative project, but its own projects are required to be of comparable effort. (e) Standard...

A Critical Review on Tubercles Design for Propellers

NASA Astrophysics Data System (ADS)

Seeni, A.; Rajendran, P.; Kutty, H. A.

2018-05-01

The design of propellers in aeronautics is still earning high interest. This has led to the application of biomimetic for improving aerodynamic performance. One such design is the usage of tubercles in either leading or trailing edge of airfoils. So the usage of tubercles has so far been in the design of wing or wind-turbines. Recent studies have aimed to study tubercles for the design of a propeller. The studies have so far gained reputations in improving the aerodynamic performance on a few but not all of the airfoil shapes. Similar results have been identified for propeller designs with improvement in thrust at low torque. We have so far led research works on developing new propeller designs with the aim to improve the thrust and torque performance of propeller. A review of recent studies has been performed to study the state-of-the-art. The results of this work will be discussed in this paper.

DSN 70-meter antenna microwave optics design and performance improvements. Part 2: Comparison with measurements

NASA Technical Reports Server (NTRS)

Bathker, D. A.; Slobin, S. D.

1989-01-01

The measured Deep Space Network (DSN) 70-meter antenna performance at S- and X-bands is compared with the design expectations. A discussion of natural radio-source calibration standards is given. New estimates of DSN 64-meter antenna performance are given, based on improved values of calibration source flux and size correction. A comparison of the 64- and 70-meter performances shows that average S-band peak gain improvement is 1.94 dB, compared with a design expectation of 1.77 dB. At X-band, the average peak gain improvement is 2.12 dB, compared with the (coincidentally similar) design expectation of 1.77 dB. The average measured 70-meter S-band peak gain exceeds the nominal design-expected gain by 0.02 dB; the average measured 70-meter X-band peak gain is 0.14 dB below the nominal design-expected gain.

Performance analysis and improvement of WPAN MAC for home networks.

PubMed

Mehta, Saurabh; Kwak, Kyung Sup

2010-01-01

The wireless personal area network (WPAN) is an emerging wireless technology for future short range indoor and outdoor communication applications. The IEEE 802.15.3 medium access control (MAC) is proposed to coordinate the access to the wireless medium among the competing devices, especially for short range and high data rate applications in home networks. In this paper we use analytical modeling to study the performance analysis of WPAN (IEEE 802.15.3) MAC in terms of throughput, efficient bandwidth utilization, and delay with various ACK policies under error channel condition. This allows us to introduce a K-Dly-ACK-AGG policy, payload size adjustment mechanism, and Improved Backoff algorithm to improve the performance of the WPAN MAC. Performance evaluation results demonstrate the impact of our improvements on network capacity. Moreover, these results can be very useful to WPAN application designers and protocol architects to easily and correctly implement WPAN for home networking.

Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality.

PubMed

Backman, Chantal; Vanderloo, Saskia; Forster, Alan John

2016-09-01

Measuring and monitoring overall health system performance is complex and challenging but is crucial to improving quality of care. Today's health care organizations are increasingly being held accountable to develop and implement actions aimed at improving the quality of care, reducing costs, and achieving better patient-centered care. This paper describes the development of the Collaborative for Excellence in Healthcare Quality (CEHQ), a 5-year initiative to achieve higher quality of patient care in university hospitals across Canada. This bottom-up initiative took place between 2010 and 2015, and was successful in engaging health care leaders in the development of a common framework and set of performance measures for reporting and benchmarking, as well as working on initiatives to improve performance. Despite its successes, future efforts are needed to provide clear national leadership on standards for measuring performance. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Flashing characters with famous faces improves ERP-based brain-computer interface performance

NASA Astrophysics Data System (ADS)

Kaufmann, T.; Schulz, S. M.; Grünzinger, C.; Kübler, A.

2011-10-01

Currently, the event-related potential (ERP)-based spelling device, often referred to as P300-Speller, is the most commonly used brain-computer interface (BCI) for enhancing communication of patients with impaired speech or motor function. Among numerous improvements, a most central feature has received little attention, namely optimizing the stimulus used for eliciting ERPs. Therefore we compared P300-Speller performance with the standard stimulus (flashing characters) against performance with stimuli known for eliciting particularly strong ERPs due to their psychological salience, i.e. flashing familiar faces transparently superimposed on characters. Our results not only indicate remarkably increased ERPs in response to familiar faces but also improved P300-Speller performance due to a significant reduction of stimulus sequences needed for correct character classification. These findings demonstrate a promising new approach for improving the speed and thus fluency of BCI-enhanced communication with the widely used P300-Speller.

Improving guideline concordance in multidisciplinary teams: preliminary results of a cluster-randomized trial evaluating the effect of a web-based audit and feedback intervention with outreach visits

PubMed Central

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

2015-01-01

Despite their widespread use, audit and feedback (A&F) interventions show variable effectiveness on improving professional performance. Based on known facilitators of successful A&F interventions, we developed a web-based A&F intervention with indicator-based performance feedback, benchmark information, action planning and outreach visits. The goal of the intervention was to engage with multidisciplinary teams to overcome barriers to guideline concordance and to improve overall team performance in the field of cardiac rehabilitation (CR). To assess its effectiveness we conducted a cluster-randomized trial in 18 CR clinics (14,847 patients) already working with computerized decision support (CDS). Our preliminary results showed no increase in concordance with guideline recommendations regarding prescription of CR therapies. Future analyses will investigate whether our intervention did improve team performance on other quality indicators. PMID:26958310

Performance Analysis and Improvement of WPAN MAC for Home Networks

PubMed Central

Mehta, Saurabh; Kwak, Kyung Sup

2010-01-01

The wireless personal area network (WPAN) is an emerging wireless technology for future short range indoor and outdoor communication applications. The IEEE 802.15.3 medium access control (MAC) is proposed to coordinate the access to the wireless medium among the competing devices, especially for short range and high data rate applications in home networks. In this paper we use analytical modeling to study the performance analysis of WPAN (IEEE 802.15.3) MAC in terms of throughput, efficient bandwidth utilization, and delay with various ACK policies under error channel condition. This allows us to introduce a K-Dly-ACK-AGG policy, payload size adjustment mechanism, and Improved Backoff algorithm to improve the performance of the WPAN MAC. Performance evaluation results demonstrate the impact of our improvements on network capacity. Moreover, these results can be very useful to WPAN application designers and protocol architects to easily and correctly implement WPAN for home networking. PMID:22319274

Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture

PubMed Central

Johnson, Eric J.; Hassin, Ran; Baker, Tom; Bajger, Allison T.; Treuer, Galen

2013-01-01

Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a “smart” default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484

A novel double loop control model design for chemical unstable processes.

PubMed

Cong, Er-Ding; Hu, Ming-Hui; Tu, Shan-Tung; Xuan, Fu-Zhen; Shao, Hui-He

2014-03-01

In this manuscript, based on Smith predictor control scheme for unstable process in industry, an improved double loop control model is proposed for chemical unstable processes. Inner loop is to stabilize integrating the unstable process and transform the original process to first-order plus pure dead-time dynamic stable process. Outer loop is to enhance the performance of set point response. Disturbance controller is designed to enhance the performance of disturbance response. The improved control system is simple with exact physical meaning. The characteristic equation is easy to realize stabilization. Three controllers are separately design in the improved scheme. It is easy to design each controller and good control performance for the respective closed-loop transfer function separately. The robust stability of the proposed control scheme is analyzed. Finally, case studies illustrate that the improved method can give better system performance than existing design methods. © 2013 ISA Published by ISA All rights reserved.

Integrated versus isolated training of the hemiparetic upper extremity in haptically rendered virtual environments.

PubMed

Qiu, Qinyin; Fluet, Gerard G; Saleh, Soha; Lafond, Ian; Merians, Alma S; Adamovich, Sergei V

2010-01-01

This paper describes the preliminary results of an ongoing study of the effects of two training approaches on motor function and learning in persons with hemi paresis due to cerebrovascular accidents. Eighteen subjects with chronic stroke performed eight, three-hour sessions of sensorimotor training in haptically renedered environments. Eleven subjects performed training activities that integrated hand and arm movement while another seven subjects performed activities that trained the hand and arm with separately. As a whole, the eighteen subjects made statistically significant improvements in motor function as evidenced by robust improvements in Wolf Motor Function Test times and corresponding improvements in Jebsen Test of Hand Function times. There were no significant between group effects for these tests. However, the two training approaches elicited different patterns and magnitudes of performance improvement that suggest that they may elicit different types of change in motor learning and or control.

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

Support Vector Machines to improve physiologic hot flash measures: application to the ambulatory setting.

PubMed

Thurston, Rebecca C; Hernandez, Javier; Del Rio, Jose M; De La Torre, Fernando

2011-07-01

Most midlife women have hot flashes. The conventional criterion (≥2 μmho rise/30 s) for classifying hot flashes physiologically has shown poor performance. We improved this performance in the laboratory with Support Vector Machines (SVMs), a pattern classification method. We aimed to compare conventional to SVM methods to classify hot flashes in the ambulatory setting. Thirty-one women with hot flashes underwent 24 h of ambulatory sternal skin conductance monitoring. Hot flashes were quantified with conventional (≥2 μmho/30 s) and SVM methods. Conventional methods had low sensitivity (sensitivity=.57, specificity=.98, positive predictive value (PPV)=.91, negative predictive value (NPV)=.90, F1=.60), with performance lower with higher body mass index (BMI). SVMs improved this performance (sensitivity=.87, specificity=.97, PPV=.90, NPV=.96, F1=.88) and reduced BMI variation. SVMs can improve ambulatory physiologic hot flash measures. Copyright © 2010 Society for Psychophysiological Research.

Feasibility of peer assessment and clinical audit to self-regulate the quality of physiotherapy services: a mixed methods study

PubMed Central

Nijhuis-van der Sanden, Maria W G; Driehuis, Femke; Heerkens, Yvonne F; van der Vleuten, Cees P M; van der Wees, Philip J

2017-01-01

Objectives To evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation strategy and (3) impact on quality improvement. Design Mixed methods study. Participants and setting 64 physiotherapists working in primary care, organised in a network of communities of practice in the Netherlands. Methods The programme contained: (1) two cycles of online self-assessment and peer assessment (PA) of clinical performance using client records and video-recordings of client communication followed by face-to-face group discussions, and (2) clinical audit assessing organisational performance. Assessment was based on predefined performance indicators which could be scored on a 5-point Likert scale. Discussions addressed performance standards and scoring differences. All feasibility domains were evaluated qualitatively with two focus groups and 10 in-depth interviews. In addition, we evaluated the impact on quality improvement quantitatively by comparing self-assessment and PA scores in cycles 1 and 2. Results We identified critical success features relevant to programme development and implementation, such as clarifying expectations at baseline, training in PA skills, prolonged engagement with video-assessment and competent group coaches. Self-reported impact on quality improvement included awareness of clinical and organisational performance, improved evidence-based practice and client-centeredness and increased motivation to self-direct quality improvement. Differences between self-scores and peer scores on performance indicators were not significant. Between cycles 1 and 2, scores for record keeping showed significant improvement, however not for client communication. Conclusions This study demonstrated that bottom-up initiatives to improve healthcare quality can be effective. The results justify ongoing evaluation to inform nationwide implementation when the critical success features are addressed. Further research is necessary to explore the sustainability of the results and the impact on client outcomes in a full-scale study. PMID:28188156

Acute, low-dose methamphetamine administration improves attention/information processing speed and working memory in methamphetamine-dependent individuals displaying poorer cognitive performance at baseline.

PubMed

Mahoney, James J; Jackson, Brian J; Kalechstein, Ari D; De La Garza, Richard; Newton, Thomas F

2011-03-30

Abstinent methamphetamine (Meth) dependent individuals demonstrate poorer performance on tests sensitive to attention/information processing speed, learning and memory, and working memory when compared to non-Meth dependent individuals. The poorer performance on these tests may contribute to the morbidity associated with Meth-dependence. In light of this, we sought to determine the effects of acute, low-dose Meth administration on attention, working memory, and verbal learning and memory in 19 non-treatment seeking, Meth-dependent individuals. Participants were predominantly male (89%), Caucasian (63%), and cigarette smokers (63%). Following a four day, drug-free washout period, participants were given a single-blind intravenous infusion of saline, followed the next day by 30 mg of Meth. A battery of neurocognitive tasks was administered before and after each infusion, and performance on measures of accuracy and reaction time were compared between conditions. While acute Meth exposure did not affect test performance for the entire sample, participants who demonstrated relatively poor performance on these tests at baseline, identified using a median split on each test, showed significant improvement on measures of attention/information processing speed and working memory when administered Meth. Improved performance was seen on the following measures of working memory: choice reaction time task (p≤0.04), a 1-back task (p≤0.01), and a 2-back task (p≤0.04). In addition, those participants demonstrating high neurocognitive performance at baseline experienced similar or decreased performance following Meth exposure. These findings suggest that acute administration of Meth may temporarily improve Meth-associated neurocognitive performance in those individuals experiencing lower cognitive performance at baseline. As a result, stimulants may serve as a successful treatment for improving cognitive functioning in those Meth-dependent individuals experiencing neurocognitive impairment. Copyright © 2010 Elsevier B.V. All rights reserved.

How to Sustain Change and Support Continuous Quality Improvement

PubMed Central

McQuillan, Rory; Harel, Ziv; Weizman, Adam V.; Thomas, Alison; Nesrallah, Gihad; Bell, Chaim M.; Chan, Christopher T.; Chertow, Glenn M.

2016-01-01

To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. However, most organizational change is not maintained. In this next article in this Moving Points in Nephrology feature on quality improvement, we provide health care professionals with strategies to sustain and support quality improvement. Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. Many of these tools rely on principles of visual management, which are systems transparent and simple so that every staff member can rapidly distinguish normal from abnormal working conditions. Even when quality improvement methods are properly applied, the success of a project still depends on contextual factors. Context refers to aspects of the local setting in which the project operates. Context affects resources, leadership support, data infrastructure, team motivation, and team performance. For these reasons, the same project may thrive in a supportive context and fail in a different context. To demonstrate the practical applications of these quality improvement principles, these principles are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). PMID:27016498

Impact of Time-of-Flight on PET Tumor Detection

PubMed Central

Kadrmas, Dan J.; Casey, Michael E.; Conti, Maurizio; Jakoby, Bjoern W.; Lois, Cristina; Townsend, David W.

2009-01-01

Time-of-flight (TOF) PET uses very fast detectors to improve localization of events along coincidence lines-of-response. This information is then utilized to improve the tomographic reconstruction. This work evaluates the effect of TOF upon an observer's performance for detecting and localizing focal warm lesions in noisy PET images. Methods An advanced anthropomorphic lesion-detection phantom was scanned 12 times over 3 days on a prototype TOF PET/CT scanner (Siemens Medical Solutions). The phantom was devised to mimic whole-body oncologic 18F-FDG PET imaging, and a number of spheric lesions (diameters 6–16 mm) were distributed throughout the phantom. The data were reconstructed with the baseline line-of-response ordered-subsets expectation-maximization algorithm, with the baseline algorithm plus point spread function model (PSF), baseline plus TOF, and with both PSF+TOF. The lesion-detection performance of each reconstruction was compared and ranked using localization receiver operating characteristics (LROC) analysis with both human and numeric observers. The phantom results were then subjectively compared to 2 illustrative patient scans reconstructed with PSF and with PSF+TOF. Results Inclusion of TOF information provides a significant improvement in the area under the LROC curve compared to the baseline algorithm without TOF data (P = 0.002), providing a degree of improvement similar to that obtained with the PSF model. Use of both PSF+TOF together provided a cumulative benefit in lesion-detection performance, significantly outperforming either PSF or TOF alone (P < 0.002). Example patient images reflected the same image characteristics that gave rise to improved performance in the phantom data. Conclusion Time-of-flight PET provides a significant improvement in observer performance for detecting focal warm lesions in a noisy background. These improvements in image quality can be expected to improve performance for the clinical tasks of detecting lesions and staging disease. Further study in a large clinical population is warranted to assess the benefit of TOF for various patient sizes and count levels, and to demonstrate effective performance in the clinical environment. PMID:19617317

Experimental and Numerical Optimization of a High-Lift System to Improve Low-Speed Performance, Stability, and Control of an Arrow-Wing Supersonic Transport

NASA Technical Reports Server (NTRS)

Hahne, David E.; Glaab, Louis J.

1999-01-01

An investigation was performed to evaluate leading-and trailing-edge flap deflections for optimal aerodynamic performance of a High-Speed Civil Transport concept during takeoff and approach-to-landing conditions. The configuration used for this study was designed by the Douglas Aircraft Company during the 1970's. A 0.1-scale model of this configuration was tested in the Langley 30- by 60-Foot Tunnel with both the original leading-edge flap system and a new leading-edge flap system, which was designed with modem computational flow analysis and optimization tools. Leading-and trailing-edge flap deflections were generated for the original and modified leading-edge flap systems with the computational flow analysis and optimization tools. Although wind tunnel data indicated improvements in aerodynamic performance for the analytically derived flap deflections for both leading-edge flap systems, perturbations of the analytically derived leading-edge flap deflections yielded significant additional improvements in aerodynamic performance. In addition to the aerodynamic performance optimization testing, stability and control data were also obtained. An evaluation of the crosswind landing capability of the aircraft configuration revealed that insufficient lateral control existed as a result of high levels of lateral stability. Deflection of the leading-and trailing-edge flaps improved the crosswind landing capability of the vehicle considerably; however, additional improvements are required.

Effects of a Six-Week Strength Training Programme on Change of Direction Performance in Youth Team Sport Athletes

PubMed Central

Bourgeois, Frank A.; Gamble, Paul; Gill, Nic D.; McGuigan, Mike R.

2017-01-01

This study investigated the effects of eccentric phase-emphasis strength training (EPE) on unilateral strength and performance in 180- and 45-degree change of direction (COD) tasks in rugby union players. A 12-week cross-over design was used to compare the efficacy of resistance training executed with 3 s eccentric duration (EPE, n = 12) against conventional strength training, with no constraints on tempo (CON, n = 6). Players in each condition were categorised as ‘fast’ (FAST) or ‘slow’ (SLOW) using median trial times from baseline testing. Players recorded greater isometric strength improvements following EPE (ES = −0.54 to 1.80). Whilst these changes were not immediate, players improved in strength following cessation. Improvements in 180-degree COD performance was recorded at all test-points following EPE (ES = −1.32 to −0.15). Improvements in 45-degree COD performance were apparent for FAST following CON (ES = −0.96 to 0.10), but CON was deleterious for SLOW (ES = −0.60 to 1.53). Eccentric phase-emphasis strength training shows potential for sustained strength enhancement. Positive performance changes in COD tasks were category- and condition-specific. The data indicate the greatest improvement occurred at nine weeks following resistance training in these players. Performance benefits may also be specific to COD task, player category, and relative to emphasis on eccentric phase activity. PMID:29910443

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.

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.

Low-frequency group exercise improved the motor functions of community-dwelling elderly people in a rural area when combined with home exercise with self-monitoring

PubMed Central

Matsubayashi, Yoshito; Asakawa, Yasuyoshi; Yamaguchi, Haruyasu

2016-01-01

[Purpose] This study examined whether low-frequency group exercise improved the motor functions of community-dwelling elderly people in a rural area when combined with home exercise with self-monitoring. [Subjects] The subjects were community-dwelling elderly people in a rural area of Japan. [Methods] One group (n = 50) performed group exercise combined with home exercise with self-monitoring. Another group (n = 37) performed group exercise only. Low-frequency group exercise (warm-up, exercises for motor functions, and cool-down) was performed in seven 40 to 70-minute sessions over 9 weeks by both groups. Five items of motor functions were assessed before and after the intervention. [Results] Significant interactions were observed between groups and assessment times for all motor functions. Improvements in motor functions were significantly greater in the group that performed group exercise combined with home exercise with self-monitoring than in the group that performed group exercise only. Post-hoc comparisons revealed significant differences in 3 items of motor functions. No significant improvements were observed in motor functions in the group that performed group exercise only. [Conclusions] Group exercise combined with home exercise with self-monitoring improved motor functions in the setting of low-frequency group exercise for community-dwelling elderly people in a rural area. PMID:27065520

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

PubMed

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

2013-07-01

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

Use of a disclosed plaque visualization technique improved the self-performed, tooth brushing ability of primary schoolchildren.

PubMed

Chounchaisithi, Napa; Santiwong, Busayarat; Sutthavong, Sirikarn; Asvanit, Pompun

2014-02-01

Disclosing agents have a long history of use as an aid in children's tooth brushing instruction. However, their benefit when used to improve self-performed tooth brushing ability without any tooth brushing instruction has not been investigated. To evaluate the effect of disclosed plaque visualization on improving the self-performed, tooth brushing ability of primary school children. A cluster-randomized, crossover study was conducted in Nakhon Nayok province, Thailand. A total of 122 second-grade schoolchildren, aged 8-10 years old, from 12 schools were randomly divided into 2 groups. The first group was assigned to brush with disclosed plaque visualization, while the other group brushed without disclosed plaque visualization. One month later the groups switched procedures. Tooth brushing ability was evaluated by the subjects' reduction in patient hygiene performance (PHP) scores. The data were analyzed using repeated-measures analysis of variance, with significance set at p<0.05. Disclosed plaque visualization had a significant effect on improving the children's self-performed, tooth brushing ability in all areas of the mouth (p<0.001), particularly for anterior teeth, mandibular teeth, buccal surfaces, and areas adjacent to the gingival margin (p<0.001). Disclosed plaque visualization is a viable technique to improve children's self-performed tooth brushing ability, and could be used in school-based oral health promotion programs.

Exercise training for intermittent claudication.

PubMed

McDermott, Mary M

2017-11-01

The objective of this study was to provide an overview of evidence regarding exercise therapies for patients with lower extremity peripheral artery disease (PAD). This manuscript summarizes the content of a lecture delivered as part of the 2016 Crawford Critical Issues Symposium. Multiple randomized clinical trials demonstrate that supervised treadmill exercise significantly improves treadmill walking performance in people with PAD and intermittent claudication symptoms. A meta-analysis of 25 randomized trials demonstrated a 180-meter increase in treadmill walking distance in response to supervised exercise interventions compared with a nonexercising control group. Supervised treadmill exercise has been inaccessible to many patients with PAD because of lack of medical insurance coverage. However, in 2017, the Centers for Medicare and Medicaid Services issued a decision memorandum to support health insurance coverage of 12 weeks of supervised treadmill exercise for patients with walking impairment due to PAD. Recent evidence also supports home-based walking exercise to improve walking performance in people with PAD. Effective home-exercise programs incorporate behavioral change interventions such as a remote coach, goal setting, and self-monitoring. Supervised treadmill exercise programs preferentially improve treadmill walking performance, whereas home-based walking exercise programs preferentially improve corridor walking, such as the 6-minute walk test. Clinical trial evidence also supports arm or leg ergometry exercise to improve walking endurance in people with PAD. Treadmill walking exercise appears superior to resistance training alone for improving walking endurance. Supervised treadmill exercise significantly improves treadmill walking performance in people with PAD by approximately 180 meters compared with no exercise. Recent evidence suggests that home-based exercise is also effective and preferentially improves over-ground walking performance, such as the 6-minute walk test. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Study of Potential for Motor Vehicle Fuel Economy Improvement : Technology Panel Report

DOT National Transportation Integrated Search

1975-01-01

The authors evaluate individual technologies which could produce improved automobile fuel economy in the areas of vehicle improvement (reduced weight and aerodynamic drag), transmission improvement, engine improvements and reduced performance acceler...

Targeting nursing homes under the Quality Improvement Organization program's 9th statement of work.

PubMed

Stevenson, David G; Mor, Vincent

2009-09-01

In the Quality Improvement Organization (QIO) program's latest Statement of Work, the Centers for Medicare and Medicaid Services (CMS) is targeting its nursing home activities toward facilities that perform poorly on two quality measures-pressure ulcers and restraint use. The designation of target facilities is a shift in strategy for CMS and a direct response to criticism that QIO program resources were not being targeted effectively to facilities or clinical areas that most needed improvement. Using administrative data, this article analyzes implications of using narrowly defined criteria to identify facilities that need improvement, particularly in light of considerable evidence showing that nursing home quality is multidimensional and may change over time. The analyses show that one in four facilities is targeted for improvement nationally but that approximately half of some states' facilities are targeted while other states have almost none targeted. The analyses also convey deeper limitations to using threshold values on individual measures to identify poorly performing homes. Target facilities can be among the top performers on a range of other quality measures, and their performance on targeted measures themselves may change over time. The implication of these features is that a very different group of facilities would have been chosen had the QIO program targeted other measures or examined performance at a different point in time. Ultimately, CMS has chosen a blunt instrument to identify poorly performing nursing homes, and supplemental strategies-such as soliciting input from state survey agencies and more closely aligning quality improvement and quality assurance efforts-should be considered to address potential limitations.

MEASUREMENT: ACCOUNTING FOR RELIABILITY IN PERFORMANCE ESTIMATES.

PubMed

Waterman, Brian; Sutter, Robert; Burroughs, Thomas; Dunagan, W Claiborne

2014-01-01

When evaluating physician performance measures, physician leaders are faced with the quandary of determining whether departures from expected physician performance measurements represent a true signal or random error. This uncertainty impedes the physician leader's ability and confidence to take appropriate performance improvement actions based on physician performance measurements. Incorporating reliability adjustment into physician performance measurement is a valuable way of reducing the impact of random error in the measurements, such as those caused by small sample sizes. Consequently, the physician executive has more confidence that the results represent true performance and is positioned to make better physician performance improvement decisions. Applying reliability adjustment to physician-level performance data is relatively new. As others have noted previously, it's important to keep in mind that reliability adjustment adds significant complexity to the production, interpretation and utilization of results. Furthermore, the methods explored in this case study only scratch the surface of the range of available Bayesian methods that can be used for reliability adjustment; further study is needed to test and compare these methods in practice and to examine important extensions for handling specialty-specific concerns (e.g., average case volumes, which have been shown to be important in cardiac surgery outcomes). Moreover, it's important to note that the provider group average as a basis for shrinkage is one of several possible choices that could be employed in practice and deserves further exploration in future research. With these caveats, our results demonstrate that incorporating reliability adjustment into physician performance measurements is feasible and can notably reduce the incidence of "real" signals relative to what one would expect to see using more traditional approaches. A physician leader who is interested in catalyzing performance improvement through focused, effective physician performance improvement is well advised to consider the value of incorporating reliability adjustments into their performance measurement system.

Modeling and performance improvement of the constant power regulator systems in variable displacement axial piston pump.

PubMed

Park, Sung Hwan; Lee, Ji Min; Kim, Jong Shik

2013-01-01

An irregular performance of a mechanical-type constant power regulator is considered. In order to find the cause of an irregular discharge flow at the cut-off pressure area, modeling and numerical simulations are performed to observe dynamic behavior of internal parts of the constant power regulator system for a swashplate-type axial piston pump. The commercial numerical simulation software AMESim is applied to model the mechanical-type regulator with hydraulic pump and simulate the performance of it. The validity of the simulation model of the constant power regulator system is verified by comparing simulation results with experiments. In order to find the cause of the irregular performance of the mechanical-type constant power regulator system, the behavior of main components such as the spool, sleeve, and counterbalance piston is investigated using computer simulation. The shape modification of the counterbalance piston is proposed to improve the undesirable performance of the mechanical-type constant power regulator. The performance improvement is verified by computer simulation using AMESim software.

Attention Modifies Spatial Resolution According to Task Demands.

PubMed

Barbot, Antoine; Carrasco, Marisa

2017-03-01

How does visual attention affect spatial resolution? In texture-segmentation tasks, exogenous (involuntary) attention automatically increases resolution at the attended location, which improves performance where resolution is too low (at the periphery) but impairs performance where resolution is already too high (at central locations). Conversely, endogenous (voluntary) attention improves performance at all eccentricities, which suggests a more flexible mechanism. Here, using selective adaptation to spatial frequency, we investigated the mechanism by which endogenous attention benefits performance in resolution tasks. Participants detected a texture target that could appear at several eccentricities. Adapting to high or low spatial frequencies selectively affected performance in a manner consistent with changes in resolution. Moreover, adapting to high, but not low, frequencies mitigated the attentional benefit at central locations where resolution was too high; this shows that attention can improve performance by decreasing resolution. Altogether, our results indicate that endogenous attention benefits performance by modulating the contribution of high-frequency information in order to flexibly adjust spatial resolution according to task demands.

Ready to rumble: how team personality composition and task conflict interact to improve performance.

PubMed

Bradley, Bret H; Klotz, Anthony C; Postlethwaite, Bennett E; Brown, Kenneth G

2013-03-01

Although prior work has proposed a number of conditions under which task conflict in teams may improve performance, composition variables have been left unexplored. Given the effects of personality traits on team processes and outcomes demonstrated in prior work, investigating whether specific personality compositions influence the effect of task conflict on team performance is critical to researchers' understanding of conflict in teams. Our results indicate that team-level averages of both openness to experience and emotional stability function as moderators of the relationship between task conflict and team performance. Specifically, task conflict had a positive impact on performance in teams with high levels of openness or emotional stability; in contrast, task conflict had a negative impact on performance in teams with low levels of openness or emotional stability. Thus, when task conflict emerges, teams composed of members who are open minded or emotionally stable are best able to leverage conflict to improve performance. Implications for theory and practice are discussed.

Attention Modifies Spatial Resolution According to Task Demands

PubMed Central

Barbot, Antoine; Carrasco, Marisa

2017-01-01

How does visual attention affect spatial resolution? In texture-segmentation tasks, exogenous (involuntary) attention automatically increases resolution at the attended location, which improves performance where resolution is too low (at the periphery) but impairs performance where resolution is already too high (at central locations). Conversely, endogenous (voluntary) attention improves performance at all eccentricities, which suggests a more flexible mechanism. Here, using selective adaptation to spatial frequency, we investigated the mechanism by which endogenous attention benefits performance in resolution tasks. Participants detected a texture target that could appear at several eccentricities. Adapting to high or low spatial frequencies selectively affected performance in a manner consistent with changes in resolution. Moreover, adapting to high, but not low, frequencies mitigated the attentional benefit at central locations where resolution was too high; this shows that attention can improve performance by decreasing resolution. Altogether, our results indicate that endogenous attention benefits performance by modulating the contribution of high-frequency information in order to flexibly adjust spatial resolution according to task demands. PMID:28118103

Alkaline fuel cell performance investigation

NASA Technical Reports Server (NTRS)

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

1988-01-01

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

Alkaline fuel cell performance investigation

NASA Technical Reports Server (NTRS)

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

1988-01-01

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

Motor-Enriched Learning Activities Can Improve Mathematical Performance in Preadolescent Children.

PubMed

Beck, Mikkel M; Lind, Rune R; Geertsen, Svend S; Ritz, Christian; Lundbye-Jensen, Jesper; Wienecke, Jacob

2016-01-01

Objective: An emerging field of research indicates that physical activity can benefit cognitive functions and academic achievements in children. However, less is known about how academic achievements can benefit from specific types of motor activities (e.g., fine and gross) integrated into learning activities. Thus, the aim of this study was to investigate whether fine or gross motor activity integrated into math lessons (i.e., motor-enrichment) could improve children's mathematical performance. Methods: A 6-week within school cluster-randomized intervention study investigated the effects of motor-enriched mathematical teaching in Danish preadolescent children ( n = 165, age = 7.5 ± 0.02 years). Three groups were included: a control group (CON), which received non-motor enriched conventional mathematical teaching, a fine motor math group (FMM) and a gross motor math group (GMM), which received mathematical teaching enriched with fine and gross motor activity, respectively. The children were tested before (T0), immediately after (T1) and 8 weeks after the intervention (T2). A standardized mathematical test (50 tasks) was used to evaluate mathematical performance. Furthermore, it was investigated whether motor-enriched math was accompanied by different effects in low and normal math performers. Additionally, the study investigated the potential contribution of cognitive functions and motor skills on mathematical performance. Results: All groups improved their mathematical performance from T0 to T1. However, from T0 to T1, the improvement was significantly greater in GMM compared to FMM (1.87 ± 0.71 correct answers) ( p = 0.02). At T2 no significant differences in mathematical performance were observed. A subgroup analysis revealed that normal math-performers benefitted from GMM compared to both CON 1.78 ± 0.73 correct answers ( p = 0.04) and FMM 2.14 ± 0.72 correct answers ( p = 0.008). These effects were not observed in low math-performers. The effects were partly accounted for by visuo-spatial short-term memory and gross motor skills. Conclusion: The study demonstrates that motor enriched learning activities can improve mathematical performance. In normal math performers GMM led to larger improvements than FMM and CON. This was not the case for the low math performers. Future studies should further elucidate the neurophysiological mechanisms underlying the observed behavioral effects.

Motor-Enriched Learning Activities Can Improve Mathematical Performance in Preadolescent Children

PubMed Central

Beck, Mikkel M.; Lind, Rune R.; Geertsen, Svend S.; Ritz, Christian; Lundbye-Jensen, Jesper; Wienecke, Jacob

2016-01-01

Objective: An emerging field of research indicates that physical activity can benefit cognitive functions and academic achievements in children. However, less is known about how academic achievements can benefit from specific types of motor activities (e.g., fine and gross) integrated into learning activities. Thus, the aim of this study was to investigate whether fine or gross motor activity integrated into math lessons (i.e., motor-enrichment) could improve children's mathematical performance. Methods: A 6-week within school cluster-randomized intervention study investigated the effects of motor-enriched mathematical teaching in Danish preadolescent children (n = 165, age = 7.5 ± 0.02 years). Three groups were included: a control group (CON), which received non-motor enriched conventional mathematical teaching, a fine motor math group (FMM) and a gross motor math group (GMM), which received mathematical teaching enriched with fine and gross motor activity, respectively. The children were tested before (T0), immediately after (T1) and 8 weeks after the intervention (T2). A standardized mathematical test (50 tasks) was used to evaluate mathematical performance. Furthermore, it was investigated whether motor-enriched math was accompanied by different effects in low and normal math performers. Additionally, the study investigated the potential contribution of cognitive functions and motor skills on mathematical performance. Results: All groups improved their mathematical performance from T0 to T1. However, from T0 to T1, the improvement was significantly greater in GMM compared to FMM (1.87 ± 0.71 correct answers) (p = 0.02). At T2 no significant differences in mathematical performance were observed. A subgroup analysis revealed that normal math-performers benefitted from GMM compared to both CON 1.78 ± 0.73 correct answers (p = 0.04) and FMM 2.14 ± 0.72 correct answers (p = 0.008). These effects were not observed in low math-performers. The effects were partly accounted for by visuo-spatial short-term memory and gross motor skills. Conclusion: The study demonstrates that motor enriched learning activities can improve mathematical performance. In normal math performers GMM led to larger improvements than FMM and CON. This was not the case for the low math performers. Future studies should further elucidate the neurophysiological mechanisms underlying the observed behavioral effects. PMID:28066215

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.

The potential application of behavior-based safety in the trucking industry

DOT National Transportation Integrated Search

2000-04-01

Behavior-based safety (BBS) is a set of methods to improve safety performance in the workplace by engaging workers in the improvement process, identifying critical safety behaviors, performing observations to gather data, providing feedback to encour...

Assessing BMP Performance Using Microtox Toxicity Analysis

EPA Science Inventory

Best Management Practices (BMPs) have been shown to be effective in reducing runoff and pollutants from urban areas and thus provide a mechanism to improve downstream water quality. Currently, BMP performance regarding water quality improvement is assessed through measuring each...

Subsurface Remediation: Improving Long-Term Monitoring and Remedial Systems Performance Conference Proceedings

EPA Pesticide Factsheets

This document summarizes the presentations and workshops of a conference on improving long-term monitoring (LTM) and remedial systems performance that was held in St. Louis, Missouri between June 8th to 11th, 1999.

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

On the use of controls for subsonic transport performance improvement: Overview and future directions

NASA Technical Reports Server (NTRS)

Gilyard, Glenn; Espana, Martin

1994-01-01

Increasing competition among airline manufacturers and operators has highlighted the issue of aircraft efficiency. Fewer aircraft orders have led to an all-out efficiency improvement effort among the manufacturers to maintain if not increase their share of the shrinking number of aircraft sales. Aircraft efficiency is important in airline profitability and is key if fuel prices increase from their current low. In a continuing effort to improve aircraft efficiency and develop an optimal performance technology base, NASA Dryden Flight Research Center developed and flight tested an adaptive performance seeking control system to optimize the quasi-steady-state performance of the F-15 aircraft. The demonstrated technology is equally applicable to transport aircraft although with less improvement. NASA Dryden, in transitioning this technology to transport aircraft, is specifically exploring the feasibility of applying adaptive optimal control techniques to performance optimization of redundant control effectors. A simulation evaluation of a preliminary control law optimizes wing-aileron camber for minimum net aircraft drag. Two submodes are evaluated: one to minimize fuel and the other to maximize velocity. This paper covers the status of performance optimization of the current fleet of subsonic transports. Available integrated controls technologies are reviewed to define approaches using active controls. A candidate control law for adaptive performance optimization is presented along with examples of algorithm operation.