Key Performance Indicators in the Evaluation of the Quality of Radiation Safety Programs.

PubMed

Schultz, Cheryl Culver; Shaffer, Sheila; Fink-Bennett, Darlene; Winokur, Kay

2016-08-01

Beaumont is a multiple hospital health care system with a centralized radiation safety department. The health system operates under a broad scope Nuclear Regulatory Commission license but also maintains several other limited use NRC licenses in off-site facilities and clinics. The hospital-based program is expansive including diagnostic radiology and nuclear medicine (molecular imaging), interventional radiology, a comprehensive cardiovascular program, multiple forms of radiation therapy (low dose rate brachytherapy, high dose rate brachytherapy, external beam radiotherapy, and gamma knife), and the Research Institute (including basic bench top, human and animal). Each year, in the annual report, data is analyzed and then tracked and trended. While any summary report will, by nature, include items such as the number of pieces of equipment, inspections performed, staff monitored and educated and other similar parameters, not all include an objective review of the quality and effectiveness of the program. Through objective numerical data Beaumont adopted seven key performance indicators. The assertion made is that key performance indicators can be used to establish benchmarks for evaluation and comparison of the effectiveness and quality of radiation safety programs. Based on over a decade of data collection, and adoption of key performance indicators, this paper demonstrates one way to establish objective benchmarking for radiation safety programs in the health care environment.

Pilot application study of corridor performance indicators

DOT National Transportation Integrated Search

1998-09-16

The need for effective multimodal performance indicators (or measures) is becoming increasingly important for adequate planning in all sizes of transportation environments, including small and medium-size communities. These measures are essential for...

Bureau of Indian Education 2010-2011 (Based on SY 2009-2010 Data) Special Education Indicator Performance

ERIC Educational Resources Information Center

Bureau of Indian Education, 2012

2012-01-01

This report presents Special Education Indicator Performance data tables for 174 Bureau of Indian Education schools. Indicators include: (1) Graduation Rate; (2) Dropouts; (3) Assessment Targets; (4) Assessment Targets--Reading; (5) Assessment Targets--Mathematics; (6) Suspensions and Expulsions--High School; (7) Suspensions and…

Bureau of Indian Education 2012-2013 (Based on SY 2011-2012 Data) Special Education Indicator Performance

ERIC Educational Resources Information Center

Bureau of Indian Education, 2013

2013-01-01

This report presents Special Education Indicator Performance data tables for 173 Bureau of Indian Education schools. Indicators include: (1) Graduation Rate; (2) Dropouts; (3) Assessment Targets; (4) Assessment Targets--Reading; (5) Assessment Targets--Mathematics; (6) Suspensions and Expulsions--High School; (7) Suspensions and…

Performance Indicators in Math: Implications for Brief Experimental Analysis of Academic Performance

ERIC Educational Resources Information Center

VanDerheyden, Amanda M.; Burns, Matthew K.

2009-01-01

Brief experimental analysis (BEA) can be used to specify intervention characteristics that produce positive learning gains for individual students. A key challenge to the use of BEA for intervention planning is the identification of performance indicators (including topography of the skill, measurement characteristics, and decision criteria) that…

Strategic planning by independent community pharmacies.

PubMed

Harrison, Donald L

2005-01-01

(1) To assess the degree and level of use of the strategic planning process (none, partly, fully) by independent community pharmacy owners/managers and (2) to evaluate the relationships between independent community pharmacy owners/managers' level of strategic planning and indicators of pharmacy performance; including new and refill prescriptions filled, gross margin, rated patient care performance, rated dispensing performance, rated non-pharmacy performance, and rated financial performance. Cross-sectional study. United States. Nationwide random sample of 1,250 owners/managers of independent community pharmacies. Mailed survey. Quality of strategic planning conducted; pharmacy performance measures. Only 141 of 527 (26.8%) usable responses indicated use of some (77 pharmacies, 54.6%) or all (64 pharmacies, 45.4%) of the seven steps typical of strategic planning. Significant associations were observed between the level of strategic planning use and all pharmacy performance variables assessed, including indicators such as greater numbers of new and refill prescriptions dispensed, gross margins, patient care performance, dispensing performance, non-pharmacy performance, and financial performance. Greater ratings of pharmacy performance were significantly associated with the level of strategic planning use. Respondents who fully used strategic planning had significantly higher indicators than partial users; respondents who partly used the process had significantly higher ratings than respondents who did not conduct strategic planning.

Bureau of Indian Education 2011-2012 (Based on SY 2010-2011 Data) Revised 06/01/2013 Special Education Indicator Performance

ERIC Educational Resources Information Center

Bureau of Indian Education, 2013

2013-01-01

This report presents Special Education Indicator Performance data tables for 173 Bureau of Indian Education schools. Indicators include: (1) Graduation Rate; (2) Dropouts; (3) Assessment Targets; (4) Assessment Targets--Reading; (5) Assessment Targets--Mathematics; (6) Suspensions and Expulsions--High School; (7) Suspensions and…

Hardware enabled performance counters with support for operating system context switching

DOEpatents

Salapura, Valentina; Wisniewski, Robert W.

2015-06-30

A device for supporting hardware enabled performance counters with support for context switching include a plurality of performance counters operable to collect information associated with one or more computer system related activities, a first register operable to store a memory address, a second register operable to store a mode indication, and a state machine operable to read the second register and cause the plurality of performance counters to copy the information to memory area indicated by the memory address based on the mode indication.

Predictors of performance in an ophthalmology residency program.

PubMed

Alfawaz, Abdullah M; Al-Dahmash, Saad A

2016-06-01

To assess the value of current selection criteria and additional factors as predictors of performance in an ophthalmology residency training program. A retrospective study. Data were collected from the files of 166 residents who were collectively trained in an ophthalmology residency program from 2000 to 2013. The program's selection criteria included medical school grade point average (GPA), Saudi licensing examination (SLE) score, multiple-choice question ophthalmology selection (MCQ) examination score, and interview mark. Indicators of performance included average scores in the promotion examination for 4 years of training (average R), King Saud University fellowship examination (KSU) score, and Saudi Board in Ophthalmology examination (SBO) score. An average of KSU and SBO scores was also used as a performance indicator. Times of program completion and average performance score across all years in the residency program were used as second-level indicators of performance. There were strong correlations between the MCQ examination score and each training performance indicator (average R, KSU score, SBO score, and average of KSU and SBO scores; p = 0.002, 0.008, 0.05, and 0.002, respectively). The interview mark correlated well with average R (p = 0.001) but not with other indicators. The MCQ examination score and the interview mark were the only predictors of second-level indicators of performance (p = 0.009 and 0.029, respectively). The MCQ examination score and interview mark were the 2 best predictors of performance as an ophthalmology resident. GPA and SLE score were poor predictors of performance. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Theoretical investigation of the upper and lower bounds of a generalized dimensionless bearing health indicator

NASA Astrophysics Data System (ADS)

Wang, Dong; Tsui, Kwok-Leung

2018-01-01

Bearing-supported shafts are widely used in various machines. Due to harsh working environments, bearing performance degrades over time. To prevent unexpected bearing failures and accidents, bearing performance degradation assessment becomes an emerging topic in recent years. Bearing performance degradation assessment aims to evaluate the current health condition of a bearing through a bearing health indicator. In the past years, many signal processing and data mining based methods were proposed to construct bearing health indicators. However, the upper and lower bounds of these bearing health indicators were not theoretically calculated and they strongly depended on historical bearing data including normal and failure data. Besides, most health indicators are dimensional, which connotes that these health indicators are prone to be affected by varying operating conditions, such as varying speeds and loads. In this paper, based on the principle of squared envelope analysis, we focus on theoretical investigation of bearing performance degradation assessment in the case of additive Gaussian noises, including distribution establishment of squared envelope, construction of a generalized dimensionless bearing health indicator, and mathematical calculation of the upper and lower bounds of the generalized dimensionless bearing health indicator. Then, analyses of simulated and real bearing run to failure data are used as two case studies to illustrate how the generalized dimensionless health indicator works and demonstrate its effectiveness in bearing performance degradation assessment. Results show that squared envelope follows a noncentral chi-square distribution and the upper and lower bounds of the generalized dimensionless health indicator can be mathematically established. Moreover, the generalized dimensionless health indicator is sensitive to an incipient bearing defect in the process of bearing performance degradation.

20 CFR 666.100 - What performance indicators must be included in a State's plan?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., respectively and the two customer satisfaction indicators. (1) For the Adult program, these indicators are: (i...) A single customer satisfaction measure for employers and a single customer satisfaction indicator...

Development of a performance-based industrial energy efficiency indicator for corn refining plants.

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

Boyd, G. A.; Decision and Information Sciences; USEPA

2006-07-31

Organizations that implement strategic energy management programs have the potential to achieve sustained energy savings if the programs are carried out properly. A key opportunity for achieving energy savings that plant managers can take is to determine an appropriate level of energy performance by comparing their plant's performance with that of similar plants in the same industry. Manufacturing facilities can set energy efficiency targets by using performance-based indicators. The U.S. Environmental Protection Agency (EPA), through its ENERGY STAR{reg_sign} program, has been developing plant energy performance indicators (EPIs) to encourage a variety of U.S. industries to use energy more efficiently. Thismore » report describes work with the corn refining industry to provide a plant-level indicator of energy efficiency for facilities that produce a variety of products--including corn starch, corn oil, animal feed, corn sweeteners, and ethanol--for the paper, food, beverage, and other industries in the United States. Consideration is given to the role that performance-based indicators play in motivating change; the steps needed to develop indicators, including interacting with an industry to secure adequate data for an indicator; and the actual application and use of an indicator when complete. How indicators are employed in the EPA's efforts to encourage industries to voluntarily improve their use of energy is discussed as well. The report describes the data and statistical methods used to construct the EPI for corn refining plants. Individual equations are presented, as are the instructions for using them in an associated Excel spreadsheet.« less

An Olfactory Indicator for Acid-Base Titrations.

ERIC Educational Resources Information Center

Flair, Mark N.; Setzer, William N.

1990-01-01

The use of an olfactory acid-base indicator in titrations for visually impaired students is discussed. Potential olfactory indicators include eugenol, thymol, vanillin, and thiophenol. Titrations performed with each indicator with eugenol proved to be successful. (KR)

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.

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.

Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

PubMed

Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

2018-05-24

The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.

Perkins Core Performance Measures: Results and Targets, 1999-2000.

ERIC Educational Resources Information Center

McHewitt, Earl R.; Taylor, Garry

This document describes the Virginia Community College System (VCCS) Core Indicators for the Perkins III Core Performance Standards and Measures. Core indicators and measures include: (1) student attainment, measured by academic and technical skills; (2) completion, measured by graduation rate; (3) placement and persistence, measured by placement,…

Performance Assessment of Communicable Disease Surveillance in Disasters: A Systematic Review

PubMed Central

Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbarisari, Ali

2015-01-01

Background: This study aimed to identify the indices and frameworks that have been used to assess the performance of communicable disease surveillance (CDS) in response to disasters and other emergencies, including infectious disease outbreaks. Method: In this systematic review, PubMed, Google Scholar, Scopus, ScienceDirect, ProQuest databases and grey literature were searched until the end of 2013. All retrieved titles were examined in accordance with inclusion criteria. Abstracts of the relevant titles were reviewed and eligible abstracts were included in a list for data abstraction. Finally, the study variables were extracted. Results: Sixteen articles and one book were found relevant to our study objectives. In these articles, 31 criteria and 35 indicators were used or suggested for the assessment/evaluation of the performance of surveillance systems in disasters. The Centers for Disease Control (CDC) updated guidelines for the evaluation of public health surveillance systems were the most widely used. Conclusion: Despite the importance of performance assessment in improving CDS in response to disasters, there is a lack of clear and accepted frameworks. There is also no agreement on the use of existing criteria and indices. The only relevant framework is the CDC guideline, which is a common framework for assessing public health surveillance systems as a whole. There is an urgent need to develop appropriate frameworks, criteria, and indices for specifically assessing the performance of CDS in response to disasters and other emergencies, including infectious diseases outbreaks. Key words: Disasters, Emergencies, Communicable Diseases, Surveillance System, Performance Assessment PMID:25774323

Indicators of Performance. Papers Presented at the Annual Conference of the Society for Research into Higher Education (15th, Brighton, England, December 19-20, 1979).

ERIC Educational Resources Information Center

Billing, David, Ed.

Thirty-two papers on performance indicators are presented based on the conference themes of performance of the higher education system at the national level, institutional evaluation, and assessment of staff and students. Papers and authors include the following: "Higher Education Systems at National Level" (A. Thompson); "The CNAA…

Decision-making and cognitive abilities: A review of associations between Iowa Gambling Task performance, executive functions, and intelligence.

PubMed

Toplak, Maggie E; Sorge, Geoff B; Benoit, André; West, Richard F; Stanovich, Keith E

2010-07-01

The Iowa Gambling Task (IGT) has been used to study decision-making differences in many different clinical and developmental samples. It has been suggested that IGT performance captures abilities that are separable from cognitive abilities, including executive functions and intelligence. The purpose of the current review was to examine studies that have explicitly examined the relationship between IGT performance and these cognitive abilities. We included 43 studies that reported correlational analyses with IGT performance, including measures of inhibition, working memory, and set-shifting as indices of executive functions, as well as measures of verbal, nonverbal, and full-scale IQ as indices of intelligence. Overall, only a small proportion of the studies reported a statistically significant relationship between IGT performance and these cognitive abilities. The majority of studies reported a non-significant relationship. Of the minority of studies that reported statistically significant effects, effect sizes were, at best, small to modest, and confidence intervals were large, indicating that considerable variability in performance on the IGT is not captured by current measures of executive function and intelligence. These findings highlight the separability between decision-making on the IGT and cognitive abilities, which is consistent with recent conceptualizations that differentiate rationality from intelligence. 2010 Elsevier Ltd. All rights reserved.

Environmental performance policy indicators for the public sector: the case of the defence sector.

PubMed

Ramos, Tomás B; Alves, Inês; Subtil, Rui; Joanaz de Melo, João

2007-03-01

The development of environmental performance policy indicators for public services, and in particular for the defence sector, is an emerging issue. Despite a number of recent initiatives there has been little work done in this area, since the other sectors usually focused on are agriculture, transport, industry, tourism and energy. This type of tool can be an important component for environmental performance evaluation at policy level, when integrated in the general performance assessment system of public missions and activities. The main objective of this research was to develop environmental performance policy indicators for the public sector, specifically applied to the defence sector. Previous research included an assessment of the environmental profile, through the evaluation of how environmental management practices have been adopted in this sector and an assessment of environmental aspects and impacts. This paper builds upon that previous research, developing an indicator framework--SEPI--supported by the selection and construction of environmental performance indicators. Another aim is to discuss how the current environmental indicator framework can be integrated into overall performance management. The Portuguese defence sector is presented and the usefulness of this methodology demonstrated. Feasibility and relevancy criteria are applied to evaluate the set of indicators proposed, allowing indicators to be scored and indicators for the policy level to be obtained.

Baby-MONITOR: A Composite Indicator of NICU Quality

PubMed Central

Kowalkowski, Marc A.; Zupancic, John A. F.; Pietz, Kenneth; Richardson, Peter; Draper, David; Hysong, Sylvia J.; Thomas, Eric J.; Petersen, Laura A.; Gould, Jeffrey B.

2014-01-01

BACKGROUND AND OBJECTIVES: NICUs vary in the quality of care delivered to very low birth weight (VLBW) infants. NICU performance on 1 measure of quality only modestly predicts performance on others. Composite measurement of quality of care delivery may provide a more comprehensive assessment of quality. The objective of our study was to develop a robust composite indicator of quality of NICU care provided to VLBW infants that accurately discriminates performance among NICUs. METHODS: We developed a composite indicator, Baby-MONITOR, based on 9 measures of quality chosen by a panel of experts. Measures were standardized, equally weighted, and averaged. We used the California Perinatal Quality Care Collaborative database to perform across-sectional analysis of care given to VLBW infants between 2004 and 2010. Performance on the Baby-MONITOR is not an absolute marker of quality but indicates overall performance relative to that of the other NICUs. We used sensitivity analyses to assess the robustness of the composite indicator, by varying assumptions and methods. RESULTS: Our sample included 9023 VLBW infants in 22 California regional NICUs. We found significant variations within and between NICUs on measured components of the Baby-MONITOR. Risk-adjusted composite scores discriminated performance among this sample of NICUs. Sensitivity analysis that included different approaches to normalization, weighting, and aggregation of individual measures showed the Baby-MONITOR to be robust (r = 0.89–0.99). CONCLUSIONS: The Baby-MONITOR may be a useful tool to comprehensively assess the quality of care delivered by NICUs. PMID:24918221

New York harbor water quality survey, 1993. (Includes appendices). Final report

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

Brosnan, T.M.; O`Shea, M.L.

1994-11-30

The 84th Water Quality Survey of New York Harbor was performed by the New York City Department of Environmental Protection in 1993. Common indicators of water quality which were monitored include human health indicators, such as the sewage-related coliform bacteria, and environmental health indicators such as dissolved oxygen, the nutrients nitrogen and phosphorus, and phytoplankton densities as estimated from chlorophyll `a`.

Monitoring the Performance of Educational Institutions: A Spur for the Implementation of Systemic Changes in Higher Education. Part Two

ERIC Educational Resources Information Center

Karelina, Irina Georgievna; Sobolev, Alexander Borisovich; Sorokin, Sviatoslav Olegovich

2016-01-01

The article discusses a comprehensive reporting and monitoring framework used to evaluate the performance of state and private higher education institutions. By analyzing diversified indicators including regulatory compliance, organizational and economic indicators, training and research, and other metrics, the authors spotlight key developments…

Performance Indicators and the Management of Quality in Education.

ERIC Educational Resources Information Center

Cuttance, Peter

Issues that affect the use of performance indicators in managing educational quality are discussed in this paper. Recent changes in public-sector organizational management include the development of strategies for the management of change itself and the changing role of the public sector. A trend within the public sector is an increase in the…

Evaluating National Environmental Sustainability: Performance Measures and Influential Factors for OECD-Member Countries featuring Canadian Performance and Policy Implications

NASA Astrophysics Data System (ADS)

Calbick, Kenneth S.

This research reviews five studies that evaluate national environmental sustainability with composite indices; performs uncertainty and sensitivity analyses of techniques for building a composite index; completes principal components factor analysis to help build subindices measuring waste and pollution, sustainable energy, sustainable food, nature conservation, and sustainable cities (Due to its current importance, the greenhouse gases (GHG) indicator is included individually as another policy measure.); analyses factors that seem to influence performance: climate, population growth, population density, economic output, technological development, industrial structure, energy prices, environmental governance, pollution abatement and control expenditures, and environmental pricing; and explores Canadian policy implications of the results. The techniques to build composite indices include performance indicator selection, missing data treatment, normalisation technique, scale-effect adjustments, weights, and aggregation method. Scale-effect adjustments and normalisation method are significant sources of uncertainty inducing 68% of the observed variation in a country's final rank at the 95% level of confidence. Choice of indicators also introduces substantial variation as well. To compensate for this variation, the current study recommends that a composite index should always be analysed with other policy subindices and individual indicators. Moreover, the connection between population and consumption indicates that per capita scale-effect adjustments should be used for certain indicators. Rather than ranking normalisation, studies should use a method that retains information from the raw indicator values. Multiple regression and cluster analyses indicate economic output, environmental governance, and energy prices are major influential factors, with energy prices the most important. It is statistically significant for five out of seven performance measures at the 95% level of confidence: 37% variance explained on the environmental sustainability performance composite indicator out of 73%, 55% (of 55%) on the waste and pollution subindex, 20% (of 70%) on the sustainable energy subindex, 5% (of 100%) on the sustainable cities subindex, and 55% (of 81%) on the GHG indicator. Energy prices are relevant to Canadian policy; increasing prices could substantially improve Canada's performance. Policy makers should increase energy prices through a carbon pricing strategy that is congruent with the ecological fiscal reform advanced by the National Round Table on the Environment and the Economy. Keywords: sustainable development; composite indices; environmental policy; environmental governance; energy prices; Canada.

20 CFR 669.500 - What performance measures and standards apply to the NFJP?

Code of Federal Regulations, 2010 CFR

2010-04-01

... must be included in the approved plan. (b) We may develop additional performance indicators with... service area economy and local demographics of eligible MSFW's. The levels of performance for these...

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

PubMed Central

Atkinson, Sarah; Haran, Dave

2004-01-01

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

The Impact of Performance Funding on Institutional Performance over Time: Evidence from South Korean Universities

ERIC Educational Resources Information Center

Yi, Pilnam; Kwak, Jinsook; Kim, Junyeop

2015-01-01

Performance funding for higher education has gained popularity in many countries, but its impact on institutional performance remains unclear. This study investigates the impact of performance funding on the institutional performance of Korean universities over time. The institutional performance indicators used include graduates' employment rate,…

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

Using DEMATEL approach to develop relationships of performance indicators on sustainable service only supply chain performance measurement

NASA Astrophysics Data System (ADS)

Leksono, EB; Suparno; Vanany, I.

2018-04-01

Service only supply chain (SOSC) concept is service supply chain (SSC) implementation on pure services. The globalization and stakeholder pressure makes operation of SSC should give the attention to the environment effect, community, economic and intangibility assets. SOSC performance measurement (SOSCPM) may be developed for measuring of performance for sustainability aspects and intangibility assets to meet customer satisfaction. This article discusses sustainable SOSCPM based on balanced scorecard (BSC), include sustainability aspects, intangibility and relations between perspectives and indicators. From literature review, it is found 34 performance indicators that must be confirm to expert and SC actors by survey. From survey validation using weighted average and level of consensus, it is found 29 valid indicators for processed by DEMATEL. From DEMATEL, it is found 26 indicators can be used on sustainable SOSCPM. Furthermore, innovation and growth perspective most influence to other, and customer perspective most important. Intangibility indicators incorporated on innovation and growth perspective very related with human resources. Finally, relations between perspectives and indicator used to design of BSC strategy maps.

Conceptual and Empirical Differences among Various Value-Added Models for Accountability

ERIC Educational Resources Information Center

Timmermans, Anneke C.; Doolaard, Simone; de Wolf, Inge

2011-01-01

Accountability systems in education generally include indicators of student performance. However, these indicators often differ considerably among the various systems. More and more countries try to include value-added measures, mainly because they do not want to hold schools accountable for differences in their initial intake of students. This…

Performance indicators for maternity care in a circumpolar context: a scoping review

PubMed Central

Rich, Rebecca; D'Hont, Thomsen; Linton, Janice; Murphy, Kellie E.; Veillard, Jeremy; Chatwood, Susan

2016-01-01

Background In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served. Objective To identify recommended performance/quality indicators for use in circumpolar maternity care systems. Methods We searched Scopus, Ebscohost databases (including Academic Search Complete and CINAHL), the Global Health Database, High North Research Documents, and online grey literature. Articles were included if they focused on maternal health indicators in the population of interest (Indigenous women, women receiving care in circumpolar or remote regions). Articles were excluded if they were not related to pregnancy, birth or the immediate post-partum or neonatal periods. Two reviewers independently reviewed articles for inclusion and extracted relevant data. Results Twenty-six documents were included. Twelve were government documents, seven were review articles or indicator compilations, four were indicator sets recommended by academics or non-governmental organizations and three were research papers. We extracted and categorized 81 unique health indicators. The majority of indicators reflected health systems processes and outcomes during the antenatal and intra-partum periods. Only two governmental indicator sets explicitly considered the needs of Indigenous peoples. Conclusions This review demonstrates that, although most circumpolar health systems engage in performance reporting for maternity care, efforts to capture local priorities and values are limited in most regions. Future work in this area should involve northern stakeholders in the process of indicator selection and development. PMID:27938636

Performance indicators for maternity care in a circumpolar context: a scoping review.

PubMed

Rich, Rebecca; D'Hont, Thomsen; Linton, Janice; Murphy, Kellie E; Veillard, Jeremy; Chatwood, Susan

2016-01-01

In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served. To identify recommended performance/quality indicators for use in circumpolar maternity care systems. We searched Scopus, Ebscohost databases (including Academic Search Complete and CINAHL), the Global Health Database, High North Research Documents, and online grey literature. Articles were included if they focused on maternal health indicators in the population of interest (Indigenous women, women receiving care in circumpolar or remote regions). Articles were excluded if they were not related to pregnancy, birth or the immediate post-partum or neonatal periods. Two reviewers independently reviewed articles for inclusion and extracted relevant data. Twenty-six documents were included. Twelve were government documents, seven were review articles or indicator compilations, four were indicator sets recommended by academics or non-governmental organizations and three were research papers. We extracted and categorized 81 unique health indicators. The majority of indicators reflected health systems processes and outcomes during the antenatal and intra-partum periods. Only two governmental indicator sets explicitly considered the needs of Indigenous peoples. This review demonstrates that, although most circumpolar health systems engage in performance reporting for maternity care, efforts to capture local priorities and values are limited in most regions. Future work in this area should involve northern stakeholders in the process of indicator selection and development.

Performance indicators for maternity care in a circumpolar context: a scoping review.

PubMed

Rich, Rebecca; D'Hont, Thomsen; Linton, Janice; Murphy, Kellie E; Veillard, Jeremy; Chatwood, Susan

2016-01-01

Background In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served. Objective To identify recommended performance/quality indicators for use in circumpolar maternity care systems. Methods We searched Scopus, Ebscohost databases (including Academic Search Complete and CINAHL), the Global Health Database, High North Research Documents, and online grey literature. Articles were included if they focused on maternal health indicators in the population of interest (Indigenous women, women receiving care in circumpolar or remote regions). Articles were excluded if they were not related to pregnancy, birth or the immediate post-partum or neonatal periods. Two reviewers independently reviewed articles for inclusion and extracted relevant data. Results Twenty-six documents were included. Twelve were government documents, seven were review articles or indicator compilations, four were indicator sets recommended by academics or non-governmental organizations and three were research papers. We extracted and categorized 81 unique health indicators. The majority of indicators reflected health systems processes and outcomes during the antenatal and intra-partum periods. Only two governmental indicator sets explicitly considered the needs of Indigenous peoples. Conclusions This review demonstrates that, although most circumpolar health systems engage in performance reporting for maternity care, efforts to capture local priorities and values are limited in most regions. Future work in this area should involve northern stakeholders in the process of indicator selection and development.

Performance indicators analysis at Brazilian and Italian women's volleyball leagues according to game location, game outcome, and set number.

PubMed

Campos, Fabio A D; Stanganélli, Luiz C R; Campos, Leandra C B; Pasquarelli, Bruno N; Gómez, Miguel-Angel

2014-04-01

This study was done to investigate the advantage of playing at home in elite women's volleyball leagues and the influence of performance indicators in the game score according to set number. The sample consisted of 240 games of the Brazilian Volleyball League (n = 132 games) and the Italian Volleyball League (n = 108 games) from the 2011-2012 season. The relationship of performance indicators (including serve, attack, block, and opponents' errors) with the game outcome (win or lose) was assessed. The results showed that there was a home advantage effect in women's volleyball leagues, with a higher prevalence of victory for the home teams in Brazilian and Italian leagues (58 and 56%, respectively). When related to the performance indicators and among the aspects that were most highly correlated with victory, the attack was the technical indicator that explained most of the results of volleyball games.

Assessing Space Utilisation Relative to Key Performance Indicators--How Well, Not How Much, Space Is Used

ERIC Educational Resources Information Center

Fleming, Simon; Apps, Nathan; Harbon, Paul; Baldock, Clive

2012-01-01

Efficient use of resources, including space, is critical in academic departments. Traditional space auditing simply assesses occupancy levels. We present a novel approach which assesses not just the extent to which space is used, but also how well it is used. We link space use quantitatively to key performance indicators in a research-intensive…

Performance and quality indicators for the management of non-cancer chronic pain: a scoping review protocol.

PubMed

Zidarov, Diana; Visca, Regina; Gogovor, Amédé; Ahmed, Sara

2016-02-19

Chronic pain is a public health problem of epidemic proportion in most countries with important physical, psychological, social and economic consequences. The management of chronic pain is complex and requires an integrated network approach between all levels of the healthcare system and the involvement of several health professionals from different disciplines. Measuring the performance of organisations that provide care to individuals with chronic pain is essential to improve quality of care and requires the use of relevant performance and quality indicators. A scoping review methodology will be used to synthesise the evidence on performance and quality indicators developed for non-cancer chronic pain management across the continuum of care. The following electronic databases will be searched from 2000 onwards: Cochrane Effective Practice and Organisation of Care (EPOC) Review Group Specialised Register; Cochrane Library; EMBASE; PubMed; CINAHL; PsycINFO; ProQuest Dissertations and Theses. All types of studies will be included if these are concerned with performance or quality indicators in adults with chronic non-cancer pain. In addition, searches will be conducted on provincial, national and international health organisations as well as health professional and scientific associations' websites. A qualitative descriptive approach will be used to describe characteristics of each indicator. All identified indicators will be classified according to dimensions covered by Donabedian and the Triple Aim frameworks. The scoping review findings will inform the development of a performance measurement system comprising a list of performance indicators with their level of evidence which can be used by stakeholders to evaluate the quality of care for individuals with chronic non-cancer pain at the patient, institutional and system level. The results will be disseminated via several knowledge translation strategies, including 2 stakeholder meetings, publication and presentation at conferences. 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/

The Association between Meditation Practice and Job Performance: A Cross-Sectional Study.

PubMed

Shiba, Koichiro; Nishimoto, Masahiro; Sugimoto, Minami; Ishikawa, Yoshiki

2015-01-01

Many previous studies have shown that meditation practice has a positive impact on cognitive and non-cognitive functioning, which are related to job performance. Thus, the aims of this study were to (1) estimate the prevalence of meditation practice, (2) identify the characteristics of individuals who practice meditation, and (3) examine the association between meditation practice and job performance. Two population-based, cross-sectional surveys were conducted. In study 1, we examined the prevalence of meditation practice and the characteristics of the persons practicing meditation; in Study 2, we examined the association between meditation practice and job performance. The outcome variables included work engagement, subjective job performance, and job satisfaction. The Utrecht Work Engagement Scale was used to assess work engagement, the World Health Organization Health and Work Performance Questionnaire (HPQ) was used to measure subjective job performance, and a scale developed by the Japanese government was used to assess job satisfaction. Hierarchical multiple regression analyses were used in Study 2. Demographic characteristics and behavioral risk factors were included as covariates in the analyses. The results of Study 1 indicated that 3.9% of persons surveyed (n = 30,665) practiced meditation; these individuals were younger and had a higher education, higher household income, higher stress level, and lower body mass index than those who did not practice meditation. The results of Study 2 (n = 1,470) indicated that meditation practice was significantly predictive of work engagement (β = 0.112, p < .001), subjective job performance (β = 0.116, p < .001), and job satisfaction (β = 0.079, p = .002), even after adjusting for covariates (β = 0.083, p < .001; β = 0.104, p < .001; β = 0.060, p = .015, respectively). The results indicate that meditation practice may positively influence job performance, including job satisfaction, subjective job performance, and work engagement.

Noncredible cognitive performance at clinical evaluation of adult ADHD: An embedded validity indicator in a visuospatial working memory test.

PubMed

Fuermaier, Anselm B M; Tucha, Oliver; Koerts, Janneke; Lange, Klaus W; Weisbrod, Matthias; Aschenbrenner, Steffen; Tucha, Lara

2017-12-01

The assessment of performance validity is an essential part of the neuropsychological evaluation of adults with attention-deficit/hyperactivity disorder (ADHD). Most available tools, however, are inaccurate regarding the identification of noncredible performance. This study describes the development of a visuospatial working memory test, including a validity indicator for noncredible cognitive performance of adults with ADHD. Visuospatial working memory of adults with ADHD (n = 48) was first compared to the test performance of healthy individuals (n = 48). Furthermore, a simulation design was performed including 252 individuals who were randomly assigned to either a control group (n = 48) or to 1 of 3 simulation groups who were requested to feign ADHD (n = 204). Additional samples of 27 adults with ADHD and 69 instructed simulators were included to cross-validate findings from the first samples. Adults with ADHD showed impaired visuospatial working memory performance of medium size as compared to healthy individuals. Simulation groups committed significantly more errors and had shorter response times as compared to patients with ADHD. Moreover, binary logistic regression analysis was carried out to derive a validity index that optimally differentiates between true and feigned ADHD. ROC analysis demonstrated high classification rates of the validity index, as shown in excellent specificity (95.8%) and adequate sensitivity (60.3%). The visuospatial working memory test as presented in this study therefore appears sensitive in indicating cognitive impairment of adults with ADHD. Furthermore, the embedded validity index revealed promising results concerning the detection of noncredible cognitive performance of adults with ADHD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Impact of hybrid delivery of education on student academic performance and the student experience.

PubMed

Congdon, Heather Brennan; Nutter, Douglas A; Charneski, Lisa; Butko, Peter

2009-11-12

To compare student academic performance and the student experience in the first-year doctor of pharmacy (PharmD) program between the main and newly opened satellite campuses of the University of Maryland. Student performance indicators including graded assessments, course averages, cumulative first-year grade point average (GPA), and introductory pharmacy practice experience (IPPE) evaluations were analyzed retrospectively. Student experience indicators were obtained via an online survey instrument and included involvement in student organizations; time-budgeting practices; and stress levels and their perceived effect on performance. Graded assessments, course averages, GPA, and IPPE evaluations were indistinguishable between campuses. Students' time allocation was not different between campuses, except for time spent attending class and watching lecture videos. There was no difference between students' stress levels at each campus. The implementation of a satellite campus to expand pharmacy education yielded academic performance and student engagement comparable to those from traditional delivery methods.

Usefulness and Validity of Continuous Performance Tests in the Diagnosis of Attention-Deficit Hyperactivity Disorder Children.

PubMed

Berger, Itai; Slobodin, Ortal; Cassuto, Hanoch

2017-02-01

Despite the popularity of continuous performance tests (CPT) in supporting the diagnostic procedure of attention-deficit hyperactivity disorder (ADHD), these measures are still controversial mainly due to limited sensitivity, specificity, and ecological validity. Thus, there continues to be a need for further validation of these objective attention measures. The purpose of this study was to evaluate the usefulness of a CPT that includes environmental distracting stimuli, in supporting the diagnosis of ADHD in children. Participants were 798 children aged 7-12 years (493 boys and 305 girls). The ADHD group included 339 children, whereas the control group included 459 children without ADHD. The study employed the MOXO-CPT, which incorporates visual and auditory stimuli serving as environmental distractors. Compared to their unaffected peers, children with ADHD received significantly lower scores in all 4 CPT indices: attention, timing, hyperactivity, and impulsivity. Specifically, ADHD children were less attended to the stimuli and performed fewer reactions on accurate timing. Furthermore, children with ADHD performed significantly more impulsive and hyperactive responses than controls. Receiver operating characteristic analysis revealed fair to excellent diagnostic ability of all CPT indices except impulsivity, which showed poor ability to distinguish ADHD children from controls. The test's total score yielded excellent diagnostic performance. MOXO-CPT consistently distinguished between children with ADHD and their unaffected peers, so that children with ADHD performed worse than controls in all study indices. Integration of CPT indices improves the diagnostic capacity of ADHD and may better reflect the complexity and heterogeneity of ADHD. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Characterizing Cognitive Performance in a Large Longitudinal Study of Aging with Computerized Semantic Indices of Verbal Fluency

PubMed Central

Pakhomov, Serguei VS; Eberly, Lynn; Knopman, David

2016-01-01

A computational approach for estimating several indices of performance on the animal category verbal fluency task was validated, and examined in a large longitudinal study of aging. The performance indices included the traditional verbal fluency score, size of semantic clusters, density of repeated words, as well as measures of semantic and lexical diversity. Change over time in these measures was modeled using mixed effects regression in several groups of participants, including those that remained cognitively normal throughout the study (CN) and those that were diagnosed with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) dementia at some point subsequent to the baseline visit. The results of the study show that, with the exception of mean cluster size, the indices showed significantly greater declines in the MCI and AD dementia groups as compared to CN participants. Examination of associations between the indices and cognitive domains of memory, attention and visuospatial functioning showed that the traditional verbal fluency scores were associated with declines in all three domains, whereas semantic and lexical diversity measures were associated with declines only in the visuospatial domain. Baseline repetition density was associated with declines in memory and visuospatial domains. Examination of lexical and semantic diversity measures in subgroups with high vs. low attention scores (but normal functioning in other domains) showed that the performance of individuals with low attention was influenced more by word frequency rather than strength of semantic relatedness between words. These findings suggest that various automatically semantic indices may be used to examine various aspects of cognitive performance affected by dementia. PMID:27245645

A framework to assess management performance in district health systems: a qualitative and quantitative case study in Iran.

PubMed

Tabrizi, Jafar Sadegh; Gholipour, Kamal; Iezadi, Shabnam; Farahbakhsh, Mostafa; Ghiasi, Akbar

2018-01-01

The aim was to design a district health management performance framework for Iran's healthcare system. The mixed-method study was conducted between September 2015 and May 2016 in Tabriz, Iran. In this study, the indicators of district health management performance were obtained by analyzing the 45 semi-structured surveys of experts in the public health system. Content validity of performance indicators which were generated in qualitative part were reviewed and confirmed based on content validity index (CVI). Also content validity ratio (CVR) was calculated using data acquired from a survey of 21 experts in quantitative part. The result of this study indicated that, initially, 81 indicators were considered in framework of district health management performance and, at the end, 53 indicators were validated and confirmed. These indicators were classified in 11 categories which include: human resources and organizational creativity, management and leadership, rules and ethics, planning and evaluation, district managing, health resources management and economics, community participation, quality improvement, research in health system, health information management, epidemiology and situation analysis. The designed framework model can be used to assess the district health management and facilitates performance improvement at the district level.

[Quality indicators in the acute coronary syndrome for the analysis of the pre- and in-hospital care process].

PubMed

Felices-Abad, F; Latour-Pérez, J; Fuset-Cabanes, M P; Ruano-Marco, M; Cuñat-de la Hoz, J; del Nogal-Sáez, F

2010-01-01

We present a map of 27 indicators to measure the care quality given to patients with acute coronary syndrome attended in the pre- and hospital area. This includes technical process indicators (registration of care intervals, performance of electrocardiogram, monitoring and vein access, assessment of prognostic risk, hemorrhage and in-hospital mortality, use of reperfusion techniques and performance of echocardiograph), pharmacological process indicators (platelet receptors inhibition, anticoagulation, thrombolysis, beta-blockers, angiotensin converting inhibitors and lipid lowering drugs) and outcomes indicators (quality scales of the care given and mortality). Copyright © 2010 Elsevier España, S.L. y SEMICYUC. All rights reserved.

How different is cancer control across Canada? Comparing performance indicators for prevention, screening, diagnosis, and treatment.

PubMed

Rahal, R; Chadder, J; DeCaria, K; Lockwood, G; Bryant, H

2017-04-01

Meaningful performance measures are an important part of the toolkit for health system improvement. The Canadian Partnership Against Cancer has been reporting on pan-Canadian cancer system performance indicators since 2009-work that has led to the availability of standardized measures that can help to shed light on the extent of variation and opportunities for quality improvement across the country. Those measures include a core set of system indicators ranging from prevention and screening, through diagnosis and treatment, to survivorship and end-of-life care. Key indicators were calculated and graphed, showing the range from worst to best result for the provinces and territories included in the data. There were often significant differences in cancer system performance between provinces and territories. For example, smoking prevalence rates ranged from 14% to 62%. The 90th percentile wait times from an abnormal breast screen to resolution (without biopsy) ranged from 4 weeks to 8 weeks. The percentage of breast cancer resections that used breast-conserving surgery rather than mastectomy ranged from 38% to 75%. Clinical trial participation rates for adults ranged from 0.2% to 6.6%. Variations in performance indicators between Canadian jurisdictions suggest potential differences in the planning and delivery of cancer control services and in clinical practice patterns and patient outcomes. Understanding sources of variation can help to identify opportunities for improvements in the quality and outcomes of cancer control service delivery in each province and territory.

Measuring the globalization of cities from the new regionalism perspective.

PubMed

Ergüzel, Oylum Şehvez; Tunahan, Hakan; Esen, Sinan

2016-01-01

The study aims to analyze the export performance of countries and of cities within them to identify synchronized or unsynchronized movement between them. In the empirical part of the study, the measurements used to analyze the export performance of the countries included in the literature are applied to establish the export performance of a single city-Sakarya, Turkey. These measurements include the Herfindahl-Hirchman product and market concentration indices, the Lawrence index, the trade complementarity index, and the Grubel-Lloyd intra-industry index, as well as additional indicators with local or regional contexts. The limited number of studies analyzing the export competitiveness of a single city with relevant formats in the literature reveal the significance of the study.

Applications of the balanced scorecard for strategic management and performance measurement in the health sector.

PubMed

Behrouzi, Farshad; Shaharoun, Awaluddin Mohamed; Ma'aram, Azanizawati

2014-05-01

In order to attain a useful balanced scorecard (BSC), appropriate performance perspectives and indicators are crucial to reflect all strategies of the organisation. The objectives of this survey were to give an insight regarding the situation of the BSC in the health sector over the past decade, and to afford a generic approach of the BSC development for health settings with specific focus on performance perspectives, performance indicators and BSC generation. After an extensive search based on publication date and research content, 29 articles published since 2002 were identified, categorised and analysed. Four critical attributes of each article were analysed, including BSC generation, performance perspectives, performance indicators and auxiliary tools. The results showed that 'internal business process' was the most notable BSC perspective as it was included in all reviewed articles. After investigating the literature, it was concluded that its comprehensiveness is the reason for the importance and high usage of this perspective. The findings showed that 12 cases out of 29 reviewed articles (41%) exceeded the maximum number of key performance indicators (KPI) suggested in a previous study. It was found that all 12 cases were large organisations with numerous departments (e.g. national health organisations). Such organisations require numerous KPI to cover all of their strategic objectives. It was recommended to utilise the cascaded BSC within such organisations to avoid complexity and difficulty in gathering, analysing and interpreting performance data. Meanwhile it requires more medical staff to contribute in BSC development, which will result in greater reliability of the BSC.

Prioritizing public- private partnership models for public hospitals of iran based on performance indicators.

PubMed

Gholamzadeh Nikjoo, Raana; Jabbari Beyrami, Hossein; Jannati, Ali; Asghari Jaafarabadi, Mohammad

2012-01-01

The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals. In this mixed (quantitative-qualitative) study, systematic review and expert panel has been done to identify varied models of PPP as well as performance indicators. In the second step we prioritized performance indicator and PPP models based on selected performance indicators by Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 and Expert Choice11 software's. In quality - effectiveness area, indicators like the rate of hospital infections (100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patient satisfaction percentage (53%), in accessibility equity area indicators such as average inpatient waiting time (100%) and average outpatient waiting time (74%), and in financial - efficiency area, indicators including average length of stay (100%), bed occupation ratio (99%), specific income to total cost ratio (97%) have been chosen to be the most key performance indicators. In the pri¬oritization of the PPP models clinical outsourcing, management, privatization, BOO (build, own, operate) and non-clinical outsourcing models, achieved high priority for various performance in¬dicator areas. This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different.

Prioritizing Public- Private Partnership Models for Public Hospitals of Iran Based on Performance Indicators

PubMed Central

Gholamzadeh Nikjoo, Raana; Jabbari Beyrami, Hossein; Jannati, Ali; Asghari Jaafarabadi, Mohammad

2012-01-01

Background: The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals. Methods: In this mixed (quantitative-qualitative) study, systematic review and expert panel has been done to identify varied models of PPP as well as performance indicators. In the second step we prioritized performance indicator and PPP models based on selected performance indicators by Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 and Expert Choice11 software’s. Results: In quality – effectiveness area, indicators like the rate of hospital infections (100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patient satisfaction percentage (53%), in accessibility equity area indicators such as average inpatient waiting time (100%) and average outpatient waiting time (74%), and in financial – efficiency area, indicators including average length of stay (100%), bed occupation ratio (99%), specific income to total cost ratio (97%) have been chosen to be the most key performance indicators. In the pri¬oritization of the PPP models clinical outsourcing, management, privatization, BOO (build, own, operate) and non-clinical outsourcing models, achieved high priority for various performance in¬dicator areas. Conclusion: This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different. PMID:24688942

Game Indicators Determining Sports Performance in the NBA

PubMed Central

Mikołajec, Kazimierz; Maszczyk, Adam; Zając, Tomasz

The main goal of the present study was to identify basketball game performance indicators which best determine sports level in the National Basketball Association (NBA) league. The research material consisted of all NBA game statistics at the turn of eight seasons (2003–11) and included 52 performance variables. Through detailed analysis the variables with high influence on game effectiveness were selected for final procedures. It has been proven that a limited number of factors, mostly offensive, determines sports performance in the NBA. The most critical indicators are: Win%, Offensive EFF, 3rd Quarter PPG, Win% CG, Avg Fauls and Avg Steals. In practical applications these results connected with top teams and elite players may help coaches to design better training programs. PMID:24146715

Game Indicators Determining Sports Performance in the NBA.

PubMed

Mikołajec, Kazimierz; Maszczyk, Adam; Zając, Tomasz

2013-01-01

The main goal of the present study was to identify basketball game performance indicators which best determine sports level in the National Basketball Association (NBA) league. The research material consisted of all NBA game statistics at the turn of eight seasons (2003-11) and included 52 performance variables. Through detailed analysis the variables with high influence on game effectiveness were selected for final procedures. It has been proven that a limited number of factors, mostly offensive, determines sports performance in the NBA. The most critical indicators are: Win%, Offensive EFF, 3rd Quarter PPG, Win% CG, Avg Fauls and Avg Steals. In practical applications these results connected with top teams and elite players may help coaches to design better training programs.

The effect of automated monitoring and real-time prompting on nurses' hand hygiene performance.

PubMed

Levchenko, Alexander I; Boscart, Veronique M; Fernie, Geoff R

2013-10-01

Adequate hand hygiene compliance by healthcare staff is considered an effective method to reduce hospital-acquired infections. The electronic system developed at Toronto Rehabilitation Institute automatically detects hand hygiene opportunities and records hand hygiene actions. It includes an optional visual hand hygiene status indication, generates real-time hand hygiene prompting signals, and enables automated monitoring of individual and aggregated hand hygiene performance. The system was installed on a complex continuous care unit at the entrance to 17 patient rooms and a utility room. A total of 93 alcohol gel and soap dispensers were instrumented and 14 nurses were provided with the personal wearable electronic monitors. The study included three phases with the system operating in three different modes: (1) an inactive mode during the first phase when hand hygiene opportunities and hand hygiene actions were recorded but prompting and visual indication functions were disabled, (2) only hand hygiene status indicators were enabled during the second phase, and (3) both hand hygiene status and real-time hand hygiene prompting signals were enabled during the third phase. Data collection was performed automatically during all of the three phases. The system indicated significantly higher hand hygiene activity rates and compliance during the third phase, with both hand hygiene indication and real-time prompting functions enabled. To increase the efficacy of the technology, its use was supplemented with individual performance reviews of the automatically collected data.

Current Developments in Community College Performance Funding

ERIC Educational Resources Information Center

D'Amico, Mark M.; Friedel, Janice N.; Katsinas, Stephen G.; Thornton, Zoë M.

2014-01-01

Since the initiation of performance funding in Tennessee in the late 1970s, approximately 30 states have, at some point, attempted a funding model that includes performance on a set of indicators. The purpose of the present study was to capture the current status of performance funding in public statewide community college systems and to assess…

Awareness of deficits and error processing after traumatic brain injury.

PubMed

Larson, Michael J; Perlstein, William M

2009-10-28

Severe traumatic brain injury is frequently associated with alterations in performance monitoring, including reduced awareness of physical and cognitive deficits. We examined the relationship between awareness of deficits and electrophysiological indices of performance monitoring, including the error-related negativity and posterror positivity (Pe) components of the scalp-recorded event-related potential, in 16 traumatic brain injury survivors who completed a Stroop color-naming task while event-related potential measurements were recorded. Awareness of deficits was measured as the discrepancy between patient and significant-other ratings on the Frontal Systems Behavior Scale. The amplitude of the Pe, but not error-related negativity, was reliably associated with decreased awareness of deficits. Results indicate that Pe amplitude may serve as an electrophysiological indicator of awareness of abilities and deficits.

Is medical perspective on clinical governance practices associated with clinical units' performance and mortality? A cross-sectional study through a record-linkage procedure.

PubMed

Sarchielli, Guido; De Plato, Giovanni; Cavalli, Mario; Albertini, Stefano; Nonni, Ilaria; Bencivenni, Lucia; Montali, Arianna; Ventura, Antonio; Montali, Francesca

2016-01-01

Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units' performance measured through mortality rates and efficiency indicators. This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians) working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors' knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units' performance indicators which include patients' mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators. The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units' efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility). These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units' mortality rates (odds ratio, -8.677; 95% confidence interval, -16.654, -0.700). The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful the clinical governance tools application on its own clinical practice.

Using distance technologies to facilitate a learning collaborative to implement stagewise treatment.

PubMed

Covell, Nancy H; Foster, Forrest P; Margolies, Paul J; Lopez, Luis O; Dixon, Lisa B

2015-06-01

This report describes experiences and outcomes of an online learning collaborative focused on implementation of stagewise treatment. Eleven participating programs convened online monthly for a year. Between meetings, program staff created an implementation plan and programs collected performance indicator data, including assessment of staff knowledge of integrated treatment for people with co-occurring disorders, whether a person's current stage of treatment was documented in his or her chart, and whether the treatments were appropriate for the stage of treatment. Descriptive statistics were used to characterize performance indicators and feedback. Wilcoxon matched-pairs signed-rank tests examined changes in performance indicators over time. Program staff generally demonstrated significant improvements in performance indicators over time and rated the distance learning collaborative favorably. Distance learning collaboratives can be structured to provide opportunities for program staff to interact and learn from one another and to implement and sustain changes.

Future Performance Trend Indicators: A Current Value Approach to Human Resources Accounting. Report II: Internal Consistencies and Relationships to Performance in Organization VI. Technical Report.

ERIC Educational Resources Information Center

Pecorella, Patricia A.; Bowers, David G.

Conventional accounting systems provide no indication as to what conditions and events lead to reported outcomes, since they traditionally do not include measurements of the human organization and its relationship to events at the outcome stage. Human resources accounting is used to measure these additional types of data. This research is…

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

PubMed

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

2014-12-01

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

Investigating gender violence in Jamaica.

PubMed

Spiring, Fred

2014-01-01

As Jamaica moves through implementation of their National Policy on Gender Equality and develops harassment legislation, this article attempts to investigate current levels and trends of gender-based violence in Jamaica. All analyses make use of existing data and data formats in developing performance indicators that illustrate the current state of gender violence in Jamaica. The analyses provide a baseline for the future assessment and comparison with internationally accepted gender-based violence indicators. All source data has been included to facilitate comparisons and discussions regarding related levels and trends of violence as well as addressing performance indicator effectiveness.

Characterizing cognitive performance in a large longitudinal study of aging with computerized semantic indices of verbal fluency.

PubMed

Pakhomov, Serguei V S; Eberly, Lynn; Knopman, David

2016-08-01

A computational approach for estimating several indices of performance on the animal category verbal fluency task was validated, and examined in a large longitudinal study of aging. The performance indices included the traditional verbal fluency score, size of semantic clusters, density of repeated words, as well as measures of semantic and lexical diversity. Change over time in these measures was modeled using mixed effects regression in several groups of participants, including those that remained cognitively normal throughout the study (CN) and those that were diagnosed with mild cognitive impairment (MCI) or Alzheimer's disease (AD) dementia at some point subsequent to the baseline visit. The results of the study show that, with the exception of mean cluster size, the indices showed significantly greater declines in the MCI and AD dementia groups as compared to CN participants. Examination of associations between the indices and cognitive domains of memory, attention and visuospatial functioning showed that the traditional verbal fluency scores were associated with declines in all three domains, whereas semantic and lexical diversity measures were associated with declines only in the visuospatial domain. Baseline repetition density was associated with declines in memory and visuospatial domains. Examination of lexical and semantic diversity measures in subgroups with high vs. low attention scores (but normal functioning in other domains) showed that the performance of individuals with low attention was influenced more by word frequency rather than strength of semantic relatedness between words. These findings suggest that various automatically semantic indices may be used to examine various aspects of cognitive performance affected by dementia. Copyright © 2016 Elsevier Ltd. All rights reserved.

NASA's Evolutionary Xenon Thruster (NEXT) Prototype Model 1R (PM1R) Ion Thruster and Propellant Management System Wear Test Results

NASA Technical Reports Server (NTRS)

VanNoord, Jonathan L.; Soulas, George C.; Sovey, James S.

2010-01-01

The results of the NEXT wear test are presented. This test was conducted with a 36-cm ion engine (designated PM1R) and an engineering model propellant management system. The thruster operated with beam extraction for a total of 1680 hr and processed 30.5 kg of xenon during the wear test, which included performance testing and some operation with an engineering model power processing unit. A total of 1312 hr was accumulated at full power, 277 hr at low power, and the remainder was at intermediate throttle levels. Overall ion engine performance, which includes thrust, thruster input power, specific impulse, and thrust efficiency, was steady with no indications of performance degradation. The propellant management system performed without incident during the wear test. The ion engine and propellant management system were also inspected following the test with no indication of anomalous hardware degradation from operation.

Incentives for Better Performance in Health Care

PubMed Central

Abduljawad, Asaad; Al-Assaf, Assaf F.

2011-01-01

Incentives for better performance in health care have several modes and methods. They are designed to motivate and encourage people to perform well and improve their outcomes. They may include monetary or non-monetary incentives and may be applied to consumers, individual providers or institutions. One such model is the Pay-for-Performance system. In this system, beneficiaries are compared with one another based on a set of performance indicators and those that achieve a high level of performance are rewarded financially. This system is meant to recognise and primarily to reward high performers. Its goal is to encourage beneficiaries to strive for better performance. This system has been applied in several countries and for several recipients and settings. Early indications show that this system has had mixed effects on performance. PMID:21969891

Normal weight children have higher cognitive performance - Independent of physical activity, sleep, and diet.

PubMed

Hjorth, Mads F; Sørensen, Louise B; Andersen, Rikke; Dyssegaard, Camilla B; Ritz, Christian; Tetens, Inge; Michaelsen, Kim F; Astrup, Arne; Egelund, Niels; Sjödin, Anders

2016-10-15

Aside from the health consequences, observational studies indicate that being overweight may also negatively affect cognitive function. However, existing evidence has to a large extent not controlled for the possible confounding effect of having different lifestyles. Therefore, the objective was to examine the independent associations between weight status and lifestyle indicators with cognitive performance in 8-11year old Danish children. The analyses included 828 children (measured in 2011-2012) each having one to three measurement occasions separated by approximately 100days. Dietary intake, physical activity, sedentary time, and sleep duration were measured using dietary records and accelerometers. The Children's Sleep Habits Questionnaire was used to access sleep problems and the Andersen test was carried out to estimate cardio-respiratory fitness (CRF). Weight status (underweight, normal weight, and overweight/obese) was defined according to body mass index and cognitive performance was assessed using the d2-test of attention, a reading test, and a math test. A linear mixed model including a number of fixed and random effects was used to test associations between lifestyle indicators as well as BMI category and cognitive performance. After adjustment for demographics, socioeconomics, and multiple lifestyle indicators, normal weight children had higher cognitive test scores than overweight/obese and underweight children of up to 89% and 48% of expected learning within one school year (P<0.05). Daily breakfast consumption, fewer sleep problems, higher CRF, less total physical activity, more sedentary time, and less light physical activity were associated with higher cognitive performance independently of each other in at least one of the three cognitive tests (P<0.05). Normal weight children had higher cognitive performance compared to overweight/obese as well as underweight children, independent of multiple lifestyle indicators. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of Gear Condition Indicator Performance on Rotorcraft Fleet

NASA Technical Reports Server (NTRS)

Antolick, Lance J.; Branning, Jeremy S.; Wade, Daniel R.; Dempsey, Paula J.

2010-01-01

The U.S. Army is currently expanding its fleet of Health Usage Monitoring Systems (HUMS) equipped aircraft at significant rates, to now include over 1,000 rotorcraft. Two different on-board HUMS, the Honeywell Modern Signal Processing Unit (MSPU) and the Goodrich Integrated Vehicle Health Management System (IVHMS), are collecting vibration health data on aircraft that include the Apache, Blackhawk, Chinook, and Kiowa Warrior. The objective of this paper is to recommend the most effective gear condition indicators for fleet use based on both a theoretical foundation and field data. Gear diagnostics with better performance will be recommended based on both a theoretical foundation and results of in-fleet use. In order to evaluate the gear condition indicator performance on rotorcraft fleets, results of more than five years of health monitoring for gear faults in the entire HUMS equipped Army helicopter fleet will be presented. More than ten examples of gear faults indicated by the gear CI have been compiled and each reviewed for accuracy. False alarms indications will also be discussed. Performance data from test rigs and seeded fault tests will also be presented. The results of the fleet analysis will be discussed, and a performance metric assigned to each of the competing algorithms. Gear fault diagnostic algorithms that are compliant with ADS-79A will be recommended for future use and development. The performance of gear algorithms used in the commercial units and the effectiveness of the gear CI as a fault identifier will be assessed using the criteria outlined in the standards in ADS-79A-HDBK, an Army handbook that outlines the conversion from Reliability Centered Maintenance to the On-Condition status of Condition Based Maintenance.

Analysis of the Seismic Performance of Isolated Buildings according to Life-Cycle Cost

PubMed Central

Dang, Yu; Han, Jian-ping; Li, Yong-tao

2015-01-01

This paper proposes an indicator of seismic performance based on life-cycle cost of a building. It is expressed as a ratio of lifetime damage loss to life-cycle cost and determines the seismic performance of isolated buildings. Major factors are considered, including uncertainty in hazard demand and structural capacity, initial costs, and expected loss during earthquakes. Thus, a high indicator value indicates poor building seismic performance. Moreover, random vibration analysis is conducted to measure structural reliability and evaluate the expected loss and life-cycle cost of isolated buildings. The expected loss of an actual, seven-story isolated hospital building is only 37% of that of a fixed-base building. Furthermore, the indicator of the structural seismic performance of the isolated building is much lower in value than that of the structural seismic performance of the fixed-base building. Therefore, isolated buildings are safer and less risky than fixed-base buildings. The indicator based on life-cycle cost assists owners and engineers in making investment decisions in consideration of structural design, construction, and expected loss. It also helps optimize the balance between building reliability and building investment. PMID:25653677

Analysis of the seismic performance of isolated buildings according to life-cycle cost.

PubMed

Dang, Yu; Han, Jian-Ping; Li, Yong-Tao

2015-01-01

This paper proposes an indicator of seismic performance based on life-cycle cost of a building. It is expressed as a ratio of lifetime damage loss to life-cycle cost and determines the seismic performance of isolated buildings. Major factors are considered, including uncertainty in hazard demand and structural capacity, initial costs, and expected loss during earthquakes. Thus, a high indicator value indicates poor building seismic performance. Moreover, random vibration analysis is conducted to measure structural reliability and evaluate the expected loss and life-cycle cost of isolated buildings. The expected loss of an actual, seven-story isolated hospital building is only 37% of that of a fixed-base building. Furthermore, the indicator of the structural seismic performance of the isolated building is much lower in value than that of the structural seismic performance of the fixed-base building. Therefore, isolated buildings are safer and less risky than fixed-base buildings. The indicator based on life-cycle cost assists owners and engineers in making investment decisions in consideration of structural design, construction, and expected loss. It also helps optimize the balance between building reliability and building investment.

Relationship of Rotation Timing to Pattern of Clerkship Performance in Psychiatry

ERIC Educational Resources Information Center

Park, Robin S.; Chibnall, John T.; Morrow, Andrew

2005-01-01

Objective: The authors investigated the association between psychiatry clerkship timing and pattern of student performance. Student rotation timing preference and specialty choice were explored as potential moderators. Methods: Archival data from six classes of third-year medical students were analyzed. Performance indicators included the National…

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...

Stereotype threat? Effects of inquiring about test takers' gender on conceptual test performance in physics

NASA Astrophysics Data System (ADS)

Maries, Alexandru; Singh, Chandralekha

2015-12-01

It has been found that activation of a stereotype, for example by indicating one's gender before a test, typically alters performance in a way consistent with the stereotype, an effect called "stereotype threat." On a standardized conceptual physics assessment, we found that asking test takers to indicate their gender right before taking the test did not deteriorate performance compared to an equivalent group who did not provide gender information. Although a statistically significant gender gap was present on the standardized test whether or not students indicated their gender, no gender gap was observed on the multiple-choice final exam students took, which included both quantitative and conceptual questions on similar topics.

Identifying the performance characteristics of a winning outcome in elite mixed martial arts competition.

PubMed

James, Lachlan P; Robertson, Sam; Haff, G Gregory; Beckman, Emma M; Kelly, Vincent G

2017-03-01

To determine those performance indicators that have the greatest influence on classifying outcome at the elite level of mixed martial arts (MMA). A secondary objective was to establish the efficacy of decision tree analysis in explaining the characteristics of victory when compared to alternate statistical methods. Cross-sectional observational. Eleven raw performance indicators from male Ultimate Fighting Championship bouts (n=234) from July 2014 to December 2014 were screened for analysis. Each raw performance indicator was also converted to a rate-dependent measure to be scaled to fight duration. Further, three additional performance indicators were calculated from the dataset and included in the analysis. Cohen's d effect sizes were employed to determine the magnitude of the differences between Wins and Losses, while decision tree (chi-square automatic interaction detector (CHAID)) and discriminant function analyses (DFA) were used to classify outcome (Win and Loss). Effect size comparisons revealed differences between Wins and Losses across a number of performance indicators. Decision tree (raw: 71.8%; rate-scaled: 76.3%) and DFA (raw: 71.4%; rate-scaled 71.2%) achieved similar classification accuracies. Grappling and accuracy performance indicators were the most influential in explaining outcome. The decision tree models also revealed multiple combinations of performance indicators leading to victory. The decision tree analyses suggest that grappling activity and technique accuracy are of particular importance in achieving victory in elite-level MMA competition. The DFA results supported the importance of these performance indicators. Decision tree induction represents an intuitive and slightly more accurate approach to explaining bout outcome in this sport when compared to DFA. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Quality Indicators for Multidisciplinary Team Functioning in Community-Based Children’s Mental Health Services

PubMed Central

Kutash, Krista; Acri, Mary; Pollock, Michele; Armusewicz, Kelsey; Hoagwood, Kimberly Eaton

2014-01-01

The current study examined the organizational social context in 21 community-based programs serving youth at-risk for out-of-home care due to emotional or behavioral disorders and their families and program performance on five quality indicators of team functioning in teams that included a family support specialist. Results indicate that programs with higher performance on structures to facilitate teamwork, informal communication mechanisms among team members, and the ability to integrate family support specialists as equal members of the team showed more positive organizational functioning. Implications for the role of quality indicators in health care reform efforts are discussed. PMID:23873037

Anchorage School District Profile of Performance, 1998-1999. Assessment and Evaluation Report.

ERIC Educational Resources Information Center

Fenton, Ray

The "Profile of Performance" is the Anchorage School District, Alaska, report card to the School Board and community on academic achievement. Part 1 of the report provides a summary of performance across the entire district on a variety of indicators of achievement. It includes an overview of district performance and an examination of…

Impact of Hybrid Delivery of Education on Student Academic Performance and the Student Experience

PubMed Central

Nutter, Douglas A.; Charneski, Lisa; Butko, Peter

2009-01-01

Objectives To compare student academic performance and the student experience in the first-year doctor of pharmacy (PharmD) program between the main and newly opened satellite campuses of the University of Maryland. Methods Student performance indicators including graded assessments, course averages, cumulative first-year grade point average (GPA), and introductory pharmacy practice experience (IPPE) evaluations were analyzed retrospectively. Student experience indicators were obtained via an online survey instrument and included involvement in student organizations; time-budgeting practices; and stress levels and their perceived effect on performance. Results Graded assessments, course averages, GPA, and IPPE evaluations were indistinguishable between campuses. Students' time allocation was not different between campuses, except for time spent attending class and watching lecture videos. There was no difference between students' stress levels at each campus. Conclusions The implementation of a satellite campus to expand pharmacy education yielded academic performance and student engagement comparable to those from traditional delivery methods. PMID:19960080

[Balanced scorecard for performance measurement of a nursing organization in a Korean hospital].

PubMed

Hong, Yoonmi; Hwang, Kyung Ja; Kim, Mi Ja; Park, Chang Gi

2008-02-01

The purpose of this study was to develop a balanced scorecard (BSC) for performance measurement of a Korean hospital nursing organization and to evaluate the validity and reliability of performance measurement indicators. Two hundred fifty-nine nurses in a Korean hospital participated in a survey questionnaire that included 29-item performance evaluation indicators developed by investigators of this study based on the Kaplan and Norton's BSC (1992). Cronbach's alpha was used to test the reliability of the BSC. Exploratory and confirmatory factor analysis with a structure equation model (SEM) was applied to assess the construct validity of the BSC. Cronbach's alpha of 29 items was .948. Factor analysis of the BSC showed 5 principal components (eigen value >1.0) which explained 62.7% of the total variance, and it included a new one, community service. The SEM analysis results showed that 5 components were significant for the hospital BSC tool. High degree of reliability and validity of this BSC suggests that it may be used for performance measurements of a Korean hospital nursing organization. Future studies may consider including a balanced number of nurse managers and staff nurses in the study. Further data analysis on the relationships among factors is recommended.

Implementing standardized performance indicators to improve hypertension control at both the population and healthcare organization levels

PubMed Central

Campbell, Norm; Ordunez, Pedro; Jafe, Marc G.; Orias, Marcelo; DiPete, Donald J.; Patel, Pragna; Khan, Nadia; Onuma, Oyere; Lackland, Daniel T.

2017-01-01

The ability to reliably evaluate the impact of interventions and changes in hypertension prevalence and control is critical if the burden of hypertension-related disease is to be reduced. Previously, a World Hypertension League Expert Committee made recommendations to standardize the reporting of population blood pressure surveys. We have added to those recommendations and also provide modified recommendations from a Pan American Health Organization expert meeting for “performance indicators” to be used to evaluate clinical practices. Core indicators for population surveys are recommended to include: (1) mean systolic blood pressure and (2) mean diastolic blood pressure, and the prevalences of: (3) hypertension, (4) awareness of hypertension, (5) drug-treated hypertension, and (6) drug-treated and controlled hypertension. Core indicators for clinical registries are recommended to include: (1) the prevalence of diagnosed hypertension and (2) the ratio of diagnosed hypertension to that expected by population surveys, and the prevalences of: (3) controlled hypertension, (4) lack of blood pressure measurement within a year in people diagnosed with hypertension, and (5) missed visits by people with hypertension. Definitions and additional indicators are provided. Widespread adoption of standardized population and clinical hypertension performance indicators could represent a major step forward in the effort to control hypertension. PMID:28191704

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

USDA-ARS?s Scientific Manuscript database

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

Performance indicators used to assess the quality of primary dental care.

PubMed

González, Grisel Zacca; Klazinga, Niek; ten Asbroek, Guus; Delnoij, Diana M

2006-12-01

An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a health care system, the sources for data collection and finally, the dimensions of quality measured by these indicators. An explorative study of the international literature was conducted using medical databases, journals and books, and official websites of organisations and associations. This resulted in a set of 57 indicators, which were classified into the following dimensions for each intended user group: For patients: health outcomes and subjective indicators; for professionals: their performance and the rates of success, failure and complications; for health care system managers and policymakers: their resources, finances and health care utilisation. A set of 57 performance indicators were identified to assess the quality of primary dental care at the levels of patients, professionals and the health care system. These indicators could be used by managers and decision-makers at any level of the health care system according to the characteristics of the services.

Fusion of Optimized Indicators from Advanced Driver Assistance Systems (ADAS) for Driver Drowsiness Detection

PubMed Central

Daza, Iván G.; Bergasa, Luis M.; Bronte, Sebastián; Yebes, J. Javier; Almazán, Javier; Arroyo, Roberto

2014-01-01

This paper presents a non-intrusive approach for monitoring driver drowsiness using the fusion of several optimized indicators based on driver physical and driving performance measures, obtained from ADAS (Advanced Driver Assistant Systems) in simulated conditions. The paper is focused on real-time drowsiness detection technology rather than on long-term sleep/awake regulation prediction technology. We have developed our own vision system in order to obtain robust and optimized driver indicators able to be used in simulators and future real environments. These indicators are principally based on driver physical and driving performance skills. The fusion of several indicators, proposed in the literature, is evaluated using a neural network and a stochastic optimization method to obtain the best combination. We propose a new method for ground-truth generation based on a supervised Karolinska Sleepiness Scale (KSS). An extensive evaluation of indicators, derived from trials over a third generation simulator with several test subjects during different driving sessions, was performed. The main conclusions about the performance of single indicators and the best combinations of them are included, as well as the future works derived from this study. PMID:24412904

The Association between Meditation Practice and Job Performance: A Cross-Sectional Study

PubMed Central

Sugimoto, Minami; Ishikawa, Yoshiki

2015-01-01

Many previous studies have shown that meditation practice has a positive impact on cognitive and non-cognitive functioning, which are related to job performance. Thus, the aims of this study were to (1) estimate the prevalence of meditation practice, (2) identify the characteristics of individuals who practice meditation, and (3) examine the association between meditation practice and job performance. Two population-based, cross-sectional surveys were conducted. In study 1, we examined the prevalence of meditation practice and the characteristics of the persons practicing meditation; in Study 2, we examined the association between meditation practice and job performance. The outcome variables included work engagement, subjective job performance, and job satisfaction. The Utrecht Work Engagement Scale was used to assess work engagement, the World Health Organization Health and Work Performance Questionnaire (HPQ) was used to measure subjective job performance, and a scale developed by the Japanese government was used to assess job satisfaction. Hierarchical multiple regression analyses were used in Study 2. Demographic characteristics and behavioral risk factors were included as covariates in the analyses. The results of Study 1 indicated that 3.9% of persons surveyed (n = 30,665) practiced meditation; these individuals were younger and had a higher education, higher household income, higher stress level, and lower body mass index than those who did not practice meditation. The results of Study 2 (n = 1,470) indicated that meditation practice was significantly predictive of work engagement (β = 0.112, p < .001), subjective job performance (β = 0.116, p < .001), and job satisfaction (β = 0.079, p = .002), even after adjusting for covariates (β = 0.083, p < .001; β = 0.104, p < .001; β = 0.060, p = .015, respectively). The results indicate that meditation practice may positively influence job performance, including job satisfaction, subjective job performance, and work engagement. PMID:26024382

Liquid cooled data center design selection

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

Chainer, Timothy J.; Iyengar, Madhusudan K.; Parida, Pritish R.

Input data, specifying aspects of a thermal design of a liquid cooled data center, is obtained. The input data includes data indicative of ambient outdoor temperature for a location of the data center; and/or data representing workload power dissipation for the data center. The input data is evaluated to obtain performance of the data center thermal design. The performance includes cooling energy usage; and/or one pertinent temperature associated with the data center. The performance of the data center thermal design is output.

Association between attempted suicide and academic performance indicators among middle and high school students in Mexico: results from a national survey.

PubMed

Orozco, Ricardo; Benjet, Corina; Borges, Guilherme; Moneta Arce, María Fátima; Fregoso Ito, Diana; Fleiz, Clara; Villatoro, Jorge Ameth

2018-01-01

Students' mental health is associated to academic performance. In high income countries, higher students' grades are related to lower odds of suicidal behaviors, but studies on other indicators of academic performance are more limited, specially in middle income countries. Data from 28,519 middle and high school students selected with multistage clustered sampling in the Mexican National Survey of Student's Drug Use. Using a self-administered questionnaire, lifetime suicidal attempt and four indicators of academic performance were assessed: age inconsistency with grade level, not being a student in the last year, perceived academic performance and number of failed courses. Multiple logistic regression models were used to control for sociodemographic and school characteristics. The lifetime prevalence of attempted suicide was 3.0% for middle school students and 4.2% for high school students. Among middle school students, statistically adjusted significant associations of suicide attempt with academic performance indicators were: not being a student the year before, worse self-perceived performance and a higher number of failed courses; among high school students, predictors were failed courses and self-perceived academic performance, with ORs of 1.65 and 1.96 for the categories of good and fair/poor respectively, compared to those who reported very good performance. Self-perceived academic performance was the main indicator for suicide in both school levels. Suicide prevention efforts in Mexico's schools should include asking students about the perception they have about their own academic performance.

Pathology Reports

MedlinePlus

... pathology report will include the results of these tests. For example, the pathology report may include information obtained from ... markers or indicators of a specific cancer. For example, the Philadelphia chromosome ... ( 3 ). Some tests that might be performed on a tissue sample ...

Gastrointestinal endoscopy in pregnancy

PubMed Central

Savas, Nurten

2014-01-01

Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. PMID:25386072

Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises

PubMed Central

2012-01-01

Background Disaster medicine is a fairly young scientific discipline and there is a need for the development of new methods for evaluation and research. This includes full-scale disaster exercisers. A standardized concept on how to evaluate these exercises, could lead to easier identification of pitfalls caused by system-errors in the organization. The aim of this study was to demonstrate the feasibility of using a combination of performance and outcome indicators so that results can be compared in standardized full-scale exercises. Methods Two multidisciplinary, full-scale exercises were studied in 2008 and 2010. The panorama had the same setup. Sets of performance indicators combined with indicators for unfavorable patient outcome were recorded in predesigned templates. Evaluators, all trained in a standardized way at a national disaster medicine centre, scored the results on predetermined locations; at the scene, at hospital and at the regional command and control. Results All data regarding the performance indicators of the participants during the exercises were obtained as well as all data regarding indicators for patient outcome. Both exercises could therefore be compared regarding performance (processes) as well as outcome indicators. The data from the performance indicators during the exercises showed higher scores for the prehospital command in the second exercise 15 points and 3 points respectively. Results from the outcome indicators, patient survival and patient complications, demonstrated a higher number of preventable deaths and a lower number of preventable complications in the exercise 2010. In the exercise 2008 the number of preventable deaths was lower and the number of preventable complications was higher. Conclusions Standardized multidisciplinary, full-scale exercises in different settings can be conducted and evaluated with performance indicators combined with outcome indicators enabling results from exercises to be compared. If exercises are performed in a standardized way, results may serve as a basis for lessons learned. Future use of the same concept using the combination of performance indicators and patient outcome indicators may demonstrate new and important evidence that could lead to new and better knowledge that also may be applied during real incidents. PMID:22929479

Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises.

PubMed

Rådestad, Monica; Nilsson, Heléne; Castrén, Maaret; Svensson, Leif; Rüter, Anders; Gryth, Dan

2012-08-28

Disaster medicine is a fairly young scientific discipline and there is a need for the development of new methods for evaluation and research. This includes full-scale disaster exercisers. A standardized concept on how to evaluate these exercises, could lead to easier identification of pitfalls caused by system-errors in the organization. The aim of this study was to demonstrate the feasibility of using a combination of performance and outcome indicators so that results can be compared in standardized full-scale exercises. Two multidisciplinary, full-scale exercises were studied in 2008 and 2010. The panorama had the same setup. Sets of performance indicators combined with indicators for unfavorable patient outcome were recorded in predesigned templates. Evaluators, all trained in a standardized way at a national disaster medicine centre, scored the results on predetermined locations; at the scene, at hospital and at the regional command and control. All data regarding the performance indicators of the participants during the exercises were obtained as well as all data regarding indicators for patient outcome. Both exercises could therefore be compared regarding performance (processes) as well as outcome indicators. The data from the performance indicators during the exercises showed higher scores for the prehospital command in the second exercise 15 points and 3 points respectively. Results from the outcome indicators, patient survival and patient complications, demonstrated a higher number of preventable deaths and a lower number of preventable complications in the exercise 2010. In the exercise 2008 the number of preventable deaths was lower and the number of preventable complications was higher. Standardized multidisciplinary, full-scale exercises in different settings can be conducted and evaluated with performance indicators combined with outcome indicators enabling results from exercises to be compared. If exercises are performed in a standardized way, results may serve as a basis for lessons learned. Future use of the same concept using the combination of performance indicators and patient outcome indicators may demonstrate new and important evidence that could lead to new and better knowledge that also may be applied during real incidents.

Determining and Communicating the Value of the Special Library.

ERIC Educational Resources Information Center

Matthews, Joseph R.

2003-01-01

Discusses performance measures for libraries that will indicate the goodness of the library and its services. Highlights include a general evaluation model that includes input, process, output, and outcome measures; balanced scorecard approach that includes financial perspectives; focusing on strategy; strategies for change; user criteria for…

THE DYNAMIC INTER-RELATIONSHIP BETWEEN OBESITY AND SCHOOL PERFORMANCE: NEW EMPIRICAL EVIDENCE FROM AUSTRALIA.

PubMed

Nghiem, Son; Hoang, Viet-Ngu; Vu, Xuan-Binh; Wilson, Clevo

2017-12-04

This paper proposes a new empirical model for examining the relationship between obesity and school performance using the simultaneous equation modelling approach. The lagged effects of both learning and health outcomes were included to capture both the dynamic and inter-relational aspects of the relationship between obesity and school performance. The empirical application of this study used comprehensive data from the first five waves of the Longitudinal Study of Australian Children (LSAC), which commenced in 2004 (wave 1) and was repeated every two years until 2018. The study sample included 10,000 children, equally divided between two cohorts (infants and children) across Australia. The empirical results show that past learning and obesity status are strongly associated with most indicators of school outcomes, including reading, writing, spelling, grammar and numeracy national tests, and scores from the internationally standardized Peabody Picture Vocabulary Test and the Matrix Reasoning Test. The main findings of this study are robust due to the choice of obesity indicator and estimation methods.

An empirical comparison of key statistical attributes among potential ICU quality indicators.

PubMed

Brown, Sydney E S; Ratcliffe, Sarah J; Halpern, Scott D

2014-08-01

Good quality indicators should have face validity, relevance to patients, and be able to be measured reliably. Beyond these general requirements, good quality indicators should also have certain statistical properties, including sufficient variability to identify poor performers, relative insensitivity to severity adjustment, and the ability to capture what providers do rather than patients' characteristics. We assessed the performance of candidate indicators of ICU quality on these criteria. Indicators included ICU readmission, mortality, several length of stay outcomes, and the processes of venous-thromboembolism and stress ulcer prophylaxis provision. Retrospective cohort study. One hundred thirty-eight U.S. ICUs from 2001-2008 in the Project IMPACT database. Two hundred sixty-eight thousand eight hundred twenty-four patients discharged from U.S. ICUs. None. We assessed indicators' (1) variability across ICU-years; (2) degree of influence by patient vs. ICU and hospital characteristics using the Omega statistic; (3) sensitivity to severity adjustment by comparing the area under the receiver operating characteristic curve (AUC) between models including vs. excluding patient variables, and (4) correlation between risk adjusted quality indicators using a Spearman correlation. Large ranges of among-ICU variability were noted for all quality indicators, particularly for prolonged length of stay (4.7-71.3%) and the proportion of patients discharged home (30.6-82.0%), and ICU and hospital characteristics outweighed patient characteristics for stress ulcer prophylaxis (ω, 0.43; 95% CI, 0.34-0.54), venous thromboembolism prophylaxis (ω, 0.57; 95% CI, 0.53-0.61), and ICU readmissions (ω, 0.69; 95% CI, 0.52-0.90). Mortality measures were the most sensitive to severity adjustment (area under the receiver operating characteristic curve % difference, 29.6%); process measures were the least sensitive (area under the receiver operating characteristic curve % differences: venous thromboembolism prophylaxis, 3.4%; stress ulcer prophylaxis, 2.1%). None of the 10 indicators was clearly and consistently correlated with a majority of the other nine indicators. No indicator performed optimally across assessments. Future research should seek to define and operationalize quality in a way that is relevant to both patients and providers.

Performance in wild ungulates: measuring population density and condition of individuals

Treesearch

John G. Kie

1988-01-01

Measures of performance in wild ungulates can include characteristics indicative of condition and health such as body weights, fat reserves, blood values, reproductive rates, and parasite loads. Performance may also be inferred from habitat-related factors, such as diet and nutritional intake. However, these parameters interact with population density to form a...

Perkins Core Performance Measures Results and Targets, 2000-2001.

ERIC Educational Resources Information Center

McHewitt, Earl R.; Taylor, Garry

This is a report on 2000-2001 Perkins III core performance standards and measures for the Virginia Community College System (VCCS). Perkins performance measure definitions for the system were finalized with the Virginia and federal departments of education in fall 2000. Core indicators include: (1) student attainment, which measures academic and…

Hospitals' Internal Accountability

PubMed Central

Kraetschmer, Nancy; Jass, Janak; Woodman, Cheryl; Koo, Irene; Kromm, Seija K.; Deber, Raisa B.

2014-01-01

This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements. PMID:25305387

Performance index for virtual reality phacoemulsification surgery

NASA Astrophysics Data System (ADS)

Söderberg, Per; Laurell, Carl-Gustaf; Simawi, Wamidh; Skarman, Eva; Nordqvist, Per; Nordh, Leif

2007-02-01

We have developed a virtual reality (VR) simulator for phacoemulsification (phaco) surgery. The current work aimed at developing a performance index that characterizes the performance of an individual trainee. We recorded measurements of 28 response variables during three iterated surgical sessions in 9 subjects naive to cataract surgery and 6 experienced cataract surgeons, separately for the sculpting phase and the evacuation phase of phacoemulsification surgery. We further defined a specific performance index for a specific measurement variable and a total performance index for a specific trainee. The distribution function for the total performance index was relatively evenly distributed both for the sculpting and the evacuation phase indicating that parametric statistics can be used for comparison of total average performance indices for different groups in the future. The current total performance index for an individual considers all measurement variables included with the same weight. It is possible that a future development of the system will indicate that a better characterization of a trainee can be obtained if the various measurements variables are given specific weights. The currently developed total performance index for a trainee is statistically an independent observation of that particular trainee.

A Mediation Analysis on the Relationship of Physical Fitness Components, Obesity, and Academic Performance in Children.

PubMed

Muntaner-Mas, Adrià; Pere, Palou; Vidal-Conti, Josep; Esteban-Cornejo, Irene

2018-04-20

To examine the relationship between a battery of obesity indicators and physical fitness components with academic performance in children and to explore the combined and mediation role of the physical fitness components in the relationship between obesity and academic performance in children. A cross-sectional study including data from 250 Spanish schoolchildren (Balearic Islands) between 10 and 12 years of age (mean age, 10.98 ± 0.76 years) was conducted. Obesity measures (body mass index, body fat, waist circumference, hip circumference, and waist-to-height ratio), physical fitness components (cardiorespiratory fitness, muscular fitness, and speed-agility), and academic performance (Spanish language, Catalan language, English language, natural sciences, social sciences, arts, physical education, religion, and grade point average [GPA]) were collected. All obesity measures were negatively related to at least 3 of the 10 academic indicators, including GPA (β range, -0.135 to -0.229; all P < .05). Cardiorespiratory fitness and speed-agility were positively related to all academic indicators (β range, 0.182 to 0.350; all P < .046) and muscular fitness with 3 academic indicators (β range, 0.143 to 0.253; all P < .039). Children considered as fit had better academic performance than their unfit peers (score +0.75; P = .001). The association between body mass index and GPA was mediated by cardiorespiratory fitness and speed-agility. This investigation contributes to the current knowledge by adding evidence about the crucial role of physical fitness in terms of academic performance rather than obesity status, suggesting that physical fitness may ameliorate the negative influence of obesity on academic performance. Copyright © 2018 Elsevier Inc. All rights reserved.

A comparison of four embedded validity indices for the RBANS in a memory disorders clinic.

PubMed

Paulson, Daniel; Horner, Michael David; Bachman, David

2015-05-01

This examination of four embedded validity indices for the Repeated Battery for the Assessment of Neuropsychological Status (RBANS) explores the potential utility of integrating cognitive and self-reported depressive measures. Examined indices include the proposed RBANS Performance Validity Index (RBANS PVI) and the Charleston Revised Index of Effort for the RBANS (CRIER). The CRIER represented the novel integration of cognitive test performance and depression self-report information. The sample included 234 patients without dementia who could be identified as having demonstrated either valid or invalid responding, based on standardized criteria. Sensitivity and specificity for invalid responding varied widely, with the CRIER emerging as the best all-around index (sensitivity = 0.84, specificity = 0.90, AUC = 0.94). Findings support the use of embedded response validity indices, and suggest that the integration of cognitive and self-report depression data may optimize detection of invalid responding among older Veterans. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dashboard report on performance on select quality indicators to cancer care providers.

PubMed

Stattin, Pär; Sandin, Fredrik; Sandbäck, Torsten; Damber, Jan-Erik; Franck Lissbrant, Ingela; Robinson, David; Bratt, Ola; Lambe, Mats

2016-01-01

Cancer quality registers are attracting increasing attention as important, but still underutilized sources of clinical data. To optimize the use of registers in quality assurance and improvement, data have to be rapidly collected, collated and presented as actionable, at-a-glance information to the reporting departments. This article presents a dashboard performance report on select quality indicators to cancer care providers. Ten quality indicators registered on an individual patient level in the National Prostate Cancer Register of Sweden and recommended by the National Prostate Cancer Guidelines were selected. Data reported to the National Prostate Cancer Register are uploaded within 24 h to the Information Network for Cancer Care platform. Launched in 2014, "What''s Going On, Prostate Cancer" provides rapid, at-a-glance performance feedback to care providers. The indicators include time to report to the National Prostate Cancer Register, waiting times, designated clinical nurse specialist, multidisciplinary conference, adherence to guidelines for diagnostic work-up and treatment, and documentation and outcome of treatment. For each indicator, three performance levels were defined. What's Going On, a dashboard performance report on 10 selected quality indicators to cancer care providers, provides an example of how data in cancer quality registers can be transformed into condensed, at-a-glance information to be used as actionable metrics for quality assurance and improvement.

Associations of medical student personality and health/wellness characteristics with their medical school performance across the curriculum.

PubMed

Haight, Scott J; Chibnall, John T; Schindler, Debra L; Slavin, Stuart J

2012-04-01

To assess the relationships of cognitive and noncognitive performance predictors to medical student preclinical and clinical performance indicators across medical school years 1 to 3 and to evaluate the association of psychological health/wellness factors with performance. In 2010, the authors conducted a cross-sectional, correlational, retrospective study of all 175 students at the Saint Louis University School of Medicine who had just completed their third (first clinical) year. Students were asked to complete assessments of personality, stress, anxiety, depression, social support, and community cohesion. Performance measures included total Medical College Admission Test (MCAT) score, preclinical academic grades, National Board of Medical Examiners subject exam scores, United States Medical Licensing Examination Step 1 score, clinical evaluations, and Humanism in Medicine Honor Society nominations. A total of 152 students (87%) participated. MCAT scores predicted cognitive performance indicators (academic tests), whereas personality variables (conscientiousness, extraversion, empathy) predicted noncognitive indicators (clinical evaluations, humanism nominations). Conscientiousness predicted all clinical skills, extraversion predicted clinical skills reflecting interpersonal behavior, and empathy predicted motivation. Health/wellness variables had limited associations with performance. In multivariate analyses that included control for shelf exam scores, conscientiousness predicted clinical evaluations, and extraversion and empathy predicted humanism nominations. This study identified two sets of skills (cognitive, noncognitive) used during medical school, with minimal overlap across the types of performance (e.g., exam performance versus clinical interpersonal skills) they predict. Medical school admission and evaluation efforts may need to be modified to reflect the importance of personality and other noncognitive factors.

Academic Success Among Mexican American Women in a Community College.

ERIC Educational Resources Information Center

Castellanos, Mary; Fujitsubo, Lani C.

1997-01-01

Discusses a study conducted to show how factors such as depression, somatization, and acculturation affect the academic performance of Mexican-American women in community colleges. Results indicate these variables have no significant relationship to academic performance. Includes 24 citations. (JDI)

Use of EEG workload indices for diagnostic monitoring of vigilance decrement.

PubMed

Kamzanova, Altyngul T; Kustubayeva, Almira M; Matthews, Gerald

2014-09-01

A study was run to test which of five electroencephalographic (EEG) indices was most diagnostic of loss of vigilance at two levels of workload. EEG indices of alertness include conventional spectral power measures as well as indices combining measures from multiple frequency bands, such as the Task Load Index (TLI) and the Engagement Index (El). However, it is unclear which indices are optimal for early detection of loss of vigilance. Ninety-two participants were assigned to one of two experimental conditions, cued (lower workload) and uncued (higher workload), and then performed a 40-min visual vigilance task. Performance on this task is believed to be limited by attentional resource availability. EEG was recorded continuously. Performance, subjective state, and workload were also assessed. The task showed a vigilance decrement in performance; cuing improved performance and reduced subjective workload. Lower-frequency alpha (8 to 10.9 Hz) and TLI were most sensitive to the task parameters. The magnitude of temporal change was larger for lower-frequency alpha. Surprisingly, higher TLI was associated with superior performance. Frontal theta and El were influenced by task workload only in the final period of work. Correlational data also suggested that the indices are distinct from one another. Lower-frequency alpha appears to be the optimal index for monitoring vigilance on the task used here, but further work is needed to test how diagnosticity of EEG indices varies with task demands. Lower-frequency alpha may be used to diagnose loss of operator alertness on tasks requiring vigilance.

Active non-volatile memory post-processing

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

Kannan, Sudarsun; Milojicic, Dejan S.; Talwar, Vanish

A computing node includes an active Non-Volatile Random Access Memory (NVRAM) component which includes memory and a sub-processor component. The memory is to store data chunks received from a processor core, the data chunks comprising metadata indicating a type of post-processing to be performed on data within the data chunks. The sub-processor component is to perform post-processing of said data chunks based on said metadata.

Modeling of Karachaganak field development

NASA Astrophysics Data System (ADS)

Sadvakasov, A. A.; Shamsutdinova, G. F.; Almukhametova, E. M.; Gabdrakhmanov, N. Kh

2018-05-01

Management of a geological deposit includes the study and analysis of oil recovery, identification of factors influencing production performance and oil-bearing rock flooding, reserve recovery and other indicators characterizing field development in general. Regulation of oil deposits exploitation is a mere control over the fluid flow within a reservoir, which is ensured through the designed system of development via continuous improvement of production and injection wells placement, optimum performance modes, service conditions of downhole and surface oil-field equipment taking into account various changes and physical-geological properties of a field when using modern equipment to obtain the best performance indicators.

Load Index Metrics for an Optimized Management of Web Services: A Systematic Evaluation

PubMed Central

Souza, Paulo S. L.; Santana, Regina H. C.; Santana, Marcos J.; Zaluska, Ed; Faical, Bruno S.; Estrella, Julio C.

2013-01-01

The lack of precision to predict service performance through load indices may lead to wrong decisions regarding the use of web services, compromising service performance and raising platform cost unnecessarily. This paper presents experimental studies to qualify the behaviour of load indices in the web service context. The experiments consider three services that generate controlled and significant server demands, four levels of workload for each service and six distinct execution scenarios. The evaluation considers three relevant perspectives: the capability for representing recent workloads, the capability for predicting near-future performance and finally stability. Eight different load indices were analysed, including the JMX Average Time index (proposed in this paper) specifically designed to address the limitations of the other indices. A systematic approach is applied to evaluate the different load indices, considering a multiple linear regression model based on the stepwise-AIC method. The results show that the load indices studied represent the workload to some extent; however, in contrast to expectations, most of them do not exhibit a coherent correlation with service performance and this can result in stability problems. The JMX Average Time index is an exception, showing a stable behaviour which is tightly-coupled to the service runtime for all executions. Load indices are used to predict the service runtime and therefore their inappropriate use can lead to decisions that will impact negatively on both service performance and execution cost. PMID:23874776

Converging Indicators for Assessing Individual Differences in Adaptation to Extreme Environments: Preliminary Report

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Toscano, William B.; DeRoshia, Charles W.; Taylor, Bruce; Hines, Seleimah; Bright, Andrew; Dodds, Anika

2006-01-01

This paper describes the development and validation of a new methodology for assessing the deleterious effects of spaceflight on crew health and performance. It is well known that microgravity results in various physiological alterations, e.g., headward fluid shifts which can impede physiological adaptation. Other factors that may affect crew operational efficiency include disruption of sleep-wake cycles, high workload, isolation, confinement, stress and fatigue. From an operational perspective, it is difficult to predict which individuals will be most or least affected in this unique environment given that most astronauts are first-time flyers. During future lunar and Mars missions space crews will include both men and women of multi-national origins, different professional backgrounds, and various states of physical condition. Therefore, new methods or technologies are needed to monitor and predict astronaut performance and health, and to evaluate the effects of various countermeasures on crew during long duration missions. This paper reviews several studies conducted in both laboratory and operational environments with men and women ranging in age between 18 to 50 years. The studies included the following: soldiers performing command and control functions during mobile operations in enclosed armored vehicles; subjects participating in laboratory tests of an anti-motion sickness medication; subjects exposed to chronic hypergravity aboard a centrifuge, and subject responses to 36-hours of sleep deprivation. Physiological measurements, performance metrics, and subjective self-reports were collected in each study. The results demonstrate that multivariate converging indicators provide a significantly more reliable method for assessing environmental effects on performance and health than any single indicator.

Endovascular uterine artery interventions

PubMed Central

Das, Chandan J; Rathinam, Deepak; Manchanda, Smita; Srivastava, D N

2017-01-01

Percutaneous vascular embolization plays an important role in the management of various gynecologic and obstetric abnormalities. Transcatheter embolization is a minimally invasive alternative procedure to surgery with reduced morbidity and mortality, and preserves the patient's future fertility potential. The clinical indications for transcatheter embolization are much broader and include many benign gynecologic conditions, such as fibroid, adenomyosis, and arteriovenous malformations (AVMs), as well as intractable bleeding due to inoperable advanced-stage malignancies. The most well-known and well-studied indication is uterine fibroid embolization. Uterine artery embolization (UAE) may be performed to prevent or treat bleeding associated with various obstetric conditions, including postpartum hemorrhage (PPH), placental implantation abnormality, and ectopic pregnancy. Embolization of the uterine artery or the internal iliac artery also may be performed to control pelvic bleeding due to coagulopathy or iatrogenic injury. This article discusses these gynecologic and obstetric indications for transcatheter embolization and reviews procedural techniques and outcomes. PMID:29379246

Tank 241-B-108, cores 172 and 173 analytical results for the final report

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

Nuzum, J.L., Fluoro Daniel Hanford

1997-03-04

The Data Summary Table (Table 3) included in this report compiles analytical results in compliance with all applicable DQOS. Liquid subsamples that were prepared for analysis by an acid adjustment of the direct subsample are indicated by a `D` in the A column in Table 3. Solid subsamples that were prepared for analysis by performing a fusion digest are indicated by an `F` in the A column in Table 3. Solid subsamples that were prepared for analysis by performing a water digest are indicated by a I.wl. or an `I` in the A column of Table 3. Due to poormore » precision and accuracy in original analysis of both Lower Half Segment 2 of Core 173 and the core composite of Core 173, fusion and water digests were performed for a second time. Precision and accuracy improved with the repreparation of Core 173 Composite. Analyses with the repreparation of Lower Half Segment 2 of Core 173 did not show improvement and suggest sample heterogeneity. Results from both preparations are included in Table 3.« less

Development of a Situational Judgment Test as a Predictor of College Student Performance

ERIC Educational Resources Information Center

Matošková, Jana; Kovárík, Martin

2017-01-01

It has been suggested that tacit knowledge may be a good predictor of performance in college. The purpose of this study was to investigate the extent to which a situational judgment test developed to measure tacit knowledge correlates with predictors and indicators of college performance. This situational judgment test includes eight situations…

Examination of Cognitive and Instrumental Functional Performance as Indicators for Driving Cessation Risk across 3 Years

ERIC Educational Resources Information Center

Ackerman, Michelle L.; Edwards, Jerri D.; Ross, Lesley A.; Ball, Karlene K.; Lunsman, Melissa

2008-01-01

Purpose: The purpose of this study was to prospectively examine the role of cognitive and instrumental functional performance in driving cessation while simultaneously accounting for any contributions of demographics, vision, physical performance, and health among a sample of older adults without dementia. Design and Methods: Included in the…

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

ERIC Educational Resources Information Center

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

2010-01-01

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

Developing and Using Dashboard Indicators in Student Affairs Assessment

ERIC Educational Resources Information Center

Mitchell, Joshua J.; Ryder, Andrew J.

2013-01-01

Dashboard systems are increasingly popular as assessment and performance management tools in higher education. This chapter examines the use of dashboards in student affairs, including examples of key indicators and considerations for developing and implementing these tools. The chapter begins with an overview of the origins of dashboards, from…

Families Are Learning in Science Museums.

ERIC Educational Resources Information Center

Borun, Minda; And Others

1996-01-01

Reports on a study designed to identify and measure family learning in science museums. Findings indicate that families do learn from exhibits and the level of learning is related to specific observed behaviors. Grouping these behaviors as performance indicators provides a useful measure of exhibit learning. Appendixes include a demographic…

Association of school performance indicators with implementation of the healthy kids, smart kids programme: case study.

PubMed

Nansel, Tonja R; Huang, Terry T K; Rovner, Alisha J; Sanders-Butler, Yvonne

2010-01-01

The purpose of the present analysis was to examine secular trends in school performance indicators in relationship to the implementation of a programme targeting the school food and physical activity environment. Data on available school performance indicators were obtained; retrospective analyses were conducted to assess trends in indicators in association with programme implementation; each outcome was regressed v. year, beginning with the year prior to programme implementation. The Healthy Kids, Smart Kids programme, a grass-roots effort to enhance the school food and physical activity environment in the Browns Mill Elementary School in Georgia. Data included publicly available school records from the years 1995 to 2006. The number of nurse, counselling and disciplinary referrals per 100 students demonstrated a downward trend, while standardized test scores demonstrated an upward trend beginning in the year of programme implementation. School year was a significant predictor of all indicators. Promoting nutrition and physical activity within the school environment may be a promising approach for enhancing both student health and educational outcomes.

Quality and performance indicators in an academic department of head and neck surgery.

PubMed

Weber, Randal S; Lewis, Carol M; Eastman, Scott D; Hanna, Ehab Y; Akiwumi, Olubumi; Hessel, Amy C; Lai, Stephen Y; Kian, Leslie; Kupferman, Michael E; Roberts, Dianna B

2010-12-01

to create a method for assessing physician performance and care outcomes that are adjusted for procedure acuity and patient comorbidity. between 2004 and 2008 surgical procedures performed by 10 surgeons were stratified into high-acuity procedures (HAPs) and low-acuity procedures (LAPs). Risk adjustment was made for comorbid conditions examined singly or in groups of 2 or more. a tertiary care medical center. a total of 2618 surgical patients. performance measures included length of stay; return to operating room within 7 days of surgery; and the occurrence of mortality, hospital readmission, transfusion, and wound infection within 30 days of surgery. the transfusion rate was 2.7% and 40.6% for LAPs and HAPs, respectively. Wound infection rates were 1.4% for LAPs vs 14.1% for HAPs, while 30-day mortality rate was 0.3% and 1.6% for LAPs and HAPs, respectively. The mean (SD) hospital stay for LAPs was 2.1 (3.6) vs 10.5 (7.0) days for HAPs. Negative performance factors were significantly higher for patients who underwent HAPs and had comorbid conditions. Differences among surgeons significantly affect the incidence of negative performance indicators. Factors affecting performance measures were procedure acuity, the surgeon, and comorbidity, in order of decreasing significance. Surgeons were ranked low, middle, and high based on negative performance indicators. performance measures following oncologic procedures were significantly affected by comorbid conditions and by procedure acuity. Although the latter most strongly affects quality and performance indicators, both should weigh heavily in physician comparisons. The incidence of negative performance indicators was also influenced by the individual surgeon. These data may serve as a tool to evaluate and improve physician performance and outcomes and to develop risk-adjusted benchmarks. Ultimately, reimbursement may be tied to quantifiable measures of physician and institutional performance.

Can we trust the calculation of texture indices of CT images? A phantom study.

PubMed

Caramella, Caroline; Allorant, Adrien; Orlhac, Fanny; Bidault, Francois; Asselain, Bernard; Ammari, Samy; Jaranowski, Patricia; Moussier, Aurelie; Balleyguier, Corinne; Lassau, Nathalie; Pitre-Champagnat, Stephanie

2018-04-01

Texture analysis is an emerging tool in the field of medical imaging analysis. However, many issues have been raised in terms of its use in assessing patient images and it is crucial to harmonize and standardize this new imaging measurement tool. This study was designed to evaluate the reliability of texture indices of CT images on a phantom including a reproducibility study, to assess the discriminatory capacity of indices potentially relevant in CT medical images and to determine their redundancy. For the reproducibility and discriminatory analysis, eight identical CT acquisitions were performed on a phantom including one homogeneous insert and two close heterogeneous inserts. Texture indices were selected for their high reproducibility and capability of discriminating different textures. For the redundancy analysis, 39 acquisitions of the same phantom were performed using varying acquisition parameters and a correlation matrix was used to explore the 2 × 2 relationships. LIFEx software was used to explore 34 different parameters including first order and texture indices. Only eight indices of 34 exhibited high reproducibility and discriminated textures from each other. Skewness and kurtosis from histogram were independent from the six other indices but were intercorrelated, the other six indices correlated in diverse degrees (entropy, dissimilarity, and contrast of the co-occurrence matrix, contrast of the Neighborhood Gray Level difference matrix, SZE, ZLNU of the Gray-Level Size Zone Matrix). Care should be taken when using texture analysis as a tool to characterize CT images because changes in quantitation may be primarily due to internal variability rather than from real physio-pathological effects. Some textural indices appear to be sufficiently reliable and capable to discriminate close textures on CT images. © 2018 American Association of Physicists in Medicine.

Research Frontiers in Public Sector Performance Measurement

NASA Astrophysics Data System (ADS)

Zhonghua, Cai; Ye, Wang

In "New Public Management" era, performance measurement has been widely used in managerial practices of public sectors. From the content and features of performance measurement, this paper aims to explore inspirations on Chinese public sector performance measurement, which based on a review of prior literatures including influencial factors, methods and indicators of public sector performance evaluation. In the end, arguments are presented in this paper pointed out the direction of future researches in this field.

Performance evaluation of hospitals that provide care in the public health system, Brazil.

PubMed

Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

2015-01-01

OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

Performance evaluation of hospitals that provide care in the public health system, Brazil

PubMed Central

Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

2015-01-01

OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimento s de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals. PMID:26247385

Progress and Promise: Results from the Boston Pilot Schools

ERIC Educational Resources Information Center

Tung, Rosann; Ouimette, Monique; Rugen, Leah

2006-01-01

New research conducted by Boston's Center for Collaborative Education documents significant achievement by students who attend the city's Pilot Schools. Pilot School students are performing better than the district averages across every indicator of student engagement and performance, including the statewide standardized assessment (MCAS). In…

Proposed biopsy performance benchmarks for MRI based on an audit of a large academic center.

PubMed

Sedora Román, Neda I; Mehta, Tejas S; Sharpe, Richard E; Slanetz, Priscilla J; Venkataraman, Shambhavi; Fein-Zachary, Valerie; Dialani, Vandana

2018-05-01

Performance benchmarks exist for mammography (MG); however, performance benchmarks for magnetic resonance imaging (MRI) are not yet fully developed. The purpose of our study was to perform an MRI audit based on established MG and screening MRI benchmarks and to review whether these benchmarks can be applied to an MRI practice. An IRB approved retrospective review of breast MRIs was performed at our center from 1/1/2011 through 12/31/13. For patients with biopsy recommendation, core biopsy and surgical pathology results were reviewed. The data were used to derive mean performance parameter values, including abnormal interpretation rate (AIR), positive predictive value (PPV), cancer detection rate (CDR), percentage of minimal cancers and axillary node negative cancers and compared with MG and screening MRI benchmarks. MRIs were also divided by screening and diagnostic indications to assess for differences in performance benchmarks amongst these two groups. Of the 2455 MRIs performed over 3-years, 1563 were performed for screening indications and 892 for diagnostic indications. With the exception of PPV2 for screening breast MRIs from 2011 to 2013, PPVs were met for our screening and diagnostic populations when compared to the MRI screening benchmarks established by the Breast Imaging Reporting and Data System (BI-RADS) 5 Atlas ® . AIR and CDR were lower for screening indications as compared to diagnostic indications. New MRI screening benchmarks can be used for screening MRI audits while the American College of Radiology (ACR) desirable goals for diagnostic MG can be used for diagnostic MRI audits. Our study corroborates established findings regarding differences in AIR and CDR amongst screening versus diagnostic indications. © 2017 Wiley Periodicals, Inc.

Development and assessment of national performance indicators for infection prevention and control and antimicrobial stewardship in European long-term care facilities.

PubMed

Cookson, B; Mackenzie, D; Kafatos, G; Jans, B; Latour, K; Moro, M L; Ricchizzi, E; Van de Mortel, M; Suetens, C; Fabry, J

2013-09-01

Healthcare-associated infections in long-term care facilities (LTCFs) are of increasing importance. To develop consensus national performance indicators (NPIs) for infection control (ICPI) and antimicrobial stewardship (ASPI) in LTCFs, and assess the performance of 32 European countries against these NPIs. Previously established European standards were the basis for consensus and the same iterative approach with national representatives from the 32 countries. A World Health Organization scoring system recorded how close each country was to implementing each standard. The 42 agreed component indicators were grouped into six NPI categories: 'national programme', 'guidelines', 'expert advice', 'IC structure' (not present in the ASPI), 'surveillance' and 'composite'. 'Guidelines' scored the highest mean total possible score (60%, range 20-100%), followed by 'composite' (53%, range 30-100%), 'expert advice' (48%, range 20-100%), 'surveillance' (47%, range 20-83%), 'national programme' (42%, range 20-100%) and 'IC structure' (39%, range 20-100%). Although several scores were low, some countries were able to implement all NPIs, indicating that this was feasible. Most NPIs were very significantly related, indicating that they were considered to be important by the countries. 'Guidelines' and 'IC structure' were significantly related to European region (P ≤ 0.05). Accreditation/inspection was not evident in seven (22%) countries, nine (28%) countries had accreditation/inspection that included IC assessments, and seven (22%) countries had accreditation/inspection that included IC and antimicrobial stewardship assessments. Multi-variable analysis found that only the NPI and the ICPI 'expert advice' were associated with accreditation/inspection which included IC and antimicrobial stewardship. The identified gaps represent significant potential patient safety issues. The NPIs should serve as a basis for monitoring improvements over the coming years. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Army Sustainability Report 2010

DTIC Science & Technology

2011-09-01

a vastly complex concept: it is an organizing principle that factors mission, environment, community and economic benefit into each of its...Report on a minimum of 10 performance indicators, including at least one from each of : economic , social and environmental Report on a minimum...FY09 in a partial performance baseline. It is based on a subset of the economic , environmental and social responsibility performance

Prechamber Compression-Ignition Engine Performance

NASA Technical Reports Server (NTRS)

Moore, Charles S; Collins, John H , Jr

1938-01-01

Single-cylinder compression-ignition engine tests were made to investigate the performance characteristics of prechamber type of cylinder head. Certain fundamental variables influencing engine performance -- clearance distribution, size, shape, and direction of the passage connecting the cylinder and prechamber, shape of prechamber, cylinder clearance, compression ratio, and boosting -- were independently tested. Results of motoring and of power tests, including several typical indicator cards, are presented.

Public perceptions of key performance indicators of healthcare in Alberta, Canada.

PubMed

Northcott, Herbert C; Harvey, Michael D

2012-06-01

To examine the relationship between public perceptions of key performance indicators assessing various aspects of the health-care system. Cross-sequential survey research. Annual telephone surveys of random samples of adult Albertans selected by random digit dialing and stratified according to age, sex and region (n = 4000 for each survey year). The survey questionnaires included single-item measures of key performance indicators to assess public perceptions of availability, accessibility, quality, outcome and satisfaction with healthcare. Cronbach's α and factor analysis were used to assess the relationship between key performance indicators focusing on the health-care system overall and on a recent interaction with the health-care system. The province of Alberta, Canada during the years 1996-2004. Four thousand adults randomly selected each survey year. Survey questions measuring public perceptions of healthcare availability, accessibility, quality, outcome and satisfaction with healthcare. Factor analysis identified two principal components with key performance indicators focusing on the health system overall loading most strongly on the first component and key performance indicators focusing on the most recent health-care encounter loading most strongly on the second component. Assessments of the quality of care most recently received, accessibility of that care and perceived outcome of care tended to be higher than the more general assessments of overall health system quality and accessibility. Assessments of specific health-care encounters and more general assessments of the overall health-care system, while related, nevertheless comprise separate dimensions for health-care evaluation.

Differentiating the grades of thymic epithelial tumor malignancy using textural features of intratumoral heterogeneity via (18)F-FDG PET/CT.

PubMed

Lee, Hyo Sang; Oh, Jungsu S; Park, Young Soo; Jang, Se Jin; Choi, Ik Soo; Ryu, Jin-Sook

2016-05-01

We aimed to explore the ability of textural heterogeneity indices determined by (18)F-FDG PET/CT for grading the malignancy of thymic epithelial tumors (TETs). We retrospectively enrolled 47 patients with pathologically proven TETs who underwent pre-treatment (18)F-FDG PET/CT. TETs were classified by pathological results into three subgroups with increasing grades of malignancy: low-risk thymoma (LRT; WHO classification A, AB and B1), high-risk thymoma (B2 and B3), and thymic carcinoma (TC). Using (18)F-FDG PET/CT, we obtained conventional imaging indices including SUVmax and 20 intratumoral heterogeneity indices: i.e., four local-scale indices derived from the neighborhood gray-tone difference matrix (NGTDM), eight regional-scale indices from the gray-level run-length matrix (GLRLM), and eight regional-scale indices from the gray-level size zone matrix (GLSZM). Area under the receiver operating characteristic curve (AUC) was used to demonstrate the abilities of the imaging indices for differentiating subgroups. Multivariable logistic regression analysis was performed to show the independent significance of the textural indices. Combined criteria using optimal cutoff values of the SUVmax and a best-performing heterogeneity index were applied to investigate whether they improved differentiation between the subgroups. Most of the GLRLM and GLSZM indices and the SUVmax showed good or fair discrimination (AUC >0.7) with best performance for some of the GLRLM indices and the SUVmax, whereas the NGTDM indices showed relatively inferior performance. The discriminative ability of some of the GLSZM indices was independent from that of SUVmax in multivariate analysis. Combined use of the SUVmax and a GLSZM index improved positive predictive values for LRT and TC. Texture analysis of (18)F-FDG PET/CT scans has the potential to differentiate between TET tumor grades; regional-scale indices from GLRLM and GLSZM perform better than local-scale indices from the NGTDM. The SUVmax and heterogeneity indices may have complementary value in differentiating TET subgroups.

The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.

PubMed

Tu, Jack V; Maclagan, Laura C; Ko, Dennis T; Atzema, Clare L; Booth, Gillian L; Johnston, Sharon; Tu, Karen; Lee, Douglas S; Bierman, Arlene; Hall, Ruth; Bhatia, R Sacha; Gershon, Andrea S; Tobe, Sheldon W; Sanmartin, Claudia; Liu, Peter; Chu, Anna

2017-04-25

High-quality ambulatory care can reduce cardiovascular disease risk, but important gaps exist in the provision of cardiovascular preventive care. We sought to develop a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. As part of the Cardiovascular Health in Ambulatory Care Research Team initiative, we established a 14-member multidisciplinary expert panel to develop a set of indicators for measuring primary prevention performance in ambulatory cardiovascular care. We used a 2-stage modified Delphi panel process to rate potential indicators, which were identified from the literature and national cardiovascular organizations. The top-rated indicators were pilot tested to determine their measurement feasibility with the use of data routinely collected in the Canadian health care system. A set of 28 indicators of primary prevention performance were identified, which were grouped into 5 domains: risk factor prevalence, screening, management, intermediate outcomes and long-term outcomes. The indicators reflect the major cardiovascular risk factors including smoking, obesity, hypertension, diabetes, dyslipidemia and atrial fibrillation. All indicators were determined to be amenable to measurement with the use of population-based administrative (physician claims, hospital admission, laboratory, medication), survey or electronic medical record databases. The Cardiovascular Health in Ambulatory Care Research Team indicators of primary prevention performance provide a framework for the measurement of cardiovascular primary prevention efforts in Canada. The indicators may be used by clinicians, researchers and policy-makers interested in measuring and improving the prevention of cardiovascular disease in ambulatory care settings. Copyright 2017, Joule Inc. or its licensors.

The Relative Influence of Several Factors on Simulation Performance.

ERIC Educational Resources Information Center

Gosenpud, Jerry; Miesing, Paul

1992-01-01

Describes a study that examined the relative impact of 44 independent variables on performance in a business simulation used in an administrative policy course. Categories of variables include ability, motivation, interest, confidence, cohesion, and organizational formality; and results indicate that motivation and interest have the most effect on…

Annual Performance Reports: 2002-2003 State Assessment Data

ERIC Educational Resources Information Center

Thurlow, Martha L.; Moen, Ross E.; Wiley, Hilda I.

2005-01-01

States and other educational entities receiving Part B funding under the Individuals with Disabilities Education Act (IDEA) submitted their Annual Performance Reports to the U.S. Secretary of Education on or before March 31, 2004. These reports contained information on a variety of indicators, including assessment participation and performance…

21 CFR 900.23 - Evaluation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Evaluation. 900.23 Section 900.23 Food and Drugs... STANDARDS ACT MAMMOGRAPHY States as Certifiers § 900.23 Evaluation. FDA shall evaluate annually the performance of each certification agency. The evaluation shall include the use of performance indicators that...

Time-History Data of Maneuvers Performed by a Republic F84G Airplane During Squadron Operational Training

NASA Technical Reports Server (NTRS)

Hamer, Harold A.; Mayo, Alton P.

1953-01-01

Preliminary results of one phase of a control-motion study program involving several jet fighter-type airplanes are presented in time-history form and are summarized as maximum measured quantities plotted against indicated airspeed. The results pertain to approximately 1,000 maneuvers performed by a Republic F-84G jet-fighter airplane during squadron operational training. The data include most tactical maneuvers of which the F-84G airplane is capable. Maneuvers were performed at pressure altitudes of 0 to 30,000 feet with indicated airspeeds ranging from the stalling speed to approximately 515 knots.

Performance of Mentik Wangi rice (Oryza sativa, L.) M2 generation from gamma ray irradiation

NASA Astrophysics Data System (ADS)

Yunus, A.; Parjanto; Nandariyah; Wulandari, S.

2018-03-01

The objective of this research is to produce Mentik Wangi rice with shorter flowering age, shorter rice stem and high yield. This research was conducted in Palur Village, Mojolaban Sub-district, Sukoharjo District, from April to August 2016. This research used descriptive method, performed by observing each individual and comparing to the control average. Observational variables included plant height, total number of tillers, number of productive tillers, panicle length, number of grain per panicle, panicle density index, 1,000 filled seed weight, seed weight of cluster, flowering age and M2 mutant selection. The results showed that there were several plants indicated mutation, there were 7 plants indicate short stem mutation with height 85 cm to 97 cm. The plants which indicated short flowering age were 5 weeks after planting up to 6 weeks after planting. The mutated plants indicating of the highest number of productive tillers which were 27 up to 36. Each component result includes total number of tillers, number of productive tillers, number of grain of panicle as well as the weight of 1000 seeds in the plant indicated some mutation that has a high level of diversity in each treatment.

Home Health Agency Performance in the United States: 2011–15

PubMed Central

Wang, Yun; Spatz, Erica S.; Tariq, Maliha; Angraal, Suveen; Krumholz, Harlan M.

2017-01-01

OBJECTIVES To evaluate home health agency quality performance. DESIGN Observational study. SETTING Home health agencies PARTICIPANTS All Medicare-certified agencies with at least 6 months of data from 2011 to 2015. MEASUREMENTS Twenty-two quality indicators, five patient survey indicators, and their composite scores. RESULTS The study included 11,462 Medicare-certified home health agencies that served 92.4% of all ZIP codes nationwide, accounting for 315.2 million people. The mean composite scores were 409.1 ± 22.7 out of 500 with the patient survey indicators and 492.3 ± 21.7 out of 600 without the patient survey indicators. Home health agency performance on 27 quality indicators varied, with the coefficients of dispersion ranging from 4.9 to 62.8. Categorization of agencies into performance quartiles revealed that 3,179 (27.7%) were in the low-performing group (below 25th percentile) at least one time during the period from 2011–12 to 2014–15 and that 493 were in the low-performing group throughout the study period. Geographic variation in agency performance was observed. Agencies with longer Medicare-certified years were more likely to have high-performing scores; agencies providing partial services, with proprietary ownership, and those with long travel distances to reach patients had lower performance. Agencies serving low-income counties and counties with lower proportions of women and senior residences and greater proportions of Hispanic residents were more likely to attain lower performance scores. CONCLUSION Home health agency performance on several quality indicators varied, and many agencies were persistently in the lowest quartile of performance. Still, there is a need to improve the quality of care of all agencies. Many parts of the United States, particularly lower-income areas and areas with more Hispanic residents, are more likely to receive lower quality home health care. PMID:28960228

Evaluation of two new surrogate indices including parameters not using insulin to assess insulin sensitivity/resistance in non-diabetic postmenopausal women: a MONET group study.

PubMed

Bastard, J-P; Lavoie, M-E; Messier, V; Prud'homme, D; Rabasa-Lhoret, R

2012-06-01

The study evaluated and compared, with other surrogate indices of insulin sensitivity/resistance (IS/R), the relevance of the TyG index, a product of fasting glucose and triglyceride (TG) levels, and the EGIR index, which includes TG, high-density lipoprotein cholesterol (HDL-c) and waist circumference in its formula to estimate IS/R, in non-diabetic postmenopausal women. A secondary analysis was performed using the baseline data for 163 non-diabetic postmenopausal women from the Montreal-Ottawa New Emerging Team (MONET) population database. The subjects participated in hyperinsulinaemic-euglycaemic (HIEG) clamp and oral glucose tolerance (OGTT) tests. Correlations and comparisons between surrogate indices were performed in addition to inter-rater agreement tests. The optimal value of surrogate indices for diagnosis of IS/R was established on a receiver operating characteristic (ROC) scatter plot. A significant correlation was found between the HIEG clamp and all IS/R surrogate indices tested [r=-0.370 (TyG index) to 0.608 (SIisOGTT index); P<0.001]. On ROC curve analysis, a higher AUROC was found for SIisOGTT (0.791) than for TyG and EGIR (0.706 and 0.675, respectively; P=0.07 and P<0.05, respectively). The TyG and EGIR IS/R indices were only relatively modestly related to the HIEG clamp. In contrast, both fasting- and OGTT-derived IS/R surrogate indices, which include insulin values in their formulae, appeared to be more accurate in estimating IS/R in our study population. Thus, the TyG and EGIR IS/R indices need to be tested and validated more extensively in different populations before being put to large-scale clinical use. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Education at a Glance 2013: OECD Indicators

ERIC Educational Resources Information Center

OECD Publishing, 2013

2013-01-01

"Education at a Glance: OECD Indicators" is the authoritative source for accurate and relevant information on the state of education around the world. It provides data on the structure, finances, and performance of education systems in more than 40 countries, including OECD members and G20 partners. Featuring more than 100 charts, 200…

An Analysis of the U.S. Army’s T-11 Advanced Tactical Parachute System and Potential Path Forward

DTIC Science & Technology

2016-12-01

Oversight Council JRTC Joint Readiness Training Center JWG Joint Working Group kias Knots indicated air speed KPP Key Performance Parameter KSA Key...AGL +/- 125 feet altitude holding error) at 130 - 150 knots indicated airspeed ( KIAS ) with a parachutist weighing 332 pounds including equipment

Risky Decision Making Assessed With the Gambling Task in Adults with HIV

PubMed Central

Hardy, David J.; Hinkin, Charles H.; Castellon, Steven A.; Levine, Andrew J.; Lam, Mona N.

2010-01-01

Decision making was assessed using a laboratory gambling task in 67 adults with the Human Immunodeficiency Virus (HIV+) and in 19 HIV-seronegative (HIV−) control participants. Neurocognitive test performance across several domains was also analyzed to examine potential cognitive mechanisms of gambling task performance. As predicted, the HIV+ group performed worse on the gambling task, indicating greater risky decision making. Specifically, the HIV+ group selected more cards from the “risky” or disadvantageous deck that included relatively large payoffs but infrequent large penalties. The control group also selected such risky cards but quickly learned to avoid them. Exploratory analyses also indicated that in the HIV+ group, but not in the control group, gambling task performance was correlated with Stroop Interference performance and long delay free recall on the California Verbal Learning Test, suggesting the role of inhibitory processes and verbal memory in the poorer gambling task performance in HIV. These findings indicate the usefulness of the gambling task as a laboratory tool to examine risky decision making and cognition in the HIV population. PMID:16719628

Executive Functions Do Not Mediate Prospective Relations between Indices of Physical Activity and Academic Performance: The Active Smarter Kids (ASK) Study.

PubMed

Aadland, Katrine N; Ommundsen, Yngvar; Aadland, Eivind; Brønnick, Kolbjørn S; Lervåg, Arne; Resaland, Geir K; Moe, Vegard F

2017-01-01

Changes in cognitive function induced by physical activity have been proposed as a mechanism for the link between physical activity and academic performance. The aim of this study was to investigate if executive function mediated the prospective relations between indices of physical activity and academic performance in a sample of 10-year-old Norwegian children. The study included 1,129 children participating in the Active Smarter Kids (ASK) trial, followed over 7 months. Structural equation modeling (SEM) with a latent variable of executive function (measuring inhibition, working memory, and cognitive flexibility) was used in the analyses. Predictors were objectively measured physical activity, time spent sedentary, aerobic fitness, and motor skills. Outcomes were performance on national tests of numeracy, reading, and English (as a second language). Generally, indices of physical activity did not predict executive function and academic performance. A modest mediation effect of executive function was observed for the relation between motor skills and academic performance. Trial registration: Clinicaltrials.gov registry, trial registration number: NCT02132494.

Executive Functions Do Not Mediate Prospective Relations between Indices of Physical Activity and Academic Performance: The Active Smarter Kids (ASK) Study

PubMed Central

Aadland, Katrine N.; Ommundsen, Yngvar; Aadland, Eivind; Brønnick, Kolbjørn S.; Lervåg, Arne; Resaland, Geir K.; Moe, Vegard F.

2017-01-01

Changes in cognitive function induced by physical activity have been proposed as a mechanism for the link between physical activity and academic performance. The aim of this study was to investigate if executive function mediated the prospective relations between indices of physical activity and academic performance in a sample of 10-year-old Norwegian children. The study included 1,129 children participating in the Active Smarter Kids (ASK) trial, followed over 7 months. Structural equation modeling (SEM) with a latent variable of executive function (measuring inhibition, working memory, and cognitive flexibility) was used in the analyses. Predictors were objectively measured physical activity, time spent sedentary, aerobic fitness, and motor skills. Outcomes were performance on national tests of numeracy, reading, and English (as a second language). Generally, indices of physical activity did not predict executive function and academic performance. A modest mediation effect of executive function was observed for the relation between motor skills and academic performance. Trial registration: Clinicaltrials.gov registry, trial registration number: NCT02132494. PMID:28706500

Quantitative performance targets by using balanced scorecard system: application to waste management and public administration.

PubMed

Mendes, Paula; Nunes, Luis Miguel; Teixeira, Margarida Ribau

2014-09-01

This article demonstrates how decision-makers can be guided in the process of defining performance target values in the balanced scorecard system. We apply a method based on sensitivity analysis with Monte Carlo simulation to the municipal solid waste management system in Loulé Municipality (Portugal). The method includes two steps: sensitivity analysis of performance indicators to identify those performance indicators with the highest impact on the balanced scorecard model outcomes; and sensitivity analysis of the target values for the previously identified performance indicators. Sensitivity analysis shows that four strategic objectives (IPP1: Comply with the national waste strategy; IPP4: Reduce nonrenewable resources and greenhouse gases; IPP5: Optimize the life-cycle of waste; and FP1: Meet and optimize the budget) alone contribute 99.7% of the variability in overall balanced scorecard value. Thus, these strategic objectives had a much stronger impact on the estimated balanced scorecard outcome than did others, with the IPP1 and the IPP4 accounting for over 55% and 22% of the variance in overall balanced scorecard value, respectively. The remaining performance indicators contribute only marginally. In addition, a change in the value of a single indicator's target value made the overall balanced scorecard value change by as much as 18%. This may lead to involuntarily biased decisions by organizations regarding performance target-setting, if not prevented with the help of methods such as that proposed and applied in this study. © The Author(s) 2014.

Develop a PWL System for Dense Graded Hot Mix Asphalt Construction, Including Pay Factors

DOT National Transportation Integrated Search

2015-01-01

This research project developed a PWL system that the Nevada DOT can effectively implement on the construction of dense graded HMA mixtures. The PWL system includes pay factors that are based on pavement performance indicators such as rutting and cra...

Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model.

PubMed

Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

2012-01-01

Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. This is a combination (quantitative-qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective.

Timed Up and Go test, atrophy of medial temporal areas and cognitive functions in community-dwelling older adults with normal cognition and mild cognitive impairment.

PubMed

Kose, Yujiro; Ikenaga, Masahiro; Yamada, Yosuke; Morimura, Kazuhiro; Takeda, Noriko; Ouma, Shinji; Tsuboi, Yoshio; Yamada, Tatsuo; Kimura, Misaka; Kiyonaga, Akira; Higaki, Yasuki; Tanaka, Hiroaki

2016-12-01

This study aimed to ascertain if performance on the Timed Up and Go (TUG) test is associated with indicators of brain volume and cognitive functions among community-dwelling older adults with normal cognition or mild cognitive impairment. Participants were 80 community-dwelling older adults aged 65-89years (44 men, 36 women), including 20 with mild cognitive impairment. Participants completed the TUG and a battery of cognitive assessments, including the Mini-Mental State Examination (MMSE), the Logical Memory I and II (LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and the Trail Making Test A and B (TMT-A, TMT-B). Bilateral, right- and left-side medial temporal area atrophy as well as whole gray and white matter indices were determined with the Voxel-based Specific Regional Analysis System for Alzheimer's Disease. We divided participants into three groups based on TUG performance: "better" (≤6.9s); "normal" (7-10s); and "poor" (≥10.1s). Worse TMT-A and TMT-B performance showed significant independent associations with worse TUG performance (P<0.05, P<0.01 for trend, respectively). After adjusting for covariates, severe atrophy of bilateral, right-, and left-side medial temporal areas were significantly independently associated with worse TUG performance (P<0.05 for trend). However, no significant associations were found between MMSE, LM-I, LM-II, whole gray and white matter indices, and TUG performance. Worse TUG performance is related to poor performance on TMT-A and TMT-B, and is independently associated with severe medial temporal area atrophy in community-dwelling older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

Rib fracture repair: indications, technical issues, and future directions.

PubMed

Nirula, Raminder; Diaz, Jose J; Trunkey, Donald D; Mayberry, John C

2009-01-01

Rib fracture repair has been performed at selected centers around the world for more than 50 years; however, the operative indications have not been established and are considered controversial. The outcome of a strictly nonoperative approach may not be optimal. Potential indications for rib fracture repair include flail chest, painful, movable rib fractures refractory to conventional pain management, chest wall deformity/defect, rib fracture nonunion, and during thoracotomy for other traumatic indication. Rib fracture repair is technically challenging secondary to the human rib's relatively thin cortex and its tendency to fracture obliquely. Nonetheless, several effective repair systems have been developed. Future directions for progress on this important surgical problem include the development of minimally invasive techniques and the conduct of multicenter, randomized trials.

[Consolidation of international guidelines for the management of canine populations in urban areas and proposal of performance indicators].

PubMed

Garcia, Rita de Cassia Maria; Calderón, Néstor; Ferreira, Fernando

2012-08-01

The objective of this study is to propose a generic program for the management of urban canine populations with suggestion of performance indicators. The following international guidelines on canine population management were revised and consolidated: World Health Organization, World Organisation for Animal Health, World Society for the Protection of Animals, International Companion Animal Management Coalition, and the Food and Agriculture Organization. Management programs should cover: situation diagnosis, including estimates of population size; social participation with involvement of various sectors in the planning and execution of strategies; educational actions to promote humane values, animal welfare, community health, and responsible ownership (through purchase or adoption); environmental and waste management to eliminate sources of food and shelter; registration and identification of animals; animal health care, reproductive control; prevention and control of zoonoses; control of animal commerce; management of animal behavior and adequate solutions for abandoned animals; and laws regulating responsible ownership, prevention of abandonment and zoonoses. To monitor these actions, four groups of indicators are suggested: animal population indicators, human/animal interaction indicators, public service indicators, and zoonosis indicators. The management of stray canine populations requires political, sanitary, ethologic, ecologic, and humanitarian strategies that are socially acceptable and environmentally sustainable. Such measures must also include the control of zoonoses such as rabies and leishmaniasis, considering the concept of "one health," which benefits both the animals and people in the community.

Does adoption of electronic health records improve organizational performances of hospital surgical units? Results from the French e-SI (PREPS-SIPS) study.

PubMed

Plantier, Morgane; Havet, Nathalie; Durand, Thierry; Caquot, Nicolas; Amaz, Camille; Philip, Irène; Biron, Pierre; Perrier, Lionel

2017-02-01

Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the organizational performances of acute care hospital surgical units throughout France. This retrospective study was based on data derived from three national databases for year the 2012: IPAQSS (Indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. National data and methodological support were provided by the French Ministry of Health (DGOS) and the French National Authority for Health (HAS). Multivariate linear models were used to assess four organizational performance indicators: the occupancy rate of surgical inpatient beds, operating room utilization, the activity per surgeon, and the activity per both nurse anesthetist and anesthesiologist which were dependent variables. Several independent variables were taken into account, including the degree of EHR use. The models revealed a significant positive impact of EHR use on operating room utilization and bed occupancy rates for surgical inpatient units. No significant association was found between the activity per surgeon or the activity per nurse anesthetist and anesthesiologist with EHR use. All four organizational performance indicators were impacted by the type of hospital, the geographical region, and the severity of the pathologies. We were able to verify the purported potential benefits of EHR use on the organizational performances of surgical units in French hospitals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

Code of Federal Regulations, 2013 CFR

2013-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

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

Code of Federal Regulations, 2012 CFR

2012-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

Sustainability at the local scale: defining highly aggregated indices for assessing environmental performance. The province of Reggio Emilia (Italy) as a case study.

PubMed

Clerici, Nicola; Bodini, Antonio; Ferrarini, Alessandro

2004-10-01

In order to achieve improved sustainability, local authorities need to use tools that adequately describe and synthesize environmental information. This article illustrates a methodological approach that organizes a wide suite of environmental indicators into few aggregated indices, making use of correlation, principal component analysis, and fuzzy sets. Furthermore, a weighting system, which includes stakeholders' priorities and ambitions, is applied. As a case study, the described methodology is applied to the Reggio Emilia Province in Italy, by considering environmental information from 45 municipalities. Principal component analysis is used to condense an initial set of 19 indicators into 6 fundamental dimensions that highlight patterns of environmental conditions at the provincial scale. These dimensions are further aggregated in two indices of environmental performance through fuzzy sets. The simple form of these indices makes them particularly suitable for public communication, as they condensate a wide set of heterogeneous indicators. The main outcomes of the analysis and the potential applications of the method are discussed.

Analysis of Factors that Predict Clinical Performance in Medical School

ERIC Educational Resources Information Center

White, Casey B.; Dey, Eric L.; Fantone, Joseph C.

2009-01-01

Academic achievement indices including GPAs and MCAT scores are used to predict the spectrum of medical student academic performance types. However, use of these measures ignores two changes influencing medical school admissions: student diversity and affirmative action, and an increased focus on communication skills. To determine if GPA and MCAT…

Results of the 1974 NACUBO Comparative Performance Study and Investment Questionnaire.

ERIC Educational Resources Information Center

National Association of College and University Business Officers, Washington, DC.

The 1974 Comparative Performance Study includes 150 endowment pools representing 136 institutions. The market value of the pools which provided information as of June 30, 1974, was 6.9 billion dollars. The study identifies endowment pools by code and indicates each pool's investment objective, approximate market value, the percentage in cash and…

Perkins Core Performance Measures: Results and Targets, 2001-2002.

ERIC Educational Resources Information Center

McHewitt, Earl R.; Taylor, Garry

This report addresses the Virginia Community College System's (VCCS) core performance standards and measures for the years 2001-2002. There are four core indicators through which the VCCS is assessed. They are the following: (1) student attainment including academic and technical skills; (2) completion/graduation rate using first time, full-time…

State and Local Tax Performance, 1981 (Basic Tabulations).

ERIC Educational Resources Information Center

Quindry, Kenneth E.; Schoening, Niles C.

Fiscal year 1981 state and local tax performance data are presented, which indicate comparative utilization of taxable resources. Estimates are provided of tax ability for 15 major taxes and total taxes, and tax ability to tax collections for the 50 states and their subdivisions is compared. Tables include the following: population, personal…

Academic Risk Among Inner-City Adolescents: The Role of Personal Attributes

PubMed Central

Ripple, Carol H.; Luthar, Suniya S.

2012-01-01

In this 3-year prospective study, we explored antecedents of school-based adjustment among 134 inner-city high-school students. We examined the role of freshman-year risk and protective factors in relation to dropout status and senior-year adjustment indices among those who remained in school, including academic performance, psychological symptoms, and drug use. Although each single attribute included in this study has been linked to poor academic performance in previous investigations, the primary goal in this study was to determine which attributes were strongly related to academic problems when considered together. In addition, we sought to establish whether risk factors associated with dropout were the same as those that predicted academic problems among students who remained in school. Findings indicated that freshman-year attendance and demographic indices were most strongly predictive of dropout. Among adolescents who remained in school, freshman academic success was robustly linked to senior-year competence. Implications for identifying inner-city high-school students at high risk for academic problems are discussed. PMID:24839305

Association of school performance indicators with implementation of the Healthy Kids, Smart Kids program: case study

PubMed Central

Nansel, Tonja R.; Huang, Terry T.K.; Rovner, Alisha J.; Sanders-Butler, Yvonne

2009-01-01

Objective: The purpose of this analysis was to examine secular trends in school performance indicators in relationship to the implementation of a program targeting the school food and physical activity environment. Design: Data on available school performance indicators were obtained; retrospective analyses were conducted to assess trends in indicators in association with program implementation; each outcome was regressed on year, beginning with the year prior to program implementation. Setting: The Healthy Kids, Smart Kids program was a grass-roots effort to enhance the school food and physical activity environment in the Browns Mill Elementary School in Georgia. Subjects: Data included publicly available school records from the years 1995 to 2006. Results: The number of nurse, counseling, and disciplinary referrals per 100 students demonstrated a downward trend, while standardized test scores demonstrated an upward trend beginning the year of program implementation. School year was a significant predictor of all indicators. Conclusions: Promoting nutrition and physical activity within the school environment may be a promising approach for enhancing both student health and educational outcomes. PMID:19454125

Stapled haemorrhoidopexy: a consensus position paper by an international working party - indications, contra-indications and technique.

PubMed

Corman, M L; Gravié, J-F; Hager, T; Loudon, M A; Mascagni, D; Nyström, P-O; Seow-Choen, F; Abcarian, H; Marcello, P; Weiss, E; Longo, A

2003-07-01

An international working party with experience in the performance of an alternative haemorrhoid operation through the use of the circular stapler was convened for the purpose of developing a consensus as to the criteria for undertaking this procedure. The agenda consisted of first, naming the operation; second, the indications and contra-indications for its performance; and third, the preferred surgical technique. Among the recommendations for individuals who plan to embark on this surgery are that experience with anorectal surgery and an understanding of anorectal anatomy are requisites; experience with circular stapling devices is essential; and the surgeon must attend a formal course which should include lectures, videos, the application of the instrument in models, and observation of the operation as performed by a surgeon recognized by his or her peers-leading ultimately to undertaking the procedure while being observed by an experienced surgeon. Following satisfactory completion of the above, independent responsibility should be determined by an individual's department of surgery.

Proposal of quality indicators for cardiac rehabilitation after acute coronary syndrome in Japan: a modified Delphi method and practice test.

PubMed

Ohtera, Shosuke; Kanazawa, Natsuko; Ozasa, Neiko; Ueshima, Kenji; Nakayama, Takeo

2017-01-27

Cardiac rehabilitation is underused and its quality in practice is unclear. A quality indicator is a measurable element of clinical practice performance. This study aimed to propose a set of quality indicators for cardiac rehabilitation following an acute coronary event in the Japanese population and conduct a small-size practice test to confirm feasibility and applicability of the indicators in real-world clinical practice. This study used a modified Delphi technique (the RAND/UCLA appropriateness method), a consensus method which involves an evidence review, a face-to-face multidisciplinary panel meeting and repeated anonymous rating. Evidence to be reviewed included clinical practice guidelines available in English or Japanese and existing quality indicators. Performance of each indicator was assessed retrospectively using medical records at a university hospital in Japan. 10 professionals in cardiac rehabilitation for the consensus panel. In the literature review, 23 clinical practice guidelines and 16 existing indicators were identified to generate potential indicators. Through the consensus-building process, a total of 30 indicators were assessed and finally 13 indicators were accepted. The practice test (n=39) revealed that 74% of patients underwent cardiac rehabilitation. Median performance of process measures was 93% (IQR 46-100%). 'Communication with the doctor who referred the patient to cardiac rehabilitation' and 'continuous participation in cardiac rehabilitation' had low performance (32% and 38%, respectively). A modified Delphi technique identified a comprehensive set of quality indicators for cardiac rehabilitation. The single-site, small-size practice test confirmed that most of the proposed indicators were measurable in real-world clinical practice. However, some clinical processes which are not covered by national health insurance in Japan had low performance. Further studies will be needed to clarify and improve the quality of care in cardiac rehabilitation. 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/.

Performance of Malaysian Medical Journals

PubMed Central

Abrizah, Abdullah

2016-01-01

Indexation status matters for scholarly journal prestige and trust. The performance of Malaysian medical journals at the international level is gauged through the global citation databases, and at the national level through MyCite, a national citation indexing system. The performance indicators include journals publication productivity, the citations they garner, and their scores on other bibliometric indices such as journal impact factor (IF), and h-index. There is a growing consciousness amongst journal editorials to improve quality and increase chances of getting indexed in MyCite. Although it is now possible to gauge journal performance within Malaysia, through MyCite, the government and public are concerned about journal performance in international databases. Knowing the performance of journals in MyCite will help the editors and publishers to improve the quality and visibility of Malaysian journals and strategise to bring their journal to the international level of indexation. PMID:27547108

Age-related changes in executive control and their relationships with activity performance in handwriting.

PubMed

Rosenblum, Sara; Engel-Yeger, Batya; Fogel, Yael

2013-04-01

Deterioration in the frontal and prefrontal cortex associated with executive functions (EF) occurs with age and may be associated with changes in daily performance. The aim of the present study was to describe changes occurring with age in Executive Functions (EF) and handwriting activity, as well as to analyze relationships between age, EF and handwriting performance. The study population included 80 healthy participants (aged 31 to 76+) living in the community. After answering five questions about their writing habits, the participants completed the Behavioral Assessment of the Dysexecutive Syndrome (BADS). In addition, they performed a handwriting task on a digitizer included in the Computerized Penmanship Evaluation Tool (ComPET), which provides kinematic measures of the handwriting process. Significant differences were found between the four age groups for both EF and temporal and spatial handwriting measures. A series of regressions indicated that age predicted 35% of the variance of the BADS profile score (EF control) and 32% of the variance of in-air time while writing. The results of this study indicated age effect on both EF control and handwriting performance. Possible implications for further research and clinical evaluation and intervention are discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

Comparison of echocardiographic and pressure-volume loop indices of systolic function in patients with single ventricle physiology: a preliminary report.

PubMed

Butts, Ryan J; Chowdhury, Shahryar M; Buckley, Jason; Hlavacek, Anthony M; Hsia, Tain Yen; Khambadkone, Sachin; Baker, G Hamilton

2015-01-01

Differences in ventricular geometry and physiology of patients with single ventricle anatomy complicate the application of traditional, noninvasive measurements of systolic function. We compared noninvasive measures of ventricular systolic function in single ventricle patients with invasive measures to evaluate their validity in this population. A secondary analysis of patients with single ventricle physiology enrolled in the multi-institutional research project, "multi-scale modeling of single ventricle hearts," was performed. Pressure-volume loops (PVLs) were recorded using microconductance catheters. Transthoracic echocardiogram and cardiac magnetic resonance imaging were performed on the same day. PVL indices of systolic function including end-systolic elastance (Ees), maximal rate of pressure increase (dP/dTmax), and stroke work indexed to end-diastolic volume (SW/EDV) were compared with noninvasive measures, including echocardiographic myocardial performance index (MPI), rate of pressure rise (AV valve dP/dT), isovolumic acceleration, longitudinal shortening fraction (longSF), and fractional area change (FAC). Fifteen patients had PVLs available for analysis. Eleven had a dominant right ventricle, three were status poststage 1 repair, five had superior cavopulmonary anastomosis, and seven had a total cavopulmonary anastomosis. FAC correlated with Ees (r = 0.69, P < .01), SW/EDV (r = 0.64, P = .01), and dP/dTmax (r = 0.59, P = .03). LongSF correlated with dP/dTmax (r = 0.61, P = .02) MPI, AV valve dP/dT, and isovolumic acceleration did not correlate with pressure-volume loop indices of systolic function. Obtaining PVLs via microconductance catheters can reliably be performed in the single ventricle population and serve as a method to validate echocardiographic indices in this high-risk population. Of the echocardiographic variables, FAC showed the best correlation with PVL indices. Future studies controlling for stage of palliation should be performed to further validate echocardiographic measures of systolic function in this patient population. © 2014 Wiley Periodicals, Inc.

Case-mix adjustment for diabetes indicators: a systematic review.

PubMed

Calsbeek, Hiske; Markhorst, Joekle G M; Voerman, Gerlienke E; Braspenning, Jozé C C

2016-02-01

Case-mix adjustment is generally considered indispensable for fair comparison of healthcare performance. Inaccurate results are also unfair to patients as they are ineffective for improving quality. However, little is known about what factors should be adjusted for. We reviewed case-mix factors included in adjustment models for key diabetes indicators, the rationale for their inclusion, and their impact on performance. Systematic review. This systematic review included studies published up to June 2013 addressing case-mix factors for 6 key diabetes indicators: 2 outcomes and 2 process indicators for glycated hemoglobin (A1C), low-density lipoprotein cholesterol, and blood pressure. Factors were categorized as demographic, diabetes-related, comorbidity, generic health, geographic, or care-seeking, and were evaluated on the rationale for inclusion in the adjustment models, as well as their impact on indicator scores and ranking. Thirteen studies were included, mainly addressing A1C value and measurement. Twenty-three different case-mix factors, mostly demographic and diabetes-related, were identified, and varied from 1 to 14 per adjustment model. Six studies provided selection motives for the inclusion of case-mix factors. Marital status and body mass index showed a significant impact on A1C value. For the other factors, either no or conflicting associations were reported, or too few studies (n ≤ 2) investigated this association. Scientific knowledge about the relative importance of case-mix factors for diabetes indicators is emerging, especially for demographic and diabetes-related factors and indicators on A1C, but is still limited. Because arbitrary adjustment potentially results in inaccurate quality information, meaningful stratification that demonstrates inequity in care might be a better guide, as it can be a driver for quality improvement.

Statistical Process Control: A Quality Tool for a Venous Thromboembolic Disease Registry.

PubMed

Posadas-Martinez, Maria Lourdes; Rojas, Liliana Paloma; Vazquez, Fernando Javier; De Quiros, Fernan Bernaldo; Waisman, Gabriel Dario; Giunta, Diego Hernan

2016-01-01

We aim to describe Statistical Control Process as a quality tool for the Institutional Registry of Venous Thromboembolic Disease (IRTD), a registry developed in a community-care tertiary hospital in Buenos Aires, Argentina. The IRTD is a prospective cohort. The process of data acquisition began with the creation of a computerized alert generated whenever physicians requested imaging or laboratory study to diagnose venous thromboembolism, which defined eligible patients. The process then followed a structured methodology for patient's inclusion, evaluation, and posterior data entry. To control this process, process performance indicators were designed to be measured monthly. These included the number of eligible patients, the number of included patients, median time to patient's evaluation, and percentage of patients lost to evaluation. Control charts were graphed for each indicator. The registry was evaluated in 93 months, where 25,757 patients were reported and 6,798 patients met inclusion criteria. The median time to evaluation was 20 hours (SD, 12) and 7.7% of the total was lost to evaluation. Each indicator presented trends over time, caused by structural changes and improvement cycles, and therefore the central limit suffered inflexions. Statistical process control through process performance indicators allowed us to control the performance of the registry over time to detect systematic problems. We postulate that this approach could be reproduced for other clinical registries.

Predicting performance for ecological restoration: A case study using Spartina altemiflora

USGS Publications Warehouse

Travis, S.E.; Grace, J.B.

2010-01-01

The success of population-based ecological restoration relies on the growth and reproductive performance of selected donor materials, whether consisting of whole plants or seed. Accurately predicting performance requires an understanding of a variety of underlying processes, particularly gene flow and selection, which can be measured, at least in part, using surrogates such as neutral marker genetic distances and simple latitudinal effects. Here we apply a structural equation modeling approach to understanding and predicting performance in a widespread salt marsh grass, Spartina alterniflora, commonly used for ecological restoration throughout its native range in North America. We collected source materials from throughout this range, consisting of eight clones each from 23 populations, for transplantation to a common garden site in coastal Louisiana and monitored their performance. We modeled performance as a latent process described by multiple indicator variables (e.g., clone diameter, stem number) and estimated direct and indirect influences of geographic and genetic distances on performance. Genetic distances were determined by comparison of neutral molecular markers with those from a local population at the common garden site. Geographic distance metrics included dispersal distance (the minimum distance over water between donor and experimental sites) and latitude. Model results indicate direct effects of genetic distance and latitude on performance variation among the donor sites. Standardized effect strengths indicate that performance was roughly twice as sensitive to variation in genetic distance as to latitudinal variation. Dispersal distance had an indirect influence on performance through effects on genetic distance, indicating a typical pattern of genetic isolation by distance. Latitude also had an indirect effect on genetic distance through its linear relationship with dispersal distance. Three performance indicators had significant loadings on performance alone (mean clone diameter, mean number of stems, mean number of inflorescences), while the performance indicators mean stem height and mean stem width were also influenced by latitude. We suggest that dispersal distance and latitude should provide an adequate means of predicting performance in future S. alterniflora restorations and propose a maximum sampling distance of 300 km (holding latitude constant) to avoid the sampling of inappropriate ecotypes. ?? 2010 by the Ecological Society of America.

Emergency Kausch-Whipple procedure: indications and experiences.

PubMed

Standop, Jens; Glowka, Tim; Schmitz, Volker; Schaefer, Nico; Hirner, Andreas; Kalff, Jörg C

2010-03-01

Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

Financial gains and risks in pay-for-performance bonus algorithms.

PubMed

Cromwell, Jerry; Drozd, Edward M; Smith, Kevin; Trisolini, Michael

2007-01-01

Considerable attention has been given to evidence-based process indicators associated with quality of care, while much less attention has been given to the structure and key parameters of the various pay-for-performance (P4P) bonus and penalty arrangements using such measures. In this article we develop a general model of quality payment arrangements and discuss the advantages and disadvantages of the key parameters. We then conduct simulation analyses of four general P4P payment algorithms by varying seven parameters, including indicator weights, indicator intercorrelation, degree of uncertainty regarding intervention effectiveness, and initial baseline rates. Bonuses averaged over several indicators appear insensitive to weighting, correlation, and the number of indicators. The bonuses are sensitive to disease manager perceptions of intervention effectiveness, facing challenging targets, and the use of actual-to-target quality levels versus rates of improvement over baseline.

Deterministic and fuzzy-based methods to evaluate community resilience

NASA Astrophysics Data System (ADS)

Kammouh, Omar; Noori, Ali Zamani; Taurino, Veronica; Mahin, Stephen A.; Cimellaro, Gian Paolo

2018-04-01

Community resilience is becoming a growing concern for authorities and decision makers. This paper introduces two indicator-based methods to evaluate the resilience of communities based on the PEOPLES framework. PEOPLES is a multi-layered framework that defines community resilience using seven dimensions. Each of the dimensions is described through a set of resilience indicators collected from literature and they are linked to a measure allowing the analytical computation of the indicator's performance. The first method proposed in this paper requires data on previous disasters as an input and returns as output a performance function for each indicator and a performance function for the whole community. The second method exploits a knowledge-based fuzzy modeling for its implementation. This method allows a quantitative evaluation of the PEOPLES indicators using descriptive knowledge rather than deterministic data including the uncertainty involved in the analysis. The output of the fuzzy-based method is a resilience index for each indicator as well as a resilience index for the community. The paper also introduces an open source online tool in which the first method is implemented. A case study illustrating the application of the first method and the usage of the tool is also provided in the paper.

The Role of Reliability, Vulnerability and Resilience in the Management of Water Quality Systems

NASA Astrophysics Data System (ADS)

Lence, B. J.; Maier, H. R.

2001-05-01

The risk based performance indicators reliability, vulnerability and resilience provide measures of the frequency, magnitude and duration of the failure of water resources systems, respectively. They have been applied primarily to water supply problems, including the assessment of the performance of reservoirs and water distribution systems. Applications to water quality case studies have been limited, although the need to consider the length and magnitude of violations of a particular water quality standard has been recognized for some time. In this research, the role of reliability, vulnerability and resilience in water quality management applications is investigated by examining their significance as performance measures for water quality systems and assessing their potential for assisting in decision making processes. The importance of each performance indicator is discussed and a framework for classifying such systems, based on the relative significance of each of these indicators, is introduced and illustrated qualitatively with various case studies. Quantitative examples drawn from both lake and river water quality modeling exercises are then provided.

Quality and Performance Indicators in an Academic Department of Head and Neck Surgery

PubMed Central

Weber, Randal S.; Lewis, Carol M.; Eastman, Scott D.; Hanna, Ehab Y.; Akiwumi, Olubumi; Hessel, Amy C.; Lai, Stephen Y.; Kian, Leslie; Kupferman, Michael E.; Roberts, Dianna B.

2018-01-01

Objective To create a method for assessing physician performance and care outcomes that are adjusted for procedure acuity and patient comorbidity. Design Between 2004 and 2008 surgical procedures performed by 10 surgeons were stratified into high-acuity procedures (HAPs) and low-acuity procedures (LAPs). Risk adjustment was made for comorbid conditions examined singly or in groups of 2 or more. Setting A tertiary care medical center. Patients A total of 2618 surgical patients. Main Outcome Measures Performance measures included length of stay; return to operating room within 7 days of surgery; and the occurrence of mortality, hospital readmission, transfusion, and wound infection within 30 days of surgery. Results The transfusion rate was 2.7% and 40.6% for LAPs and HAPs, respectively. Wound infection rates were 1.4% for LAPs vs 14.1% for HAPs, while 30-day mortality rate was 0.3% and 1.6% for LAPs and HAPs, respectively. The mean (SD) hospital stay for LAPs was 2.1 (3.6) vs 10.5 (7.0) days for HAPs. Negative performance factors were significantly higher for patients who underwent HAPs and had comorbid conditions. Differences among surgeons significantly affect the incidence of negative performance indicators. Factors affecting performance measures were procedure acuity, the surgeon, and comorbidity, in order of decreasing significance. Surgeons were ranked low, middle, and high based on negative performance indicators. Conclusions Performance measures following oncologic procedures were significantly affected by comorbid conditions and by procedure acuity. Although the latter most strongly affects quality and performance indicators, both should weigh heavily in physician comparisons. The incidence of negative performance indicators was also influenced by the individual surgeon. These data may serve as a tool to evaluate and improve physician performance and outcomes and to develop risk-adjusted benchmarks. Ultimately, reimbursement may be tied to quantifiable measures of physician and institutional performance. PMID:21173370

The double-edged sword of grandiose narcissism: implications for successful and unsuccessful leadership among U.S. Presidents.

PubMed

Watts, Ashley L; Lilienfeld, Scott O; Smith, Sarah Francis; Miller, Joshua D; Campbell, W Keith; Waldman, Irwin D; Rubenzer, Steven J; Faschingbauer, Thomas J

2013-12-01

Recent research and theorizing suggest that narcissism may predict both positive and negative leadership behaviors. We tested this hypothesis with data on the 42 U.S. presidents up to and including George W. Bush, using (a) expert-derived narcissism estimates, (b) independent historical surveys of presidential performance, and (c) largely or entirely objective indicators of presidential performance. Grandiose, but not vulnerable, narcissism was associated with superior overall greatness in an aggregate poll; it was also positively associated with public persuasiveness, crisis management, agenda setting, and allied behaviors, and with several objective indicators of performance, such as winning the popular vote and initiating legislation. Nevertheless, grandiose narcissism was also associated with several negative outcomes, including congressional impeachment resolutions and unethical behaviors. We found that presidents exhibit elevated levels of grandiose narcissism compared with the general population, and that presidents' grandiose narcissism has been rising over time. Our findings suggest that grandiose narcissism may be a double-edged sword in the leadership domain.

Developing performance indicators for clinical governance in dimensions of risk management and clinical effectiveness.

PubMed

Azami-Aghdash, Saber; Tabrizi, Jafar Sadegh; Sadeghi-Bazargani, Homayoun; Hajebrahimi, Sakineh; Naghavi-Behzad, Mohammad

2015-04-01

This study has been designed and conducted to develop domestic indicators for evaluating the performance of clinical governance in dimensions of risk management and clinical effectiveness. This study implemented a 5-stage process including conducting a comprehensive literature review, expert panel (∼ 1000 h per person per session, 11 experts), semi-structured interviews, a 2-round Delphi study (33 experts were in attendance) and a final expert panel (8 experts were in attendance). East Azerbaijan-Iran Province. Fifty-six specialists and experts in different fields of medical sciences. Importance and applicability of indicators. Using a thorough literature review, 361 indicators (129 risk management indicators in 4 dimensions and 232 clinical effectiveness indicators in 18 dimensions) were found. After conducting expert panels and interviews, the number of indicators decreased to 168 cases (65 risk management indicators in 4 dimensions and 103 clinical effectiveness indicators in 12 dimensions). Two rounds of Delphi identified four indicators that were omitted. The members of the final expert panel agreed on 113 indicators (43 risk management indicators in 4 dimensions and 70 clinical effectiveness indicators in 11 dimensions). In this study, indicators for assessing clinical governance in domains of risk management and clinical effectiveness were designed that can be used by policy-makers and other authorities for improving the quality of services and evaluating the performance of clinical governance. Those indicators can be used with slight modifications in other countries having healthcare systems similar to that of Iran. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations.

PubMed

Corrêa Junior, Mário Dias; Passini Júnior, Renato

2016-06-01

Introduction Episiotomy is a controversial procedure, especially because the discussion that surrounds it has gone beyond the field of scientific debate, being adopted as an indicator of the "humanization of childbirth". The scientific literature indicates that episiotomy should not be performed routinely, but selectively. Objectives To review the literature in order to assess whether the implementation of selective episiotomy protects against severe perineal lacerations, the indications for the procedure, and the best technique to perform it. Methods A literature search was performed in PubMed using the terms episiotomy or perineal lacerations, and the filter clinical trial. The articles concerning the risk of severe perineal lacerations with or without episiotomy, perineal protection, or episiotomy techniques were selected. Results A total of 141 articles were identified, and 24 of them were included in the review. Out of the 13 studies that evaluated the risk of severe lacerations with and without episiotomy, 5 demonstrated a protective role of selective episiotomy, and 4 showed no significant differences between the groups. Three small studies confirmed the finding that episiotomy should be performed selectively and not routinely, and one study showed that midline episiotomy increased the risk of severe lacerations. The most cited indications were primiparity, fetal weight greater than 4 kg, prolonged second stage, operative delivery, and shoulder dystocia. As for the surgical technique, episiotomies performed with wider angles (> 40°) and earlier in the second stage (before "crowning ") appeared to be more protective. Conclusions Selective episiotomy decreases the risk of severe lacerations when compared with the non-performance or the performance of routine episiotomy. The use of a proper surgical technique is fundamental to obtain better results, especially in relation to the angle of incision, the distance from the vaginal introitus, and the correct timing for performing the procedure. Not performing the episiotomy when indicated or not applying the correct technique may increase the risk of severe perineal lacerations. Thieme Publicações Ltda Rio de Janeiro, Brazil.

Research and proposal on selective catalytic reduction reactor optimization for industrial boiler.

PubMed

Yang, Yiming; Li, Jian; He, Hong

2017-08-24

The advanced computational fluid dynamics (CFD) software STAR-CCM+ was used to simulate a denitrification (De-NOx) project for a boiler in this paper, and the simulation result was verified based on a physical model. Two selective catalytic reduction (SCR) reactors were developed: reactor 1 was optimized and reactor 2 was developed based on reactor 1. Various indicators, including gas flow field, ammonia concentration distribution, temperature distribution, gas incident angle, and system pressure drop were analyzed. The analysis indicated that reactor 2 was of outstanding performance and could simplify developing greatly. Ammonia injection grid (AIG), the core component of the reactor, was studied; three AIGs were developed and their performances were compared and analyzed. The result indicated that AIG 3 was of the best performance. The technical indicators were proposed for SCR reactor based on the study. Flow filed distribution, gas incident angle, and temperature distribution are subjected to SCR reactor shape to a great extent, and reactor 2 proposed in this paper was of outstanding performance; ammonia concentration distribution is subjected to ammonia injection grid (AIG) shape, and AIG 3 could meet the technical indicator of ammonia concentration without mounting ammonia mixer. The developments above on the reactor and the AIG are both of great application value and social efficiency.

Return on investment in healthcare leadership development programs.

PubMed

Jeyaraman, Maya M; Qadar, Sheikh Muhammad Zeeshan; Wierzbowski, Aleksandra; Farshidfar, Farnaz; Lys, Justin; Dickson, Graham; Grimes, Kelly; Phillips, Leah A; Mitchell, Jonathan I; Van Aerde, John; Johnson, Dave; Krupka, Frank; Zarychanski, Ryan; Abou-Setta, Ahmed M

2018-02-05

Purpose Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments. Design/methodology/approach The authors performed a scoping review using the Arksey and O'Malley framework, searching eight databases from 2006 through June 2016. Findings Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail. Originality/value This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations.

Shoe collar height effect on athletic performance, ankle joint kinematics and kinetics during unanticipated maximum-effort side-cutting performance.

PubMed

Lam, Gilbert Wing Kai; Park, Eun Jung; Lee, Ki-Kwang; Cheung, Jason Tak-Man

2015-01-01

Side-step cutting manoeuvres comprise the coordination between planting and non-planting legs. Increased shoe collar height is expected to influence ankle biomechanics of both legs and possibly respective cutting performance. This study examined the shoe collar height effect on kinematics and kinetics of planting and non-planting legs during an unanticipated side-step cutting. Fifteen university basketball players performed maximum-effort side-step cutting to the left 45° direction or a straight ahead run in response to a random light signal. Seven successful cutting trials were collected for each condition. Athletic performance, ground reaction force, ankle kinematics and kinetics of both legs were analysed using paired t-tests. Results indicated that high-collar shoes resulted in less ankle inversion and external rotation during initial contact for the planting leg. The high-collar shoes also exhibited a smaller ankle range of motion in the sagittal and transverse planes for both legs, respectively. However, no collar effect was found for ankle moments and performance indicators including cutting performance time, ground contact time, propulsion ground reaction forces and impulses. These findings indicated that high-collar shoes altered ankle positioning and restricted ankle joint freedom movements in both legs, while no negative effect was found for athletic cutting performance.

Monitoring the Performance of Educational Institutions: A Spur for the Implementation of Systemic Changes in Higher Education. Part One

ERIC Educational Resources Information Center

Karelina, Irina Georgievna; Sobolev, Alexander Borisovich; Sorokin, Sviatoslav Olegovich

2016-01-01

The article discusses the deployment of a comprehensive reporting and monitoring framework used to evaluate the performance of state and private higher education institutions in Russia. By referring to diversified indicators including organizational, financial and economic, training, research, graduate employment, and other metrics, the authors…

The Impact of Student Composition on Schools' Value-Added Performance: A Comparison of Seven Empirical Studies

ERIC Educational Resources Information Center

Timmermans, Anneke C.; Thomas, Sally M.

2015-01-01

In many countries, policy makers struggle with the development of value-added indicators of school performance for educational accountability purposes and in particular with the choice whether school context measured in the form of student composition variables should be included. This study investigates differences between 7 empirical studies…

Anchorage School District Profile of Performance 1996-97. Assessment and Evaluation Report #97-3.

ERIC Educational Resources Information Center

Fenton, Ray

This report focuses on student achievement across the Anchorage (Alaska) school district and within its individual programs. It does not include information on the social and physical wellness of the district's students. The first section of the report provides an overview of district performance on critical achievement indicators, and the second…

Using Publicly Reported Nursing-Sensitive Screening Indicators to Measure Hospital Performance: The Netherlands Experience in 2011.

PubMed

Stalpers, Dewi; van der Linden, Dimitri; Kaljouw, Marian J; Schuurmans, Marieke J

2016-01-01

Deliberate screening allows detection of health risks that are otherwise not noticeable and allows expedient intervention to minimize complications and optimize outcomes, especially during critical events like hospitalization. Little research has evaluated the usefulness of screening performance and outcome indicators as measures to differentiate nursing quality, although policymakers are using them to benchmark hospitals. The aims of this study were to examine hospital performance based on nursing-sensitive screening indicators and to assess associations with hospital characteristics and nursing-sensitive outcomes for patients. A secondary use of nursing-sensitive data from the Dutch Health Care Inspectorate was performed, including the mandatory screening and outcome indicators related to delirium, malnutrition, pain and pressure ulcers. The sample consisted of all 93 hospitals in the Netherlands in 2011. High- and low-performing hospitals were determined based on the overall proportion of screened patients. Descriptive statistics and analysis of variance were used to examine screening performances in relation to hospital characteristics and nursing-sensitive outcomes. Over all hospitals, the average screening rates ranged from 59% (delirium) to 94% (pain). Organizational characteristics were not different in high- and low-performing hospitals. The hospitals with the best overall screening performances had significantly better results regarding protein intake within malnourished patients (p < .01). For mortality, marginal significant effects did not remain after controlling for organizational structures. No associations were found with prevalence of pressure ulcers and patient self-reported pain scores. The screening for patient risks is an important nursing task. Our findings suggest that nursing-sensitive screening indicators may be relevant measures for benchmarking nursing quality in hospitals. Time-trend studies are required to support our findings and to further investigate relations with nursing-sensitive outcomes.

Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model

PubMed Central

Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

2012-01-01

Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. Conclusion: One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective. PMID:23555104

What Is Nursing Home Quality and How Is It Measured?

PubMed Central

Castle, Nicholas G.; Ferguson, Jamie C.

2010-01-01

Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO) model is used to frame the discussion. Current quality indicators and quality initiatives are discussed, including those included in the Facility Quality Indicator Profile Report, Nursing Home Compare, deficiency citations included as part of Medicare/Medicaid certification, and the Advancing Excellence Campaign. Results: Current quality indicators are presented as a mix of structural, process, and outcome measures, each of which has noted advantages and disadvantages. We speculate on steps that need to be taken in the future to address and potentially improve the quality of care provided by nursing homes, including report cards, pay for performance, market-based incentives, and policy developments in the certification process. Areas for future research are identified throughout the review. Implications: We conclude that improvements in nursing home quality have likely occurred, but improvements are still needed. PMID:20631035

Entropy as a Gene-Like Performance Indicator Promoting Thermoelectric Materials.

PubMed

Liu, Ruiheng; Chen, Hongyi; Zhao, Kunpeng; Qin, Yuting; Jiang, Binbin; Zhang, Tiansong; Sha, Gang; Shi, Xun; Uher, Ctirad; Zhang, Wenqing; Chen, Lidong

2017-10-01

High-throughput explorations of novel thermoelectric materials based on the Materials Genome Initiative paradigm only focus on digging into the structure-property space using nonglobal indicators to design materials with tunable electrical and thermal transport properties. As the genomic units, following the biogene tradition, such indicators include localized crystal structural blocks in real space or band degeneracy at certain points in reciprocal space. However, this nonglobal approach does not consider how real materials differentiate from others. Here, this study successfully develops a strategy of using entropy as the global gene-like performance indicator that shows how multicomponent thermoelectric materials with high entropy can be designed via a high-throughput screening method. Optimizing entropy works as an effective guide to greatly improve the thermoelectric performance through either a significantly depressed lattice thermal conductivity down to its theoretical minimum value and/or via enhancing the crystal structure symmetry to yield large Seebeck coefficients. The entropy engineering using multicomponent crystal structures or other possible techniques provides a new avenue for an improvement of the thermoelectric performance beyond the current methods and approaches. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Valuing the human asset - the impact of university placements on academic performance and graduate employment amongst management students

NASA Astrophysics Data System (ADS)

Brooks, R.

2012-05-01

The employment market for graduates is competitive with employers requiring appropriate work experience in addition to academic qualifications. Sandwich courses, where up to a year is spent in industry, provide an opportunity for structured work experience to be gained alongside studying. Benefits of placements include improved academic performance and the development of transferable skills to increase employability. This paper evaluates the impact of placements on academic performance and graduate employment among management students. Analysing performance data and graduate destinations data, results indicate that management students completing a placement are more likely to perform better academically with improvements in their personal grades between year 2 and the final year. Additionally, a qualitative themed analysis of student experiences indicates placement students feel more confident in engaging with the graduate recruitment process, with a better understanding of their personal skills and an ability to articulate their experience in relation to the workplace.

A Systematic Review of the Amount of Water per Person per Day Needed to Prevent Morbidity and Mortality in (Post-)Disaster Settings

PubMed Central

De Buck, Emmy; Borra, Vere; De Weerdt, Elfi; Vande Veegaete, Axel; Vandekerckhove, Philippe

2015-01-01

Background In order to improve the effectiveness and efficiency of humanitarian efforts, minimum standards for humanitarian assistance and key indicators, showing whether a standard has been attained, have been developed. However, many of these standards and indicators are based on a consensus on best practices and experiences in humanitarian response, because relevant evidence on the impact of humanitarian interventions is often lacking. Objectives One important example of a standard in humanitarian aid in a disaster setting is “water quantity.” The accompanying indicator states how many litres of water are needed per person per day in a disaster setting. It was our objective to determine the evidence base behind this indicator, in order to improve health outcomes such as morbidity (e.g., diarrhoea) and mortality. Methods A systematic review was performed searching The Cochrane Library, Medline and Embase. We included studies performed during disasters and in refugee camps that reported a specific water amount and health-related outcomes related to water shortages, including diarrhoea, cholera, and mortality. We used GRADE to determine the quality of evidence. Results Out of 3,630 articles, 111 references relevant to our question were selected. Based on our selection criteria, we finally retained 6 observational studies, including 1 study that was performed during the disaster and 5 studies in a post-disaster phase. From two studies there is conclusive evidence on the relationship between the amount of water received and diarrhoea or mortality rates in refugee camps. However, overall, these studies do not contain enough data with relevance to a specific amount of water, and the level of evidence is very low. Conclusions More primary research on water amounts in a disaster setting is necessary, so that the humanitarian sector can further professionalise its water-related standards, indicators and interventions. PMID:25961720

Gaps in Addressing Cardiovascular Risk in Rheumatoid Arthritis: Assessing Performance Using Cardiovascular Quality Indicators.

PubMed

Barber, Claire E H; Esdaile, John M; Martin, Liam O; Faris, Peter; Barnabe, Cheryl; Guo, Selynne; Lopatina, Elena; Marshall, Deborah A

2016-11-01

Cardiovascular disease (CVD) is a major comorbidity for patients with rheumatoid arthritis (RA). This study sought to determine the performance of 11 recently developed CVD quality indicators (QI) for RA in clinical practice. Medical charts for patients with RA (early disease or biologic-treated) followed at 1 center were retrospectively reviewed. A systematic assessment of adherence to 11 QI over a 2-year period was completed. Performance on the QI was reported as a percentage pass rate. There were 170 charts reviewed (107 early disease and 63 biologic-treated). The most frequent CVD risk factors present at diagnosis (early disease) and biologic start (biologic-treated) included hypertension (26%), obesity (25%), smoking (21%), and dyslipidemia (15%). Performance on the CVD QI was highly variable. Areas of low performance (< 10% pass rates) included documentation of a formal CVD risk assessment, communication to the primary care physician (PCP) that patients with RA were at increased risk of CVD, body mass index documentation and counseling if overweight, communication to a PCP about an elevated blood pressure, and discussion of risks and benefits of antiinflammatories in patients at CVD risk. Rates of diabetes screening and lipid screening were 67% and 69%, respectively. The area of highest performance was observed for documentation of intent to taper corticosteroids (98%-100% for yrs 1 and 2, respectively). Gaps in CVD risk management were found and highlight the need for quality improvements. Key targets for improvement include coordination of CVD care between rheumatology and primary care, and communication of increased CVD risk in RA.

Quality of Care in Performance-Based Financing: How It Is Incorporated in 32 Programs Across 28 Countries

PubMed Central

Gergen, Jessica; Josephson, Erik; Coe, Martha; Ski, Samantha; Madhavan, Supriya; Bauhoff, Sebastian

2017-01-01

ABSTRACT Objective: To describe how quality of care is incorporated into performance-based financing (PBF) programs, what quality indicators are being used, and how these indicators are measured and verified. Methods: An exploratory scoping methodology was used to characterize the full range of quality components in 32 PBF programs, initiated between 2008 and 2015 in 28 low- and middle-income countries, totaling 68 quality tools and 8,490 quality indicators. The programs were identified through a review of the peer-reviewed and gray literature as well as through expert consultation with key donor representatives. Findings: Most of the PBF programs were implemented in sub-Saharan Africa and most were funded primarily by the World Bank. On average, PBF quality tools contained 125 indicators predominately assessing maternal, newborn, and child health and facility management and infrastructure. Indicators were primarily measured via checklists (78%, or 6,656 of 8,490 indicators), which largely (over 90%) measured structural aspects of quality, such as equipment, beds, and infrastructure. Of the most common indicators across checklists, 74% measured structural aspects and 24% measured processes of clinical care. The quality portion of the payment formulas were in the form of bonuses (59%), penalties (27%), or both (hybrid) (14%). The median percentage (of a performance payment) allocated to health facilities was 60%, ranging from 10% to 100%, while the median percentage allocated to health care providers was 55%, ranging from 20% to 80%. Nearly all of the programs included in the analysis (91%, n=29) verified quality scores quarterly (every 3 months), typically by regional government teams. Conclusion: PBF is a potentially appealing instrument to address shortfalls in quality of care by linking verified performance measurement with strategic incentives and could ultimately help meet policy priorities at the country and global levels, including the ambitious Sustainable Development Goals. The substantial variation and complexity in how PBF programs incorporate quality of care considerations suggests a need to further examine whether differences in design are associated with differential program impacts. PMID:28298338

Quality of Care in Performance-Based Financing: How It Is Incorporated in 32 Programs Across 28 Countries.

PubMed

Gergen, Jessica; Josephson, Erik; Coe, Martha; Ski, Samantha; Madhavan, Supriya; Bauhoff, Sebastian

2017-03-24

To describe how quality of care is incorporated into performance-based financing (PBF) programs, what quality indicators are being used, and how these indicators are measured and verified. An exploratory scoping methodology was used to characterize the full range of quality components in 32 PBF programs, initiated between 2008 and 2015 in 28 low- and middle-income countries, totaling 68 quality tools and 8,490 quality indicators. The programs were identified through a review of the peer-reviewed and gray literature as well as through expert consultation with key donor representatives. Most of the PBF programs were implemented in sub-Saharan Africa and most were funded primarily by the World Bank. On average, PBF quality tools contained 125 indicators predominately assessing maternal, newborn, and child health and facility management and infrastructure. Indicators were primarily measured via checklists (78%, or 6,656 of 8,490 indicators), which largely (over 90%) measured structural aspects of quality, such as equipment, beds, and infrastructure. Of the most common indicators across checklists, 74% measured structural aspects and 24% measured processes of clinical care. The quality portion of the payment formulas were in the form of bonuses (59%), penalties (27%), or both (hybrid) (14%). The median percentage (of a performance payment) allocated to health facilities was 60%, ranging from 10% to 100%, while the median percentage allocated to health care providers was 55%, ranging from 20% to 80%. Nearly all of the programs included in the analysis (91%, n=29) verified quality scores quarterly (every 3 months), typically by regional government teams. PBF is a potentially appealing instrument to address shortfalls in quality of care by linking verified performance measurement with strategic incentives and could ultimately help meet policy priorities at the country and global levels, including the ambitious Sustainable Development Goals. The substantial variation and complexity in how PBF programs incorporate quality of care considerations suggests a need to further examine whether differences in design are associated with differential program impacts. © Gergen et al.

A Large Catalog of Multiwavelength GRB Afterglows. I. Color Evolution and Its Physical Implication

NASA Astrophysics Data System (ADS)

Li, Liang; Wang, Yu; Shao, Lang; Wu, Xue-Feng; Huang, Yong-Feng; Zhang, Bing; Ryde, Felix; Yu, Hoi-Fung

2018-02-01

The spectrum of gamma-ray burst (GRB) afterglows can be studied with color indices. Here, we present a large comprehensive catalog of 70 GRBs with multiwavelength optical transient data on which we perform a systematic study to find the temporal evolution of color indices. We categorize them into two samples based on how well the color indices are evaluated. The Golden sample includes 25 bursts mostly observed by GROND, and the Silver sample includes 45 bursts observed by other telescopes. For the Golden sample, we find that 96% of the color indices do not vary over time. However, the color indices do vary during short periods in most bursts. The observed variations are consistent with effects of (i) the cooling frequency crossing the studied energy bands in a wind medium (43%) and in a constant-density medium (30%), (ii) early dust extinction (12%), (iii) transition from reverse-shock to forward-shock emission (5%), or (iv) an emergent SN emission (10%). We also study the evolutionary properties of the mean color indices for different emission episodes. We find that 86% of the color indices in the 70 bursts show constancy between consecutive ones. The color index variations occur mainly during the late GRB–SN bump, the flare, and early reverse-shock emission components. We further perform a statistical analysis of various observational properties and model parameters (spectral index {β }o{CI}, electron spectral indices p CI, etc.) using color indices. Overall, we conclude that ∼90% of colors are constant in time and can be accounted for by the simplest external forward-shock model, while the varying color indices call for more detailed modeling.

Using intraindividual variability to detect malingering in cognitive performance.

PubMed

Strauss, E; Hultsch, D F; Hunter, M; Slick, D J; Patry, B; Levy-Bencheton, J

1999-11-01

The utility of measures for detecting malingering was evaluated using a simulation design in which half the participants were encouraged to do their best and half were asked to feign head injury. Particular attention was focused on the utility of repeated assessment (intraindividual variability) in discriminating the groups. Participants were tested on three occasions on measures commonly used to detect malingering including a specific symptom validity test (SVT). The results indicated that multiple measures of malingering obtained in single assessment (occasion one) discriminated the groups effectively. In addition, however, intraindividual variability in performance, particularly of indicators from the SVT, provided unique information beyond level of performance. The results suggest that response inconsistency across testing sessions may be a clinically useful measure for the detection of malingering.

Improved optical design of nontracking concentrators

NASA Astrophysics Data System (ADS)

Kwan, B. M.; Bannerot, R. B.

1984-08-01

Optical designs based on a two reflections or less criterion have been developed for one and two-facet trapezoidal concentrators. Collector designs resulting from this criterion have been evaluated with the aid of a ray-trace computer simulation which includes the effects of nonideal reflectors. Results indicate a marked increase in performance, particularly for the one-facet designs, as compared to the collectors previously designed with the one reflection or less criterion. A significant result is that when a proper accounting is made for the actual acceptance angle for the concentrators, the performances of the optimal one and two-facet designs become nearly identical, indicating that the previously held contention that improved performance could be achieved with multifaceted reflectors (geometrically approaching the compound parabolic shape) may be incorrect.

Prevalence of Invalid Performance on Baseline Testing for Sport-Related Concussion by Age and Validity Indicator.

PubMed

Abeare, Christopher A; Messa, Isabelle; Zuccato, Brandon G; Merker, Bradley; Erdodi, Laszlo

2018-03-12

Estimated base rates of invalid performance on baseline testing (base rates of failure) for the management of sport-related concussion range from 6.1% to 40.0%, depending on the validity indicator used. The instability of this key measure represents a challenge in the clinical interpretation of test results that could undermine the utility of baseline testing. To determine the prevalence of invalid performance on baseline testing and to assess whether the prevalence varies as a function of age and validity indicator. This retrospective, cross-sectional study included data collected between January 1, 2012, and December 31, 2016, from a clinical referral center in the Midwestern United States. Participants included 7897 consecutively tested, equivalently proportioned male and female athletes aged 10 to 21 years, who completed baseline neurocognitive testing for the purpose of concussion management. Baseline assessment was conducted with the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT), a computerized neurocognitive test designed for assessment of concussion. Base rates of failure on published ImPACT validity indicators were compared within and across age groups. Hypotheses were developed after data collection but prior to analyses. Of the 7897 study participants, 4086 (51.7%) were male, mean (SD) age was 14.71 (1.78) years, 7820 (99.0%) were primarily English speaking, and the mean (SD) educational level was 8.79 (1.68) years. The base rate of failure ranged from 6.4% to 47.6% across individual indicators. Most of the sample (55.7%) failed at least 1 of 4 validity indicators. The base rate of failure varied considerably across age groups (117 of 140 [83.6%] for those aged 10 years to 14 of 48 [29.2%] for those aged 21 years), representing a risk ratio of 2.86 (95% CI, 2.60-3.16; P < .001). The results for base rate of failure were surprisingly high overall and varied widely depending on the specific validity indicator and the age of the examinee. The strong age association, with 3 of 4 participants aged 10 to 12 years failing validity indicators, suggests that the clinical interpretation and utility of baseline testing in this age group is questionable. These findings underscore the need for close scrutiny of performance validity indicators on baseline testing across age groups.

Trends Supporting the In-Field Use of Wearable Inertial Sensors for Sport Performance Evaluation: A Systematic Review.

PubMed

Camomilla, Valentina; Bergamini, Elena; Fantozzi, Silvia; Vannozzi, Giuseppe

2018-03-15

Recent technological developments have led to the production of inexpensive, non-invasive, miniature magneto-inertial sensors, ideal for obtaining sport performance measures during training or competition. This systematic review evaluates current evidence and the future potential of their use in sport performance evaluation. Articles published in English (April 2017) were searched in Web-of-Science, Scopus, Pubmed, and Sport-Discus databases. A keyword search of titles, abstracts and keywords which included studies using accelerometers, gyroscopes and/or magnetometers to analyse sport motor-tasks performed by athletes (excluding risk of injury, physical activity, and energy expenditure) resulted in 2040 papers. Papers and reference list screening led to the selection of 286 studies and 23 reviews. Information on sport, motor-tasks, participants, device characteristics, sensor position and fixing, experimental setting and performance indicators was extracted. The selected papers dealt with motor capacity assessment (51 papers), technique analysis (163), activity classification (19), and physical demands assessment (61). Focus was placed mainly on elite and sub-elite athletes (59%) performing their sport in-field during training (62%) and competition (7%). Measuring movement outdoors created opportunities in winter sports (8%), water sports (16%), team sports (25%), and other outdoor activities (27%). Indications on the reliability of sensor-based performance indicators are provided, together with critical considerations and future trends.

Material selection indices for design of surgical instruments with long tubular shafts.

PubMed

Nelson, Carl A

2013-02-01

In any medical device design process, material selection plays an important role. For devices which sustain mechanical loading, strength and stiffness requirements can be significant drivers of the design. This paper examines the specific case of minimally invasive surgical instruments, including robotic instruments, having long, tubular shafts. Material properties-based selection indices are derived for achieving high performance of these devices in terms of strength and stiffness, and the use of these indices for informing the medical device design problem is illustrated.

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

PubMed

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

2015-01-01

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

EFFECTIVE INDICES FOR MONITORING MENTAL WORKLOAD WHILE PERFORMING MULTIPLE TASKS.

PubMed

Hsu, Bin-Wei; Wang, Mao-Jiun J; Chen, Chi-Yuan; Chen, Fang

2015-08-01

This study identified several physiological indices that can accurately monitor mental workload while participants performed multiple tasks with the strategy of maintaining stable performance and maximizing accuracy. Thirty male participants completed three 10-min. simulated multitasks: MATB (Multi-Attribute Task Battery) with three workload levels. Twenty-five commonly used mental workload measures were collected, including heart rate, 12 HRV (heart rate variability), 10 EEG (electroencephalography) indices (α, β, θ, α/θ, θ/β from O1-O2 and F4-C4), and two subjective measures. Analyses of index sensitivity showed that two EEG indices, θ and α/θ (F4-C4), one time-domain HRV-SDNN (standard deviation of inter-beat intervals), and four frequency-domain HRV: VLF (very low frequency), LF (low frequency), %HF (percentage of high frequency), and LF/HF were sensitive to differentiate high workload. EEG α/θ (F4-C4) and LF/HF were most effective for monitoring high mental workload. LF/HF showed the highest correlations with other physiological indices. EEG α/θ (F4-C4) showed strong correlations with subjective measures across different mental workload levels. Operation strategy would affect the sensitivity of EEG α (F4-C4) and HF.

Admission Criteria, Program Outcomes, and NCLEX-RN(RTM) Success in Second Degree Students

ERIC Educational Resources Information Center

Rowland, Janet Wedge

2013-01-01

The purpose of this retrospective study was to examine the outcome performance of second degree students in an Accelerated BSN (ABSN) and an Entry Level MSN (ELMSN) program. In addition to student demographics (ethnicity/race, age, and gender), study variables included admission and end-of-program indicators. Admission criteria included the…

The role of indicator species: Neotropical migratory song birds

Treesearch

Theodore R. Simons; Kerry N. Rabenold; David A. Buehler; Jaime A. Collazo; Kathleen E. Franzreb

1999-01-01

Southern Appalachian forests support some of the richest avian diversity in North America, including some 75 species of Neotropical migrants, birds that perform the remarkable feat of making much of the Western Hemisphere their home. This diverse group includes the swallows, kingbirds, and other flycatchers that feed in the air on flying insects. The Eastern kingbird...

The Effect of Summer on Value-Added Assessments of Teacher and School Performance

ERIC Educational Resources Information Center

Palardy, Gregory J.; Peng, Luyao

2015-01-01

This study examines the effects of including the summer period on value-added assessments (VAA) of teacher and school performance at the early grades. The results indicate that 40-62% of the variance in VAA estimates originates from the summer period, depending on the outcome (i.e., reading or math achievement gains). Furthermore, when summer is…

Computers for Cognitive Development in Early Childhood--The Teacher's Role in the Computer Learning Environment

ERIC Educational Resources Information Center

Nir-Gal, Ofra; Klein, Pnina S.

2004-01-01

This study was designed to examine the effect of different kinds of adult mediation on the cognitive performance of young children who used computers. The study sample included 150 kindergarten children aged 5-6. The findings indicate that children who engaged in adult-mediated computer activity improved the level of their cognitive performance on…

Academic Development of First-Year Living-Learning Program Students before and after Hurricanes Katrina and Rita of 2005

ERIC Educational Resources Information Center

Rohli, Robert V.; Keppler, Kurt J.; Winkler, Daniel L.

2013-01-01

Previous research suggests that the far-reaching impacts of hurricanes include the academic performance of students. In an examination of such impacts, we found a trend toward self-perceived decline in some performance indicators relative to students at peer universities. However, few longitudinal impacts were found, perhaps because of the sense…

Text Possession and Teachers' Pedagogical Practices in the Teaching of Prose Literature-in-English in Some Schools in Ibadan

ERIC Educational Resources Information Center

Ezeokoli, F. O.; Igubor, P.

2014-01-01

Performance in school examinations has remained one of the reliable indices of the quality of education in many countries. For over two decades in Nigeria, students' performance in most subjects on the school curriculum including Literature-in-English has been persistently declining. A number of explanations are offered for this unsatisfactory…

Readmission After Gynecologic Surgery: A Comparison of Procedures for Benign and Malignant Indications.

PubMed

Cory, Lori; Latif, Nawar; Brensinger, Colleen; Zhang, Xiaochen; Giuntoli, Robert L; Burger, Robert A; Morgan, Mark; Ko, Emily

2017-08-01

To compare 30-day postsurgical readmission rates and associated risk factors for readmission among women undergoing gynecologic surgery for benign and malignant conditions. In a retrospective cohort study, we identified patients after surgery for benign and malignant gynecologic conditions in the National Surgical Quality Improvement Program database between January 1, 2011, and December 31, 2012. Data collected included surgical factors, perioperative characteristics, surgical complications, and 30-day readmissions. The primary study outcome was readmission rates after gynecologic surgery for benign and oncologic conditions. Secondary study outcomes were risk factors associated with readmission among gynecologic surgeries performed for benign and oncologic conditions. Approximately 3% (1,444/46,718) compared with 8.2% (623/7,641) of patients who underwent gynecologic surgery for benign and malignant indications, respectively, were readmitted (P<.01). Compared with patients with benign surgical indications, those with uterine cancer (readmission rate 6.6%; odds ratio [OR] 2.21, 95% CI 1.95-2.51), ovarian cancer (readmission rate 10.9%; OR 3.82, 95% CI 3.29-4.45), and cervical cancer (readmission rate 10.1%; OR 3.51, 95% CI 2.71-4.53) were more likely to be readmitted. In multivariable models, independent risk factors for readmission for gynecologic cancer surgery included worse preoperative conditions (OR 1.49, 95% CI 1.17-1.90) and major complications (OR 17.84, 95% CI 14.19-22.43). In comparison, independent risk factors for readmission after surgery for benign indications included comorbid conditions (OR 1.36, 95% CI 1.18-1.57), operative time (15-59 minutes: referent; 60 minutes or greater: 1.37, 95% CI 1.14-1.63) and major complications (OR 53.91, 95% CI 46.98-61.85). Among gynecologic surgeries, those performed for oncologic indications were associated with readmission rates 2.8 times that of surgeries performed for benign indications. In adjusted models, worse preoperative conditions and surgical complications remained independent risk factors associated with the higher rate of readmission among patients with gynecologic cancer.

Comparing the Performance of Improved Classify-Analyze Approaches For Distal Outcomes in Latent Profile Analysis

PubMed Central

Dziak, John J.; Bray, Bethany C.; Zhang, Jieting; Zhang, Minqiang; Lanza, Stephanie T.

2016-01-01

Several approaches are available for estimating the relationship of latent class membership to distal outcomes in latent profile analysis (LPA). A three-step approach is commonly used, but has problems with estimation bias and confidence interval coverage. Proposed improvements include the correction method of Bolck, Croon, and Hagenaars (BCH; 2004), Vermunt’s (2010) maximum likelihood (ML) approach, and the inclusive three-step approach of Bray, Lanza, & Tan (2015). These methods have been studied in the related case of latent class analysis (LCA) with categorical indicators, but not as well studied for LPA with continuous indicators. We investigated the performance of these approaches in LPA with normally distributed indicators, under different conditions of distal outcome distribution, class measurement quality, relative latent class size, and strength of association between latent class and the distal outcome. The modified BCH implemented in Latent GOLD had excellent performance. The maximum likelihood and inclusive approaches were not robust to violations of distributional assumptions. These findings broadly agree with and extend the results presented by Bakk and Vermunt (2016) in the context of LCA with categorical indicators. PMID:28630602

Analysis of the performance of contractualization primary health care indicators in the period 2009-2015 in Lisbon and Tagus Valley.

PubMed

Monteiro, Baltazar Ricardo; Candoso, Fátima; Reis, Magda; Bastos, Sónia

2017-03-01

Reforms started in 1996 intended that Regional Health Administrations (ARS) should play a relevant role in the process of transforming an integrated model towards a contractual health care model. The essential tool of this transformation would be the Contractualization Agency, established in each ARS. Its role in the new contractualization culture was to negotiate prospective budgets with health care institutions, which included Primary Health Care (PHC). This paper is a longitudinal analysis of the development of a set of nine PHC contractualization indicators in three Health Center Clusters (ACeS) of the Regional Health Administration of Lisbon and Tagus Valley (ARSLVT). We have noticed that the setting of goals, in terms of external contractualization and its monitoring and follow-up are decisive and help health professionals to define trajectories and performance goals. We also recognize the need to revise baseline indicators by developing them into outcome indicators.

A business model for managing system change through strategic financing and performance indicators: a case study.

PubMed

Armstrong, Mary I; Milch, Heidi; Curtis, Peter; Endress, Phillip

2012-06-01

This article describes how a system of care operated by a county government agency used a fiscal crisis as the opportunity to reform its children's system. A cross-system response to the crisis is outlined that includes a system of care framework coupled with a business model, inter-departmental collaboration and leadership, the use of strategic reinvestment strategies, and a quality improvement system that focuses on key indicators. Implementation of the system change is described with a specific focus on cross-system entry points, financing strategies that re-allocate funds from deep-end programs to community-based services, and management oversight through the use of performance indicators to monitor and support effectiveness. This article examines the results of the system change, including the diversion of youth from system penetration, the reduction in residential treatment bed days, the re-allocation of these savings to community-based services, and the outcomes of children who were diverted from residential care and served in the community. The article offers a number of recommendations for other communities contemplating system change.

A Methodology for Evaluating and Ranking Water Quantity Indicators in Support of Ecosystem-Based Management

NASA Astrophysics Data System (ADS)

James, C. Andrew; Kershner, Jessi; Samhouri, Jameal; O'Neill, Sandra; Levin, Phillip S.

2012-03-01

Ecosystem-based Management (EBM) is an approach that includes different management priorities and requires a balance between anthropogenic and ecological resource demands. Indicators can be used to monitor ecosystem status and trends, and assess whether projects and/or programs are leading to the achievement of management goals. As such, the careful selection of a suite of indicators is a crucial exercise. In this paper we describe an indicator evaluation and selection process designed to support the EBM approach in Puget Sound. The first step in this process was the development of a general framework for selecting indicators. The framework, designed to transparently include both scientific and policy considerations into the selection and evaluation process, was developed and then utilized in the organization and determination of a preliminary set of indicators. Next, the indicators were assessed against a set of nineteen distinct criteria that describe the model characteristics of an indicator. A literature review was performed for each indicator to determine the extent to which it satisfied each of the evaluation criteria. The result of each literature review was summarized in a numerical matrix, allowing comparison, and demonstrating the extent of scientific reliability. Finally, an approach for ranking indicators was developed to explore the effects of intended purpose on indicator selection. We identified several sets of scientifically valid and policy-relevant indicators that included metrics such as annual-7 day low flow and water system reliability, which are supportive of the EBM approach in the Puget Sound.

Assisting Hand Assessment and Children's Hand-Use Experience Questionnaire -Observed Versus Perceived Bimanual Performance in Children with Unilateral Cerebral Palsy.

PubMed

Ryll, Ulrike C; Bastiaenen, Carolien H G; Eliasson, Ann-Christin

2017-05-01

To explore the differences, relationship, and extent of agreement between the Assisting Hand Assessment (AHA), measuring observed ability to perform bimanual tasks, and the Children's Hand-Use Experience Questionnaire (CHEQ), assessing experienced bimanual performance. This study investigates a convenience sample of 34 children (16 girls) with unilateral cerebral palsy aged 6-18 years (mean 12.1, SD 3.9) in a cross-sectional design. The AHA and CHEQ subscales share 8-25% of their variance (R 2 ). Bland-Altman plots for AHA and all three CHEQ subscales indicate good average agreement, with a mean difference approaching zero but large 95% confidence intervals. Limits of agreement were extremely wide, indicating considerable disagreement between AHA and CHEQ subscales. AHA and CHEQ seem to measure different though somewhat related constructs of bimanual performance. Results of this investigation reinforce the recommendation to use both instruments to obtain complementary information about bimanual performance including observed and perceived performance of children with unilateral cerebral palsy.

Cockpit integration from a pilot's point of view

NASA Technical Reports Server (NTRS)

Green, D. L.

1982-01-01

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

[Identifying indicators of good practice in clinical and healthcare management].

PubMed

Bermúdez Tamayo, C; Olry de Labry Lima, A; García Mochón, L

To identify good practices in order to develop and implement indicators of health outcomes for clinical and healthcare management, as well as the characteristics for an indicator to be considered adequate. A scoping review was performed, with the following phases: 1) Search and identification of bibliography. 2) Selection of relevant documents. Including those studies that discussed issues related to good practices for the use of health indicators in the management field. Those published in a language other than English or Spanish or before 2006 were excluded. 3) Analysis and extraction of information. 4) Consultation with stakeholders, using a qualitative methodology through Concept Mapping, with the participation of 40 experts (decision-makers, scientific societies, and health professionals). The data collection process included an inductive and structured procedure, with prioritisation of ideas grouped into clusters, according to feasibility and importance criteria (0-10 scale). Good practices identified 2 levels: 1) macro-management: Define a framework for the evaluation of indicators and establish a benchmark of indicators. 2) meso-management: Establish indicators according to evidence and expert consensus, taking into account priority areas and topics, testing before final use, and communicate results adequately. The characteristics of a suitable indicator are: 1) Approach of an important issue, 2) Scientific validity, 3) Possibility of measurement with reliable data, 4) Meaning of useful and applicable measurement, and 5) Wide scope. The best practices for the use of indicators in clinical and healthcare management can make it easier to monitor performance and accountability, as well as to support the decision-making addressed at the development of initiatives for quality improvement. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

SEWER PIPELINE PERFORMANCE INDICATORS

EPA Science Inventory

Wastewater collection systems are an extensive part of the nation's infrastructure. In the United States, approximately 150 million people are served by about 19,000 municipal wastewater collection systems representing about 500,000 miles of sewer pipe (not including privately o...

Generalization of Clustering Coefficients to Signed Correlation Networks

PubMed Central

Costantini, Giulio; Perugini, Marco

2014-01-01

The recent interest in network analysis applications in personality psychology and psychopathology has put forward new methodological challenges. Personality and psychopathology networks are typically based on correlation matrices and therefore include both positive and negative edge signs. However, some applications of network analysis disregard negative edges, such as computing clustering coefficients. In this contribution, we illustrate the importance of the distinction between positive and negative edges in networks based on correlation matrices. The clustering coefficient is generalized to signed correlation networks: three new indices are introduced that take edge signs into account, each derived from an existing and widely used formula. The performances of the new indices are illustrated and compared with the performances of the unsigned indices, both on a signed simulated network and on a signed network based on actual personality psychology data. The results show that the new indices are more resistant to sample variations in correlation networks and therefore have higher convergence compared with the unsigned indices both in simulated networks and with real data. PMID:24586367

Assessing health system performance in developing countries: a review of the literature.

PubMed

Kruk, Margaret Elizabeth; Freedman, Lynn P

2008-03-01

With the setting of ambitious international health goals and an influx of additional development assistance for health, there is growing interest in assessing the performance of health systems in developing countries. This paper proposes a framework for the assessment of health system performance and reviews the literature on indicators currently in use to measure performance using online medical and public health databases. This was complemented by a review of relevant books and reports in the grey literature. The indicators were organized into three categories: effectiveness, equity, and efficiency. Measures of health system effectiveness were improvement in health status, access to and quality of care and, increasingly, patient satisfaction. Measures of equity included access and quality of care for disadvantaged groups together with fair financing, risk protection and accountability. Measures of efficiency were appropriate levels of funding, the cost-effectiveness of interventions, and effective administration. This framework and review of indicators may be helpful to health policy makers interested in assessing the effects of different policies, expenditures, and organizational structures on health outputs and outcomes in developing countries.

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

PubMed

Ehrmeyer, Sharon S; Laessig, Ronald H

2004-08-02

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

The Stroop test as a measure of performance validity in adults clinically referred for neuropsychological assessment.

PubMed

Erdodi, Laszlo A; Sagar, Sanya; Seke, Kristian; Zuccato, Brandon G; Schwartz, Eben S; Roth, Robert M

2018-06-01

This study was designed to develop performance validity indicators embedded within the Delis-Kaplan Executive Function Systems (D-KEFS) version of the Stroop task. Archival data from a mixed clinical sample of 132 patients (50% male; M Age = 43.4; M Education = 14.1) clinically referred for neuropsychological assessment were analyzed. Criterion measures included the Warrington Recognition Memory Test-Words and 2 composites based on several independent validity indicators. An age-corrected scaled score ≤6 on any of the 4 trials reliably differentiated psychometrically defined credible and noncredible response sets with high specificity (.87-.94) and variable sensitivity (.34-.71). An inverted Stroop effect was less sensitive (.14-.29), but comparably specific (.85-90) to invalid performance. Aggregating the newly developed D-KEFS Stroop validity indicators further improved classification accuracy. Failing the validity cutoffs was unrelated to self-reported depression or anxiety. However, it was associated with elevated somatic symptom report. In addition to processing speed and executive function, the D-KEFS version of the Stroop task can function as a measure of performance validity. A multivariate approach to performance validity assessment is generally superior to univariate models. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The importance of metrics for evaluating scientific performance

NASA Astrophysics Data System (ADS)

Miyakawa, Tsuyoshi

Evaluation of scientific performance is a major factor that determines the behavior of both individual researchers and the academic institutes to which they belong. Because the number of researchers heavily outweighs the number of available research posts, and the competitive funding accounts for an ever-increasing proportion of research budget, some objective indicators of research performance have gained recognition for increasing transparency and openness. It is common practice to use metrics and indices to evaluate a researcher's performance or the quality of their grant applications. Such measures include the number of publications, the number of times these papers are cited and, more recently, the h-index, which measures the number of highly-cited papers the researcher has written. However, academic institutions and funding agencies in Japan have been rather slow to adopt such metrics. In this article, I will outline some of the currently available metrics, and discuss why we need to use such objective indicators of research performance more often in Japan. I will also discuss how to promote the use of metrics and what we should keep in mind when using them, as well as their potential impact on the research community in Japan.

Feasibility of evaluating quality cancer care using registry data and electronic health records: a population-based study.

PubMed

Caldarella, Adele; Amunni, Gianni; Angiolini, Catia; Crocetti, Emanuele; Di Costanzo, Francesco; Di Leo, Angelo; Giusti, Francesco; Pegna, Andrea Lopes; Mantellini, Paola; Luzzatto, Lucio; Paci, Eugenio

2012-08-01

To evaluate the quality of patients care, a set of indicators of the standards of cancer care were defined. We developed a set of indicators to assess the implementation in daily practice of recommendation produced by a regional network (Istituto Toscano Tumori). This set was tested in a retrospective study in the resident population of the Tuscany Region; the regional health system is organized on 12 local health authorities which refer to three macro areas (Area Vasta). The study included incident colorectal, lung and breast cancer cases listed in 2004 for the Tuscan Cancer Registry, a population-based registry which collected tumor cases diagnosed in all residents in Tuscany. Electronic data from registry database were used to determine the compliance with each indicator for patients in 2004. To validate the results, an ad hoc clinical survey including the same geographical area for the year 2006 was performed. None. The proportion of patients who fulfilled each of the indicators. Our study showed the feasibility of the evaluation of the quality of cancer care using cancer registry population-based data and major computerized information systems. The estimation of the selected indicators confirmed a good homogeneity among areas, and globally revealed a good intraregional performance. Further work is needed to develop specific quality measures, particularly about structural data and to continually revise indicators of quality of care. Data from a cancer registry, however, can be useful to evaluate quality of cancer care.

Quality indicators for the assessment and management of pain in the emergency department: a systematic review.

PubMed

Stang, Antonia Schirmer; Hartling, Lisa; Fera, Cassandra; Johnson, David; Ali, Samina

2014-01-01

Evidence indicates that pain is undertreated in the emergency department (ED). The first step in improving the pain experience for ED patients is to accurately and systematically assess the actual care being provided. Identifying gaps in the assessment and treatment of pain and improving patient outcomes requires relevant, evidence-based performance measures. To systematically review the literature and identify quality indicators specific to the assessment and management of pain in the ED. Four major bibliographical databases were searched from January 1980 to December 2010, and relevant journals and conference proceedings were manually searched. Original research that described the development or collection of data on one or more quality indicators relevant to the assessment or management of pain in the ED was included. The search identified 18,078 citations. Twenty-three articles were included: 15 observational (cohort) studies; three before-after studies; three audits; one quality indicator development study; and one survey. Methodological quality was moderate, with weaknesses in the reporting of study design and methodology. Twenty unique indicators were identified, with the majority (16 of 20) measuring care processes. Overall, 91% (21 of 23) of the studies reported indicators for the assessment or management of presenting pain, as opposed to procedural pain. Three of the studies included children; however, none of the indicators were developed specifically for a pediatric population. Gaps in the existing literature include a lack of measures reflecting procedural pain, patient outcomes and the pediatric population. Future efforts should focus on developing indicators specific to these key areas.

Health systems performance in sub-Saharan Africa: governance, outcome and equity.

PubMed

Olafsdottir, Anna E; Reidpath, Daniel D; Pokhrel, Subhash; Allotey, Pascale

2011-04-16

The literature on health systems focuses largely on the performance of healthcare systems operationalised around indicators such as hospital beds, maternity care and immunisation coverage. A broader definition of health systems however, needs to include the wider determinants of health including, possibly, governance and its relationship to health and health equity. The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. Using cross sectional data from 46 countries in the African region of the World Health Organization, an ecological analysis was conducted to examine the relationship between governance and health systems performance. The data were analysed using multiple linear regression and a standard progressive modelling procedure. The under-five mortality rate (U5MR) was used as the health outcome measure and the ratio of U5MR in the wealthiest and poorest quintiles was used as the measure of health equity. Governance was measured using two contextually relevant indices developed by the Mo Ibrahim Foundation. Governance was strongly associated with U5MR and moderately associated with the U5MR quintile ratio. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR. Governance was not, however, significantly associated with equity in U5MR outcomes. This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. The association suggests there might be a causal relationship. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. Further research will be needed to assess the causal relationship, and its generalizability beyond U5MR as a health outcome measure, as well as the geographical generalizability of the results.

Bladder augmentation using the gastrointestinal tract. Indication, follow up and complications.

PubMed

Escudero, R Molina; Patiño, G Escribano; Fernández, E Rodríguez; Gil, M J Cancho; García, E Lledó; Alonso, A Husillos; Piniés, G Ogaya; Sánchez, J Piñeiro; Fernández, C Hernández

2011-12-01

The purpose of bladder augmentation using the gastrointestinal tract is to create a low-pressure and high-capacity reservoir, permitting suitable continence and voiding, preserving the upper urinary tract. To analyze the indications, complications and results of our series of augmentation enterocystoplasties. We retrospectively reviewed patients undergoing augmentation enterocystoplasty in our department between 1997 and 2010, both included. The indications were: Interstitial cystitis, neurogenic bladder and inflammatory bladder retraction. In all cases a cystography, urethrocystoscopy, urodynamic study and studies of each condition. Bladder release is performed by means of medial laparotomy and an extraperitoneal approach with bivalve opening to the urethral orifices. The bladder augmentation is performed with a 15-20 cm segment of detubularized ileum obtained at 20 cm from the ileocecal valve; in cases of kidney failure, a 7-cm gastric body wedge is added. The bladder catheter was removed following cystogram after 15 days. Monitoring was performed by means of ultrasound with postvoid residual, blood analyses, urine culture and voiding diary. We performed a descriptive study of the demographic characteristics, postoperative complications according to the Clavien classification and in the long term. We included 24 patients, 19 women and 5 men with a mean age of 48.5 years and a median of 47 (21-77). Mean follow up was 7.5 years with a median of 8 (1-11). The indications were: 7 interstitial cystitis, 8 bladder retraction and 7 neurogenic bladder. There were no intraoperative complications. The postoperative complications were 3 Clavien I, 2 type II, 2 IIIA and 1 IIIB. In the long term, 3 patients presented urinary incontinence, 2 mild metabolic acidosis, 5 required self-catheterization, 6 bladder stones, 2 febrile urinary tract infections and 1 stricture of the anastomotic mouth. In three cases, an ileogastrocystoplasty was performed without hydroelectrolytic impairment or impairment of kidney function. In selected patients, augmentation enterocystoplasty constitutes an efficacious therapeutic option in the treatment of lower urinary tract dysfunction with scant morbidity and few complications.

Health systems performance in sub-Saharan Africa: governance, outcome and equity

PubMed Central

2011-01-01

Background The literature on health systems focuses largely on the performance of healthcare systems operationalised around indicators such as hospital beds, maternity care and immunisation coverage. A broader definition of health systems however, needs to include the wider determinants of health including, possibly, governance and its relationship to health and health equity. The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. Methods Using cross sectional data from 46 countries in the African region of the World Health Organization, an ecological analysis was conducted to examine the relationship between governance and health systems performance. The data were analysed using multiple linear regression and a standard progressive modelling procedure. The under-five mortality rate (U5MR) was used as the health outcome measure and the ratio of U5MR in the wealthiest and poorest quintiles was used as the measure of health equity. Governance was measured using two contextually relevant indices developed by the Mo Ibrahim Foundation. Results Governance was strongly associated with U5MR and moderately associated with the U5MR quintile ratio. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR. Governance was not, however, significantly associated with equity in U5MR outcomes. Conclusion This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. The association suggests there might be a causal relationship. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. Further research will be needed to assess the causal relationship, and its generalizability beyond U5MR as a health outcome measure, as well as the geographical generalizability of the results. PMID:21496303

Evaluation of Augmented Reality Feedback in Surgical Training Environment.

PubMed

Zahiri, Mohsen; Nelson, Carl A; Oleynikov, Dmitry; Siu, Ka-Chun

2018-02-01

Providing computer-based laparoscopic surgical training has several advantages that enhance the training process. Self-evaluation and real-time performance feedback are 2 of these advantages, which avoid dependency of trainees on expert feedback. The goal of this study was to investigate the use of a visual time indicator as real-time feedback correlated with the laparoscopic surgical training. Twenty novices participated in this study working with (and without) different presentations of time indicators. They performed a standard peg transfer task, and their completion times and muscle activity were recorded and compared. Also of interest was whether the use of this type of feedback induced any side effect in terms of motivation or muscle fatigue. Of the 20 participants, 15 (75%) preferred using a time indicator in the training process rather than having no feedback. However, time to task completion showed no significant difference in performance with the time indicator; furthermore, no significant differences in muscle activity or muscle fatigue were detected with/without time feedback. The absence of significant difference between task performance with/without time feedback shows that using visual real-time feedback can be included in surgical training based on user preference. Trainees may benefit from this type of feedback in the form of increased motivation. The extent to which this can influence training frequency leading to performance improvement is a question for further study.

Trends in the distribution of donor corneal tissue and indications for corneal transplantation: the New Zealand National Eye Bank Study 2000-2009.

PubMed

Cunningham, William J; Brookes, Nigel H; Twohill, Helen C; Moffatt, S Louise; Pendergrast, David G C; Stewart, Joanna M; McGhee, Charles N J

2012-03-01

To investigate the indications for corneal transplantation and the distribution of donor corneal tissue in New Zealand. Analysis of the prospective database of the New Zealand National Eye Bank. A total of 2205 corneal transplants were assessed. New Zealand National Eye Bank records were analysed for the decade 2000-2009. Variables analysed included donor corneal tissue distribution (including public and private sectors), indications for transplantation, donor corneal tissue recipient demographics (age and gender) and corneal transplantation type. An average of 220 corneal transplants were performed each year over the 10-year period (n=2205). The median recipient age was 45years (range 3 to 102years) and 54.0% of recipients were male. In total 71.8% of transplants were performed in the public health sector. Surgeons in the Auckland metropolitan area performed 47.2% of all corneal transplants. The most common indications for corneal transplantation were: keratoconus (41.1%), repeat transplant (17.0%), aphakic/pseudophakic bullous keratopathy (13.9%), corneal dystrophy (10.7%), keratitis (7.9%) and trauma (3.7%). Overall, penetrating keratoplasty accounted for 90.7% of all corneal transplants, however, during the latter half of the study there was a progressive shift in transplantation type, with deep anterior lamellar keratoplasty and Descemet's stripping endothelial keratoplasty combined accounting for 32.3% of all transplants in the final year of the study period. This New Zealand National Eye Bank study provides valuable data regarding the indications for corneal transplantation, transplant recipient demographics and changes in transplantation type in New Zealand over the past decade. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

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.

Test results of a 40-kW Stirling engine and comparison with the NASA Lewis computer code predictions

NASA Technical Reports Server (NTRS)

Allen, David J.; Cairelli, James E.

1988-01-01

A Stirling engine was tested without auxiliaries at Nasa-Lewis. Three different regenerator configurations were tested with hydrogen. The test objectives were: (1) to obtain steady-state and dynamic engine data, including indicated power, for validation of an existing computer model for this engine; and (2) to evaluate structurally the use of silicon carbide regenerators. This paper presents comparisons of the measured brake performance, indicated mean effective pressure, and cyclic pressure variations from those predicted by the code. The silicon carbide foam generators appear to be structurally suitable, but the foam matrix showed severely reduced performance.

Penetrating keratoplasty in infancy and early childhood.

PubMed

Reidy, J J

2001-08-01

Penetrating keratoplasty in infants and young children is performed on an infrequent basis. The most common indication is visually significant congenital corneal opacity. Surgery must be performed early to avoid amblyopia. Surgical techniques differ from those used in adult penetrating keratoplasty because of the reduced ocular rigidity encountered in infants and young children. Use of a multispecialty team approach is important to improve visual outcome. Poor prognostic indicators include bilateral disease, concomitant infantile glaucoma, lensectomy and vitrectomy at the time of surgery, previous graft failure, extensive goniosynechiae, and extensive corneal vascularization. Prompt postoperative optical rehabilitation, combined with occlusion therapy when appropriate, is an important determinant of success.

Talent identification and recruitment in youth soccer: Recruiter's perceptions of the key attributes for player recruitment.

PubMed

Larkin, Paul; O'Connor, Donna

2017-01-01

Using the modified Delphi method, we aimed to understand the attributes youth coaches and recruiters perceive as important when identifying skilled youth performance at the entry level of representative soccer in Australia (i.e., Under 13 years). Furthermore, we also aimed to describe the current methods youth coaches and recruiters use to assess and identify these attributes in youth players. Australian regional youth technical directors and coaches (n = 20) completed a three stage process, including an initial interview and two subsequent questionnaires, whereby attributes and qualities associated with talent identification were rated and justified according to the importance for youth player performance and talent identification. Results indicate a hierarchy of attributes recruiters perceive as important for Under 13 soccer performance, including technical (i.e., first touch, striking the ball, one-versus-one ability, and technical ability under pressure), tactical (i.e., decision-making ability) and psychological attributes (i.e., coachability and positive attitude). In addition, the findings indicated attributes and qualities not emphasised within the talent identification process including, physiological, anthropometrical, sociological and several psychological attributes. It is suggested talent recruiters apply a holistic multidisciplinary approach to talent identification, with the current findings potentially providing initial evidence to suggest recruiters do consider numerous attributes when selecting and identifying youth players.

Talent identification and recruitment in youth soccer: Recruiter’s perceptions of the key attributes for player recruitment

PubMed Central

2017-01-01

Using the modified Delphi method, we aimed to understand the attributes youth coaches and recruiters perceive as important when identifying skilled youth performance at the entry level of representative soccer in Australia (i.e., Under 13 years). Furthermore, we also aimed to describe the current methods youth coaches and recruiters use to assess and identify these attributes in youth players. Australian regional youth technical directors and coaches (n = 20) completed a three stage process, including an initial interview and two subsequent questionnaires, whereby attributes and qualities associated with talent identification were rated and justified according to the importance for youth player performance and talent identification. Results indicate a hierarchy of attributes recruiters perceive as important for Under 13 soccer performance, including technical (i.e., first touch, striking the ball, one-versus-one ability, and technical ability under pressure), tactical (i.e., decision-making ability) and psychological attributes (i.e., coachability and positive attitude). In addition, the findings indicated attributes and qualities not emphasised within the talent identification process including, physiological, anthropometrical, sociological and several psychological attributes. It is suggested talent recruiters apply a holistic multidisciplinary approach to talent identification, with the current findings potentially providing initial evidence to suggest recruiters do consider numerous attributes when selecting and identifying youth players. PMID:28419175

Protocols and Results of Resident Neurosurgeon's Transfemoral Catheter Angiography Training Supervised by Neuroendovascular Specialists

PubMed Central

Shin, Dong-Seong; Yeo, Dong-Kyu; Hwang, Sun-Chul; Park, Sukh-Que

2013-01-01

Objective Transfemoral catheter angiography (TFCA) is a basic procedure in neurovascular surgery with increasing importance in surgical and non-invasive treatments. Unfortunately, resident neurosurgeons have relatively few opportunities to perform TFCA in most institutions. We report a method developed in our hospital for training resident neurosurgeons to perform TFCA and evaluate the efficacy of this training. Methods From May 2011 to September 2011, a total of 112 consecutive patients underwent TFCA by one resident neurosurgeon supervised by two neuroendovascular specialists. Patients who underwent elective diagnostic procedures were included in this study. Patients who underwent endovascular treatment were excluded. Demographic data, indications for TFCA, side of approach, number of selected arteries, and complications were analyzed. Results This study included 64 males and 48 females with a mean age of 51.6 (12-81) years. All procedures were performed in the angiography suite. Common indications for procedures were as follows: stroke-induced symptoms in 61 patients (54.5%), Moyamoya disease and arteriovenous malformation in 13 patients (11.6%), and unruptured intracranial aneurysm in eight patients (7.1%). Right and left femoral puncture was performed in 98.2% and 1.8% of patients, respectively. A total of 465 selective angiographies were performed without complications. Angiographic examination was performed on 4.15 vessels per patient. Conclusion TFCA can be performed safely by resident neurosurgeons based on anatomical study and a meticulous protocol under the careful supervision of neuroendovascular specialists. PMID:24175020

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

PubMed Central

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

2017-01-01

Introduction the World Health Organization (WHO), Ethiopia country office, introduced an accountability framework into its Polio Eradication Program in 2014 with the aim of improving the program's performance. Our study aims to evaluate staff performance and key program indicators following the introduction of the accountability framework. Methods the impact of the WHO accountability framework was reviewed after its first year of implementation from June 2014 to June 2015. We analyzed selected program and staff performance indicators associated with acute flaccid paralysis (AFP) surveillance from a database available at WHO. Data on managerial actions taken were also reviewed. Performance of a total of 38 staff was evaluated during our review. Results our review of results for the first four quarters of implementation of the polio eradication accountability framework showed improvement both at the program and individual level when compared with the previous year. Managerial actions taken during the study period based on the results from the monitoring tool included eleven written acknowledgments, six discussions regarding performance improvement, six rotations of staff, four written first-warning letters and nine non-renewal of contracts. Conclusion the introduction of the accountability framework resulted in improvement in staff performance and overall program indicators for AFP surveillance. PMID:28890753

Effect of height on motor coordination in college students participating in a dancesport program.

PubMed

Li, Xiaoxin; Wang, Huazhuo; Yang, Yaohua; Qi, Chunying; Wang, Fei; Jin, Man

2015-03-01

Athlete screening tools combine measures of physical performance and morphometric parameters unique to each sport. Given the increasing competitiveness of dancesport, we designed the present quasi-experimental study to analyze the relationship between body height and motor coordination in college students. Six hundred eighty-six students were randomly selected to participate in a dancing sport program that consisted of 16 weeks (32 hrs) of training. The program included an assessment of basic skills (rhythm, movement specificity, intensity, expressive force, and action coherence) and skills related to a doubles dance routine. Male and female students were divided into four single-sex groups based on their heights (each group had a 5-cm range), and the average scores for each performance indicator were analyzed. A one-way ANOVA revealed significant differences in performance scores for each indicator of basic skills and double routine skills between the different height groups. Male in the 175-179 cm group and female students in the 165-169 cm group had the best performance scores on each indicator, while the shortest students had the worst performance scores. The height of students participating in sport dancing training had an impact on dancesport performance and motor coordination, counter to the traditional belief that shorter people have better coordination.

Reliability and validity assessment of administrative databases in measuring the quality of rectal cancer management.

PubMed

Corbellini, Carlo; Andreoni, Bruno; Ansaloni, Luca; Sgroi, Giovanni; Martinotti, Mario; Scandroglio, Ildo; Carzaniga, Pierluigi; Longoni, Mauro; Foschi, Diego; Dionigi, Paolo; Morandi, Eugenio; Agnello, Mauro

2018-01-01

Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases. Between May 2012 and November 2014, a clinical survey was done on 498 Lombardy patients who had rectal cancer and underwent surgical resection. These collected data were compared with the information extracted from administrative sources including Hospital Discharge Dataset, drug database, daycare activity data, fee-exemption database, and regional screening program database. The agreement evaluation was performed using a set of 12 quality indicators. Patient complexity was a difficult indicator to measure for lack of clinical data. Preoperative staging was another suboptimal indicator due to the frequent missing administrative registration of tests performed. The agreement between the 2 data sources regarding chemoradiotherapy treatments was high. Screening detection, minimally invasive techniques, length of stay, and unpreventable readmissions were detected as reliable quality indicators. Postoperative morbidity could be a useful indicator but its agreement was lower, as expected. Healthcare administrative databases are large and real-time collected repositories of data useful in measuring quality in a healthcare system. Our investigation reveals that the reliability of indicators varies between them. Ideally, a combination of data from both sources could be used in order to improve usefulness of less reliable indicators.

Assessing the environmental performance of construction materials testing using EMS: An Australian study.

PubMed

Dejkovski, Nick

2016-10-01

This paper reports the audit findings of the waste management practices at 30 construction materials testing (CMT) laboratories (constituting 4.6% of total accredited CMT laboratories at the time of the audit) that operate in four Australian jurisdictions and assesses the organisation's Environmental Management System (EMS) for indicators of progress towards sustainable development (SD). In Australia, waste indicators are 'priority indicators' of environmental performance yet the quality and availability of waste data is poor. National construction and demolition waste (CDW) data estimates are not fully disaggregated and the contribution of CMT waste (classified as CDW) to the national total CDW landfill burden is difficult to quantify. The environmental and human impacts of anthropogenic release of hazardous substances contained in CMT waste into the ecosphere can be measured by construing waste indicators from the EMS. An analytical framework for evaluating the EMS is developed to elucidate CMT waste indicators and assess these indicators against the principle of proportionality. Assessing against this principle allows for: objective evaluations of whether the environmental measures prescribed in the EMS are 'proportionate' to the 'desired' (subjective) level of protection chosen by decision-makers; and benchmarking CMT waste indicators against aspirational CDW targets set by each Australian jurisdiction included in the audit. Construed together, the EMS derived waste indicators and benchmark data provide a composite indicator of environmental performance and progress towards SD. The key audit findings indicate: CMT laboratories have a 'poor' environmental performance (and overall progress towards SD) when EMS waste data are converted into indicator scores and assessed against the principle of proportionality; CMT waste recycling targets are lower when benchmarked against jurisdictional CDW waste recovery targets; and no significant difference in the average quantity of waste diversion away from landfill was observed for laboratories with ISO14001 EMS certification compared to non-ISO14001 certified laboratories. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of expected-value information and display format on recognition of aircraft subsystem abnormalities

NASA Technical Reports Server (NTRS)

Palmer, Michael T.; Abbott, Kathy H.

1994-01-01

This study identifies improved methods to present system parameter information for detecting abnormal conditions and to identify system status. Two workstation experiments were conducted. The first experiment determined if including expected-value-range information in traditional parameter display formats affected subject performance. The second experiment determined if using a nontraditional parameter display format, which presented relative deviation from expected value, was better than traditional formats with expected-value ranges included. The inclusion of expected-value-range information onto traditional parameter formats was found to have essentially no effect. However, subjective results indicated support for including this information. The nontraditional column deviation parameter display format resulted in significantly fewer errors compared with traditional formats with expected-value-ranges included. In addition, error rates for the column deviation parameter display format remained stable as the scenario complexity increased, whereas error rates for the traditional parameter display formats with expected-value ranges increased. Subjective results also indicated that the subjects preferred this new format and thought that their performance was better with it. The column deviation parameter display format is recommended for display applications that require rapid recognition of out-of-tolerance conditions, especially for a large number of parameters.

Role of self-sufficiency, productivity and diversification on the economic sustainability of farming systems with autochthonous sheep breeds in less favoured areas in Southern Europe.

PubMed

Ripoll-Bosch, R; Joy, M; Bernués, A

2014-08-01

Traditional mixed livestock cereal- and pasture-based sheep farming systems in Europe are threatened by intensification and specialisation processes. However, the intensification process does not always yield improved economic results or efficiency. This study involved a group of farmers that raised an autochthonous sheep breed (Ojinegra de Teruel) in an unfavourable area of North-East Spain. This study aimed to typify the farms and elucidate the existing links between economic performance and certain sustainability indicators (i.e. productivity, self-sufficiency and diversification). Information was obtained through direct interviews with 30 farms (73% of the farmers belonging to the breeders association). Interviews were conducted in 2009 and involved 32 indicators regarding farm structure, management and economic performance. With a principal component analysis, three factors were obtained explaining 77.9% of the original variance. This factors were named as inputs/self-sufficiency, which included the use of on-farm feeds, the amount of variable costs per ewe and economic performance; productivity, which included lamb productivity and economic autonomy; and productive orientation, which included the degree of specialisation in production. A cluster analysis identified the following four groups of farms: high-input intensive system; low-input self-sufficient system; specialised livestock system; and diversified crops-livestock system. In conclusion, despite the large variability between and within groups, the following factors that explain the economic profitability of farms were identified: (i) high feed self-sufficiency and low variable costs enhance the economic performance (per labour unit) of the farms; (ii) animal productivity reduces subsidy dependence, but does not necessarily imply better economic performance; and (iii) diversity of production enhances farm flexibility, but is not related to economic performance.

One-man, self-contained CO2 concentrating system

NASA Technical Reports Server (NTRS)

Wynveen, R. A.; Schubert, F. H.; Powell, J. D.

1972-01-01

A program to design, fabricate, and test a 1-man, self-contained, electrochemical CO2 concentrating system is described. The system was designed with electronic controls and instrumentation to regulate performance, to analyze and display performance trends, and to detect and isolate faults. Ground support accessories were included to provide power, fluids, and a Parametric Data Display allowing real time indication of operating status in engineering units.

Attacking and defensive styles of play in soccer: analysis of Spanish and English elite teams.

PubMed

Fernandez-Navarro, Javier; Fradua, Luis; Zubillaga, Asier; Ford, Paul R; McRobert, Allistair P

2016-12-01

The aim of this study was to define and categorise different styles of play in elite soccer and associated performance indicators by using factor analysis. Furthermore, the observed teams were categorised using all factor scores. Data were collected from 97 matches from the Spanish La Liga and the English Premier League from the seasons 2006-2007 and 2010-2011 using the Amisco® system. A total of 19 performance indicators, 14 describing aspects of attacking play and five describing aspects of defensive play, were included in the factor analysis. Six factors, representing 12 different styles of play (eight attacking and four defensive), had eigenvalues greater than 1 and explained 87.54% of the total variance. Direct and possession styles of play, defined by factor 1, were the most apparent styles. Factor analysis used the performance indicators to cluster each team's style of play. Findings showed that a team's style of play was defined by specific performance indicators and, consequently, teams can be classified to create a playing style profile. For practical implications, playing styles profiling can be used to compare different teams and prepare for opponents in competition. Moreover, teams could use specific training drills directed to improve their styles of play.

Is pain assessment feasible as a performance indicator for Dutch nursing homes? A cross-sectional approach.

PubMed

Boerlage, Anneke A; Masman, Anniek D; Hagoort, Jacobus; Tibboel, Dick; Baar, Frans P M; van Dijk, Monique

2013-03-01

Quality of care gains transparency with the help of performance indicators. For Dutch nursing homes, the current set of performance indicators does not include pain. To determine the feasibility of pain assessment as performance indicator, information about pain prevalence and analgesic prescription in one nursing home was collected. Within the time span of 3 days, pain intensity was measured in 91% of the residents (201 out of 221), either with a numeric rating scale, a verbal rating scale, or the Rotterdam Elderly Pain Observation Scale (REPOS). Numerical rating was used for 72%, verbal rating for 3%, and REPOS observation for 25% of the residents. Pain was substantial in 65 residents (32%), who received the following analgesic prescription: World Health Organization (WHO) step 1, 45%; WHO step 3, 12%; and neuroactive agents, 5%. Thirty-eight percent of these residents were in pain and received no analgesics. Residents with substantial pain significantly more often received analgesics (p = .007). Results suggest that pain assessment is feasible in a nursing home and would stimulate staff attention to pain. Further investigation is necessary to find out if a pain algorithm is feasible and will lead to improved pain treatment. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Evaluating performance in sweat testing in medical biochemistry laboratories in Croatia.

PubMed

Aralica, Merica; Krleza, Jasna Lenicek

2017-02-15

Sweat test has a diagnostic role in evaluation of cystic fibrosis. Its performance includes sweat stimulation, collection and analysis. All listed may be sources of inconsistencies in everyday practice. The aim of this study was an evaluation of external quality assessment (EQA) of sweat chloride measurement including sweat test performance in medical biochemistry laboratories in Croatia. EQA for sweat chloride measurement was provided by Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM) in five consecutive exercises to medical biochemistry laboratories (MBL) that offered sweat testing. A questionnaire regarding all phases of testing was mailed to involved MBL (N = 10). Survey results were compared to current guidelines for sweat test performance. Reported results of EQA in 2015 exercises showed coefficients of variation (CV) from 28.9%, 29.0% to 35.3%, respectively. An introduction of uniform sweat chloride measurement protocol resulted in CV of 15.5% and 14.7% reported in following two exercises in 2016. All MBL included in this study replied to the questionnaire. Results reported by MBL indicated: lack of patient information policy (7/10), use of unacceptable electrodes (6/9), misuse of minimum of acceptable sweat weight (6/9), lack of internal quality assessment (5/9) and recommended reference ranges (5/9 and 4/9). Agreements to guidelines were found in approach to unsuitable patients (9/10) and sweat collection (8/9). Presented results indicate major weak points of current practice in sweat test performance in Croatian MBL and stress the need for its standardization on a national level.

Evaluating performance in sweat testing in medical biochemistry laboratories in Croatia

PubMed Central

Aralica, Merica; Krleza, Jasna Lenicek

2017-01-01

Introduction Sweat test has a diagnostic role in evaluation of cystic fibrosis. Its performance includes sweat stimulation, collection and analysis. All listed may be sources of inconsistencies in everyday practice. The aim of this study was an evaluation of external quality assessment (EQA) of sweat chloride measurement including sweat test performance in medical biochemistry laboratories in Croatia. Materials and methods EQA for sweat chloride measurement was provided by Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM) in five consecutive exercises to medical biochemistry laboratories (MBL) that offered sweat testing. A questionnaire regarding all phases of testing was mailed to involved MBL (N = 10). Survey results were compared to current guidelines for sweat test performance. Results Reported results of EQA in 2015 exercises showed coefficients of variation (CV) from 28.9%, 29.0% to 35.3%, respectively. An introduction of uniform sweat chloride measurement protocol resulted in CV of 15.5% and 14.7% reported in following two exercises in 2016. All MBL included in this study replied to the questionnaire. Results reported by MBL indicated: lack of patient information policy (7/10), use of unacceptable electrodes (6/9), misuse of minimum of acceptable sweat weight (6/9), lack of internal quality assessment (5/9) and recommended reference ranges (5/9 and 4/9). Agreements to guidelines were found in approach to unsuitable patients (9/10) and sweat collection (8/9). Conclusion Presented results indicate major weak points of current practice in sweat test performance in Croatian MBL and stress the need for its standardization on a national level. PMID:28392735

Selection of key financial indicators: a literature, panel and survey approach.

PubMed

Pink, George H; Daniel, Imtiaz; Hall, Linda McGillis; McKillop, Ian

2007-01-01

Since 1998, most hospitals in Ontario have voluntarily participated in one of the largest and most ambitious publicly available performance-reporting initiatives in the world. This article describes the method used to select key financial indicators for inclusion in the report including the literature review, panel and survey approaches that were used. The results for five years of recent data for Ontario hospitals are also presented.

Cosmetic surgery growth and correlations with financial indices: a comparative study of the United Kingdom and United States from 2002-2011.

PubMed

Nassab, Reza; Harris, Paul

2013-05-01

Over the past 10 years, there has been significant fluctuation in the yearly growth rates for cosmetic surgery procedures in both the United States and the United Kingdom. The authors compare cosmetic surgical procedure rates in the United Kingdom and United States with the macroeconomic climate of each region to determine whether there is a direct relationship between cosmetic surgery rates and economic health. The authors analyzed annual cosmetic surgery statistics from the British Association of Aesthetic Plastic Surgeons and the American Society for Aesthetic Plastic Surgery for 2002-2011 against economic indices from both regions, including the gross domestic product (GDP), consumer prices indices (CPI), and stock market reports. There was a 285.9% increase in the United Kingdom and a 1.1% increase in the United States in the number of procedures performed between 2002 and 2011. There were significant positive correlations between the number of cosmetic procedures performed in the United Kingdom and both the GDP (r = 0.986, P < .01) and CPI (r = 0.955, P < .01). Analysis of the US growth rates failed to show a significant relationship with any indices. UK interest rates showed a significant negative correlation (r = -0.668, P < .05) with procedures performed, whereas US interest rates showed a significant positive correlation. Data from the United States and United Kingdom suggest 2 very different growth patterns in the number of cosmetic surgeries being performed as compared with the economy in each region. Economic indices are accurate indicators of numbers of procedures being performed in the United Kingdom, whereas rates in the United States seem independent of those factors.

Memory-focused interventions for people with cognitive disorders: A systematic review and meta-analysis of randomized controlled studies.

PubMed

Yang, Hui-Ling; Chan, Pi-Tuan; Chang, Pi-Chen; Chiu, Huei-Ling; Sheen Hsiao, Shu-Tai; Chu, Hsin; Chou, Kuei-Ru

2018-02-01

A better understanding of people with cognitive disorders improves performance on memory tasks through memory-focused interventions are needed. The purpose of this study was to assess the effect of memoryfocused interventions on cognitive disorders through a meta-analysis. Systematic review and meta-analysis. The online electronic databases PubMed, the Cochrane Library, Ovid-Medline, CINHAL, PsycINFO, Ageline, and Embase (up to May 2017) were used in this study. No language restriction was applied to the search. Objective memory (learning and memory function, immediate recall, delayed recall, and recognition) was the primary indicator and subjective memory performance, global cognitive function, and depression were the secondary indicators. The Hedges' g of change, subgroup analyses, and meta-regression were analyzed on the basis of the characteristics of people with cognitive disorders. A total of 27 studies (2177 participants, mean age=75.80) reporting RCTs were included in the meta-analysis. The results indicated a medium-to-large effect of memory-focused interventions on learning and memory function (Hedges' g=0.62) and subjective memory performance (Hedges' g=0.67), a small-to-medium effect on delayed recall and depression, and a small effect on immediate recall and global cognitive function (all p<0.05) compared with the control. Subgroup analysis and meta-regression indicated that the effects on learning and memory function were more profound in the format of memory training, individual training, shorter treatment duration, and more than eight treatment sessions, and the effect size indicated the MMSE score was the most crucial indicator (β=-0.06, p=0.04). This is first comprehensive meta-analysis of special memory domains in people with cognitive disorders. The results revealed that memory-focused interventions effectively improved memory-related performance in people with cognitive disorders. An appropriately designed intervention can effectively improve memory function, reduce disability progression, and improve mood state in people with cognitive disorders. Additional randomized controlled trials including measures of recognition, global cognitive function, and depression should be conducted and analyzed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Functioning: the third health indicator in the health system and the key indicator for rehabilitation.

PubMed

Stucki, Gerold; Bickenbach, Jerome

2017-02-01

In this methodological note on applying the ICF in rehabilitation, we introduce functioning as the third health indicator complementing the established indicators mortality and morbidity. Together, these three provide a complete set of indicators for monitoring the performance of health strategies in health systems. When applying functioning as the third health indicator across the five health strategies, it is fundamental to distinguish between biological health and lived health. For rehabilitation, functioning is the key indicator. Since we can now code mortality and morbidity data with the ICD, and functioning data with the ICF, and since given current plans to including functioning properties in the proposed ICD-11 revision, we should in the future be able to report on all three health indicators.

Identifying the most significant indicators of the total road safety performance index.

PubMed

Tešić, Milan; Hermans, Elke; Lipovac, Krsto; Pešić, Dalibor

2018-04-01

The review of the national and international literature dealing with the assessment of the road safety level has shown great efforts of the authors who tried to define the methodology for calculating the composite road safety index on a territory (region, state, etc.). The procedure for obtaining a road safety composite index of an area has been largely harmonized. The question that has not been fully resolved yet concerns the selection of indicators. There is a wide range of road safety indicators used to show a road safety situation on a territory. Road safety performance index (RSPI) obtained on the basis of a larger number of safety performance indicators (SPIs) enable decision makers to more precisely define the earlier goal- oriented actions. However, recording a broader comprehensive set of SPIs helps identify the strengths and weaknesses of a country's road safety system. Providing high quality national and international databases that would include comparable SPIs seems to be difficult since a larger number of countries dispose of a small number of identical indicators available for use. Therefore, there is a need for calculating a road safety performance index with a limited number of indicators (RSPI ln n ) which will provide a comparison of a sufficient quality, of as many countries as possible. The application of the Data Envelopment Analysis (DEA) method and correlative analysis has helped to check if the RSPI ln n is likely to be of sufficient quality. A strong correlation between the RSPI ln n and the RSPI has been identified using the proposed methodology. Based on this, the most contributing indicators and methodologies for gradual monitoring of SPIs, have been defined for each country analyzed. The indicator monitoring phases in the analyzed countries have been defined in the following way: Phase 1- the indicators relating to alcohol, speed and protective systems; Phase 2- the indicators relating to roads and Phase 3- the indicators relating to trauma management. This will help achieve the standardization of indicators including data collection procedures and selection of the key list of indicators that need to be monitored. Based on the results, it has been concluded that the use of the most contributing indicators will make it possible to assess the level of road safety on a territory, with an acceptable quality score by focusing on the low-ranked countries. A smaller set of significant indicators defined in this manner can serve for a fast and simple understanding of a road safety situation and assessment of effects of measures undertaken. Also, this universal index approach is applicable in cases when a broader comprehensive set of indicators is analyzed, which provides a more accurate identification of weaker points and rank the countries in a more meaningful way. Copyright © 2018 Elsevier Ltd. All rights reserved.

HIRDLS Cryocooler Subsystem on-orbit Performance

NASA Astrophysics Data System (ADS)

Lock, J.; Stack, R.; Glaister, D. S.; Gully, W.

2006-04-01

This paper describes the HIRDLS (High Resolution Dynamic Limb Sounder) Cryocooler Subsystem (CSS) and its on-orbit flight performance. The HIRDLS Instrument was launched on July 15, 2004 as part of the NASA GSFC EOS Aura platform. Ball Aerospace provided the CSS, which includes the long life Stirling cryocooler (cooling at 59 K), cold plumbing to connect the cooler to the instrument Detector Subsystem, an ambient radiator to reject the cooler dissipation, and a vacuum enclosure system that enabled bench top ground testing. As of August 20, 2005, the cryocooler has over 9,000 hours of continuous operation with performance that exceeds requirements. Of note is that the CSS has experienced virtually no change in performance, including no indication of external contamination related degradation that has been evident on several other cryocooler systems in space flights. This steady performance can be attributed to the multi-layer insulation (MLI) based insulation design, which will be described in the paper.

Trends Supporting the In-Field Use of Wearable Inertial Sensors for Sport Performance Evaluation: A Systematic Review

PubMed Central

2018-01-01

Recent technological developments have led to the production of inexpensive, non-invasive, miniature magneto-inertial sensors, ideal for obtaining sport performance measures during training or competition. This systematic review evaluates current evidence and the future potential of their use in sport performance evaluation. Articles published in English (April 2017) were searched in Web-of-Science, Scopus, Pubmed, and Sport-Discus databases. A keyword search of titles, abstracts and keywords which included studies using accelerometers, gyroscopes and/or magnetometers to analyse sport motor-tasks performed by athletes (excluding risk of injury, physical activity, and energy expenditure) resulted in 2040 papers. Papers and reference list screening led to the selection of 286 studies and 23 reviews. Information on sport, motor-tasks, participants, device characteristics, sensor position and fixing, experimental setting and performance indicators was extracted. The selected papers dealt with motor capacity assessment (51 papers), technique analysis (163), activity classification (19), and physical demands assessment (61). Focus was placed mainly on elite and sub-elite athletes (59%) performing their sport in-field during training (62%) and competition (7%). Measuring movement outdoors created opportunities in winter sports (8%), water sports (16%), team sports (25%), and other outdoor activities (27%). Indications on the reliability of sensor-based performance indicators are provided, together with critical considerations and future trends. PMID:29543747

On the use of the h-index in evaluating chemical research

PubMed Central

2013-01-01

Background The h index bibliometric indicator for evaluating scientists and scientific institutions plays an increasingly important role in evaluating contemporary scientific research, including chemistry. Results Citations are meaningful. The best way of measuring performance is to use the informed peer review, where peers judge on the base of a bibliometric report, once the limits and advantages of bibliometric indicators have been thoroughly understood. Conclusions Expanded and improved use of bibliometric indicators such as the h index in a useful and wise manner is suggested. PMID:23899251

A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status.

PubMed

Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

2015-01-01

Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students' academic performance in the comprehensive basic sciences examination. According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination.

Using GAMM to examine inter-individual heterogeneity in thermal performance curves for Natrix natrix indicates bet hedging strategy by mothers.

PubMed

Vickers, Mathew J; Aubret, Fabien; Coulon, Aurélie

2017-01-01

The thermal performance curve (TPC) illustrates the dependence on body- and therefore environmental- temperature of many fitness-related aspects of ectotherm ecology and biology including foraging, growth, predator avoidance, and reproduction. The typical thermal performance curve model is linear in its parameters despite the well-known, strong, non-linearity of the response of performance to temperature. In addition, it is usual to consider a single model based on few individuals as descriptive of a species-level response to temperature. To overcome these issues, we used generalized additive mixed modeling (GAMM) to estimate thermal performance curves for 73 individual hatchling Natrix natrix grass snakes from seven clutches, taking advantage of the structure of GAMM to demonstrate that almost 16% of the deviance in thermal performance curves is attributed to inter-individual variation, while only 1.3% is attributable to variation amongst clutches. GAMM allows precise estimation of curve characteristics, which we used to test hypotheses on tradeoffs thought to constrain the thermal performance curve: hotter is better, the specialist-generalist trade off, and resource allocation/acquisition. We observed a negative relationship between maximum performance and performance breadth, indicating a specialist-generalist tradeoff, and a positive relationship between thermal optimum and maximum performance, suggesting "hotter is better". There was a significant difference among matrilines in the relationship between Area Under the Curve and maximum performance - relationship that is an indicator of evenness in acquisition or allocation of resources. As we used unfed hatchlings, the observed matriline effect indicates divergent breeding strategies among mothers, with some mothers provisioning eggs unequally resulting in some offspring being better than others, while other mothers provisioned the eggs more evenly, resulting in even performance throughout the clutch. This observation is reminiscent of bet-hedging strategies, and implies the possibility for intra-clutch variability in the TPCs to buffer N. natrix against unpredictable environmental variability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Driving Competence in Mild Dementia with Lewy Bodies: In Search of Cognitive Predictors Using Driving Simulation

PubMed Central

Yamin, Stephanie; Stinchcombe, Arne; Gagnon, Sylvain

2015-01-01

Driving is a multifactorial behaviour drawing on multiple cognitive, sensory, and physical systems. Dementia is a progressive and degenerative neurological condition that impacts the cognitive processes necessary for safe driving. While a number of studies have examined driving among individuals with Alzheimer's disease, less is known about the impact of Dementia with Lewy Bodies (DLB) on driving safety. The present study compared simulated driving performance of 15 older drivers with mild DLB with that of 21 neurologically healthy control drivers. DLB drivers showed poorer performance on all indicators of simulated driving including an increased number of collisions in the simulator and poorer composite indicators of overall driving performance. A measure of global cognitive function (i.e., the Mini Mental State Exam) was found to be related to the overall driving performance. In addition, measures of attention (i.e., Useful Field of View, UFOV) and space processing (Visual Object and Space Perception, VOSP, Test) correlated significantly with a rater's assessment of driving performance. PMID:26713169

Surgical skills needed for humanitarian missions in resource-limited settings: common operative procedures performed at Médecins Sans Frontières facilities.

PubMed

Wong, Evan G; Trelles, Miguel; Dominguez, Lynette; Gupta, Shailvi; Burnham, Gilbert; Kushner, Adam L

2014-09-01

Surgeons in high-income countries increasingly are expressing interest in global surgery and participating in humanitarian missions. Knowledge of the surgical skills required to adequately respond to humanitarian emergencies is essential to prepare such surgeons and plan for interventions. A retrospective review of all surgical procedures performed at Médecins Sans Frontières Brussels facilities from June 2008 to December 2012 was performed. Individual data points included country of project; patient age and sex; and surgical indication and surgical procedure. Between June 2008 and December 2012, a total of 93,385 procedures were performed on 83,911 patients in 21 different countries. The most common surgical indication was for fetal-maternal pathologies, accounting for 25,548 of 65,373 (39.1%) of all cases. The most common procedure was a Cesarean delivery, accounting for a total of 24,182 or 25.9% of all procedures. Herniorrhaphies (9,873/93,385, 10.6%) and minor surgeries (11,332/93,385, 12.1%), including wound debridement, abscess drainage and circumcision, were also common. A basic skill set that includes the ability to provide surgical care for a wide variety of surgical morbidities is urgently needed to cope with the surgical need of humanitarian emergencies. This review of Médecins Sans Frontières's operative procedures provides valuable insight into the types of operations with which an aspiring volunteer surgeon should be familiar. Copyright © 2014 Mosby, Inc. All rights reserved.

Measurement of predictive validity in violence risk assessment studies: a second-order systematic review.

PubMed

Singh, Jay P; Desmarais, Sarah L; Van Dorn, Richard A

2013-01-01

The objective of the present review was to examine how predictive validity is analyzed and reported in studies of instruments used to assess violence risk. We reviewed 47 predictive validity studies published between 1990 and 2011 of 25 instruments that were included in two recent systematic reviews. Although all studies reported receiver operating characteristic curve analyses and the area under the curve (AUC) performance indicator, this methodology was defined inconsistently and findings often were misinterpreted. In addition, there was between-study variation in benchmarks used to determine whether AUCs were small, moderate, or large in magnitude. Though virtually all of the included instruments were designed to produce categorical estimates of risk - through the use of either actuarial risk bins or structured professional judgments - only a minority of studies calculated performance indicators for these categorical estimates. In addition to AUCs, other performance indicators, such as correlation coefficients, were reported in 60% of studies, but were infrequently defined or interpreted. An investigation of sources of heterogeneity did not reveal significant variation in reporting practices as a function of risk assessment approach (actuarial vs. structured professional judgment), study authorship, geographic location, type of journal (general vs. specialized audience), sample size, or year of publication. Findings suggest a need for standardization of predictive validity reporting to improve comparison across studies and instruments. Copyright © 2013 John Wiley & Sons, Ltd.

OLEM Performance Assessment Information

EPA Pesticide Factsheets

This asset includes a variety of data sets that measure the performance of Office of Land and Emergency Management (OLEM) programs in support of the Office of the Chief Financial Officer's Annual Commitment System (ACS) and Performance Evaluation Reporting System (PERS). Information is drawn from OLEM's ACRES, RCRAInfo, CERCLIS/SEMS, ICIS, and LUST4 systems, as well as input manually by authorized individuals in OLEM's program offices. Information is reviewed by OLEM program staff prior to being pushed to ACS and entered into PERS. This data asset also pulls in certain performance information input directly by Regional Office staff into ACS. Information is managed by the Performance Assessment Tool (PAT) and displayed in the PAT Dashboard.Information in this asset include:--Government Performance and Results Act (GPRA) of 1993: Measures reported for Innovations, Partnerships and Communications Office (IPCO), the Office of Brownfields and Land Revitalization (OBLR), the Office of Emergency Management (OEM), the Office of Resource Conservation and Recovery (ORCR), the Office of Superfund Remediation and Technology Innovation (OSRTI), and the Office of Underground Storage Tanks (OUST).-- Performance and Environmental Results System (PERS): Includes OLEM's information on performance results and baselines for the EPA Annual Plan and Budget.--Key Performance Indicators: OLEM has identified five KPIs that are tracked annually.--Integrated Cleanup Initiative: A pilot pe

A framework to support decision making in the selection of sustainable drainage system design alternatives.

PubMed

Wang, Mingming; Sweetapple, Chris; Fu, Guangtao; Farmani, Raziyeh; Butler, David

2017-10-01

This paper presents a new framework for decision making in sustainable drainage system (SuDS) scheme design. It integrates resilience, hydraulic performance, pollution control, rainwater usage, energy analysis, greenhouse gas (GHG) emissions and costs, and has 12 indicators. The multi-criteria analysis methods of entropy weight and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) were selected to support SuDS scheme selection. The effectiveness of the framework is demonstrated with a SuDS case in China. Indicators used include flood volume, flood duration, a hydraulic performance indicator, cost and resilience. Resilience is an important design consideration, and it supports scheme selection in the case study. The proposed framework will help a decision maker to choose an appropriate design scheme for implementation without subjectivity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Training future doctors to be patient-centred: efficacy of a communication skills training (CST) programme in a Malaysian medical institution.

PubMed

Lukman, H; Beevi, Z; Yeap, R

2009-03-01

This study evaluates the efficacy of the preclinical communication skills training (CST) programme at the International Medical University in Malaysia. Efficacy indicators include students' (1) perceived competency (2) attitude (3) conceptual knowledge, and (4) performance with regard to patient-centred communication. A longitudinal study with a before-after design tracked a preclinical cohort's progress on the aforementioned indicators as they advance through the training. Results indicate that following the CST, students perceived themselves to be more competent in interpersonal communication, had more positive attitude towards patient-centred communication, and developed a better conceptual knowledge of doctor-patient communication. In addition, those with good conceptual knowledge tend to demonstrate better communication skills performance at the Objective Structure Clinical Examination 12 months following the initial CST.

Assessment of a Hospital Palliative Care Unit (HPCU) for Cancer Patients; A Conceptual Framework.

PubMed

Rouhollahi, Mohammad Reza; Saghafinia, Masoud; Zandehdel, Kazem; Motlagh, Ali Ghanbari; Kazemian, Ali; Mohagheghi, Mohammad Ali; Tahmasebi, Mamak

2015-01-01

The first hospital palliative care unit (HPCU) in Iran (FARS-HPCU) has been established in 2008 in the Cancer Institute, which is the largest referral cancer center in the country. We attempted to assess the performance of the HPCU based on a comprehensive conceptual framework. The main aim of this study was to develop a conceptual framework for assessment of the HPCU performances through designing a value chain in line with the goals and the main processes (core and support). We collected data from a variety of sources, including international guidelines, international best practices, and expert opinions in the country and compared them with national policies and priorities. We also took into consideration the trend of the HPCU development in the Cancer Institute of Iran. Through benchmarking the gap area with the performance standards, some recommendations for better outcome are proposed. The framework for performance assessment consisted of 154 process indicators (PIs), based on which the main stakeholders of the HPCU (including staff, patients, and families) offered their scoring. The outcome revealed the state of the processes as well as the gaps. Despite a significant improvement in many processes and indicators, more development in the comprehensive and integrative aspects of FARS-HPCU performance is required. Consideration of all supportive and palliative requirements of the patients through interdisciplinary and collaborative approaches is recommended.

Biomonitoring of Environmental Status and Trends (BEST) Program: selected methods for monitoring chemical contaminants and their effects in aquatic ecosystems

USGS Publications Warehouse

Schmitt, Christopher J.; Dethloff, Gail M.

2000-01-01

This document describes the suite of biological methods of the U.S. Geological Survey- Biomonitoring of Environmental Status and Trends program for monitoring chemical contaminants and their effects on fish. The methods, which were selected by panels of experts, are being field-tested in rivers of the Mississippi River, Columbia River, and Rio Grande basins. General health biomarkers include a health assessment index based on gross observation; histopathological examination of selected organs and tissues; condition factor; and the heptosomatic and splenosomatic indices. Immune system indicators are plasma lysozyme activity and measures of splenic macrophage aggregates. Reproductive biomarkers include plasma concentrations of sex steroid hormones (17b-estradiol and 11-ketotestosterone) and vitellogenin, gonadal histopathology (including reproductive stage and, in females, gonadal atresia), and the gonadosomatic index. Indicators of exposure to polycyclic aromatic and polyhalogenated hydrocarbons are the H4IIE rat hepatoma cell bioassay (performed on solvent extracts of composite fish samples) and hepatic ethoxyresorufin-O-deethylase activity. Stable nitrogen isotope ratios are used to assess the trophic position of the fish and their exposure to sewage and other animal wastes. For each indicator we describe endpoint(s) and methods, and discuss the indicator?s value and limitations for contaminant monitoring and assessment.

The calibration of specular gloss meters and gloss plates

NASA Astrophysics Data System (ADS)

Li, Tiecheng; Lai, Lei; Yin, Dejin; Ji, Muyao; Lin, Fangsheng; Shi, Leibing; Xia, Ming; Fu, Yi

2017-10-01

Specular gloss is the perception by an observer of the mirror-like appearance of a surface. Specular gloss is usually measured by a glossmeter, which can be calibrated by a group of gloss plates according to JJG 696-2015. The characteristics of a gloss meter include stability, zero error, and error of indication. The characteristics of a gloss plate include roughness and spectral transmissivity of a high gloss plate, spectral reflectivity of a ceramic gloss plate. The experiment results indicate that calibration of both gloss meters and gloss plates should be carefully performed according to the latest verification regulation in order to reduce the measurement error.

Predicting hydrological response to forest changes by simple statistical models: the selection of the best indicator of forest changes with a hydrological perspective

NASA Astrophysics Data System (ADS)

Ning, D.; Zhang, M.; Ren, S.; Hou, Y.; Yu, L.; Meng, Z.

2017-01-01

Forest plays an important role in hydrological cycle, and forest changes will inevitably affect runoff across multiple spatial scales. The selection of a suitable indicator for forest changes is essential for predicting forest-related hydrological response. This study used the Meijiang River, one of the headwaters of the Poyang Lake as an example to identify the best indicator of forest changes for predicting forest change-induced hydrological responses. Correlation analysis was conducted first to detect the relationships between monthly runoff and its predictive variables including antecedent monthly precipitation and indicators for forest changes (forest coverage, vegetation indices including EVI, NDVI, and NDWI), and by use of the identified predictive variables that were most correlated with monthly runoff, multiple linear regression models were then developed. The model with best performance identified in this study included two independent variables -antecedent monthly precipitation and NDWI. It indicates that NDWI is the best indicator of forest change in hydrological prediction while forest coverage, the most commonly used indicator of forest change is insignificantly related to monthly runoff. This highlights the use of vegetation index such as NDWI to indicate forest changes in hydrological studies. This study will provide us with an efficient way to quantify the hydrological impact of large-scale forest changes in the Meijiang River watershed, which is crucial for downstream water resource management and ecological protection in the Poyang Lake basin.

Listening Better to Look Better: The Manipulation of Linguistic Devices and Listening Skills in the Writing of "Booters," a Play for Young People

ERIC Educational Resources Information Center

Dickenson, Sarah Jane

2006-01-01

As someone who writes plays specifically for young people, this author believes she has a responsibility to create texts which are structured to help young performers extend their performance skills. This can and should include effective use of linguistic devices as well as indicating possibilities for physical gesture. The author contends that,…

Swimming Performance of Adult Asian Carp: Field Assessment Using a Mobile Swim Tunnel

DTIC Science & Technology

2016-08-01

The effect of temperature on swimming performance and oxygen consumption in adult sockeye (Oncorhynchus nerka) and coho (O. kisutch) salmon stocks...tunnel to determine the critical swim speed (Ucrit), oxygen consumption (VO2), and endurance at a single velocity. Tunnel Type Tunnel Size (L...specially designed mobile swim tunnel indicated that it might be used effectively with other large, active, free-swimming planktivores, including bigheaded

Robotic vascular resections during Whipple procedure.

PubMed

Allan, Bassan J; Novak, Stephanie M; Hogg, Melissa E; Zeh, Herbert J

2018-01-01

Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vascular resections. This report outlines our technique.

Skin grafts: a rural general surgical perspective.

PubMed

Henderson, Nigel J; Fancourt, Michael; Gilkison, William; Kyle, Stephen; Mosquera, Damien

2009-05-01

Skin grafts are a common method of closing skin defects. The literature comparing methods of graft application and subsequent outcomes is poor, but reports indicate a graft failure rate between 2 and 30%. The aim of this study was to audit our current skin graft practice. Data were collected prospectively on all skin grafts performed by the general surgical department between 1st December 2005 and 1st December 2006. A standardized proforma on each patient included data on age, gender, graft indication, application method, comorbidities, length of stay, and graft outcomes including graft take at 1, 2 and 6 weeks post-operatively. There were 85 grafts performed on 74 patients, median age 72 years (9-102 years), with 10 (12%) acute admissions. Prophylactic antibiotics were given to 50% (38 of 74) of patients. Successful grafts (>80% take) were performed in 68 (80%) patients. The overall graft complication rate was 24.7% (22 of 85 grafts). Infection occurred in 13 of 17 graft failures. No patients underwent re-operation for graft failure. Patients who received prophylactic antibiotics had a reduced risk of graft failure (Fisher's exact test, P = 0.016). Skin grafts were performed successfully in the majority of patients. Graft complication and failure rates compare well with the world literature. The use of prophylactic antibiotics was the only predictor of successful graft take.

Dedicated health systems strengthening of the Global Fund to Fight AIDS, Tuberculosis, and Malaria: an analysis of grants.

PubMed

Fan, Victoria Y; Tsai, Feng-Jen J; Shroff, Zubin C; Nakahara, Branden; Vargha, Nabil; Weathers, Scott

2017-01-01

This study aims to understand the determinants of the Global Fund to Fight AIDS, Tuberculosis, and Malaria's dedicated channel for health systems strengthening (HSS) funding across countries and to analyze their health system priorities expressed in budgets and performance indicators. We obtained publicly available data for disease-specific and HSS grants from the Global Fund over 2004-2013 prior to the new funding model. Regression analysis was employed to assess the determinants of dedicated HSS funding across 111 countries. Documents for 27 dedicated HSS grants including budgets and performance indicators were collected, and activities were analyzed by health system functions. HSS funding per capita is significantly associated with TB and HIV funding per capita, but not per capita income and health worker density. Of 27 dedicated HSS grants, 11 had line-item budgets publicly available, in which health workforce and medical products form the majority (89% or US$132 million of US$148 million) of funds. Yet these areas accounted for 41.7% (215) of total 516 performance indicators. Health worker densities were not correlated with HSS funding, despite the emphasis on health workforce in budgets and performance indicators. Priorities in health systems in line-item budgets differ from the numbers of indicators used. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Characterization of biofilm in 200W fluidized bed reactors

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

Lee, Michelle H.; Saurey, Sabrina D.; Lee, Brady D.

2014-09-29

Contaminated groundwater beneath the 200 West Area at the Hanford Site in Southeast Washington is currently being treated using a pump and treat system to remove organics, inorganics, radionuclides, and metals. A granular activated carbon-based fluidized bed reactor (FBR) has been added to remove nitrate, hexavalent chromium and carbon tetrachloride. Initial analytical results indicated the microorganisms effectively reduced many of the contaminants to less than cleanup levels. However shortly thereafter operational upsets of the FBR include carbon carry over, over production of microbial extracellular polymeric substance (biofilm) materials, and over production of hydrogen sulfide. As a result detailed investigations weremore » undertaken to understand the functional diversity and activity of the microbial community present in the FBR over time. Molecular analyses including terminal restriction fragment length polymorphism analysis, quantitative polymerase chain reaction and fluorescent in situ hybridization analyses were performed on the microbial community extracted from the biofilm within the bed and from the inoculum, to determine functional dynamics of the FBR bed over time and following operational changes. Findings from these analyses indicated: 1) the microbial community within the bed was completely different than community used for inoculation, and was likely from the groundwater; 2) analyses early in the testing showed an FBR community dominated by a few Curvibacter and Flavobacterium species; 3) the final sample taken indicated that the microbial community in the FBR bed had become more diverse; and 4) qPCR analyses indicated that bacteria involved in nitrogen cycling, including denitrifiers and anaerobic ammonia oxidizing bacteria, were dominant in the bed. These results indicate that molecular tools can be powerful for determining functional diversity within FBR type reactors. Coupled with micronutrient, influent and effluent chemistry evaluations, a more complete understanding of the balance between system additions (nutrients, groundwater) and biology can be achieved, thus increasing long-term predictions of performance. These analyses uniquely provide information that can be used in optimizing the overall performance, efficiency, and stability of the system both in real time as well as over the long-term, as the system design is altered or improved and/or new streams are added.« less

Biomarkers of Fatigue: Metabolomics Profiles Predictive of Cognitive Performance

DTIC Science & Technology

2013-05-01

metabolites. The latest version of the Human Metabolome Database (v. 2.5; released August , 2009) includes approximately 8,000 identified mammalian...monoamine oxidase; COMT , catechol-O-methyl transferase. (Modiefied from Rubí and Maechler, 2010). Ovals indicate metabolites found to be significantly

Personality Development in Public School Children. Final Report.

ERIC Educational Resources Information Center

Watt, Norman F.

Investigators compared the emotional adjustment, intellectual functioning, scholastic performance, and social behavior of 54 children who became schizophrenic mental patients with that of 143 matched controls. The following conclusions were drawn: indications of potential schizophrenia include behavioral and emotional deviation in childhood, death…

Human Factors of CC-130 Operations: Training Systems Knowledge

DTIC Science & Technology

1999-03-01

M Multimedia, Ltd. Describes their Integrated Training and Performance Support ( ITPS ) Design Methodology, which includes 5 types of goals... IBM , and American Airlines indicate that "computer-based multimedia produced a savings of 68% over conventional classroom training" (p. 4

Performance assessment in algebra learning process

NASA Astrophysics Data System (ADS)

Lestariani, Ida; Sujadi, Imam; Pramudya, Ikrar

2017-12-01

The purpose of research to describe the implementation of performance assessment on algebra learning process. The subject in this research is math educator of SMAN 1 Ngawi class X. This research includes descriptive qualitative research type. Techniques of data collecting are done by observation method, interview, and documentation. Data analysis technique is done by data reduction, data presentation, and conclusion. The results showed any indication that the steps taken by the educator in applying the performance assessment are 1) preparing individual worksheets and group worksheets, 2) preparing rubric assessments for independent worksheets and groups and 3) making performance assessments rubric to learners’ performance results with individual or groups task.

Performance Evaluation of Public Non-Profit Hospitals Using a BP Artificial Neural Network: The Case of Hubei Province in China

PubMed Central

Li, Chunhui; Yu, Chuanhua

2013-01-01

To provide a reference for evaluating public non-profit hospitals in the new environment of medical reform, we established a performance evaluation system for public non-profit hospitals. The new “input-output” performance model for public non-profit hospitals is based on four primary indexes (input, process, output and effect) that include 11 sub-indexes and 41 items. The indicator weights were determined using the analytic hierarchy process (AHP) and entropy weight method. The BP neural network was applied to evaluate the performance of 14 level-3 public non-profit hospitals located in Hubei Province. The most stable BP neural network was produced by comparing different numbers of neurons in the hidden layer and using the “Leave-one-out” Cross Validation method. The performance evaluation system we established for public non-profit hospitals could reflect the basic goal of the new medical health system reform in China. Compared with PLSR, the result indicated that the BP neural network could be used effectively for evaluating the performance public non-profit hospitals. PMID:23955238

The Alpha consensus meeting on cryopreservation key performance indicators and benchmarks: proceedings of an expert meeting.

PubMed

2012-08-01

This proceedings report presents the outcomes from an international workshop designed to establish consensus on: definitions for key performance indicators (KPIs) for oocyte and embryo cryopreservation, using either slow freezing or vitrification; minimum performance level values for each KPI, representing basic competency; and aspirational benchmark values for each KPI, representing best practice goals. This report includes general presentations about current practice and factors for consideration in the development of KPIs. A total of 14 KPIs were recommended and benchmarks for each are presented. No recommendations were made regarding specific cryopreservation techniques or devices, or whether vitrification is 'better' than slow freezing, or vice versa, for any particular stage or application, as this was considered to be outside the scope of this workshop. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Evaluation of feedback interventions for improving the quality assurance of cancer screening in Japan: study design and report of the baseline survey.

PubMed

Machii, Ryoko; Saika, Kumiko; Higashi, Takahiro; Aoki, Ayako; Hamashima, Chisato; Saito, Hiroshi

2012-02-01

The importance of quality assurance in cancer screening has recently gained increasing attention in Japan. To evaluate and improve quality, checklists and process indicators have been developed. To explore effective methods of enhancing quality in cancer screening, we started a randomized control study of the methods of evaluation and feedback for cancer control from 2009 to 2014. We randomly assigned 1270 municipal governments, equivalent to 71% of all Japanese municipal governments that performed screening programs, into three groups. The high-intensity intervention groups (n = 425) were individually evaluated using both checklist performance and process indicator values, while the low-intensity intervention groups (n= 421) were individually evaluated on the basis of only checklist performance. The control group (n = 424) received only a basic report that included the national average of checklist performance scores. We repeated the survey for each municipality's quality assurance activity performance using checklists and process indicators. In this paper, we report our study design and the result of the baseline survey. The checklist adherence rates were especially low in the checklist elements related to invitation of individuals, detailed monitoring of process indicators such as cancer detection rates according to screening histories and appropriate selection of screening facilities. Screening rate and percentage of examinees who underwent detailed examination tended to be lower for large cities when compared with smaller cities for all cancer sites. The performance of the Japanese cancer screening program in 2009 was identified for the first time.

Materials Selection for Aerospace Systems

NASA Technical Reports Server (NTRS)

Arnold, Steven M.; Cebon, David; Ashby, Mike

2012-01-01

A systematic design-oriented, five-step approach to material selection is described: 1) establishing design requirements, 2) material screening, 3) ranking, 4) researching specific candidates and 5) applying specific cultural constraints to the selection process. At the core of this approach is the definition performance indices (i.e., particular combinations of material properties that embody the performance of a given component) in conjunction with material property charts. These material selection charts, which plot one property against another, are introduced and shown to provide a powerful graphical environment wherein one can apply and analyze quantitative selection criteria, such as those captured in performance indices, and make trade-offs between conflicting objectives. Finding a material with a high value of these indices maximizes the performance of the component. Two specific examples pertaining to aerospace (engine blades and pressure vessels) are examined, both at room temperature and elevated temperature (where time-dependent effects are important) to demonstrate the methodology. The discussion then turns to engineered/hybrid materials and how these can be effectively tailored to fill in holes in the material property space, so as to enable innovation and increases in performance as compared to monolithic materials. Finally, a brief discussion is presented on managing the data needed for materials selection, including collection, analysis, deployment, and maintenance issues.

Performance Assessment of IT Governance with Balanced Score Card and COBIT 4.1 of Universitas Pendidikan Indonesia

NASA Astrophysics Data System (ADS)

Wijayanti, N. Y.; Setiawan, W.; Sukamto, R. A.

2017-02-01

Information technology’s application has become an important daily support for all sectors. Educational institutions, including Universitas Pendidikan Indonesia (UPI), enable information technology as the main asset to increase its qualities and global’s competitive power. By the importances of using information technology for almost every scope, measurement is needed to identify how optimal the IT governance is. Based on these facts, the purposes of this reaseacrh are identify the IT governance’s performance assessment indicators, discover the scores based on the indicators, and analyse IT governance’s performance in UPI. This research is using the combination of Balanced Score Card (BSC) and COBIT 4.1 as the framework to establish assessment indicators in questionnaire’s form. By combining both methods, the final scores of IT governance’s performance will represent UPI’s business goals and objectives in all sectors. This research used 26 COBIT’s processes as assessment indicator of IT performance from the maping 15 IT and business goals of COBIT, and 17 UPI’s strategic plans. The final score are 3.80 for financial perspective, 3.63 for customer perspective, 3.62 for internal business process perspective, and 3.72 for learning and growth perspective. With these scores, then the final result is each perspectives of Balanced Score Card’s current maturity levels are at level 4, which is IT process criticality is regularly defined with full support and agreement from the relevant business process owners.

Physician level reporting of surgical and pathology performance indicators: a regional study to assess feasibility and impact on quality.

PubMed

McFadyen, Craig; Lankshear, Sara; Divaris, Dimitrios; Berry, Mark; Hunter, Amber; Srigley, John; Irish, Jonathan

2015-02-01

There is increased awareness that, to minimize variation in clinician practice and improve quality, performance reporting should be implemented at the provider level. This optimizes physician engagement and creates a sense of professional responsibility for quality and performance measurement at the individual and organizational levels. Individual provider level reporting was implemented within a provincial health region involving 56 clinicians (general surgeons, surgical oncologists, urologists and pathologists). The 2 surgical pathology indicators chosen were colorectal cancer (CRC) lymph node retrieval rate and pT2 prostate cancer margin positivity rate. Surgical resections for all prostate and colorectal cancer performed between Jan. 1, 2011, and Mar. 30, 2012, were included. We used a pre- and postsurvey design to obtain physician perceptions and focus groups with program leadership to determine organizational impact. Survey results showed that respondents felt the data provided in the reports were valid (67%), consistent with expectations (70%), maintained confidentiality (80%) and were not used in a punitive manner (77%). During the study period the pT2 prostate margin positivity rate decreased from 57.1% to 27.5%. For the CRC lymph node retrieval rate indicator, high baseline performance was maintained. We developed a robust process for providing physicians with confidential, individualized surgical and pathology quality indicator reports. Our results reinforce the importance of individual physician feedback as a strategy for improving and sustaining quality in surgical and diagnostic oncology.

Impact of point-of-care ultrasound on clinical decision-making at an urban emergency department in Tanzania.

PubMed

Reynolds, Teri Ann; Amato, Stas; Kulola, Irene; Chen, Chuan-Jay Jeffrey; Mfinanga, Juma; Sawe, Hendry Robert

2018-01-01

Point of care ultrasound (PoCUS) is an efficient, inexpensive, safe, and portable imaging modality that can be particularly useful in resource-limited settings. However, its impact on clinical decision making in such settings has not been well studied. The objective of this study is to describe the utilization and impact of PoCUS on clinical decision making at an urban emergency department in Dar es Salaam, Tanzania. This was a prospective descriptive cross-sectional study of patients receiving PoCUS at Muhimbili National Hospital's Emergency Medical Department (MNH EMD). Data on PoCUS studies during a period of 10 months at MNH EMD was collected on consecutive patients during periods when research assistants were available. Data collected included patient age and sex, indications for ultrasound, findings, interpretations, and provider-reported diagnostic impression and disposition plan before and after PoCUS. Descriptive statistics, including medians and interquartile ranges, and counts and percentages, are reported. Pearson chi squared tests and p-values were used to evaluate categorical data for significant differences. PoCUS data was collected for 986 studies performed on 784 patients. Median patient age was 32 years; 56% of patients were male. Top indications for PoCUS included trauma, respiratory presentations, and abdomino-pelvic pain. The most frequent study types performed were eFAST, cardiac, and obstetric or gynaecologic studies. Overall, clinicians reported that the use of PoCUS changed either diagnostic impression or disposition plan in 29% of all cases. Rates of change in diagnostic impression or disposition plan increased to 45% in patients for whom more than one PoCUS study type was performed. In resource-limited emergency care settings, PoCUS can be utilized for a wide range of indications and has substantial impact on clinical decision making, especially when more than one study type is performed.

Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa

PubMed Central

Tripathi, Vandana; Stanton, Cynthia; Strobino, Donna; Bartlett, Linda

2015-01-01

Background High quality care is crucial in ensuring that women and newborns receive interventions that may prevent and treat birth-related complications. As facility deliveries increase in developing countries, there are concerns about service quality. Observation is the gold standard for clinical quality assessment, but existing observation-based measures of obstetric quality of care are lengthy and difficult to administer. There is a lack of consensus on quality indicators for routine intrapartum and immediate postpartum care, including essential newborn care. This study identified key dimensions of the quality of the process of intrapartum and immediate postpartum care (QoPIIPC) in facility deliveries and developed a quality assessment measure representing these dimensions. Methods and Findings Global maternal and neonatal care experts identified key dimensions of QoPIIPC through a modified Delphi process. Experts also rated indicators of these dimensions from a comprehensive delivery observation checklist used in quality surveys in sub-Saharan African countries. Potential QoPIIPC indices were developed from combinations of highly-rated indicators. Face, content, and criterion validation of these indices was conducted using data from observations of 1,145 deliveries in Kenya, Madagascar, and Tanzania (including Zanzibar). A best-performing index was selected, composed of 20 indicators of intrapartum/immediate postpartum care, including essential newborn care. This index represented most dimensions of QoPIIPC and effectively discriminated between poorly and well-performed deliveries. Conclusions As facility deliveries increase and the global community pays greater attention to the role of care quality in achieving further maternal and newborn mortality reduction, the QoPIIPC index may be a valuable measure. This index complements and addresses gaps in currently used quality assessment tools. Further evaluation of index usability and reliability is needed. The availability of a streamlined, comprehensive, and validated index may enable ongoing and efficient observation-based assessment of care quality during labor and delivery in sub-Saharan Africa, facilitating targeted quality improvement. PMID:26107655

Low yield of routine duodenal biopsies for evaluation of abdominal pain

PubMed Central

Dubin, Sterling M; Kwong, Wilson T; Kalmaz, Denise; Savides, Thomas J

2015-01-01

AIM: To determine the yield of biopsying normal duodenal mucosa for investigation of abdominal pain. METHODS: This is a retrospective chart review of consecutive patients who underwent esophagogastroduodenoscopy (EGD) with duodenal biopsies of normal appearing duodenal mucosa for an indication that included abdominal pain. All the patients in this study were identified from an electronic endoscopy database at a single academic medical center and had an EGD with duodenal biopsies performed over a 4-year period. New diagnoses that were made as a direct result of duodenal biopsies were identified. All duodenal pathology reports and endoscopy records were reviewed for indications to perform the examination as well as the findings; all the medical records were reviewed. Exclusion criteria included age less than 18 years, duodenal mass, nodule, or polyp, endoscopic duodenitis, duodenal scalloping, known celiac disease, positive celiac serology, Crohns disease, or history of bone marrow transplant. Information was collected in a de-identified database with pertinent demographic information including human immunodeficiency virus (HIV) status, and descriptive statistics were performed. RESULTS: About 300 patients underwent EGD with biopsies of benign appearing or normal appearing duodenal mucosa. The mean age of patients was 44.1 ± 16.8 years; 189 of 300 (63%) were female. A mean of 4.3 duodenal biopsies were performed in each patient. In the subgroup of patients with abdominal pain without anemia, diarrhea, or weight loss the mean age was 43.4 ± 16.3 years. Duodenal biopsies performed for an indication that included abdominal pain resulting in 4 new diagnoses (3 celiac disease and 1 giardiasis) for an overall yield of 1.3%. 183 patients with abdominal pain without anemia, diarrhea, or weight loss (out of the total 300 patients) underwent duodenal biopsy of duodenal mucosa resulting in three new diagnoses (two cases of celiac disease and one giardiasis) for a yield of 1.6%. Duodenal biopsies of 19 HIV patients presenting for evaluation of abdominal pain did not reveal any new diagnoses. Information pertaining to new diagnoses is provided. CONCLUSION: Routine biopsy of normal appearing duodena in patients with abdominal pain should be reserved for those with a high pre-test probability given its low diagnostic yield. PMID:26139995

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

PubMed

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

2015-03-01

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

Vulvar intraepithelial neoplasia--the need for auditable measures of management.

PubMed

Athavale, Ram; Naik, R; Godfrey, K A; Cross, P; Hatem, M H; de Barros Lopes, A

2008-03-01

Surgical excision is currently the standard treatment for vulvar intraepithelial neoplasia (VIN). To date it has proved difficult to evaluate the management of VIN in reported series due to heterogeneity in datasets. The objective of this study was to justify standardised data presentation to permit comparison between series and facilitate determination of an optimal strategy for management of VIN. We propose auditable indicators of performance to benchmark management and outcomes. This may also enable definition of a surgical control arm for future novel therapy studies. Data from the Northern Gynaecological Oncology Centre (NGOC), UK on women with proven VIN diagnosed between 1989 and 2004 who attended the vulvar review clinic are presented and analysed alongside three large retrospective series by Jones et al. [Jones RW, Rowan DM, Stewart AW. Vulvar intraepithelial neoplasia: aspects of the natural history and outcome in 405 women. Obstet Gynecol 2005;106(6):1319-26], Herod et al. [Herod JJ, Shafi MI, Rollason TP, Jordan JA, Luesley DM. Vulvar intraepithelial neoplasia: long term follow up of treated and untreated women. Br J Obstet Gynaecol 1996;103(5):446-52], McNally et al. [McNally OM, Mulvany NJ, Pagano R, Quinn MA, Rome RM. VIN 3: a clinicopathologic review. Int J Gynecol Cancer 2002;12(5):490-5] against proposed performance indicators to illustrate the deficiencies in current data presentation. Demographics and indicators such as degree of pathological expertise, definition of early stromal invasion and use of International Society for the study of Vulvovaginal Disease (ISSVD) classification were usually well documented. The description of lesions including size and focality were not always documented, nor the proportion examined by co-specialists. Numbers of primary treatments were well described but the indications for treatment, completeness of excision and VIN subclassification were not. Subsequent surgical treatments were inconsistently reported including the pathological details and intervals between treatments. Symptomatology was not well reported. Information on follow-up intervals and duration of follow-up with an indication of patient compliance was inadequate. Outcome data on recurrence of VIN and progression to carcinoma (early stromal invasion or frankly invasive carcinoma) were included in all series. Consensus on the ideal management of VIN or evaluation of new strategies will prove impossible without standardised data presentation. We propose a number of performance indicators that will facilitate evaluation of future studies or series against the current benchmark of surgical treatment for VIN.

Perceptions of transcatheter device closure of patent ductus arteriosus in veterinary cardiology and evaluation of a canine model to simulate device placement: a preliminary study.

PubMed

Saunders, A B; Keefe, L; Birch, S A; Wierzbicki, M A; Maitland, D J

2017-06-01

The purpose of this study was to evaluate a canine patent ductus arteriosus (PDA) model developed for practicing device placement and to determine practices and perceptions regarding transcatheter closure of PDA from the veterinary cardiology community. A silicone model was developed from images obtained from a dog with a PDA and device placement was performed with catheter equipment and a document camera to simulate fluoroscopy. A total of 36 individuals including 24 diplomates and 12 residents participated, and the feedback was obtained. The study included an initial questionnaire, practice with the model, observation of device placement using the model, and a follow-up questionnaire. A total of 92% of participants including 100% of residents indicated they did not have the opportunity to practice device placement before performing the procedure and obtained knowledge of the procedure from reading journal articles or observation. Participants indicated selecting the appropriate device size (30/36, 83%) and ensuring the device is appropriately positioned before release (18/36, 50%) as the most common areas of difficulty with device placement. Confidence level was higher after practicing with the model for residents when compared with diplomates and for participants that had performed 1-15 procedures when compared with those that had performed >15 procedures. These findings suggest those that have performed fewer procedures may benefit the most from practicing with a model. This preliminary study demonstrates the feasibility of a PDA model for practicing device placement and suggests that there is a potential benefit from providing additional training resources. Copyright © 2017 Elsevier B.V. All rights reserved.

[Assessment of decontamination processes: cleaning, disinfection and sterilization in dental practice in Poland in the years 2011-2012].

PubMed

Röhm-Rodowald, Ewa; Jakimiak, Bozenna; Chojecka, Agnieszka; Zmuda-Baranowska, Magdalena; Kanclerski, Krzysztof

2012-01-01

Effective decontamination of instruments is a key element of infection control and the provision of high quality in dental care. The aim of the study was to evaluate the efficiency of decontamination procedures including cleaning, disinfection and sterilization of re-usable instruments in dental practices in Poland. The efficiency of disinfection and sterilization processes have been evaluated on the results of the questionnaires. The following information were taken into account: setting where disinfection and sterilization had been performed, preparation of dental equipment for sterilization (disinfection, washing and cleaning, packaging), the types of autoclaves and used types of sterilization cycles, routine monitoring and documentation of sterilization processes, treatment of handpieces and the frequency of surface decontamination. Data were collected from 43 dental practices (35 dental offices and 8 clinics). Disinfection and cleaning processes were performed manually in 63% of dental offices and ultrasonic baths were used in 53% of settings. Washer disinfectors were used in 23% of dental practices: in every researched clinic and in a few dental offices. All sterilization processes were performed in steam autoclaves, mainly in small steam sterilizers (81%). Dental handpieces were sterilized in 72% of practices, but only 33% of them performed sterilization in recommended cycle B. Sterilization processes were monitored with chemical indicators in 33% of practices. Biological monitoring of the processes was carried out at different intervals. Incorrect documentation of instruments and surfaces decontamination was recorded in several settings. There is still a need for improvement of decontamination processes in dental practice in Poland. Areas for improvement include: replacement of manual cleaning and disinfection processes with automatic processes, sterilization of dental handpieces after each patient, monitoring of a sterilization process with chemical and biological indicators. Reported incorrect procedures in decontamination of medical devices performed by questioned dentists and lack or inadequate response to asked questions indicate the lack of adequate knowledge about decontamination. Personnel who performs decontamination processes should be continuously trained.

Is MMTV associated with human breast cancer? Maybe, but probably not.

PubMed

Perzova, Raisa; Abbott, Lynn; Benz, Patricia; Landas, Steve; Khan, Seema; Glaser, Jordan; Cunningham, Coleen K; Poiesz, Bernard

2017-10-13

Conflicting results regarding the association of MMTV with human breast cancer have been reported. Published sequence data have indicated unique MMTV strains in some human samples. However, concerns regarding contamination as a cause of false positive results have persisted. We performed PCR assays for MMTV on human breast cancer cell lines and fresh frozen and formalin fixed normal and malignant human breast epithelial samples. Assays were also performed on peripheral blood mononuclear cells from volunteer blood donors and subjects at risk for human retroviral infections. In addition, assays were performed on DNA samples from wild and laboratory mice. Sequencing of MMTV positive samples from both humans and mice were performed and phylogenetically compared. Using PCR under rigorous conditions to prevent and detect "carryover" contamination, we did detect MMTV DNA in human samples, including breast cancer. However, the results were not consistent and seemed to be an artifact. Further, experiments indicated that the probable source of false positives was murine DNA, containing endogenous MMTV, present in our building. However, comparison of published and, herein, newly described MMTV sequences with published data, indicates that there are some very unique human MMTV sequences in the literature. While we could not confirm the true presence of MMTV in our human breast cancer subjects, the data indicate that further, perhaps more traditional, retroviral studies are warranted to ascertain whether MMTV might rarely be the cause of human breast cancer.

Developing a holistic accreditation system for medical universities of the Islamic Republic of Iran.

PubMed

Yousefy, A; Changiz, T; Yamani, N; Zahrai, R H; Ehsanpour, S

2009-01-01

This report describes the steps in the development of an accreditation system for medical universities in the Islamic Republic of Iran. The national accreditation project, supported by the government, was performed from 2001 to 2005. The project was carried out in 3 main phases, each phase including a number of tasks. After a review of the international literature on accreditation and through national consensus, a set of national institutional accreditation standards was developed, including 95 standards and 504 indicators in 10 areas. By complying with accepted national standards, Iranian medical universities will play an important role in promoting health system performance.

77 FR 37684 - National Library of Medicine; Notice of Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... for Biomedical Communications. The meeting will be open to the public as indicated below, with... National Library of Medicine, including consideration of personnel qualifications and performance, and the...

10 CFR 712.13 - Supervisory review.

Code of Federal Regulations, 2012 CFR

2012-01-01

... HRP management official. Types of behavior and conditions that would indicate a concern include, but...) Irresponsibility in performing assigned duties; (10) Inability to deal with stress, or the appearance of being under unusual stress; (11) Failure to comply with work directives, hostility or aggression toward fellow...

10 CFR 712.13 - Supervisory review.

Code of Federal Regulations, 2011 CFR

2011-01-01

... HRP management official. Types of behavior and conditions that would indicate a concern include, but...) Irresponsibility in performing assigned duties; (10) Inability to deal with stress, or the appearance of being under unusual stress; (11) Failure to comply with work directives, hostility or aggression toward fellow...

10 CFR 712.13 - Supervisory review.

Code of Federal Regulations, 2013 CFR

2013-01-01

... HRP management official. Types of behavior and conditions that would indicate a concern include, but...) Irresponsibility in performing assigned duties; (10) Inability to deal with stress, or the appearance of being under unusual stress; (11) Failure to comply with work directives, hostility or aggression toward fellow...

10 CFR 712.13 - Supervisory review.

Code of Federal Regulations, 2014 CFR

2014-01-01

... HRP management official. Types of behavior and conditions that would indicate a concern include, but...) Irresponsibility in performing assigned duties; (10) Inability to deal with stress, or the appearance of being under unusual stress; (11) Failure to comply with work directives, hostility or aggression toward fellow...

17 CFR 4.24 - General disclosures required.

Code of Federal Regulations, 2010 CFR

2010-04-01

... THE RISKS AND OTHER FACTORS NECESSARY TO EVALUATE YOUR PARTICIPATION IN THIS COMMODITY POOL. THEREFORE... DOCUMENT, INCLUDING A DESCRIPTION OF THE PRINCIPAL RISK FACTORS OF THIS INVESTMENT, AT PAGE (insert page... required past performance disclosure for such person must be indicated. (g) Principal risk factors. A...

Cooking with Fire: The Mutagenicity- and PAH-Emission Factors of Solid-Fuel Cookstoves

EPA Science Inventory

Emissions from solid fuels used for cooking cause ~4 million premature deaths per year. Advanced solid-fuel cookstoves are a potential solution, but they should be assessed by appropriate performance indicators, including biological effects. We evaluated two categories of solid...

Education in the Scottish Parliament.

ERIC Educational Resources Information Center

Donn, Gari

2000-01-01

Reviews some educational issues arising during the first year of the new Scottish Parliament. Discusses facility problems and funding needs of small rural schools, debate over what constitutes standards and which performance indicators should be included in legislation, proposed accountability structures for local education authorities, and the…

49 CFR 382.603 - Training for supervisors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... minutes of training on controlled substances use. The training will be used by the supervisors to determine whether reasonable suspicion exists to require a driver to undergo testing under § 382.307. The training shall include the physical, behavioral, speech, and performance indicators of probable alcohol...

A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status

PubMed Central

Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

2015-01-01

Background: Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. Materials and Methods: The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. Results: The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students’ academic performance in the comprehensive basic sciences examination. Conclusion: According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination. PMID:26430693

The Impact of Intraclass Correlation on the Effectiveness of Level-Specific Fit Indices in Multilevel Structural Equation Modeling

PubMed Central

Hsu, Hsien-Yuan; Lin, Jr-Hung; Kwok, Oi-Man; Acosta, Sandra; Willson, Victor

2016-01-01

Several researchers have recommended that level-specific fit indices should be applied to detect the lack of model fit at any level in multilevel structural equation models. Although we concur with their view, we note that these studies did not sufficiently consider the impact of intraclass correlation (ICC) on the performance of level-specific fit indices. Our study proposed to fill this gap in the methodological literature. A Monte Carlo study was conducted to investigate the performance of (a) level-specific fit indices derived by a partially saturated model method (e.g., CFIPS_B and CFIPS_W) and (b) SRMRW and SRMRB in terms of their performance in multilevel structural equation models across varying ICCs. The design factors included intraclass correlation (ICC: ICC1 = 0.091 to ICC6 = 0.500), numbers of groups in between-level models (NG: 50, 100, 200, and 1,000), group size (GS: 30, 50, and 100), and type of misspecification (no misspecification, between-level misspecification, and within-level misspecification). Our simulation findings raise a concern regarding the performance of between-level-specific partial saturated fit indices in low ICC conditions: the performances of both TLIPS_B and RMSEAPS_B were more influenced by ICC compared with CFIPS_B and SRMRB. However, when traditional cutoff values (RMSEA≤ 0.06; CFI, TLI≥ 0.95; SRMR≤ 0.08) were applied, CFIPS_B and TLIPS_B were still able to detect misspecified between-level models even when ICC was as low as 0.091 (ICC1). On the other hand, both RMSEAPS_B and SRMRB were not recommended under low ICC conditions. PMID:29795901

Performance indicators evaluation of the population-based breast cancer screening programme in Northern Portugal using the European Guidelines.

PubMed

Bento, Maria José; Gonçalves, Guilherme; Aguiar, Ana; Castro, Clara; Veloso, Vitor; Rodrigues, Vítor

2015-10-01

To evaluate the first 10 years of operation of the population-based breast cancer screening programme implemented in the Northern Region of Portugal, using selected recommended standard performance indicators. Data from women aged 50-69 screened with two-view mammography, biennially, in the period 2000-2009, were included. Main performance indicators were compared with the recommended levels of the European Guidelines. A total of 202,039 screening examinations were performed, 71,731 (35.5%) in the initial screening and 130,308 (64.5%) in the subsequent screening. Coverage rate by examination reached 74.3% of the target population, in the last period evaluated. Recall rates were 8.1% and 2.4% and cancer detection rates were 4.4/1000 and 2.9/1000 respectively, for initial and subsequent screenings. The breast cancer detection rate, expressed as a multiple of the background expected incidence was 3.1 in initial screen and 2.2 in subsequent screen. The incidence of invasive interval cancers met the desirable recommended levels both the first and second years since last screening examination, in the initial and subsequent screenings. Invasive tumours <15mm were 50.4% and 53.8% of the invasive cancers detected in initial and subsequent screenings. Less favourable size, grading and biomarkers expression were found in interval cancers compared to screen-detected cancers. Breast cancer screening programme in the Northern Region of Portugal was well accepted by the population. Most of the performance indicators were consistent with the desirable levels of the European Guidelines, which indicate an effective screening programme. Future research should verify the consistency of some of these results by using updated information from a larger population. Copyright © 2015 Elsevier Ltd. All rights reserved.

34 CFR 361.86 - Performance levels.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Standards and Performance Indicators § 361.86 Performance levels. (a) General. (1) Paragraph (b) of this..., new performance levels. (b) Performance levels for each performance indicator. (1)(i) The performance levels for Performance Indicators 1.1 through 1.6 are— Performance indicator Performance level by type of...

Extravehicular Activity Testing in Analog Environments: Evaluating the Effects of Center of Gravity and Environment on Human Performance

NASA Technical Reports Server (NTRS)

Gernhardt, M.L.; Chappell, S.P.

2009-01-01

The EVA Physiology, Systems and Performance (EPSP) Project is performing tests in different analog environments to understand human performance during Extravehicular Activity (EVA) with the aim of developing more safe and efficient systems for lunar exploration missions and the Constellation Program. The project is characterizing human EVA performance in studies using several test beds, including the underwater NASA Extreme Environment Mission Operations (NEEMO) and Neutral Buoyancy Laboratory (NBL) facilities, JSC fs Partial Gravity Simulator (POGO), and the NASA Reduced Gravity Office (RGO) parabolic flight aircraft. Using these varied testing environments, NASA can gain a more complete understanding of human performance issues related to EVA and the limitations of each testing environment. Tests are focused on identifying and understanding the EVA system factors that affect human performance such as center of gravity (CG), inertial mass, ground reaction forces (GRF), suit weight, and suit pressure. The test results will lead to the development of lunar EVA systems operations concepts and design requirements that optimize human performance and exploration capabilities. METHODS: Tests were conducted in the NBL and during NEEMO missions in the NOAA Aquarius Habitat. A reconfigurable back pack with repositionable mass was used to simulate Perfect, Low, Forward, High, Aft and NASA Baseline CG locations. Subjects performed simulated exploration tasks that included ambulation, kneel and recovery, rock pick-up, and shoveling. Testing using POGO, that simulates partial gravity via pneumatic weight offload system and a similar reconfigurable rig, is underway for a subset of the same tasks. Additionally, test trials are being performed on the RGO parabolic flight aircraft. Subject performance was assessed using a modified Cooper-Harper scale to assess operator compensation required to achieve desired performance. All CG locations are based on the assumption of a standardized 6 ft 180 lb subject. RESULTS: The modified Cooper-Harper Scale assesses desired task performance described as performance in a reduced gravity environment as compared to a 1G environment. Modified Cooper-Harper ratings of . 3 indicate no improvements are needed, ratings of 4-6 indicate improvements are desirable, and ratings . 7 indicate improvements are mandatory. DISCUSSION: Differences were noted in suited CH results based on environment at the same CG and suit pressure. Additionally, results suggest that CG location affects unsuited human performance. Subjects preferred locations near their natural CG over those that are high, aft, or a combination of high and aft. Further testing and analyses are planned to compare these unsuited results to suited performance.

User's design handbook for a Standardized Control Module (SCM) for DC to DC Converters, volume 2

NASA Technical Reports Server (NTRS)

Lee, F. C.

1980-01-01

A unified design procedure is presented for selecting the key SCM control parameters for an arbitrarily given power stage configuration and parameter values, such that all regulator performance specifications can be met and optimized concurrently in a single design attempt. All key results and performance indices, for buck, boost, and buck/boost switching regulators which are relevant to SCM design considerations are included to facilitate frequent references.

Measures of Time-Sharing Skill and Gender as Predictors of Flight Simulator Performance.

DTIC Science & Technology

1979-01-01

well as overall e- quations including gender as a variable. Besides gender in the overall equations, measures of time-sharing skill were the best ...study indicated the best predictors of dual or whole-task performance were other dual-tasks. Furthermore, the particular components involved in a dual...switching between tasks, or the use of efficient response strategies " (Damos and Wickens, 1977, p.2). Attentional flexibility. According to Keele

Quantitative echocardiographic measures in the assessment of single ventricle function post-Fontan: Incorporation into routine clinical practice.

PubMed

Rios, Rodrigo; Ginde, Salil; Saudek, David; Loomba, Rohit S; Stelter, Jessica; Frommelt, Peter

2017-01-01

Quantitative echocardiographic measurements of single ventricular (SV) function have not been incorporated into routine clinical practice. A clinical protocol, which included quantitative measurements of SV deformation (global circumferential and longitudinal strain and strain rate), standard deviation of time to peak systolic strain, myocardial performance index (MPI), dP/dT from an atrioventricular valve regurgitant jet, and superior mesenteric artery resistance index, was instituted for all patients with a history of Fontan procedure undergoing echocardiography. All measures were performed real time during clinically indicated studies and were included in clinical reports. A total of 100 consecutive patients (mean age = 11.95±6.8 years, range 17 months-31.3 years) completed the protocol between September 1, 2014 to April 29, 2015. Deformation measures were completed in 100% of the studies, MPI in 93%, dP/dT in 55%, and superior mesenteric artery Doppler in 82%. The studies were reviewed to assess for efficiency in completing the protocol. The average time for image acquisition was 27.4±8.8 (range 10-62 minutes). The average time to perform deformation measures was 10.8±5.5 minutes (range 5-35 minutes) and time from beginning of imaging to report completion was 53.4±13.7 minutes (range 27-107 minutes). There was excellent inter-observer reliability when deformation indices were blindly repeated. Patients with a single left ventricle had significantly higher circumferential strain and strain rate, longitudinal strain and strain rate, and dP/dT compared to a single right ventricle. There were no differences in quantitative indices of ventricular function between patients <10 vs. >10 years post-Fontan. Advanced quantitative assessment of SV function post-Fontan can be consistently and efficiently performed real time during clinically indicated echocardiograms with excellent reliability. © 2016, Wiley Periodicals, Inc.

[The study of establishment of the " Chinese provincial Blindness prevention technical guidance group performance evaluation system"].

PubMed

Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D

2016-11-11

Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems. Conclusion: This system established is appropriate at current time, and it can effectively evaluate the performance of the Chinese provincial Blindness prevention technical guidance group. (Chin J Ophthalmol, 2016, 52:814-824) .

How does audit and feedback influence intentions of health professionals to improve practice? A laboratory experiment and field study in cardiac rehabilitation.

PubMed

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

2017-04-01

To identify factors that influence the intentions of health professionals to improve their practice when confronted with clinical performance feedback, which is an essential first step in the audit and feedback mechanism. We conducted a theory-driven laboratory experiment with 41 individual professionals, and a field study in 18 centres in the context of a cluster-randomised trial of electronic audit and feedback in cardiac rehabilitation. Feedback reports were provided through a web-based application, and included performance scores and benchmark comparisons (high, intermediate or low performance) for a set of process and outcome indicators. From each report participants selected indicators for improvement into their action plan. Our unit of observation was an indicator presented in a feedback report (selected yes/no); we considered selecting an indicator to reflect an intention to improve. We analysed 767 observations in the laboratory experiment and 614 in the field study, respectively. Each 10% decrease in performance score increased the probability of an indicator being selected by 54% (OR, 1.54; 95% CI 1.29% to 1.83%) in the laboratory experiment, and 25% (OR, 1.25; 95% CI 1.13% to 1.39%) in the field study. Also, performance being benchmarked as low and intermediate increased this probability in laboratory settings. Still, participants ignored the benchmarks in 34% (laboratory experiment) and 48% (field study) of their selections. When confronted with clinical performance feedback, performance scores and benchmark comparisons influenced health professionals' intentions to improve practice. However, there was substantial variation in these intentions, because professionals disagreed with benchmarks, deemed improvement unfeasible or did not consider the indicator an essential aspect of care quality. These phenomena impede intentions to improve practice, and are thus likely to dilute the effects of audit and feedback interventions. NTR3251, pre-results. 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/.

Using learning theory, interprofessional facilitation competencies, and behavioral indicators to evaluate facilitator training.

PubMed

LeGros, Theresa A; Amerongen, Helen M; Cooley, Janet H; Schloss, Ernest P

2015-01-01

Despite the increasing need for faculty and preceptors skilled in interprofessional facilitation (IPF), the relative novelty of the field poses a challenge to the development and evaluation of IPF programs. We use learning theory and IPF competencies with associated behavioral indicators to develop and evaluate six key messages in IPF training and experience. Our mixed methods approach included two phases: quantitative data collection with embedded qualitative data, followed by qualitative data collection in explanatory sequential fashion. This enabled triangulated analyses of both data types and of facilitation behaviors from facilitator and student perspectives. Results indicate the competency-based training was effective. Facilitators felt comfortable performing behaviors associated with IPF competencies; student observations of those behaviors supported facilitator self-reported performance. Overall, students perceived more facilitation opportunities than facilitators. Findings corroborate the importance of recruiting seasoned facilitators and establishing IPF guidelines that acknowledge variable team dynamics and help facilitators recognize teachable moments.

Lexical retrieval in discourse: An early indicator of Alzheimer's dementia

PubMed Central

Pekkala, Seija; Wiener, Debra; Himali, Jayandra J.J.; Beiser, Alexa S.; Obler, Loraine K.; Liu, Yulin; McKee, Ann; Auerbach, Sanford; Seshadri, Sudha; Wolf, Philip A.; Au, Rhoda

2014-01-01

We examined the progression of lexical-retrieval deficits in individuals with neuropathologically determined Alzheimer's disease (AD; n = 23) and a comparison group without criteria for AD (n = 24) to determine whether linguistic changes were a significant marker of the disease. Our participants underwent multiple administrations of a neuropsychological battery, with initial administration occurring on average 16 years prior to death. The battery included the Boston Naming Test (BNT), a letter fluency task (FAS), and written description of the Cookie Theft Picture (CTP). Repeated measures analysis revealed that the AD-group showed progressively greater decline in FAS and CTP lexical performance than the comparison group. Cross-sectional time-specific group comparisons indicated that the CTP differentiated performance between the two groups at 7–9 years prior to death and FAS and BNT only at 2–4 years. These results suggest that lexical-retrieval deficits in written discourse serve as an early indicator of AD. PMID:23985011

Lexical retrieval in discourse: an early indicator of Alzheimer's dementia.

PubMed

Pekkala, Seija; Wiener, Debra; Himali, Jayandra J; Beiser, Alexa S; Obler, Loraine K; Liu, Yulin; McKee, Ann; Auerbach, Sanford; Seshadri, Sudha; Wolf, Philip A; Au, Rhoda

2013-12-01

We examined the progression of lexical-retrieval deficits in individuals with neuropathologically determined Alzheimer's disease (AD; n = 23) and a comparison group without criteria for AD (n = 24) to determine whether linguistic changes were a significant marker of the disease. Our participants underwent multiple administrations of a neuropsychological battery, with initial administration occurring on average 16 years prior to death. The battery included the Boston Naming Test (BNT), a letter fluency task (FAS) and written description of the Cookie Theft Picture (CTP). Repeated measures analysis revealed that the AD-group showed progressively greater decline in FAS and CTP lexical performance than the comparison group. Cross-sectional time-specific group comparisons indicated that the CTP differentiated performance between the two groups at 7-9 years prior to death and FAS and BNT only at 2-4 years. These results suggest that lexical-retrieval deficits in written discourse serve as an early indicator of AD.

Large-scale-system effectiveness analysis. Final report

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

Patton, A.D.; Ayoub, A.K.; Foster, J.W.

1979-11-01

Objective of the research project has been the investigation and development of methods for calculating system reliability indices which have absolute, and measurable, significance to consumers. Such indices are a necessary prerequisite to any scheme for system optimization which includes the economic consequences of consumer service interruptions. A further area of investigation has been joint consideration of generation and transmission in reliability studies. Methods for finding or estimating the probability distributions of some measures of reliability performance have been developed. The application of modern Monte Carlo simulation methods to compute reliability indices in generating systems has been studied.

Measured success.

PubMed

Chambers, David W

2002-01-01

Some practices "wing it," some pick outcomes after the fact in order to look good. But neither of these approaches creates much confidence that next year will be okay, let alone better. Using measurement to improve practice requires understanding the interplay among mission, vision, core values, key success factors, and performance indicators. Combined intelligently, these five elements drive strategic planning and budgeting. They also lead to monitoring progress toward success. This is best done with a balanced scorecard that includes leading and lagging indicators of mission and vision. Indicators should be sampled to represent the practice and monitored against targets to propel the practice toward success.

Physiological and Functional Alterations after Spaceflight and Bed Rest.

PubMed

Mulavara, Ajitkumar P; Peters, Brian T; Miller, Chris A; Kofman, Igor S; Reschke, Millard F; Taylor, Laura C; Lawrence, Emily L; Wood, Scott J; Laurie, Steven S; Lee, Stuart M C; Buxton, Roxanne E; May-Phillips, Tiffany R; Stenger, Michael B; Ploutz-Snyder, Lori L; Ryder, Jeffrey W; Feiveson, Alan H; Bloomberg, Jacob J

2018-04-03

Exposure to microgravity causes alterations in multiple physiological systems, potentially impacting the ability of astronauts to perform critical mission tasks. The goal of this study was to determine the effects of spaceflight on functional task performance and to identify the key physiological factors contributing to their deficits. A test battery comprised of 7 functional tests and 15 physiological measures was used to investigate the sensorimotor, cardiovascular and neuromuscular adaptations to spaceflight. Astronauts were tested before and after 6-month spaceflights. Subjects were also tested before and after 70 days of 6° head-down bed rest, a spaceflight analog, to examine the role of axial body unloading on the spaceflight results. These subjects included Control and Exercise groups to examine the effects of exercise during bed rest. Spaceflight subjects showed the greatest decrement in performance during functional tasks that required the greatest demand for dynamic control of postural equilibrium which was paralleled by similar decrements in sensorimotor tests that assessed postural and dynamic gait control. Other changes included reduced lower limb muscle performance and increased heart rate to maintain blood pressure. Exercise performed during bed rest prevented detrimental change in neuromuscular and cardiovascular function, however, both bed rest groups experienced functional and balance deficits similar to spaceflight subjects. Bed rest data indicates that body support unloading experienced during spaceflight contributes to postflight postural control dysfunction. Further, the bed rest results in the Exercise group of subjects confirm that resistance and aerobic exercises performed during spaceflight can play an integral role in maintaining neuromuscular and cardiovascular function, which can help in reducing decrements in functional performance. These results indicate that a countermeasure to mitigate postflight postural control dysfunction is required to maintain functional performance.

A conceptual framework for evaluation of public health and primary care system performance in iran.

PubMed

Jahanmehr, Nader; Rashidian, Arash; Khosravi, Ardeshir; Farzadfar, Farshad; Shariati, Mohammad; Majdzadeh, Reza; Akbari Sari, Ali; Mesdaghinia, Alireza

2015-01-26

The main objective of this study was to design a conceptual framework, according to the policies and priorities of the ministry of health to evaluate provincial public health and primary care performance and to assess their share in the overall health impacts of the community. We used several tools and techniques, including system thinking, literature review to identify relevant attributes of health system performance framework and interview with the key stakeholders. The PubMed, Scopus, web of science, Google Scholar and two specialized databases of Persian language literature (IranMedex and SID) were searched using main terms and keywords. Following decision-making and collective agreement among the different stakeholders, 51 core indicators were chosen from among 602 obtained indicators in a four stage process, for monitoring and evaluation of Health Deputies. We proposed a conceptual framework by identifying the performance area for Health Deputies between other determinants of health, as well as introducing a chain of results, for performance, consisting of Input, Process, Output and Outcome indicators. We also proposed 5 dimensions for measuring the performance of Health Deputies, consisting of efficiency, effectiveness, equity, access and improvement of health status. The proposed Conceptual Framework illustrates clearly the Health Deputies success in achieving best results and consequences of health in the country. Having the relative commitment of the ministry of health and Health Deputies at the University of Medical Sciences is essential for full implementation of this framework and providing the annual performance report.

State-of-the-Art for Small Satellite Propulsion Systems

NASA Technical Reports Server (NTRS)

Parker, Khary I.

2016-01-01

The NASA/Goddard Space Flight Center (NASA/GSFC) is in the business of performing world-class, space-based, scientific research on various spacecraft platforms, which now include small satellites (SmallSats). In order to perform world class science on a SmallSat, NASA/GSFC requires that their components be highly reliable, high performing, have low power consumption, at the lowest cost possible. The Propulsion Branch (Code 597) at NASA/GSFC has conducted a SmallSat propulsion system survey to determine their availability and level of development. Based on publicly available information and unique features, this paper discusses some of the existing SmallSat propulsion systems.. The systems described in this paper do not indicate or imply any endorsement by NASA or NASA/GSFC over those not included.

Perform - A performance optimizing computer program for dynamic systems subject to transient loadings

NASA Technical Reports Server (NTRS)

Pilkey, W. D.; Wang, B. P.; Yoo, Y.; Clark, B.

1973-01-01

A description and applications of a computer capability for determining the ultimate optimal behavior of a dynamically loaded structural-mechanical system are presented. This capability provides characteristics of the theoretically best, or limiting, design concept according to response criteria dictated by design requirements. Equations of motion of the system in first or second order form include incompletely specified elements whose characteristics are determined in the optimization of one or more performance indices subject to the response criteria in the form of constraints. The system is subject to deterministic transient inputs, and the computer capability is designed to operate with a large linear programming on-the-shelf software package which performs the desired optimization. The report contains user-oriented program documentation in engineering, problem-oriented form. Applications cover a wide variety of dynamics problems including those associated with such diverse configurations as a missile-silo system, impacting freight cars, and an aircraft ride control system.

Association of Chronic Subjective Tinnitus with Neuro- Cognitive Performance.

PubMed

Gudwani, Sunita; Munjal, Sanjay K; Panda, Naresh K; Kohli, Adarsh

2017-12-01

Chronic subjective tinnitus is associated with cognitive disruptions affecting perception, thinking, language, reasoning, problem solving, memory, visual tasks (reading) and attention. To evaluate existence of any association between tinnitus parameters and neuropsychological performance to explain cognitive processing. Study design was prospective, consisting 25 patients with idiopathic chronic subjective tinnitus and gave informed consent before planning their treatment. Neuropsychological profile included (i) performance on verbal information, comprehension, arithmetic and digit span; (ii) non-verbal performance for visual pattern completion analogies; (iii) memory performance for long-term, recent, delayed-recall, immediate-recall, verbal-retention, visualretention, visual recognition; (iv) reception, interpretation and execution for visual motor gestalt. Correlation between tinnitus onset duration/ loudness perception with neuropsychological profile was assessed by calculating Spearman's coefficient. Findings suggest that tinnitus may interfere with cognitive processing especially performance on digit span, verbal comprehension, mental balance, attention & concentration, immediate recall, visual recognition and visual-motor gestalt subtests. Negative correlation between neurocognitive tasks with tinnitus loudness and onset duration indicated their association. Positive correlation between tinnitus and visual-motor gestalt performance indicated the brain dysfunction. Tinnitus association with non-auditory processing of verbal, visual and visuo-spatial information suggested neuroplastic changes that need to be targeted in cognitive rehabilitation.

Expectations of younger patients concerning activities after knee arthroplasty: are we asking the right questions?

PubMed

Witjes, Suzanne; van Geenen, Rutger C I; Koenraadt, Koen L M; van der Hart, Cor P; Blankevoort, Leendert; Kerkhoffs, Gino M M J; Kuijer, P Paul F M

2017-02-01

Indications for total and unicondylar knee arthroplasty (KA) have expanded to younger patients, in which Patient-Reported Outcome Measures (PROMs) often show ceiling effects. This might be due to higher expectations. Our aims were to explore expectations of younger patients concerning activities in daily life, work and leisure time after KA and to assess to what extent PROMs meet and evaluate these activities of importance. Focus groups were performed among osteoarthritis (OA) patients <65 years awaiting KA, in which they indicated what activities they expected to perform better in daily life, work and leisure time after KA. Additionally, 28 activities of daily life, 17 of work and 27 of leisure time were depicted from seven PROMS, which were rated on importance, frequency and bother. A total score, representing motivation for surgery, was also calculated. Data saturation was reached after six focus groups including 37 patients. Younger OA patients expect to perform better on 16 activities after KA, including high-impact leisure time activities. From the PROMs, daily life and work activities were rated high in both importance and motivation for surgery, but for leisure time activities importance varied highly between patients. All seven PROMs score activities of importance, but no single PROM incorporates all activities rated important. Younger patients expect to perform better on many activities of daily life, work and leisure time after KA, and often at demanding levels. To measure outcomes of younger patients, we suggest using PROMs that include work and leisure time activities besides daily life activities, in which preferably scored activities can be individualized.

Five-year Retrospective Review of Physician and Non-physician Performed Ultrasound in a Canadian Critical Care Helicopter Emergency Medical Service.

PubMed

O'Dochartaigh, Domhnall; Douma, Matthew; MacKenzie, Mark

2017-01-01

To describe the use of prehospital ultrasonography (PHUS) to support interventions, when used by physician and non-physician air medical crew (AMC), in a Canadian helicopter emergency medical service (HEMS). A retrospective review was conducted of consecutive patients who underwent ultrasound examination during HEMS care from January 1, 2009 through March 10, 2014. An a priori created data form was used to record patient demographics, type of ultrasound scan performed, ultrasound findings, location of scan, type of interventions supported by PHUS, factors that affected PHUS completion, and quality indicator(s). Data analysis was performed through descriptive statistics, Student's t-test for continuous variables, Z-test for proportions, and Mann-Whitney U Test for nonparametric data. Outcomes included interventions supported by PHUS, factors associated with incomplete scans, and quality indicators associated with PHUS use. Differences between physician and AMC groups were also assessed. PHUS was used in 455 missions, 318 by AMC and 137 by physicians. In combined trauma and medical patients, in the AMC group interventions were supported by PHUS in 26% of cases (95% CI 18-34). For transport physicians the percentage support was found to be significantly greater at 45% of cases (95% CI 34-56) p = < 0.006. Incomplete PHUS scans were common and reasons included patient obesity, lack of time, patient access, and clinical reasons. Quality indicators associated with PHUS were rarely identified. The use of PHUS by both physicians and non-physicians was found to support interventions in select trauma and medical patients. Key words: emergency medical services; aircraft; helicopter; air ambulance; ultrasonography; emergency care, prehospital; prehospital emergency care.

[Indication of chemotherapy according to histological type of musculoskeletal sarcomas].

PubMed

Goto, Takahiro; Okuma, Tomotake; Ogura, Koichi; Imanishi, Jungo; Hozumi, Takahiro; Kondo, Taiji

2009-02-01

In high-grade musculoskeletal sarcomas, adjuvant chemotherapy is often performed to prevent distant metastases. As the efficacy of chemotherapy varies according to the histological type of sarcoma, its indication is determined according to the histological type and the stage. Prognoses are poor in patients with osteosarcoma, Ewing's sarcoma, or rhabdomyosarcoma, when surgery alone is performed. However, because these sarcomas are chemosensitive, their prognoses are improved with adjuvant chemotherapy, so it is absolutely necessary. Drugs commonly used for osteosarcoma include adriamycin, cisplatin, methotrexate, vincristine, and ifosfamide. For Ewing's sarcoma and rhabdomyosarcoma, vincristine, actinomycin-D, cyclophosphamide, etoposide, and ifosfamide are commonly used. On the other hand, the efficacy of chemotherapy is unclear in most of the non-round cell sarcomas, e. g., malignant fibrous histiocytoma, pleomorphic liposarcoma, and leiomyosarcoma, so adjuvant chemotherapy is relatively indicated and often performed preoperatively. The efficacy is evaluated by reduction of the tumor volume as a surrogate marker. Postoperative chemotherapy is performed when the preoperative chemotherapy is effective. Nowadays, several kinds of antitumor agents are usually used for non-round cell sarcomas, and many authors have reported various kinds of regimens and their clinical results. Among them, the key drugs are adriamycin and ifosfamide. Recently, taxanes and gemcitabine are sometimes used. For chemoresistant sarcomas, e. g., chondrosarcoma, chordoma, alveolar soft part sarcoma, chemotherapy is rarely indicated, even if the tumor is histologically high grade and large. Low-grade musculoskeletal sarcomas, e. g., low-grade chondrosarcoma, central low-grade osteosarcoma, parosteal osteosarcoma, well-differentiated liposarcoma, and dermatofibrosarcoma protuberans, are well cured only by surgical excision, and adjuvant chemotherapy is therefore not indicated. Superficially-located, small-size non-round cell sarcomas, even though histologically high grade, are well healed only by surgical excision, and adjuvant chemotherapy is rarely indicated.

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

Analysis of digester design concepts

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

Ashare, E.; Wilson, E. H.

1979-01-29

Engineering economic analyses were performed on various digester design concepts to determine the relative performance for various biomass feedstocks. A comprehensive literature survey describing the state-of-the-art of the various digestion designs is included. The digester designs included in the analyses are CSTR, plug flow, batch, CSTR in series, multi-stage digestion and biomethanation. Other process options investigated included pretreatment processes such as shredding, degritting, and chemical pretreatment, and post-digestion processes, such as dewatering and gas purification. The biomass sources considered include feedlot manure, rice straw, and bagasse. The results of the analysis indicate that the most economical (on a unit gasmore » cost basis) digester design concept is the plug flow reactor. This conclusion results from this system providing a high gas production rate combined with a low capital hole-in-the-ground digester design concept. The costs determined in this analysis do not include any credits or penalties for feedstock or by-products, but present the costs only for conversion of biomass to methane. The batch land-fill type digester design was shown to have a unit gas cost comparable to that for a conventional stirred tank digester, with the potential of reducing the cost if a land-fill site were available for a lower cost per unit volume. The use of chemical pretreatment resulted in a higher unit gas cost, primarily due to the cost of pretreatment chemical. A sensitivity analysis indicated that the use of chemical pretreatment could improve the economics provided a process could be developed which utilized either less pretreatment chemical or a less costly chemical. The use of other process options resulted in higher unit gas costs. These options should only be used when necessary for proper process performance, or to result in production of a valuable by-product.« less

New operator assistance features in the CMS Run Control System

NASA Astrophysics Data System (ADS)

Andre, J.-M.; Behrens, U.; Branson, J.; Brummer, P.; Chaze, O.; Cittolin, S.; Contescu, C.; Craigs, B. G.; Darlea, G.-L.; Deldicque, C.; Demiragli, Z.; Dobson, M.; Doualot, N.; Erhan, S.; Fulcher, J. R.; Gigi, D.; Gładki, M.; Glege, F.; Gomez-Ceballos, G.; Hegeman, J.; Holzner, A.; Janulis, M.; Jimenez-Estupiñán, R.; Masetti, L.; Meijers, F.; Meschi, E.; Mommsen, R. K.; Morovic, S.; O'Dell, V.; Orsini, L.; Paus, C.; Petrova, P.; Pieri, M.; Racz, A.; Reis, T.; Sakulin, H.; Schwick, C.; Simelevicius, D.; Vougioukas, M.; Zejdl, P.

2017-10-01

During Run-1 of the LHC, many operational procedures have been automated in the run control system of the Compact Muon Solenoid (CMS) experiment. When detector high voltages are ramped up or down or upon certain beam mode changes of the LHC, the DAQ system is automatically partially reconfigured with new parameters. Certain types of errors such as errors caused by single-event upsets may trigger an automatic recovery procedure. Furthermore, the top-level control node continuously performs cross-checks to detect sub-system actions becoming necessary because of changes in configuration keys, changes in the set of included front-end drivers or because of potential clock instabilities. The operator is guided to perform the necessary actions through graphical indicators displayed next to the relevant command buttons in the user interface. Through these indicators, consistent configuration of CMS is ensured. However, manually following the indicators can still be inefficient at times. A new assistant to the operator has therefore been developed that can automatically perform all the necessary actions in a streamlined order. If additional problems arise, the new assistant tries to automatically recover from these. With the new assistant, a run can be started from any state of the sub-systems with a single click. An ongoing run may be recovered with a single click, once the appropriate recovery action has been selected. We review the automation features of CMS Run Control and discuss the new assistant in detail including first operational experience.

New Operator Assistance Features in the CMS Run Control System

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

Andre, J.M.; et al.

During Run-1 of the LHC, many operational procedures have been automated in the run control system of the Compact Muon Solenoid (CMS) experiment. When detector high voltages are ramped up or down or upon certain beam mode changes of the LHC, the DAQ system is automatically partially reconfigured with new parameters. Certain types of errors such as errors caused by single-event upsets may trigger an automatic recovery procedure. Furthermore, the top-level control node continuously performs cross-checks to detect sub-system actions becoming necessary because of changes in configuration keys, changes in the set of included front-end drivers or because of potentialmore » clock instabilities. The operator is guided to perform the necessary actions through graphical indicators displayed next to the relevant command buttons in the user interface. Through these indicators, consistent configuration of CMS is ensured. However, manually following the indicators can still be inefficient at times. A new assistant to the operator has therefore been developed that can automatically perform all the necessary actions in a streamlined order. If additional problems arise, the new assistant tries to automatically recover from these. With the new assistant, a run can be started from any state of the sub-systems with a single click. An ongoing run may be recovered with a single click, once the appropriate recovery action has been selected. We review the automation features of CMS Run Control and discuss the new assistant in detail including first operational experience.« less

Advanced EVA Capabilities: A Study for NASA's Revolutionary Aerospace Systems Concept Program

NASA Technical Reports Server (NTRS)

Hoffman, Stephen J.

2004-01-01

This report documents the results of a study carried out as part of NASA s Revolutionary Aerospace Systems Concepts Program examining the future technology needs of extravehicular activities (EVAs). The intent of this study is to produce a comprehensive report that identifies various design concepts for human-related advanced EVA systems necessary to achieve the goals of supporting future space exploration and development customers in free space and on planetary surfaces for space missions in the post-2020 timeframe. The design concepts studied and evaluated are not limited to anthropomorphic space suits, but include a wide range of human-enhancing EVA technologies as well as consideration of coordination and integration with advanced robotics. The goal of the study effort is to establish a baseline technology "road map" that identifies and describes an investment and technical development strategy, including recommendations that will lead to future enhanced synergistic human/robot EVA operations. The eventual use of this study effort is to focus evolving performance capabilities of various EVA system elements toward the goal of providing high performance human operational capabilities for a multitude of future space applications and destinations. The data collected for this study indicate a rich and diverse history of systems that have been developed to perform a variety of EVA tasks, indicating what is possible. However, the data gathered for this study also indicate a paucity of new concepts and technologies for advanced EVA missions - at least any that researchers are willing to discuss in this type of forum.

Evaluation of Clear-Air Turbulence Diagnostics: GTG in Korea

NASA Astrophysics Data System (ADS)

Kim, J.-H.; Chun, H.-Y.; Jang, W.; Sharman, R. D.

2009-04-01

Turbulence forecasting algorithm, the Graphical Turbulence Guidance (GTG) system developed at NCAR (Sharman et al., 2006), is evaluated with available turbulence observations (e.g. pilot reports; PIREPs) reported in South Korea during the recent 4 years (2003-2007). Clear-air turbulence (CAT) is extracted from PIREPs by using cloud-to-ground lightning flash data from Korean Meteorological Administration (KMA). The GTG system includes several steps. First, 45 turbulence indices are calculated in the East Asian region near Korean peninsula using the Regional Data Assimilation and Prediction System (RDAPS) analysis data with 30 km horizontal grid spacing provided by KMA. Second, 10 CAT indices that performed ten best forecasting score are selected. The scoring method is based on the probability of detection, which is calculated using PIREPs exclusively of moderate-or-greater intensity. Various statistical examinations and sensitivity tests of the GTG system are performed by yearly and seasonally classified PIREPs in South Korea. Performance of GTG is more consistent and stable than that of any individual diagnostic in each year and season. In addition, current-year forecasting based on yearly PIREPs is better than adjacent-year forecasting and year-after-year forecasting. Seasonal forecasting is generally better than yearly forecasting, because selected CAT indices in each season represent meteorological condition much more properly than applying the selected CAT indices to all seasons. Wintertime forecasting is the best among the four seasonal forecastings. This is likely due to that the GTG system consists of many CAT indices related to jet stream, and turbulence associated with the jet can be most activated in wintertime under strong jet magnitude. On the other hand, summertime forecasting skill is much less than in wintertime. To acquire better performance for summertime forecasting, it is likely to develop more turbulence indices related to, for example, convections. By sensitivity test to the number of combined indices, it is found that yearly and seasonal GTG is the best when about 7 CAT indices are combined.

Bronchoscopy Simulation: A Brief Review

ERIC Educational Resources Information Center

Davoudi, Mohsen; Colt, Henri G.

2009-01-01

More than 500,000 flexible bronchoscopies are performed annually by chest physicians in the United States (Ernst et al., Chest 123:1693-1717, 2003). Indications include diagnosis of lung cancer and airway tumors, benign strictures, pulmonary infections, and treatment of central airway obstruction, emphysema, and intraepithelial lesions such as…

7 CFR 1730.22 - Borrower analysis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... which could indicate deterioration in the physical or cyber condition or the operational effectiveness... any, the borrower's written analysis would also include a review of the operator's performance under... analysis required by paragraph (a) of this section not more than 90 days prior to the scheduled RUS review...

Personality Factors of Elementary and Secondary Pre-Service Teachers.

ERIC Educational Resources Information Center

Baldwin, Beatrice; And Others

Research has indicated that numerous factors influence teaching performance, including nonacademic traits such as personality attributes, self-concept, commitment to teaching, and gender. This study compared the personality characteristics of elementary and secondary preservice teachers. Subjects were junior- and senior-level students (N=186) in…

A Multidimensional Analysis Tool for Visualizing Online Interactions

ERIC Educational Resources Information Center

Kim, Minjeong; Lee, Eunchul

2012-01-01

This study proposes and verifies the performance of an analysis tool for visualizing online interactions. A review of the most widely used methods for analyzing online interactions, including quantitative analysis, content analysis, and social network analysis methods, indicates these analysis methods have some limitations resulting from their…

77 FR 2510 - Proposed Information Collection; Comment Request; Quarterly Financial Report

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-18

... scope of collection. The current collection includes the Manufacturing, Mining, Wholesale Trade, Retail... economic indicator that also provides financial data essential to the estimation of key Government measures of national economic performance. The importance of this data collection is reflected by the granting...

15 CFR 200.114 - Fees and bills.

Code of Federal Regulations, 2012 CFR

2012-01-01

... for all measurement services performed by NIST, unless waived by the Director, or the Director's... request accepted by NIST is $10, unless otherwise indicated in SP 250. If apparatus is returned without... customer's device. Fees for calibrations or tests include the cost of preparation of an NIST report...

15 CFR 200.114 - Fees and bills.

Code of Federal Regulations, 2014 CFR

2014-01-01

... for all measurement services performed by NIST, unless waived by the Director, or the Director's... request accepted by NIST is $10, unless otherwise indicated in SP 250. If apparatus is returned without... customer's device. Fees for calibrations or tests include the cost of preparation of an NIST report...

15 CFR 200.114 - Fees and bills.

Code of Federal Regulations, 2011 CFR

2011-01-01

... for all measurement services performed by NIST, unless waived by the Director, or the Director's... request accepted by NIST is $10, unless otherwise indicated in SP 250. If apparatus is returned without... customer's device. Fees for calibrations or tests include the cost of preparation of an NIST report...

15 CFR 200.114 - Fees and bills.

Code of Federal Regulations, 2010 CFR

2010-01-01

... for all measurement services performed by NIST, unless waived by the Director, or the Director's... request accepted by NIST is $10, unless otherwise indicated in SP 250. If apparatus is returned without... customer's device. Fees for calibrations or tests include the cost of preparation of an NIST report...

15 CFR 200.114 - Fees and bills.

Code of Federal Regulations, 2013 CFR

2013-01-01

... for all measurement services performed by NIST, unless waived by the Director, or the Director's... request accepted by NIST is $10, unless otherwise indicated in SP 250. If apparatus is returned without... customer's device. Fees for calibrations or tests include the cost of preparation of an NIST report...

78 FR 52937 - National Institute of Mental Health; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental..., National Institute of Mental Health. The meeting will be closed to the public as indicated below in... of Mental Health, including consideration of personnel qualifications and performance, and the...

78 FR 26643 - National Institute of Mental Health; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental..., National Institute of Mental Health. The meeting will be closed to the public as indicated below in... of Mental Health, including consideration of personnel qualifications and performance, and the...

78 FR 77474 - National Institute of Mental Health; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental..., National Institute of Mental Health. The meeting will be closed to the public as indicated below in... OF MENTAL HEALTH, including consideration of personnel qualifications and performance, and the...

77 FR 12603 - National Institute of Mental Health; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental..., National Institute of Mental Health. The meeting will be closed to the public as indicated below in... of Mental Health, including consideration of personnel qualifications and performance, and the...

76 FR 22717 - National Institute of Mental Health; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental..., National Institute of Mental Health. The meeting will be closed to the public as indicated below in... of Mental Health, including consideration of personnel qualifications and performance, and the...

77 FR 29678 - National Institute of Mental Health; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental..., National Institute of Mental Health. The meeting will be closed to the public as indicated below in... of Mental Health, including consideration of personnel qualifications and performance, and the...

Thinking: How Do We Know Students Are Getting Better At It?

ERIC Educational Resources Information Center

Costa, Arthur L.

1984-01-01

Since thinking is most often performed in problem-solving situations, teachers can become observers by providing situations in which students can practice and demonstrate intelligent behaviors. Some indicators include: perseverance, precision of language, problem finding, decreased impulsivity, metacognition, checking for accuracy, transference,…

The effects of anxious responding on mental arithmetic and lexical decision task performance.

PubMed

Hopko, Derek R; McNeil, Daniel W; Lejuez, C W; Ashcraft, Mark H; Eifert, Georg H; Riel, Jim

2003-01-01

Anxiety-related responding and skill deficits historically are associated with performance-based problems such as mathematics anxiety, yet the relative contribution of these variables to substandard performance remains poorly understood. Utilizing a 7% carbon dioxide (CO2) gas to induce anxiety, the present study examined the impact of anxious responding on two performance tasks, mental arithmetic and lexical decision. Independent variables included math anxiety group, gender, and gas condition. Dependent variables included task performance and physiological and self-report indices of anxiety. A total of 64 university undergraduate students participated. Physiological and verbal-report measures of anxiety supported the utility of 7% carbon dioxide-enriched air as an anxiety-inducing stimulus. Behavioral disruption on performance tasks, however, did not differ as a function of carbon dioxide inhalation. Performance did differ as a function of math anxiety. High math anxious individuals generally exhibited higher error rates on mathematical tasks, particularly on tasks designed to measure advanced math skill and those requiring working memory resources. These findings are discussed with reference to processing efficiency theory, discordance among anxiety response systems, and the intricacies associated with skill measurement.

Use of comparative performance indicators in rehabilitation.

PubMed

Zidarov, Diana; Poissant, Lise; Sicotte, Claude

The development of performance indicators that enable benchmarking between organizations is an important mechanism for accountability, organizational learning, and performance improvement. In the province of Quebec (Canada), 21 rehabilitation organizations developed a common set of performance indicators through interorganizational collaboration. The aims of this study were to describe the rehabilitation organizations' use of a common set of performance indicators and to identify the factors influencing such use. A qualitative survey was performed. Individual semistructured interviews were conducted with executives (n = 18) working at 16 rehabilitation organizations using a common set of performance indicators. A thematic analysis of the factors of use was performed according to the Consolidated Framework for Implementation Research. The use of performance indicators was categorized as purposeful, political, or passive. Our results showed that all organizations used the common set of performance indicators. Four factors were identified as important to all the rehabilitation organizations to explain their interest in comparative performance indicators: the need to develop their own performance indicators, the compatibility of performance information with organizational needs, complexity/simplicity of performance information, and the support offered by their common association. Sixty-three percent of rehabilitation organizations made purposeful or political use of performance indicators. Three main factors contributed to typify those organizations from the others: the perceived quality of the performance indicators, the leadership of decision makers, and the resources available. Our results showed that use of performance indicators can support the initiation of projects for improving the quality of care. Key recommendations are proposed to decision makers that may enhance performance indicators' use.

[Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea].

PubMed

Min, Jun Ki; Cha, Jae Myung; Cho, Yu Kyung; Kim, Jie Hyun; Yoon, Soon Man; Im, Jong Pil; Jung, Yunho; Moon, Jeong Seop; Kim, Jin Oh; Jeen, Yoon Tae

2018-05-25

Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.

Aircraft symmetric flight optimization. [gradient techniques for supersonic aircraft control

NASA Technical Reports Server (NTRS)

Falco, M.; Kelley, H. J.

1973-01-01

Review of the development of gradient techniques and their application to aircraft optimal performance computations in the vertical plane of flight. Results obtained using the method of gradients are presented for attitude- and throttle-control programs which extremize the fuel, range, and time performance indices subject to various trajectory and control constraints, including boundedness of engine throttle control. A penalty function treatment of state inequality constraints which generally appear in aircraft performance problems is outlined. Numerical results for maximum-range, minimum-fuel, and minimum-time climb paths for a hypothetical supersonic turbojet interceptor are presented and discussed. In addition, minimum-fuel climb paths subject to various levels of ground overpressure intensity constraint are indicated for a representative supersonic transport. A variant of the Gel'fand-Tsetlin 'method of ravines' is reviewed, and two possibilities for further development of continuous gradient processes are cited - namely, a projection version of conjugate gradients and a curvilinear search.

The Proposal of Key Performance Indicators in Facility Management and Determination the Weights of Significance

NASA Astrophysics Data System (ADS)

Rimbalová, Jarmila; Vilčeková, Silvia

2013-11-01

The practice of facilities management is rapidly evolving with the increasing interest in the discourse of sustainable development. The industry and its market are forecasted to develop to include non-core functions, activities traditionally not associated with this profession, but which are increasingly being addressed by facilities managers. The scale of growth in the built environment and the consequential growth of the facility management sector is anticipated to be enormous. Key Performance Indicators (KPI) are measure that provides essential information about performance of facility services delivery. In selecting KPI, it is critical to limit them to those factors that are essential to the organization reaching its goals. It is also important to keep the number of KPI small just to keep everyone's attention focused on achieving the same KPIs. This paper deals with the determination of weights of KPI of FM in terms of the design and use of sustainable buildings.

Design, implementation and scaling up of the balanced scorecard for hospitals in Lebanon: policy coherence and application lessons for low and middle income countries.

PubMed

El-Jardali, Fadi; Saleh, Shadi; Ataya, Nour; Jamal, Diana

2011-12-01

This paper describes the development and implementation of the first national hospital performance indicators in Lebanon including its institutionalization within existing policy framework and the initiation of independent governance structure for sustainability. Guided by the Ontario Acute Care Balanced Scorecard framework, a step-wise approach was used. Guiding principles were non-punitive reporting, anonymity, voluntary participation, stakeholder involvement, consensus and feasibility. Modified Delphi technique was used, readiness assessment surveys in 52 hospitals were conducted, pilot testing and evaluation were completed in 14 hospitals. Initial balanced set of 21 indicators were selected. Findings showed wide variations in indicators' measurement in hospitals including formulas and tools. Barriers to measurement included lack of quality culture, physician resistance and resources. A gradual implementation strategy was developed and selected indicators were divided into two levels. Most piloted indicators proved to be valid, feasible and reliable. The initiative was linked to the national hospital accreditation system resulting in a balanced set of 40 indicators. An independent, not-for-profit, arm's-length organization was established. This is among the first attempts made in the East Mediterranean Region to adapt the BSC approach and translate the experience of its development to addresses local needs and contextual reality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Developing a performance measurement framework and indicators for community health service facilities in urban China.

PubMed

Wong, Sabrina T; Yin, Delu; Bhattacharyya, Onil; Wang, Bin; Liu, Liqun; Chen, Bowen

2010-11-18

China has had no effective and systematic information system to provide guidance for strengthening PHC (Primary Health Care) or account to citizens on progress. We report on the development of the China results-based Logic Model for Community Health Facilities and Stations (CHS) and a set of relevant PHC indicators intended to measure CHS priorities. We adapted the PHC Results Based Logic Model developed in Canada and current work conducted in the community health system in China to create the China CHS Logic Model framework. We used a staged approach by first constructing the framework and indicators and then validating their content through an interactive process involving policy analysis, critical review of relevant literature and multiple stakeholder consultation. The China CHS Logic Model includes inputs, activities, outputs and outcomes with a total of 287 detailed performance indicators. In these indicators, 31 indicators measure inputs, 64 measure activities, 105 measure outputs, and 87 measure immediate (n = 65), intermediate (n = 15), or final (n = 7) outcomes. A Logic Model framework can be useful in planning, implementation, analysis and evaluation of PHC at a system and service level. The development and content validation of the China CHS Logic Model and subsequent indicators provides a means for stronger accountability and a clearer sense of overall direction and purpose needed to renew and strengthen the PHC system in China. Moreover, this work will be useful in moving towards developing a PHC information system and performance measurement across districts in urban China, and guiding the pursuit of quality in PHC.

Developing a Performance Measurement Framework and Indicators for Community Health Service Facilities in Urban China

PubMed Central

2010-01-01

Background China has had no effective and systematic information system to provide guidance for strengthening PHC (Primary Health Care) or account to citizens on progress. We report on the development of the China results-based Logic Model for Community Health Facilities and Stations (CHS) and a set of relevant PHC indicators intended to measure CHS priorities. Methods We adapted the PHC Results Based Logic Model developed in Canada and current work conducted in the community health system in China to create the China CHS Logic Model framework. We used a staged approach by first constructing the framework and indicators and then validating their content through an interactive process involving policy analysis, critical review of relevant literature and multiple stakeholder consultation. Results The China CHS Logic Model includes inputs, activities, outputs and outcomes with a total of 287 detailed performance indicators. In these indicators, 31 indicators measure inputs, 64 measure activities, 105 measure outputs, and 87 measure immediate (n = 65), intermediate (n = 15), or final (n = 7) outcomes. Conclusion A Logic Model framework can be useful in planning, implementation, analysis and evaluation of PHC at a system and service level. The development and content validation of the China CHS Logic Model and subsequent indicators provides a means for stronger accountability and a clearer sense of overall direction and purpose needed to renew and strengthen the PHC system in China. Moreover, this work will be useful in moving towards developing a PHC information system and performance measurement across districts in urban China, and guiding the pursuit of quality in PHC. PMID:21087516

Connecting Different Data Sources to Assess the Interconnections between Biosecurity, Health, Welfare, and Performance in Commercial Pig Farms in Great Britain.

PubMed

Pandolfi, Fanny; Edwards, Sandra A; Maes, Dominiek; Kyriazakis, Ilias

2018-01-01

This study aimed to provide an overview of the interconnections between biosecurity, health, welfare, and performance in commercial pig farms in Great Britain. We collected on-farm data about the level of biosecurity and animal performance in 40 fattening pig farms and 28 breeding pig farms between 2015 and 2016. We identified interconnections between these data, slaughterhouse health indicators, and welfare indicator records in fattening pig farms. After achieving the connections between databases, a secondary data analysis was performed to assess the interconnections between biosecurity, health, welfare, and performance using correlation analysis, principal component analysis, and hierarchical clustering. Although we could connect the different data sources the final sample size was limited, suggesting room for improvement in database connection to conduct secondary data analyses. The farm biosecurity scores ranged from 40 to 90 out of 100, with internal biosecurity scores being lower than external biosecurity scores. Our analysis suggested several interconnections between health, welfare, and performance. The initial correlation analysis showed that the prevalence of lameness and severe tail lesions was associated with the prevalence of enzootic pneumonia-like lesions and pyaemia, and the prevalence of severe body marks was associated with several disease indicators, including peritonitis and milk spots ( r  > 0.3; P  < 0.05). Higher average daily weight gain (ADG) was associated with lower prevalence of pleurisy ( r  > 0.3; P  < 0.05), but no connection was identified between mortality and health indicators. A subsequent cluster analysis enabled identification of patterns which considered concurrently indicators of health, welfare, and performance. Farms from cluster 1 had lower biosecurity scores, lower ADG, and higher prevalence of several disease and welfare indicators. Farms from cluster 2 had higher biosecurity scores than cluster 1, but a higher prevalence of pigs requiring hospitalization and lameness which confirmed the correlation between biosecurity and the prevalence of pigs requiring hospitalization ( r  > 0.3; P  < 0.05). Farms from cluster 3 had higher biosecurity, higher ADG, and lower prevalence for some disease and welfare indicators. The study suggests a smaller impact of biosecurity on issues such as mortality, prevalence of lameness, and pig requiring hospitalization. The correlations and the identified clusters suggested the importance of animal welfare for the pig industry.

The Effect of Compression Ratio on Knock Limits of High-Performance Fuels in a CFR Engine II : Blends of 2,2,3-Trimethylpentane with 28-R

NASA Technical Reports Server (NTRS)

Tower, Leonard K

1945-01-01

The knock-limited performance of blends of 0,50; and 100 percent by volume of 2,2,3-trimethylpentane in 28-R fuel determined with a modified F-4 engine at three sets of conditions varying from severe to mild at each of three compression ratios (6.0, 8.0, and 10.0). A comparison of the knock-limited performance of 2,2,3-trimethylpentane with that of triptane (2,2,3-trimethylbutane) is included. The knock-Limited performance of 2,2,3-trimethylpontane was usually more sensitive to either compression ratio or inlet-air temperature than 28-R fuel, but the ratio of the knock-limited indicated mean effective pressure of a given blend containing 2,2,3-trimethypentane and 28-R to the indicated mean effective pressure of 28-R alone was not greatly affected by compression ratio if the engine operating conditions were mild. Although 2,2,3-trimethylpentane in general had a lower knock-limited performance than triptane, the characteristics of the two fuels were somewhat similar.

Development of an analytical microbial consortia method for enhancing performance monitoring at aerobic wastewater treatment plants.

PubMed

Razban, Behrooz; Nelson, Kristina Y; McMartin, Dena W; Cullimore, D Roy; Wall, Michelle; Wang, Dunling

2012-01-01

An analytical method to produce profiles of bacterial biomass fatty acid methyl esters (FAME) was developed employing rapid agitation followed by static incubation (RASI) using selective media of wastewater microbial communities. The results were compiled to produce a unique library for comparison and performance analysis at a Wastewater Treatment Plant (WWTP). A total of 146 samples from the aerated WWTP, comprising 73 samples of each secondary and tertiary effluent, were included analyzed. For comparison purposes, all samples were evaluated via a similarity index (SI) with secondary effluents producing an SI of 0.88 with 2.7% variation and tertiary samples producing an SI 0.86 with 5.0% variation. The results also highlighted significant differences between the fatty acid profiles of the tertiary and secondary effluents indicating considerable shifts in the bacterial community profile between these treatment phases. The WWTP performance results using this method were highly replicable and reproducible indicating that the protocol has potential as a performance-monitoring tool for aerated WWTPs. The results quickly and accurately reflect shifts in dominant bacterial communities that result when processes operations and performance change.

Uncertainty assessment of PM2.5 contamination mapping using spatiotemporal sequential indicator simulations and multi-temporal monitoring data.

PubMed

Yang, Yong; Christakos, George; Huang, Wei; Lin, Chengda; Fu, Peihong; Mei, Yang

2016-04-12

Because of the rapid economic growth in China, many regions are subjected to severe particulate matter pollution. Thus, improving the methods of determining the spatiotemporal distribution and uncertainty of air pollution can provide considerable benefits when developing risk assessments and environmental policies. The uncertainty assessment methods currently in use include the sequential indicator simulation (SIS) and indicator kriging techniques. However, these methods cannot be employed to assess multi-temporal data. In this work, a spatiotemporal sequential indicator simulation (STSIS) based on a non-separable spatiotemporal semivariogram model was used to assimilate multi-temporal data in the mapping and uncertainty assessment of PM2.5 distributions in a contaminated atmosphere. PM2.5 concentrations recorded throughout 2014 in Shandong Province, China were used as the experimental dataset. Based on the number of STSIS procedures, we assessed various types of mapping uncertainties, including single-location uncertainties over one day and multiple days and multi-location uncertainties over one day and multiple days. A comparison of the STSIS technique with the SIS technique indicate that a better performance was obtained with the STSIS method.

Uncertainty assessment of PM2.5 contamination mapping using spatiotemporal sequential indicator simulations and multi-temporal monitoring data

NASA Astrophysics Data System (ADS)

Yang, Yong; Christakos, George; Huang, Wei; Lin, Chengda; Fu, Peihong; Mei, Yang

2016-04-01

Because of the rapid economic growth in China, many regions are subjected to severe particulate matter pollution. Thus, improving the methods of determining the spatiotemporal distribution and uncertainty of air pollution can provide considerable benefits when developing risk assessments and environmental policies. The uncertainty assessment methods currently in use include the sequential indicator simulation (SIS) and indicator kriging techniques. However, these methods cannot be employed to assess multi-temporal data. In this work, a spatiotemporal sequential indicator simulation (STSIS) based on a non-separable spatiotemporal semivariogram model was used to assimilate multi-temporal data in the mapping and uncertainty assessment of PM2.5 distributions in a contaminated atmosphere. PM2.5 concentrations recorded throughout 2014 in Shandong Province, China were used as the experimental dataset. Based on the number of STSIS procedures, we assessed various types of mapping uncertainties, including single-location uncertainties over one day and multiple days and multi-location uncertainties over one day and multiple days. A comparison of the STSIS technique with the SIS technique indicate that a better performance was obtained with the STSIS method.

Performance assessment of geospatial simulation models of land-use change--a landscape metric-based approach.

PubMed

Sakieh, Yousef; Salmanmahiny, Abdolrassoul

2016-03-01

Performance evaluation is a critical step when developing land-use and cover change (LUCC) models. The present study proposes a spatially explicit model performance evaluation method, adopting a landscape metric-based approach. To quantify GEOMOD model performance, a set of composition- and configuration-based landscape metrics including number of patches, edge density, mean Euclidean nearest neighbor distance, largest patch index, class area, landscape shape index, and splitting index were employed. The model takes advantage of three decision rules including neighborhood effect, persistence of change direction, and urbanization suitability values. According to the results, while class area, largest patch index, and splitting indices demonstrated insignificant differences between spatial pattern of ground truth and simulated layers, there was a considerable inconsistency between simulation results and real dataset in terms of the remaining metrics. Specifically, simulation outputs were simplistic and the model tended to underestimate number of developed patches by producing a more compact landscape. Landscape-metric-based performance evaluation produces more detailed information (compared to conventional indices such as the Kappa index and overall accuracy) on the model's behavior in replicating spatial heterogeneity features of a landscape such as frequency, fragmentation, isolation, and density. Finally, as the main characteristic of the proposed method, landscape metrics employ the maximum potential of observed and simulated layers for a performance evaluation procedure, provide a basis for more robust interpretation of a calibration process, and also deepen modeler insight into the main strengths and pitfalls of a specific land-use change model when simulating a spatiotemporal phenomenon.

The effect of dropping height on jumping performance in trained and untrained prepubertal boys and girls.

PubMed

Bassa, Eleni I; Patikas, Dimitrios A; Panagiotidou, Aikaterini I; Papadopoulou, Sophia D; Pylianidis, Theofilos C; Kotzamanidis, Christos M

2012-08-01

Plyometric training in children, including different types of jumps, has become common practice during the last few years in different sports, although there is limited information about the adaptability of children with respect to different loads and the differences in performance between various jump types. The purpose of this study was to examine the effect of gender and training background on the optimal drop jump height of 9- to 11-year-old children. Sixty prepubertal (untrained and track and field athletes, boys and girls, equally distributed in each group [n = 15]), performed the following in random order: 3 squat jumps, 3 countermovement jumps (CMJs) and 3 drop jumps from heights of 10, 20, 30, 40, and 50 cm. The trial with the best performance in jump height of each test was used for further analysis. The jump type significantly affected the jump height. The jump height during the CMJ was the highest among all other jump types, resulting in advanced performance for both trained and untrained prepubertal boys and girls. However, increasing the dropping height did not change the jumping height or contact time during the drop jump. This possibly indicates an inability of prepubertal children to use their stored elastic energy to increase jumping height during drop jumps, irrespective of their gender or training status. This indicates that children, independent of gender and training status, have no performance gain during drop jumps from heights up to 50 cm, and therefore, it is recommended that only low drop jump heights be included in plyometric training to limit the probability of sustaining injuries.

Independent and combined influence of neonatal and current body composition on academic performance in youth: The UP & DOWN Study.

PubMed

Esteban-Cornejo, I; Tejero-González, C M; Castro-Piñero, J; Conde-Caveda, J; Cabanas-Sanchez, V; Sallis, J F; Veiga, Óscar L

2015-06-01

Unhealthy body composition is a cause for concern across the lifespan. The objective of this study was to examine the independent and combined associations between neonatal and current body composition with academic performance among youth. This cross-sectional study was conducted with a total of 1557 youth (745 girls) aged 10.4 ± 3.4 years. Birth weight and length at birth were self-reported. Current body composition was assessed by body mass index (BMI), waist circumference (WC) and percentage of body fat (BF%). Academic performance was assessed through schools records. Birth weight was related to all academic variables in boys, independent of potential confounders, including BMI; whereas WC, BMI and BF% were related to all academic performance indicators in both boys and girls, independent of potential confounders, including birth weight (all P < 0.05). In addition, the combined adverse effects of low birth weight and current overweight on academic performance were observed in both boys and girls for grade point average (GPA) indicator. Boys in the group with none adverse effect had significantly higher scores in GPA (score +0.535; 95% confidence interval, 0.082-0.989) than boys in the group of both adverse effects (P < 0.007); among girls, GPA score was higher in the group with none adverse effect than in the groups with one or two adverse effects (P for trend = 0.029). Neonatal and current body composition, both independently and combined, may influence academic performance in youth. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

Surveillance systems to track progress toward global polio eradication - worldwide, 2012-2013.

PubMed

Levitt, Alexandra; Diop, Ousmane M; Tangermann, Rudolf H; Paladin, Fem; Kamgang, Jean Baptiste; Burns, Cara C; Chenoweth, Paul J; Goel, Ajay; Wassilak, Steven G F

2014-04-25

In 2012, the World Health Assembly of the World Health Organization (WHO) declared completion of polio eradication a programmatic emergency. Polio cases are detected through surveillance of acute flaccid paralysis (AFP) cases and subsequent testing of stool specimens for polioviruses (PVs) at WHO-accredited laboratories within the Global Polio Laboratory Network (GPLN). AFP surveillance is supplemented by environmental surveillance, testing sewage samples from selected sites for PVs. Virologic surveillance, including genomic sequencing to identify isolates by genotype and measure divergence between isolates, guides Global Polio Eradication Initiative (GPEI) activities by confirming the presence of PV, tracking chains of PV transmission, and highlighting gaps in AFP surveillance quality. This report provides AFP surveillance quality indicators at national and subnational levels during 2012-2013 for countries that experienced PV cases during 2009-2013 in the WHO African Region (AFR) and Eastern Mediterranean Region (EMR), the remaining polio-endemic regions. It also summarizes the results of environmental surveillance and reviews indicators assessing the timeliness of reporting of PV isolation and of virus strain characterization globally. Regional-level performance indicators for timely reporting of PV isolation were met in five of six WHO regions in 2012 and 2013. Of 30 AFR and EMR countries that experienced cases of PV (wild poliovirus [WPV], circulating vaccine-derived poliovirus [cVDPV], or both) during 2009-2013, national performance indicator targets for AFP surveillance and collection of adequate specimens were met in 27 (90%) countries in 2012 and 22 (73%) in 2013. In 17 (57%) countries, ≥80% of the population lived in subnational areas meeting both AFP performance indicators in 2012, decreasing to 13 (43%) in 2013. To achieve polio eradication and certify interruption of PV transmission, intensive efforts to strengthen and maintain AFP surveillance are needed at subnational levels, including in field investigation and prompt collection of specimens, particularly in countries with current or recent active PV transmission.

Deriving common comorbidity indices from the MedDRA classification and exploring their performance on key outcomes in patients with rheumatoid arthritis.

PubMed

Putrik, Polina; Ramiro, Sofia; Lie, Elisabeth; Michaud, Kaleb; Kvamme, Maria K; Keszei, Andras P; Kvien, Tore K; Uhlig, Till; Boonen, Annelies

2018-03-01

To develop algorithms for calculating the Rheumatic Diseases Comorbidity Index (RDCI), Charlson-Deyo Index (CDI) and Functional Comorbidity Index (FCI) from the Medical Dictionary for Regulatory Activities (MedDRA), and to assess how these MedDRA-derived indices predict clinical outcomes, utility and health resource utilization (HRU). Two independent researchers linked the preferred terms of the MedDRA classification into the conditions included in the RDCI, the CDI and the FCI. Next, using data from the Norwegian Register-DMARD study (a register of patients with inflammatory joint diseases treated with DMARDs), the explanatory value of these indices was studied in models adjusted for age, gender and DAS28. Model fit statistics were compared in generalized estimating equation (prediction of outcome over time) models using as outcomes: modified HAQ, HAQ, physical and mental component summary of SF-36, SF6D and non-RA related HRU. Among 4126 patients with RA [72% female, mean (s.d.) age 56 (14) years], median (interquartile range) of RDCI at baseline was 0.0 (1.0) [range 0-6], CDI 0.0 (0.0) [0-7] and FCI 0.0 (1.0) [0-6]. All the comorbidity indices were associated with each outcome, and differences in their performance were moderate. The RDCI and FCI performed better on clinical outcomes: modified HAQ and HAQ, hospitalization, physical and mental component summary, and SF6D. Any non-RA related HRU was best predicted by RDCI followed by CDI. An algorithm is now available to compute three commonly used comorbidity indices from MedDRA classification. Indices performed comparably well in predicting a variety of outcomes, with the CDI performing slightly worse when predicting outcomes reflecting functioning and health. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Hardware support for collecting performance counters directly to memory

DOEpatents

Gara, Alan; Salapura, Valentina; Wisniewski, Robert W.

2012-09-25

Hardware support for collecting performance counters directly to memory, in one aspect, may include a plurality of performance counters operable to collect one or more counts of one or more selected activities. A first storage element may be operable to store an address of a memory location. A second storage element may be operable to store a value indicating whether the hardware should begin copying. A state machine may be operable to detect the value in the second storage element and trigger hardware copying of data in selected one or more of the plurality of performance counters to the memory location whose address is stored in the first storage element.

Effect of Performance Feedback on Community Health Workers’ Motivation and Performance in Madhya Pradesh, India: A Randomized Controlled Trial

PubMed Central

Matheke-Fischer, Michael; Lesh, Neal

2016-01-01

Background Small-scale community health worker (CHW) programs provide basic health services and strengthen health systems in resource-poor settings. This paper focuses on improving CHW performance by providing individual feedback to CHWs working with an mHealth program to address malnutrition in children younger than 5 years. Objective The paper aims to evaluate the immediate and retention effects of providing performance feedback and supportive supervision on CHW motivation and performance for CHWs working with an mHealth platform to reduce malnutrition in five districts of Madhya Pradesh, India. We expected a positive impact on CHW performance for the indicator they received feedback on. Performance on indicators the CHW did not receive feedback on was not expected to change. Methods In a randomized controlled trial, 60 CHWs were randomized into three treatment groups based on overall baseline performance ranks to achieve balanced treatment groups. Data for each treatment indicator were analyzed with the other two treatments acting as the control. In total, 10 CHWs were lost to follow-up. There were three performance indicators: case activity, form submissions, and duration of counseling. Each group received weekly calls to provide performance targets and discuss their performance on the specific indicator they were allocated to as well as any challenges or technical issues faced during the week for a 6-week period. Data were collected for a further 4 weeks to assess intertemporal sustained effects of the intervention. Results We found positive and significant impacts on duration of counseling, whereas case activity and number of form submissions did not show significant improvements as a result of the intervention. We found a moderate to large effect (Glass’s delta=0.97, P=.004) of providing performance feedback on counseling times in the initial 6 weeks. These effects were sustained in the postintervention period (Glass’s delta=1.69, P<.001). The counseling times decreased slightly from the intervention to postintervention period by 2.14 minutes (P=.01). Case activity improved for all CHWs after the intervention. We also performed the analysis by replacing the CHWs lost to follow-up with those in their treatment groups with the closest ranks in baseline performance and found similar results. Conclusions Calls providing performance feedback are effective in improving CHW motivation and performance. Providing feedback had a positive effect on performance in the case of duration of counseling. The results suggest that difficulty in achieving the performance target can affect results of performance feedback. Regardless of the performance information disclosed, calls can improve performance due to elements of supportive supervision included in the calls encouraging CHW motivation. PMID:27927607

Pasteur Institute of Iran--an evaluation model.

PubMed

Dejman, Masoumeh; Habibi, Elham; Baradarn Eftekhari, Monir; Falahat, Katayoun; Malekafzali, Hossein

2014-07-01

Pasteur Institute of Iran was established in 1919 with the aim to produce vaccines and prevent communicable diseases in Iran. Over time, their activities extended into areas of research, education and services. Naturally, such a vast development begs establishment of a comprehensive management and monitoring system. With this outlook, the present study was carried out with the aim to design a performance assessment model for Pasteur Institute of Iran that, in addition to determining evaluation indicators, it could prepare the necessary grounds for providing a unified assessment model for the global network of the Pasteur Institutes. This study was designed and performed in 4 stages: first; design of indicators and determining their scores. Second; editing indicators according to the outcome of discussions and debates held with members of Research Council of Pasteur Institute of Iran. Third; implementation of a pilot model based on the Institute's activities in 2011. Fourth; providing the pilot model feedback to the stakeholders and finalizing the model according to an opinion survey. Based on the results obtained, the developed indicators for Pasteur Institute of Iran evaluation were designed in 10 axes and 18 sub-axes, which included 101 major and 58 minor indicators. The axes included governance and leadership, resources and facilities, capacity building, knowledge production and collaborations, reference services, economic value of products and services, participation in industrial exhibitions, status of the institute, satisfaction and institute's role in health promotion. The indicators presented in this article have been prepared based on the balance in the Institute's four missions, to provide the basis for assessment of the Institute's activities in consecutive years, and possibility of comparison with other institutes worldwide.

Pasteur Institute of Iran- An Evaluation Model

PubMed Central

Dejman, Masoumeh; Habibi, Elham; Baradarn Eftekhari, Monir; Falahat, Katayoun; Malekafzali, Hossein

2014-01-01

Background: Pasteur Institute of Iran was established in 1919 with the aim to produce vaccines and prevent communicable diseases in Iran. Over time, their activities extended into areas of research, education and services. Naturally, such a vast development begs establishment of a comprehensive management and monitoring system. With this outlook, the present study was carried out with the aim to design a performance assessment model for Pasteur Institute of Iran that, in addition to determining evaluation indicators, it could prepare the necessary grounds for providing a unified assessment model for the global network of the Pasteur Institutes. Method: This study was designed and performed in 4 stages: first; design of indicators and determining their scores. Second; editing indicators according to the outcome of discussions and debates held with members of Research Council of Pasteur Institute of Iran. Third; implementation of a pilot model based on the Institute’s activities in 2011. Fourth; providing the pilot model feedback to the stakeholders and finalizing the model according to an opinion survey. Results: Based on the results obtained, the developed indicators for Pasteur Institute of Iran evaluation were designed in 10 axes and 18 sub-axes, which included 101 major and 58 minor indicators. The axes included governance and leadership, resources and facilities, capacity building, knowledge production and collaborations, reference services, economic value of products and services, participation in industrial exhibitions, status of the institute, satisfaction and institute’s role in health promotion. Conclusion: The indicators presented in this article have been prepared based on the balance in the Institute’s four missions, to provide the basis for assessment of the Institute’s activities in consecutive years, and possibility of comparison with other institutes worldwide. PMID:24842146

Experimental Modal Analysis and Dynamic Component Synthesis. Volume 3. Modal Parameter Estimation

DTIC Science & Technology

1987-12-01

residues as well as poles is achieved. A singular value decomposition method has been used to develop a complex mode indicator function ( CMIF )[70...which can be used to help determine the number of poles before the analysis. The CMIF is formed by performing a singular value decomposition of all of...servo systems which can include both low and high damping modes. "• CMIF can be used to indicate close or repeated eigenvalues before the parameter

The association between school-based physical activity, including physical education, and academic performance: a systematic review of the literature.

PubMed

Rasberry, Catherine N; Lee, Sarah M; Robin, Leah; Laris, B A; Russell, Lisa A; Coyle, Karin K; Nihiser, Allison J

2011-06-01

The purpose of this review is to synthesize the scientific literature that has examined the association between school-based physical activity (including physical education) and academic performance (including indicators of cognitive skills and attitudes, academic behaviors, and academic achievement). Relevant research was identified through a search of nine electronic databases using both physical activity and academic-related search terms. Forty-three articles (reporting a total of 50 unique studies) met the inclusion criteria and were read, abstracted, and coded for this synthesis. Findings of the 50 studies were then summarized. Across all the studies, there were a total of 251 associations between physical activity and academic performance, representing measures of academic achievement, academic behavior, and cognitive skills and attitudes. Slightly more than half (50.5%) of all associations examined were positive, 48% were not significant, and 1.5% were negative. Examination of the findings by each physical activity context provides insights regarding specific relationships. Results suggest physical activity is either positively related to academic performance or that there is not a demonstrated relationship between physical activity and academic performance. Results have important implications for both policy and schools. Copyright © 2010 Elsevier Inc. All rights reserved.

Air Vehicle Integration and Technology Research (AVIATR). Task Order 0003: Condition-Based Maintenance Plus Structural Integrity (CBM+SI) Demonstration (April 2011 to August 2011)

DTIC Science & Technology

2011-08-01

investigated. Implementation of this technology into the maintenance framework depends on several factors, including safety of the structural system, cost... Maintenance Parameters The F-15 Program has indicated that, in practice , maintenance actions are generally performed on flight hour multiples of 200...Risk Analysis or the Perform Cost Benefit Analysis sections of the flowchart. 4.6. Determine System Configurations The current maintenance practice

The Evaluation of Hospital Performance in Iran: A Systematic Review Article

PubMed Central

BAHADORI, Mohammadkarim; IZADI, Ahmad Reza; GHARDASHI, Fatemeh; RAVANGARD, Ramin; HOSSEINI, Seyed Mojtaba

2016-01-01

Background: This research aimed to systematically study and outline the methods of hospital performance evaluation used in Iran. Methods: In this systematic review, all Persian and English-language articles published in the Iranian and non-Iranian scientific journals indexed from Sep 2004 to Sep 2014 were studied. For finding the related articles, the researchers searched the Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, as well as the non-Iranian electronic databases, including Medline, Embase, Scopus, and Google Scholar. For reviewing the selected articles, a data extraction form, developed by the researchers was used. Results: The entire review process led to the selection of 51 articles. The publication of articles on the hospital performance evaluation in Iran has increased considerably in the recent years. Besides, among these 51 articles, 38 articles (74.51%) had been published in Persian language and 13 articles (25.49%) in English language. Eight models were recognized as evaluation model for Iranian hospitals. Totally, in 15 studies, the data envelopment analysis model had been used to evaluate the hospital performance. Conclusion: Using a combination of model to integrate indicators in the hospital evaluation process is inevitable. Therefore, the Ministry of Health and Medical Education should use a set of indicators such as the balanced scorecard in the process of hospital evaluation and accreditation and encourage the hospital managers to use them. PMID:27516991

The Evaluation of Hospital Performance in Iran: A Systematic Review Article.

PubMed

Bahadori, Mohammadkarim; Izadi, Ahmad Reza; Ghardashi, Fatemeh; Ravangard, Ramin; Hosseini, Seyed Mojtaba

2016-07-01

This research aimed to systematically study and outline the methods of hospital performance evaluation used in Iran. In this systematic review, all Persian and English-language articles published in the Iranian and non-Iranian scientific journals indexed from Sep 2004 to Sep 2014 were studied. For finding the related articles, the researchers searched the Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, as well as the non-Iranian electronic databases, including Medline, Embase, Scopus, and Google Scholar. For reviewing the selected articles, a data extraction form, developed by the researchers was used. The entire review process led to the selection of 51 articles. The publication of articles on the hospital performance evaluation in Iran has increased considerably in the recent years. Besides, among these 51 articles, 38 articles (74.51%) had been published in Persian language and 13 articles (25.49%) in English language. Eight models were recognized as evaluation model for Iranian hospitals. Totally, in 15 studies, the data envelopment analysis model had been used to evaluate the hospital performance. Using a combination of model to integrate indicators in the hospital evaluation process is inevitable. Therefore, the Ministry of Health and Medical Education should use a set of indicators such as the balanced scorecard in the process of hospital evaluation and accreditation and encourage the hospital managers to use them.

Indicators of wetland condition for the prairie pothole region of the United States.

PubMed

Guntenspergen, G R; Peterson, S A; Leibowitz, S G; Cowardin, L M

2002-09-01

We describe a study designed to evaluate the performance of wetland condition indicators of the Prairie Pothole Region (PPR) of the north central United States. Basin and landscape scale indicators were tested in 1992 and 1993 to determine their ability to discriminate between the influences of grassland dominated and cropland dominated landscapes in the PPR. Paired plots were selected from each of the major regions of the PPR. Among the landscape scale indicators tested, those most capable of distinguishing between the two landscapes were: 1) frequency of drained wetland basins. 2) total length of drainage ditch per plot, 3) amount of exposed soil in the upland subject to erosion, 4) indices of change in area of wetland covered by water, and 5) number of breeding duck pairs. Basin scale indicators including soil phosphorus concentrations and invertebrate taxa richness showed some promise: however, plant species richness was the only statistically significant basin scale indicator distinguishing grassland dominated from cropland dominated landscapes. Although our study found a number of promising candidate indicators, one of our conclusions is that basin scale indicators present a number of implementation problems. including: skill level requirements, site access denials, and recession of site access by landowners. Alternatively, we suggest that the use of landscape indicators based on remote sensing can be an effective means of assessing wetland integrity.

Development of a Web-Based Quality Dashboard Including a Toolbox to Improve Pain Management in Dutch Intensive Care.

PubMed

Roos-Blom, Marie-José; Gude, Wouter T; de Jonge, Evert; Spijkstra, Jan Jaap; van der Veer, Sabine N; Dongelmans, Dave A; de Keizer, Nicolette F

2017-01-01

Audit and feedback (A&F) is a common strategy to improve quality of care. Meta-analyses have indicated that A&F may be more effective in realizing desired change when baseline performance is low, it is delivered by a supervisor or colleague, it is provided frequently and in a timely manner, it is delivered in both verbal and written formats, and it includes specific targets and an action plan. However, there is little information to guide operationalization of these factors. Researchers have consequently called for A&F interventions featuring well-described and carefully justified components, with their theoretical rationale made explicit. This paper describes the rationale and development of a quality dashboard including an improvement toolbox for four previous developed pain indicators, guided by Control Theory.

Chorionic villus sampling for abnormal screening compared to historical indications: prevalence of abnormal karyotypes.

PubMed

Marshall, Nicole E; Fraley, Gwen; Feist, Cori; Burns, Michael J; Pereira, Leonardo

2012-08-01

To determine the prevalence of abnormal karyotype results in women undergoing chorionic villus sampling (CVS) for abnormal first trimester screening compared to CVS for historical indications (advanced maternal age (AMA) or prior aneuploidy). Retrospective cohort of all patients undergoing CVS at Oregon Health & Science University from January 2006 to June 2010. Patients were separated based on CVS indication: (1) positive ultrasound (U/S) or serum screening; or (2) AMA or prior aneuploidy with normal or no screening. Prevalence of abnormal karyotype results were compared between groups. Fetal karyotyping was successful in 500 of 506 CVS procedures performed. 203 CVS were performed for positive screening with 69 abnormal karyotypes (34.0%). 264 CVS were performed for historical indications with 11 abnormal karyotypes (4.2%). This difference was statistically significant (χ(2) 71.9, p < 0.001; OR 11.8 [95% CI 5.8, 24.6]). There were two age-related aneuplodies in AMA women without positive screening. 42 out of 44 AMA women diagnosed with aneuploidy (95.5%) had abnormal U/S and/or serum screening (35 U/S, 4 serum, 3 U/S and serum). Combined ultrasound and serum screening should be recommended to all women, including AMA women, prior to undergoing invasive testing to improve risk-based counseling and minimize morbidity.

[Public reporting of the Californian "pay for performance" conducted by the Integrated Healthcare Association (IHA)].

PubMed

Emmert, M; Schöffski, O

2007-01-01

In Germany, there is little transparency when it comes to quality of care of national health care providers. The population has hardly any opportunity to identify well-performing health-care providers. Therefore, the emerging quality improvement initiative "Pay for Performance (P4P)" developed in California, USA is examined with regard to an implementation into the German health care sector. This program wants to achieve higher levels of health care by setting both goal-oriented financial and non-financial incentives. Therefore, performance-based payment is combined with Public Reporting of the measured quality of care. As people can be influenced by the information provided, Public Reporting is supposed to have a positive effect on the quality of treatment. Published data to the American population will be highlighted as well as indications and examinations included in the P4P program. Also, it will be shown how the performance of health care providers is determined. Since published performance results can be considered not only for a specific indication but also as a whole, patients have the opportunity to choose a well-performing health-care provider, according to their specific requirements. Thus, Public Reporting might be regarded as an effective method in order to improve the quality of care provided by health-care providers. Public Reporting in P4P is already conducted in a differentiated but also in a broad context. In the development of this key success element, many stakeholders have been involved, including health-care providers. So, the presented way of Public Reporting can be regarded as a business case to learn from with regard to more transparency in the German health-care sector.

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

PubMed

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

2015-05-15

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

An association of platelet indices with blood pressure in Beijing adults: Applying quadratic inference function for a longitudinal study.

PubMed

Yang, Kun; Tao, Lixin; Mahara, Gehendra; Yan, Yan; Cao, Kai; Liu, Xiangtong; Chen, Sipeng; Xu, Qin; Liu, Long; Wang, Chao; Huang, Fangfang; Zhang, Jie; Yan, Aoshuang; Ping, Zhao; Guo, Xiuhua

2016-09-01

The quadratic inference function (QIF) method becomes more acceptable for correlated data because of its advantages over generalized estimating equations (GEE). This study aimed to evaluate the relationship between platelet indices and blood pressure using QIF method, which has not been studied extensively in real data settings.A population-based longitudinal study was conducted in Beijing from 2007 to 2012, and the median of follow-up was 6 years. A total of 6515 cases, who were aged between 20 and 65 years at baseline and underwent routine physical examinations every year from 3 Beijing hospitals were enrolled to explore the association between platelet indices and blood pressure by QIF method. The original continuous platelet indices were categorized into 4 levels (Q1-Q4) using the 3 quartiles of P25, P50, and P75 as a critical value. GEE was performed to make a comparison with QIF.After adjusting for age, usage of drugs, and other confounding factors, mean platelet volume was negatively associated with diastolic blood pressure (DBP) (Equation is included in full-text article.)in males and positively linked with systolic blood pressure (SBP) (Equation is included in full-text article.). Platelet distribution width was negatively associated with SBP (Equation is included in full-text article.). Blood platelet count was associated with DBP (Equation is included in full-text article.)in males.Adults in Beijing with prolonged exposure to extreme value of platelet indices have elevated risk for future hypertension and evidence suggesting using some platelet indices for early diagnosis of high blood pressure was provided.

A Guide to Using Case-Based Learning in Biochemistry Education

ERIC Educational Resources Information Center

Kulak, Verena; Newton, Genevieve

2014-01-01

Studies indicate that the majority of students in undergraduate biochemistry take a surface approach to learning, associated with rote memorization of material, rather than a deep approach, which implies higher cognitive processing. This behavior relates to poorer outcomes, including impaired course performance and reduced knowledge retention. The…

Science Indicators: The 1985 Report.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC. National Science Board.

This report provides basic information on patterns and trends of research and development (R&D) performance in the United States itself and in relation to other countries, as well as data on public attitudes toward science and technology. Major areas addressed in the report's eight chapters include (1) the international science and technology…

The Effect of Cooperative Groups on Math Anxiety

ERIC Educational Resources Information Center

Batton, Melissa

2010-01-01

Research indicates that many students have difficulty with mathematics, which can be attributed to many factors including math anxiety. Students who experience math anxiety have poor attitudes towards mathematics and perform below grade level based on class and statewide assessments. The purpose of this quasi-experimental quantitative study was to…

School Turnaround Leaders: Competencies for Success. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

Evidence collected over the last 30 years suggests that effective school leaders significantly influence student learning and other aspects of school performance. Documented experience also indicates that individual leaders in failing organizations in various sectors, including education, can effect rapid, dramatic improvements. School turnaround…

A Comparative Assessment of Greek Universities' Efficiency Using Quantitative Analysis

ERIC Educational Resources Information Center

Katharaki, Maria; Katharakis, George

2010-01-01

In part due to the increased demand for higher education, typical evaluation frameworks for universities often address the key issue of available resource utilisation. This study seeks to estimate the efficiency of 20 public universities in Greece through quantitative analysis (including performance indicators, data envelopment analysis (DEA) and…

The Role of the Library Media Specialist in Standards-Based Learning.

ERIC Educational Resources Information Center

Corey, Linda

2002-01-01

Discusses the role of the school library media specialist in standards-based learning. Topics include standards-based assessment; information literacy standards; collaboration with classroom teachers; benchmarks and indicators for student performance; leadership in a standards-based climate; and the use of technology to support curriculum and…

Aerobic Digestion. Student Manual. Biological Treatment Process Control.

ERIC Educational Resources Information Center

Klopping, Paul H.

This manual contains the textual material for a single-lesson unit on aerobic sludge digestion. Topic areas addressed include: (1) theory of aerobic digestion; (2) system components; (3) performance factors; (4) indicators of stable operation; and (5) operational problems and their solutions. A list of objectives, glossary of key terms, and…

Conditions of Children in California

ERIC Educational Resources Information Center

Policy Analysis for California Education, Berkeley, CA.

Although many California children are growing up in circumstances favoring school performance, many others are inhibited by poor health, poverty, low-quality child care, and other factors external to schools. This report assembles a set of indicators depicting California children's quality of life. Data are included on physical and mental health,…

General Mechanical Trades: A Curriculum Guide. Revised Edition.

ERIC Educational Resources Information Center

Henderson, W. Charles; And Others

The guide contains six sections, each consisting of one or more units of general mechanical trades instruction. The sections cover: safety and tools, measuring and blueprint reading, gas welding, arc welding, small engines, and metal work. Each unit includes performance objectives stated as terminal objectives, indicating the subject matter to be…

Laboratory evaluation of high asphalt binder replacement with recycled asphalt shingles (RAS) for a low n-design asphalt mixture.

DOT National Transportation Integrated Search

2012-10-01

This study investigated the effect of high asphalt binder replacement for a low N-design asphalt mixture including : RAP and RAS on performance indicators such as permanent deformation, fracture, fatigue potentials, and : stiffness, was studied. An e...

20 CFR 666.100 - What performance indicators must be included in a State's plan?

Code of Federal Regulations, 2011 CFR

2011-04-01

... employment; and (iv) Attainment of a recognized credential related to achievement of educational skills (such as a secondary school diploma or its recognized equivalent), or occupational skills, by participants... employment; and (iv) Attainment of a recognized credential related to achievement of educational skills (such...

(The Androgyny Dimension: A Comment on Stokes, Childs, and Fuehrer: And a Response.)

ERIC Educational Resources Information Center

Lubinski, David; Stokes, Joseph

1983-01-01

Suggests a critical methodological flaw in a study done about the relationship between the Bem Sex-Role Inventory and certain indices of self-disclosure (Stokes, et al.). Notes that multiple regression analysis was not performed in appropriate hierarchical fashion. Includes Stokes reply to the critique. (PAS)

Exploring NIR technique in rapid prediction of cotton trash components

USDA-ARS?s Scientific Manuscript database

Near infrared (NIR) spectroscopy, a useful technique due to the speed, ease of use, and adaptability to on-line or off-line implementation, has been applied to perform the qualitative classification and quantitative prediction on a number of cotton quality indices, including cotton trash from HVI, S...

Focus on Student Success: Components for Effective Summer Bridge Programs

ERIC Educational Resources Information Center

Gonzalez Quiroz, Alicia; Garza, Nora R.

2018-01-01

Using research focused on best practices, focus group information, and data analytics, the Title V: Focus on Student Success (FOSS) Grant created a model for the development, implementation, and evaluation of a summer bridge program. Results included increased academic performance indicators in first-year Hispanic college students. Validation for…

Artificial astrocytes improve neural network performance.

PubMed

Porto-Pazos, Ana B; Veiguela, Noha; Mesejo, Pablo; Navarrete, Marta; Alvarellos, Alberto; Ibáñez, Oscar; Pazos, Alejandro; Araque, Alfonso

2011-04-19

Compelling evidence indicates the existence of bidirectional communication between astrocytes and neurons. Astrocytes, a type of glial cells classically considered to be passive supportive cells, have been recently demonstrated to be actively involved in the processing and regulation of synaptic information, suggesting that brain function arises from the activity of neuron-glia networks. However, the actual impact of astrocytes in neural network function is largely unknown and its application in artificial intelligence remains untested. We have investigated the consequences of including artificial astrocytes, which present the biologically defined properties involved in astrocyte-neuron communication, on artificial neural network performance. Using connectionist systems and evolutionary algorithms, we have compared the performance of artificial neural networks (NN) and artificial neuron-glia networks (NGN) to solve classification problems. We show that the degree of success of NGN is superior to NN. Analysis of performances of NN with different number of neurons or different architectures indicate that the effects of NGN cannot be accounted for an increased number of network elements, but rather they are specifically due to astrocytes. Furthermore, the relative efficacy of NGN vs. NN increases as the complexity of the network increases. These results indicate that artificial astrocytes improve neural network performance, and established the concept of Artificial Neuron-Glia Networks, which represents a novel concept in Artificial Intelligence with implications in computational science as well as in the understanding of brain function.

An experimental investigation of multi-element airfoil ice accretion and resulting performance degradation

NASA Technical Reports Server (NTRS)

Potapczuk, Mark G.; Berkowitz, Brian M.

1989-01-01

An investigation of the ice accretion pattern and performance characteristics of a multi-element airfoil was undertaken in the NASA Lewis 6- by 9-Foot Icing Research Tunnel. Several configurations of main airfoil, slat, and flaps were employed to examine the effects of ice accretion and provide further experimental information for code validation purposes. The text matrix consisted of glaze, rime, and mixed icing conditions. Airflow and icing cloud conditions were set to correspond to those typical of the operating environment anticipated tor a commercial transport vehicle. Results obtained included ice profile tracings, photographs of the ice accretions, and force balance measurements obtained both during the accretion process and in a post-accretion evaluation over a range of angles of attack. The tracings and photographs indicated significant accretions on the slat leading edge, in gaps between slat or flaps and the main wing, on the flap leading-edge surfaces, and on flap lower surfaces. Force measurments indicate the possibility of severe performance degradation, especially near C sub Lmax, for both light and heavy ice accretion and performance analysis codes presently in use. The LEWICE code was used to evaluate the ice accretion shape developed during one of the rime ice tests. The actual ice shape was then evaluated, using a Navier-Strokes code, for changes in performance characteristics. These predicted results were compared to the measured results and indicate very good agreement.

Artificial Astrocytes Improve Neural Network Performance

PubMed Central

Porto-Pazos, Ana B.; Veiguela, Noha; Mesejo, Pablo; Navarrete, Marta; Alvarellos, Alberto; Ibáñez, Oscar; Pazos, Alejandro; Araque, Alfonso

2011-01-01

Compelling evidence indicates the existence of bidirectional communication between astrocytes and neurons. Astrocytes, a type of glial cells classically considered to be passive supportive cells, have been recently demonstrated to be actively involved in the processing and regulation of synaptic information, suggesting that brain function arises from the activity of neuron-glia networks. However, the actual impact of astrocytes in neural network function is largely unknown and its application in artificial intelligence remains untested. We have investigated the consequences of including artificial astrocytes, which present the biologically defined properties involved in astrocyte-neuron communication, on artificial neural network performance. Using connectionist systems and evolutionary algorithms, we have compared the performance of artificial neural networks (NN) and artificial neuron-glia networks (NGN) to solve classification problems. We show that the degree of success of NGN is superior to NN. Analysis of performances of NN with different number of neurons or different architectures indicate that the effects of NGN cannot be accounted for an increased number of network elements, but rather they are specifically due to astrocytes. Furthermore, the relative efficacy of NGN vs. NN increases as the complexity of the network increases. These results indicate that artificial astrocytes improve neural network performance, and established the concept of Artificial Neuron-Glia Networks, which represents a novel concept in Artificial Intelligence with implications in computational science as well as in the understanding of brain function. PMID:21526157

Hotspots identification and ranking for road safety improvement: an alternative approach.

PubMed

Coll, Bronagh; Moutari, Salissou; Marshall, Adele H

2013-10-01

During the last decade, the concept of composite performance index, brought from economic and business statistics, has become a popular practice in the field of road safety, namely for the identification and classification of worst performing areas or time slots also known as hotspots. The overall quality of a composite index depends upon the complexity of phenomena of interest as well as the relevance of the methodological approach used to aggregate the various indicators into a single composite index. However, current aggregation methods used to estimate the composite road safety performance index suffer from various deficiencies at both the theoretical and operational level; these include the correlation and compensability between indicators, the weighting of the indicators as well as their high "degree of freedom" which enables one to readily manipulate them to produce desired outcomes (Munda and Nardo, 2003, 2005, 2009). The objective of this study is to contribute to the ongoing research effort on the estimation of road safety composite index for hotspots' identification and ranking. The aggregation method for constructing the composite road safety performance index introduced in this paper, strives to minimize the aforementioned deficiencies of the current approaches. Furthermore, this new method can be viewed as an intelligent decision support system for road safety performance evaluation, in order to prioritize interventions for road safety improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison of Muscle Mass Indices Using Computed Tomography or Dual X-Ray Absorptiometry for Predicting Physical Performance in Hemodialysis Patients.

PubMed

Kang, Seok Hui; Lee, Hyun Seok; Lee, Sukyung; Cho, Ji-Hyung; Kim, Jun Chul

2017-01-01

Our study aims to evaluate the association between thigh muscle cross-sectional area (TMA) using computed tomography (CT), or appendicular skeletal muscle mass (ASM) using dual energy X-ray absorptiometry (DEXA), and physical performance levels in hemodialysis (HD) patients. Patients were included if they were on HD for ≥6 months (n = 84). ASM and TMA were adjusted to body weight (BW, kg) or height2 (Ht2, m2). Each participant performed a short physical performance battery test (SPPB), a sit-to-stand for 30 second test (STS30), a 6-minute walk test (6-MWT), a timed up and go test (TUG), and hand grip strength (HGS) test. Correlation coefficients for SPPB, GS, 5STS, STS30, 6-MWT, and TUG were highest in TMA/BW. Results from partial correlation or linear regression analyses displayed similar trends to those derived from Pearson's correlation analyses. An increase in TMA/BW or TMA/Ht2 was associated with a decreased odds ratio of low SPPB, GS, or HGS in multivariate analyses. Indices using DEXA were associated with a decreased odds ratio of a low HGS only in multivariate analysis. TMA indices using CT may be more valuable in predicting physical performance or strength in HD patients. © 2017 The Author(s). Published by S. Karger AG, Basel.

Association Between Undergraduate Performance Predictors and Academic and Clinical Performance of Osteopathic Medical Students.

PubMed

Agahi, Farshad; Speicher, Mark R; Cisek, Grace

2018-02-01

Medical schools use a variety of preadmission indices to select potential students. These indices generally include undergraduate grade point average (GPA), Medical College Admission Test (MCAT) scores, and preadmission interviews. To investigate whether the admission indices used by Midwestern University Arizona College of Osteopathic Medicine are associated with the academic and clinical performance of their students. Associations between the prematriculation variables of undergraduate science GPA, undergraduate total GPA, MCAT component scores, and interview scores and the academic and clinical variables of the first- and second-year medical school GPA, Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Cognitive Evaluation (CE) total and discipline scores, scores in clinical rotations for osteopathic competencies, COMLEX-USA Level 2-Performance Evaluation passage, and match status were evaluated. Two-tailed Pearson product-moment correlations with a Bonferroni adjustment were used to examine these relationships. The traditional predictors of science and total undergraduate GPA as well as total and component MCAT scores had small to moderate associations with first- and second-year GPA, as well as COMLEX-USA Level 1 and Level 2-CE total scores. Of all predictors, only the MCAT biological sciences score had a statistically significant correlation with failure of the COMLEX-USA Level 2-Performance Evaluation examination (P=.009). Average interview scores were associated only with the osteopathic competency of medical knowledge (r=0.233; n=209; P=.001), as assessed by clerkship preceptors. No predictors were associated with scores in objective structured clinical encounters or with failing to match to a residency position. The data indicate that traditional predictors of academic performance (undergraduate GPA, undergraduate science GPA, and MCAT scores) have small to moderate association with medical school grades and performance on COMLEX-USA Level 1 and Level 2-CE. This finding requires additional research into the value of the interview in the medical school admissions process and the availability of alternatives that allow better prediction and assessment of applicant performance.

Similarity indices based on link weight assignment for link prediction of unweighted complex networks

NASA Astrophysics Data System (ADS)

Liu, Shuxin; Ji, Xinsheng; Liu, Caixia; Bai, Yi

2017-01-01

Many link prediction methods have been proposed for predicting the likelihood that a link exists between two nodes in complex networks. Among these methods, similarity indices are receiving close attention. Most similarity-based methods assume that the contribution of links with different topological structures is the same in the similarity calculations. This paper proposes a local weighted method, which weights the strength of connection between each pair of nodes. Based on the local weighted method, six local weighted similarity indices extended from unweighted similarity indices (including Common Neighbor (CN), Adamic-Adar (AA), Resource Allocation (RA), Salton, Jaccard and Local Path (LP) index) are proposed. Empirical study has shown that the local weighted method can significantly improve the prediction accuracy of these unweighted similarity indices and that in sparse and weakly clustered networks, the indices perform even better.

First regulatory inspections measuring adherence to Good Pharmacy Practices in the public sector in Uganda: a cross-sectional comparison of performance between supervised and unsupervised facilities.

PubMed

Trap, Birna; Kikule, Kate; Vialle-Valentin, Catherine; Musoke, Richard; Lajul, Grace Otto; Hoppenworth, Kim; Konradsen, Dorthe

2016-01-01

Since its inception, the Uganda National Drug Authority (NDA) has regularly inspected private sector pharmacies to monitor adherence to Good Pharmacy Practices (GPP). This study reports findings from the first public facility inspections following an intervention (SPARS: Supervision, Performance Assessment, and Recognition Strategy) to build GPP and medicines management capacity in the public sector. The study includes 455 public facilities: 417 facilities were inspected after at least four SPARS visits by trained managerial district staff (SPARS group), 38 before any exposure to SPARS. NDA inspectors measured 10 critical, 20 major, and 37 minor GPP indicators in every facility and only accredited facilities that passed all 10 critical and failed no more than 7 major indicators. Lack of compliance for a given indicator was defined as less than 75 % facilities passing that indicator. We assessed factors associated with certification using logistic regression analysis and compared number of failed indicators between the SPARS and comparative groups using two sample t-tests with equal or unequal variance. 57.4 % of inspected facilities obtained GPP certification: 57.1 % in the SPARS and 60.5 % in the comparative group (Adj. OR = 0.91, 95 % CI 0.45-1.85, p = 0.802). Overall, facilities failed an average of 10 indicators. SPARS facilities performed better than comparative facilities (9 (SD 6.1) vs. 13 (SD 7.7) failed indicators respectively; p = 0.017), and SPARS supported facilities scored better on indicators covered by SPARS. For all indicators but one minor, performance in the SPARS group was equal to or significantly better than in unsupervised facilities. Within the SPARS (intervention) group, certified facilities had < 75 % compliance on 7 indicators (all minor), and uncertified facilities on 19 (4 critical, 2 major, and 13 minor) indicators. Half of the Ugandan population obtains medicines from the public sector. Yet, we found only 3/5 of inspected public health facilities meet GPP standards. SPARS facilities tended to perform better than unsupervised facilities, substantiating the value of supporting supervision interventions in GPP areas that need strengthening. None compliant indicators can be improved through practices and behavioral changes; some require infrastructure investments. We conclude that regular NDA inspections of public sector pharmacies in conjunction with interventions to improve GPP adherence can revolutionize patient care in Uganda.

Independent and combined influence of the components of physical fitness on academic performance in youth.

PubMed

Esteban-Cornejo, Irene; Tejero-González, Carlos Ma; Martinez-Gomez, David; del-Campo, Juan; González-Galo, Ana; Padilla-Moledo, Carmen; Sallis, James F; Veiga, Oscar L

2014-08-01

To examine the independent and combined associations of the components of physical fitness with academic performance among youths. This cross-sectional study included a total of 2038 youths (989 girls) aged 6-18 years. Cardiorespiratory capacity was measured using the 20-m shuttle run test. Motor ability was assessed with the 4×10-m shuttle run test of speed of movement, agility, and coordination. A muscular strength z-score was computed based on handgrip strength and standing long jump distance. Academic performance was assessed through school records using 4 indicators: Mathematics, Language, an average of Mathematics and Language, and grade point average score. Cardiorespiratory capacity and motor ability were independently associated with all academic variables in youth, even after adjustment for fitness and fatness indicators (all P≤.001), whereas muscular strength was not associated with academic performance independent of the other 2 physical fitness components. In addition, the combined adverse effects of low cardiorespiratory capacity and motor ability on academic performance were observed across the risk groups (P for trend<.001). Cardiorespiratory capacity and motor ability, both independently and combined, may have a beneficial influence on academic performance in youth. Copyright © 2014 Elsevier Inc. All rights reserved.

Cognitive and attitudinal predictors related to graphing achievement among pre-service elementary teachers

NASA Astrophysics Data System (ADS)

Szyjka, Sebastian P.

The purpose of this study was to determine the extent to which six cognitive and attitudinal variables predicted pre-service elementary teachers' performance on line graphing. Predictors included Illinois teacher education basic skills sub-component scores in reading comprehension and mathematics, logical thinking performance scores, as well as measures of attitudes toward science, mathematics and graphing. This study also determined the strength of the relationship between each prospective predictor variable and the line graphing performance variable, as well as the extent to which measures of attitude towards science, mathematics and graphing mediated relationships between scores on mathematics, reading, logical thinking and line graphing. Ninety-four pre-service elementary education teachers enrolled in two different elementary science methods courses during the spring 2009 semester at Southern Illinois University Carbondale participated in this study. Each subject completed five different instruments designed to assess science, mathematics and graphing attitudes as well as logical thinking and graphing ability. Sixty subjects provided copies of primary basic skills score reports that listed subset scores for both reading comprehension and mathematics. The remaining scores were supplied by a faculty member who had access to a database from which the scores were drawn. Seven subjects, whose scores could not be found, were eliminated from final data analysis. Confirmatory factor analysis (CFA) was conducted in order to establish validity and reliability of the Questionnaire of Attitude Toward Line Graphs in Science (QALGS) instrument. CFA tested the statistical hypothesis that the five main factor structures within the Questionnaire of Attitude Toward Statistical Graphs (QASG) would be maintained in the revised QALGS. Stepwise Regression Analysis with backward elimination was conducted in order to generate a parsimonious and precise predictive model. This procedure allowed the researcher to explore the relationships among the affective and cognitive variables that were included in the regression analysis. The results for CFA indicated that the revised QALGS measure was sound in its psychometric properties when tested against the QASG. Reliability statistics indicated that the overall reliability for the 32 items in the QALGS was .90. The learning preferences construct had the lowest reliability (.67), while enjoyment (.89), confidence (.86) and usefulness (.77) constructs had moderate to high reliabilities. The first four measurement models fit the data well as indicated by the appropriate descriptive and statistical indices. However, the fifth measurement model did not fit the data well statistically, and only fit well with two descriptive indices. The results addressing the research question indicated that mathematical and logical thinking ability were significant predictors of line graph performance among the remaining group of variables. These predictors accounted for 41% of the total variability on the line graph performance variable. Partial correlation coefficients indicated that mathematics ability accounted for 20.5% of the variance on the line graphing performance variable when removing the effect of logical thinking. The logical thinking variable accounted for 4.7% of the variance on the line graphing performance variable when removing the effect of mathematics ability.

Reaction time as an indicator of insufficient effort: Development and validation of an embedded performance validity parameter.

PubMed

Stevens, Andreas; Bahlo, Simone; Licha, Christina; Liske, Benjamin; Vossler-Thies, Elisabeth

2016-11-30

Subnormal performance in attention tasks may result from various sources including lack of effort. In this report, the derivation and validation of a performance validity parameter for reaction time is described, using a set of malingering-indices ("Slick-criteria"), and 3 independent samples of participants (total n =893). The Slick-criteria yield an estimate of the probability of malingering based on the presence of an external incentive, evidence from neuropsychological testing, from self-report and clinical data. In study (1) a validity parameter is derived using reaction time data of a sample, composed of inpatients with recent severe brain lesions not involved in litigation and of litigants with and without brain lesion. In study (2) the validity parameter is tested in an independent sample of litigants. In study (3) the parameter is applied to an independent sample comprising cooperative and non-cooperative testees. Logistic regression analysis led to a derived validity parameter based on median reaction time and standard deviation. It performed satisfactorily in studies (2) and (3) (study 2 sensitivity=0.94, specificity=1.00; study 3 sensitivity=0.79, specificity=0.87). The findings suggest that median reaction time and standard deviation may be used as indicators of negative response bias. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Conceptual Design Optimization of an Augmented Stability Aircraft Incorporating Dynamic Response Performance Constraints

NASA Technical Reports Server (NTRS)

Welstead, Jason

2014-01-01

This research focused on incorporating stability and control into a multidisciplinary de- sign optimization on a Boeing 737-class advanced concept called the D8.2b. A new method of evaluating the aircraft handling performance using quantitative evaluation of the sys- tem to disturbances, including perturbations, continuous turbulence, and discrete gusts, is presented. A multidisciplinary design optimization was performed using the D8.2b transport air- craft concept. The con guration was optimized for minimum fuel burn using a design range of 3,000 nautical miles. Optimization cases were run using xed tail volume coecients, static trim constraints, and static trim and dynamic response constraints. A Cessna 182T model was used to test the various dynamic analysis components, ensuring the analysis was behaving as expected. Results of the optimizations show that including stability and con- trol in the design process drastically alters the optimal design, indicating that stability and control should be included in conceptual design to avoid system level penalties later in the design process.

The development of an augmentor wing jet STOL research aircraft (modified C-8A). Volume 2: Analysis of contractor's flight test

NASA Technical Reports Server (NTRS)

Skavdahl, H.; Patterson, D. H.

1972-01-01

The initial flight test phase of the modified C-8A airplane was conducted. The primary objective of the testing was to establish the basic airworthiness of the research vehicle. This included verification of the structural design and evaluation of the aircraft's systems. Only a minimum amount of performance testing was scheduled; this has been used to provide a preliminary indication of the airplane's performance and flight characteristics for future flight planning. The testing included flutter and loads investigations up to the maximum design speed. The operational characteristics of all systems were assessed including hydraulics, environmental control system, air ducts, the vectoring conical nozzles, and the stability augmentation system (SAS). Approaches to stall were made at three primary flap settings: up, 30 deg and 65 deg, but full stalls were not scheduled. Minimum control speeds and maneuver margins were checked. All takeoffs and landings were conventional, and STOL performance was not scheduled during this phase of the evaluation.

Indices of Abdominal Adiposity and Cardiorespiratory Fitness Test Performance in Middle-School Students

PubMed Central

Burns, Ryan; Hannon, James C.; Brusseau, Timothy A.; Shultz, Barry; Eisenman, Patricia

2013-01-01

Background. Previous research suggests that use of BMI as a screening tool to assess health in youth has limitations. Valid alternative measures to assess body composition are needed to accurately identify children who are aerobically fit, which is an indicator of health status. The purpose of this study was to examine the associations between select anthropometric measures and cardiorespiratory fitness test performance in middle-school students. Methods. Participants included 134 students (65 boys and 69 girls) recruited from the 6th, 7th, and 8th grades. Anthropometric measures consisted of BMI, waist circumference (WC), waist-to-height ratio (WHtR), and percent body fat estimated from two-site skinfolds (%BF-SKF), as well as the hand-held OMRON BIA device (%BF-BIA). Cardiorespiratory fitness tests included the one-mile run and PACER test. Data were collected on four separate testing days during the students' physical education classes. Results. There were statistically significant moderate correlations between the %BF estimations, WHtR, and cardiorespiratory fitness test scores in both genders (P < .001). BMI at best only displayed weak correlations with the cardiorespiratory fitness test scores. Conclusions. The results suggest that alternative measures such as %BF-SKF, %BF-BIA, and WHtR may be more valid indicators of youth aerobic fitness lending to their preferred use over BMI. PMID:23533727

Indices of abdominal adiposity and cardiorespiratory fitness test performance in middle-school students.

PubMed

Burns, Ryan; Hannon, James C; Brusseau, Timothy A; Shultz, Barry; Eisenman, Patricia

2013-01-01

Previous research suggests that use of BMI as a screening tool to assess health in youth has limitations. Valid alternative measures to assess body composition are needed to accurately identify children who are aerobically fit, which is an indicator of health status. The purpose of this study was to examine the associations between select anthropometric measures and cardiorespiratory fitness test performance in middle-school students. Participants included 134 students (65 boys and 69 girls) recruited from the 6th, 7th, and 8th grades. Anthropometric measures consisted of BMI, waist circumference (WC), waist-to-height ratio (WHtR), and percent body fat estimated from two-site skinfolds (%BF-SKF), as well as the hand-held OMRON BIA device (%BF-BIA). Cardiorespiratory fitness tests included the one-mile run and PACER test. Data were collected on four separate testing days during the students' physical education classes. There were statistically significant moderate correlations between the %BF estimations, WHtR, and cardiorespiratory fitness test scores in both genders (P < .001). BMI at best only displayed weak correlations with the cardiorespiratory fitness test scores. The results suggest that alternative measures such as %BF-SKF, %BF-BIA, and WHtR may be more valid indicators of youth aerobic fitness lending to their preferred use over BMI.

Perceptions and Determinants of Eating for Health and Performance in High-Level Male Adolescent Rugby Union Players.

PubMed

Stokes, Emily G; Hughes, Roger; Shaw, David M; O'Connor, Helen T; Beck, Kathryn L

2018-05-28

Sports nutrition recommendations provide guidance on dietary strategies to optimise sports performance. However, research indicates that young athletes often find it difficult to follow these guidelines in practice. Limited research exists on the determinants that influence adherence to sports nutrition guidelines. This study aimed to explore the perceptions and determinants of eating for health and performance in high-level male adolescent rugby union players. Determinants were explored using semi-structured individual interviews in New Zealand high-level male rugby union players ( n = 20, 16⁻18 years). Interviews were recorded, transcribed, and then underwent thematic analysis. Perceptions of eating for health and performance included balance and variety, appropriate portions, and specific foods. Both adolescent- and sport-specific determinants influenced the food choices of participants. Determinants relevant to adolescent lifestyles included the influence of significant others such as peers and family but also included the taste, cost, convenience, and availability of food. Sports-specific determinants revolved around the desire to enhance sports performance, motivation to perform, and team culture. The media (mainstream and social media), physical appearance, and feeling good were identified as both adolescent- and sport-specific factors influencing food choice. These findings highlight the importance of having support and positive role modelling to help young athletes make optimal food choices for health and performance. Strategies to further enable healthy eating practices should aim to strengthen the support available to young athletes in the home, school, and sporting environments and should include education on appropriate social media use to inform eating for health and performance.

Contemporary considerations in concurrent endoscopic sinus surgery and rhinoplasty.

PubMed

Steele, Toby O; Gill, Amarbir; Tollefson, Travis T

2018-06-11

Characterize indications, perioperative considerations, clinical outcomes and complications for concurrent endoscopic sinus surgery (ESS) and rhinoplasty. Chronic rhinosinusitis and septal deviation with or without inferior turbinate hypertrophy independently impair patient-reported quality of life. Guidelines implore surgeons to include endoscopy to accurately evaluate patient symptoms. Complication rates parallel those of either surgery (ESS and rhinoplasty) alone and are not increased when performed concurrently. Operative time is generally longer for joint surgeries. Patient satisfaction rates are high. Concurrent functional and/or cosmetic rhinoplasty and ESS is a safe endeavor to perform in a single operative setting and most outcomes data suggest excellent patient outcomes. Additional studies that include patient-reported outcome measures are needed.

Drivers of improved health sector performance in Rwanda: a qualitative view from within.

PubMed

Sayinzoga, Felix; Bijlmakers, Leon

2016-04-08

Rwanda has achieved great improvements in several key health indicators, including maternal mortality and other health outcomes. This raises the question: what has made this possible, and what makes Rwanda so unique? We describe the results of a web-based survey among district health managers in Rwanda who gave their personal opinions on the factors that drive performance in the health sector, in particular those that determine maternal health service coverage and outcomes. The questionnaire covered the six health systems building blocks that make up the WHO framework for health systems analysis, and two additional clusters of factors that are not directly covered by the framework: community health and determinants beyond the health sector. Community health workers and health insurance come out as factors that are considered to have contributed most to Rwanda's remarkable achievements in the past decade. The results also indicate the importance of other health system features, such as managerial skills and the culture of continuous monitoring of key indicators. In addition, there are factors beyond the health sector per se, such as the widespread determination of people to increase performance and achieve targets. This determination appears multi-levelled and influenced by both intrinsic and extrinsic motivation. It is the comprehensiveness and combination of interventions that drive performance in Rwanda, rather than a single health systems strengthening intervention or a set of interventions that target a specific disease. There is need for policy makers and scholars to acknowledge the complexity of health systems, and the fact that they are dynamic and influenced by society's fabric, including the overall culture of performance management in the public sector. Rwanda's robust model is difficult to replicate and fast-tracking elsewhere in the world of some of the interventions that form part of its success will require a holistic approach.

Pretest analysis document for Semiscale Test S-LH-1

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

Shaw, R.A.

Results from various pretest calculations which were performed for Test S-LH-1 are included in this report. Test S-LH-1 has been designed to produce primary liquid holdup in the steam generator U-tubes similar to Tests S-UT-8. The analyses included in this report indicate liquid will be held in the tubes, the core liquid level will be appropriately depressed, and a core heater rod temperature excursion should occur. Several sensitivity studies are also included which identify parameters which could affect the response.

Ground-Based Telescope Parametric Cost Model

NASA Technical Reports Server (NTRS)

Stahl, H. Philip; Rowell, Ginger Holmes

2004-01-01

A parametric cost model for ground-based telescopes is developed using multi-variable statistical analysis, The model includes both engineering and performance parameters. While diameter continues to be the dominant cost driver, other significant factors include primary mirror radius of curvature and diffraction limited wavelength. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e.. multi-telescope phased-array systems). Additionally, single variable models based on aperture diameter are derived. This analysis indicates that recent mirror technology advances have indeed reduced the historical telescope cost curve.

Taiwan industrial cooperation program technology transfer for low-level radioactive waste final disposal - phase I.

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

Knowlton, Robert G.; Cochran, John Russell; Arnold, Bill Walter

2007-01-01

Sandia National Laboratories and the Institute of Nuclear Energy Research, Taiwan have collaborated in a technology transfer program related to low-level radioactive waste (LLW) disposal in Taiwan. Phase I of this program included regulatory analysis of LLW final disposal, development of LLW disposal performance assessment capabilities, and preliminary performance assessments of two potential disposal sites. Performance objectives were based on regulations in Taiwan and comparisons to those in the United States. Probabilistic performance assessment models were constructed based on limited site data using software including GoldSim, BLT-MS, FEHM, and HELP. These software codes provided the probabilistic framework, container degradation, waste-formmore » leaching, groundwater flow, radionuclide transport, and cover infiltration simulation capabilities in the performance assessment. Preliminary performance assessment analyses were conducted for a near-surface disposal system and a mined cavern disposal system at two representative sites in Taiwan. Results of example calculations indicate peak simulated concentrations to a receptor within a few hundred years of LLW disposal, primarily from highly soluble, non-sorbing radionuclides.« less

Age differences in the performance of basketball dribbling by elementary school boys.

PubMed

Caterino, M C

1991-08-01

Age differences in hand contact time and ball-to-floor distance during the performance of a basketball dribbling task by 30 5- to 6-, 7- to 8-, and 9- to 10-yr.-old boys were studied. Each age group included 10 boys, five with high rhythm audiation skill and five with low rhythm audiation skill, as measured on Gordon's Primary or Intermediate Measures of Music Audiation. Performance during eight bounces was filmed with a 16-mm camera and analyzed with a stop-action projector. Analysis of variance indicated no statistically significant differences. Observed dribbling behaviors are discussed.

Performance evaluation of two black nickel and two black chrome solar collectors

NASA Technical Reports Server (NTRS)

Losey, R.

1977-01-01

The test program was based on the evaluation of four unique solar collectors described below: (1) black nickel collector surface with a desiccant drying bed, (2) black nickel collector surface without a desiccant drying bed, (3) black chrome collector surface with a dessicant drying bed, and (4) black chrome collector surface without a desiccant drying bed. The test program included three distinct phases: Initial performance evaluation, natural environmental aging, and post-aging performance evaluation. Results of Phase III testing conclusively indicated a higher normalized efficiency for Black Chrome surfaces when compared to Black Nickel.

Assessment of collection schemes for packaging and other recyclable waste in European Union-28 Member States and capital cities.

PubMed

Seyring, Nicole; Dollhofer, Marie; Weißenbacher, Jakob; Bakas, Ioannis; McKinnon, David

2016-09-01

The Waste Framework Directive obliged European Union Member States to set up separate collection systems to promote high quality recycling for at least paper, metal, plastic and glass by 2015. As implementation of the requirement varies across European Union Member States, the European Commission contracted BiPRO GmbH/Copenhagen Resource Institute to assess the separate collection schemes in the 28 European Union Member States, focusing on capital cities and on metal, plastic, glass (with packaging as the main source), paper/cardboard and bio-waste. The study includes an assessment of the legal framework for, and the practical implementation of, collection systems in the European Union-28 Member States and an in depth-analysis of systems applied in all capital cities. It covers collection systems that collect one or more of the five waste streams separately from residual waste/mixed municipal waste at source (including strict separation, co-mingled systems, door-to-door, bring-point collection and civic amenity sites). A scoreboard including 13 indicators is elaborated in order to measure the performance of the systems with the capture rates as key indicators to identify best performers. Best performance are by the cities of Ljubljana, Helsinki and Tallinn, leading to the key conclusion that door-to-door collection, at least for paper and bio-waste, and the implementation of pay-as-you-throw schemes results in high capture and thus high recycling rates of packaging and other municipal waste. © The Author(s) 2016.

Rorschach cognitive developmental indices of mentally retarded persons: a comparison with scores on Wechsler Intelligence Scale for children-revised.

PubMed

Di Nuovo, S F; Colucci, G; Pellicciotta, A; Buono, S

1997-08-01

In a sample of 55 mentally retarded subjects (M age = 14 yr., 1 mo.) the relations between some perceptual and cognitive Rorschach indices, including the Becker's Genetic Level Score, and Wechsler Scale scores were studied. The mean Developmental Score did not increase across ages and was higher for girls than for boys, while Verbal and Performance IQs were lower for girls. The correlations confirm the hypothesis that for mentally retarded persons WISC-R scaled scores and Rorschach cognitive indices are different measures of intellective functioning. The findings are discussed with reference to the assessment and rehabilitation of retarded subjects.

A Conceptual Framework for Evaluation of Public Health and Primary Care System Performance in Iran

PubMed Central

Jahanmehr, Nader; Rashidian, Arash; Khosravi, Ardeshir; Farzadfar, Farshad; Shariati, Mohammad; Majdzadeh, Reza; Sari, Ali Akbari; Mesdaghinia, Alireza

2015-01-01

Introduction: The main objective of this study was to design a conceptual framework, according to the policies and priorities of the ministry of health to evaluate provincial public health and primary care performance and to assess their share in the overall health impacts of the community. Methods: We used several tools and techniques, including system thinking, literature review to identify relevant attributes of health system performance framework and interview with the key stakeholders. The PubMed, Scopus, web of science, Google Scholar and two specialized databases of Persian language literature (IranMedex and SID) were searched using main terms and keywords. Following decision-making and collective agreement among the different stakeholders, 51 core indicators were chosen from among 602 obtained indicators in a four stage process, for monitoring and evaluation of Health Deputies. Results: We proposed a conceptual framework by identifying the performance area for Health Deputies between other determinants of health, as well as introducing a chain of results, for performance, consisting of Input, Process, Output and Outcome indicators. We also proposed 5 dimensions for measuring the performance of Health Deputies, consisting of efficiency, effectiveness, equity, access and improvement of health status. Conclusion: The proposed Conceptual Framework illustrates clearly the Health Deputies success in achieving best results and consequences of health in the country. Having the relative commitment of the ministry of health and Health Deputies at the University of Medical Sciences is essential for full implementation of this framework and providing the annual performance report. PMID:25946937

Monitoring and predicting cognitive state and performance via physiological correlates of neuronal signals.

PubMed

Russo, Michael B; Stetz, Melba C; Thomas, Maria L

2005-07-01

Judgment, decision making, and situational awareness are higher-order mental abilities critically important to operational cognitive performance. Higher-order mental abilities rely on intact functioning of multiple brain regions, including the prefrontal, thalamus, and parietal areas. Real-time monitoring of individuals for cognitive performance capacity via an approach based on sampling multiple neurophysiologic signals and integrating those signals with performance prediction models potentially provides a method of supporting warfighters' and commanders' decision making and other operationally relevant mental processes and is consistent with the goals of augmented cognition. Cognitive neurophysiological assessments that directly measure brain function and subsequent cognition include positron emission tomography, functional magnetic resonance imaging, mass spectroscopy, near-infrared spectroscopy, magnetoencephalography, and electroencephalography (EEG); however, most direct measures are not practical to use in operational environments. More practical, albeit indirect measures that are generated by, but removed from the actual neural sources, are movement activity, oculometrics, heart rate, and voice stress signals. The goal of the papers in this section is to describe advances in selected direct and indirect cognitive neurophysiologic monitoring techniques as applied for the ultimate purpose of preventing operational performance failures. These papers present data acquired in a wide variety of environments, including laboratory, simulator, and clinical arenas. The papers discuss cognitive neurophysiologic measures such as digital signal processing wrist-mounted actigraphy; oculometrics including blinks, saccadic eye movements, pupillary movements, the pupil light reflex; and high-frequency EEG. These neurophysiological indices are related to cognitive performance as measured through standard test batteries and simulators with conditions including sleep loss, time on task, and aviation flight-induced fatigue.

Healthcare Quality Indicators for Physiotherapy Management in Hip and Knee Osteoarthritis and Rheumatoid Arthritis: A Delphi Study.

PubMed

Peter, W F; Hurkmans, E J; van der Wees, P J; Hendriks, E J M; van Bodegom-Vos, L; Vliet Vlieland, T P M

2016-12-01

The aim of the present study was to develop healthcare quality indicators (HCQIs) for the physiotherapy (PT) management of patients with hip or knee osteoarthritis (HKOA) or rheumatoid arthritis (RA) in the Netherlands. Two multidisciplinary expert panels, including patients, were instituted. A draft HCQI set was derived from recommendations included in two existing Dutch PT guidelines for HKOA and RA. The panels suggested additional topics, after which a Delphi procedure was performed. All propositions were scored for their potential to represent good-quality PT care (score range 0-9). Based on predefined rules, the Delphi panel HCQIs were discussed and selected. Lastly, every indicator was rephrased, resulting in its output consisting of a numerator and denominator, to facilitate comparisons within and among practices. After two Delphi rounds, two final sets of 17 HCQI - one for HKOA and one for RA - were composed, both containing 16 process indicators (regarding initial assessment, treatment and evaluation) and one outcome indicator. Two sets of HCQIs for PT management in HKOA and RA were developed for measuring the quality of PT care in daily clinical practice. Each indicator was formulated in a measurable way. Future research should focus on the feasibility of both indicator sets for daily clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.

20 CFR 641.700 - What performance measures/indicators apply to SCSEP grantees?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What performance measures/indicators apply to... Accountability § 641.700 What performance measures/indicators apply to SCSEP grantees? (a) Indicators of performance. There are currently eight performance measures, of which six are core indicators and two are...

V and V Efforts of Auroral Precipitation Models: Preliminary Results

NASA Technical Reports Server (NTRS)

Zheng, Yihua; Kuznetsova, Masha; Rastaetter, Lutz; Hesse, Michael

2011-01-01

Auroral precipitation models have been valuable both in terms of space weather applications and space science research. Yet very limited testing has been performed regarding model performance. A variety of auroral models are available, including empirical models that are parameterized by geomagnetic indices or upstream solar wind conditions, now casting models that are based on satellite observations, or those derived from physics-based, coupled global models. In this presentation, we will show our preliminary results regarding V&V efforts of some of the models.

Propulsion technology for an advanced subsonic transport

NASA Technical Reports Server (NTRS)

Beheim, M. A.; Antl, R. J.; Povolny, J. H.

1972-01-01

Engine design studies for future subsonic commercial transport aircraft were conducted in parallel with airframe studies. These studies surveyed a broad distribution of design variables, including aircraft configuration, payload, range, and speed, with particular emphasis on reducing noise and exhaust emissions without severe economic and performance penalties. The results indicated that an engine for an advanced transport would be similar to the currently emerging turbofan engines. Application of current technology in the areas of noise suppression and combustors imposed severe performance and economic penalties.

Interventional Radiology in Paediatrics.

PubMed

Chippington, Samantha J; Goodwin, Susie J

2015-01-01

As in adult practice, there is a growing role for paediatric interventional radiology expertise in the management of paediatric pathologies. This review is targeted for clinicians who may refer their patients to paediatric interventional radiology services, or who are responsible for patients who are undergoing paediatric interventional radiology procedures. The article includes a brief overview of the indications for intervention, techniques involved and the commonest complications. Although some of the procedures described are most commonly performed in a tertiary paediatric centre, many are performed in most Children's hospitals.

Avalanche diodes for the generation of coherent radiation

NASA Technical Reports Server (NTRS)

Penfield, P., Jr.

1973-01-01

Solid state devices and characterization, and optimum imbedding networks for realizing best performance were investigated along with a barrier injection transit time diode. These diodes were investigated for possible application as microwave amplifiers and oscillators. Measurements were made of diode noise figures in the frequency ranges of 4 - 6 GHz. Initial results indicate that a noise figure of 6 - 8 db may be possible. Optimum device structure and fabrication techniques necessary for low noise performance were investigated. Previously published documents on electrodynamics are included.

Analytical investigation of thermal barrier coatings on advanced power generation gas turbines

NASA Technical Reports Server (NTRS)

Amos, D. J.

1977-01-01

An analytical investigation of present and advanced gas turbine power generation cycles incorporating thermal barrier turbine component coatings was performed. Approximately 50 parametric points considering simple, recuperated, and combined cycles (including gasification) with gas turbine inlet temperatures from current levels through 1644K (2500 F) were evaluated. The results indicated that thermal barriers would be an attractive means to improve performance and reduce cost of electricity for these cycles. A recommended thermal barrier development program has been defined.

Kaumalapau Harbor, Hawaii, Breakwater Repair

DTIC Science & Technology

2012-05-01

agricultural economy to an economy based on tourism . Primary use of the harbor changed from the export of pineapple to the import of fuel and goods to...unit. The pulse-velocity measurement apparatus consists of a transmitter and receiver connected to electronic circuitry that generates a pulse sent...performance indices include a ME of -0.43 ft, RMSE of 0.66 ft and SI ERDC/CHL TR-12-7 86 of 0.24. In other words , the Maui SWAN model will perform as good

Shallow Habitat Air Dive Series (SHAD I and II): The Effects on Visual Performance and Physiology

DTIC Science & Technology

1974-10-02

APPLICATION Since the tests employed cover all the major, known visual symptoms of oxygen toxicity , the data indicate that man can live under...included a number of measures of visual physiology and visual performance, since many of the symptoms of oxygen toxicity involve the visual system. The...oxygen toxic - ity. Nitrogen narcosis, which normally occurs at 200 to 300 ft, is the lesser of the two problems for shaUow habitat divers, since

National Space Biomedical Research Institute (NSBRI) JSC Summer Projects

NASA Technical Reports Server (NTRS)

Dowdy, Forrest Ryan

2014-01-01

This project optimized the calorie content in a breakfast meal replacement bar for the Advanced Food Technology group. Use of multivariable optimization yielded the highest weight savings possible while simultaneously matching NASA Human Standards nutritional guidelines. The scope of this research included the study of shelf-life indicators such as water activity, moisture content, and texture analysis. Key metrics indicate higher protein content, higher caloric density, and greater mass savings as a result of the reformulation process. The optimization performed for this study demonstrated wide application to other food bars in the Advanced Food Technology portfolio. Recommendations for future work include shelf life studies on bar hardening and overall acceptability data over increased time frames and temperature fluctuation scenarios.

Bioprosthetic tissue matrices in complex abdominal wall reconstruction.

PubMed

Broyles, Justin M; Abt, Nicholas B; Sacks, Justin M; Butler, Charles E

2013-12-01

Complex abdominal defects are difficult problems encountered by surgeons in multiple specialties. Although current evidence supports the primary repair of these defects with mesh reinforcement, it is unclear which mesh is superior for any given clinical scenario. The purpose of this review was to explore the characteristics of and clinical relevance behind bioprosthetic tissue matrices in an effort to better clarify their role in abdominal wall reconstruction. We reviewed the peer-reviewed literature on the use of bioprosthetic mesh in human subjects. Basic science articles and large retrospective and prospective reviews were included in author's analysis. The clinical performance and characteristics of 13 bioprosthetic tissue matrices were evaluated. The majority of the products evaluated perform well in contaminated fields, where the risk of wound-healing difficulties is high. Clinical outcomes, which included infection, reherniation, and bulge formation, were variable, and the majority of the studies had a mean follow-up of less than 24 months. Although bioprosthetic matrix has a multitude of indications within the growing field of abdominal wall reconstruction, the functionality, regenerative capacity, and long-term fate of these products have yet to be fully established. Furthermore, the clinical performance, indications, and contraindications for each type of matrix need to be fully evaluated in long-term outcome studies.

Bioprosthetic Tissue Matrices in Complex Abdominal Wall Reconstruction

PubMed Central

Broyles, Justin M.; Abt, Nicholas B.; Sacks, Justin M.

2013-01-01

Background: Complex abdominal defects are difficult problems encountered by surgeons in multiple specialties. Although current evidence supports the primary repair of these defects with mesh reinforcement, it is unclear which mesh is superior for any given clinical scenario. The purpose of this review was to explore the characteristics of and clinical relevance behind bioprosthetic tissue matrices in an effort to better clarify their role in abdominal wall reconstruction. Methods: We reviewed the peer-reviewed literature on the use of bioprosthetic mesh in human subjects. Basic science articles and large retrospective and prospective reviews were included in author’s analysis. The clinical performance and characteristics of 13 bioprosthetic tissue matrices were evaluated. Results: The majority of the products evaluated perform well in contaminated fields, where the risk of wound-healing difficulties is high. Clinical outcomes, which included infection, reherniation, and bulge formation, were variable, and the majority of the studies had a mean follow-up of less than 24 months. Conclusions: Although bioprosthetic matrix has a multitude of indications within the growing field of abdominal wall reconstruction, the functionality, regenerative capacity, and long-term fate of these products have yet to be fully established. Furthermore, the clinical performance, indications, and contraindications for each type of matrix need to be fully evaluated in long-term outcome studies. PMID:25289285

Integral Airframe Structures (IAS): Validated Feasibility Study of Integrally Stiffened Metallic Fuselage Panels for Reducing Manufacturing Costs

NASA Technical Reports Server (NTRS)

Munroe, J.; Wilkins, K.; Gruber, M.; Domack, Marcia S. (Technical Monitor)

2000-01-01

The Integral Airframe Structures (IAS) program investigated the feasibility of using "integrally stiffened" construction for commercial transport fuselage structure. The objective of the program was to demonstrate structural performance and weight equal to current "built-up" structure with lower manufacturing cost. Testing evaluated mechanical properties, structural details, joint performance, repair, static compression, and two-bay crack residual strength panels. Alloys evaluated included 7050-T7451 plate, 7050-T74511 extrusion, 6013-T6511x extrusion, and 7475-T7351 plate. Structural performance was evaluated with a large 7475-T7351 pressure test that included the arrest of a two-bay longitudinal crack, and a measure of residual strength for a two-bay crack centered on a broken frame. Analysis predictions for the two-bay longitudinal crack panel correlated well with the test results. Analysis activity conducted by the IAS team strongly indicates that current analysis tools predict integral structural behavior as accurately as built-up structure. The cost study results indicated that, compared to built-up fabrication methods, high-speed machining structure from aluminum plate would yield a recurring cost savings of 61%. Part count dropped from 78 individual parts on a baseline panel to just 7 parts for machined IAS structure.

Recommendations for routine reporting on indications for cesarean delivery in developing countries.

PubMed

Stanton, Cynthia; Ronsmans, Carine

2008-09-01

Cesarean delivery rates are increasing rapidly in many developing countries, particularly among wealthy women. Poor women have lower rates, often so low that they do not reach the minimum rate of 1 percent. Little data are available on clinical indications for cesarean section, information that could assist in understanding why cesarean delivery rates have changed. This paper presents recommendations for routine reporting on indications for cesarean delivery in developing countries. These recommendations resulted from an international consultation of researchers held in February 2006 to promote the collection of comparable data to understand change in, or composition of, the cesarean delivery rate in developing countries. Data are presented from selected countries, categorizing cesareans by three classification systems. A single classification system was recommended for use in both high and low cesarean delivery rate settings, given that underuse and overuse of cesarean section are evident within many populations. The group recommended a hierarchical categorization, prioritizing cesareans performed for absolute maternal indications. Categorization among the remaining nonabsolute indications is based on the primary indication for the procedure and include maternal and fetal indications and psychosocial indications, required for high cesarean delivery rate settings. Data on indications for cesarean sections are available everywhere the procedure is performed. All that is required is compilation and review at facility and at higher levels. Advocacy within ministries of health and medical professional organizations is required to advance these recommendations since researchers have inadequately communicated the health effects of both underuse and overuse of cesarean delivery.

ConceFT for Time-Varying Heart Rate Variability Analysis as a Measure of Noxious Stimulation During General Anesthesia.

PubMed

Lin, Yu-Ting; Wu, Hau-Tieng

2017-01-01

Heart rate variability (HRV) offers a noninvasive way to peek into the physiological status of the human body. When this physiological status is dynamic, traditional HRV indices calculated from power spectrum do not resolve the dynamic situation due to the issue of nonstationarity. Clinical anesthesia is a typically dynamic situation that calls for time-varying HRV analysis. Concentration of frequency and time (ConceFT) is a nonlinear time-frequency (TF) analysis generalizing the multitaper technique and the synchrosqueezing transform. The result is a sharp TF representation capturing the dynamics inside HRV. Companion indices of the commonly applied HRV indices, including time-varying low-frequency power (tvLF), time-varying high-frequency power, and time-varying low-high ratio, are considered as measures of noxious stimulation. To evaluate the feasibility of the proposed indices, we apply these indices to study two different types of noxious stimulation, the endotracheal intubation and surgical skin incision, under general anesthesia. The performance was compared with traditional HRV indices, the heart rate reading, and indices from electroencephalography. The results indicate that the tvLF index performs best and outperforms not only the traditional HRV index, but also the commonly used heart rate reading. With the help of ConceFT, the proposed HRV indices are potential to provide a better quantification of the dynamic change of the autonomic nerve system. Our proposed scheme of time-varying HRV analysis could contribute to the clinical assessment of analgesia under general anesthesia.

Evaluation of CORDEX-Arctic daily precipitation and temperature-based climate indices over Canadian Arctic land areas

NASA Astrophysics Data System (ADS)

Diaconescu, Emilia Paula; Mailhot, Alain; Brown, Ross; Chaumont, Diane

2018-03-01

This study focuses on the evaluation of daily precipitation and temperature climate indices and extremes simulated by an ensemble of 12 Regional Climate Model (RCM) simulations from the ARCTIC-CORDEX experiment with surface observations in the Canadian Arctic from the Adjusted Historical Canadian Climate Dataset. Five global reanalyses products (ERA-Interim, JRA55, MERRA, CFSR and GMFD) are also included in the evaluation to assess their potential for RCM evaluation in data sparse regions. The study evaluated the means and annual anomaly distributions of indices over the 1980-2004 dataset overlap period. The results showed that RCM and reanalysis performance varied with the climate variables being evaluated. Most RCMs and reanalyses were able to simulate well climate indices related to mean air temperature and hot extremes over most of the Canadian Arctic, with the exception of the Yukon region where models displayed the largest biases related to topographic effects. Overall performance was generally poor for indices related to cold extremes. Likewise, only a few RCM simulations and reanalyses were able to provide realistic simulations of precipitation extreme indicators. The multi-reanalysis ensemble provided superior results to individual datasets for climate indicators related to mean air temperature and hot extremes, but not for other indicators. These results support the use of reanalyses as reference datasets for the evaluation of RCM mean air temperature and hot extremes over northern Canada, but not for cold extremes and precipitation indices.

Structural equation model analysis for the evaluation of overall driving performance: A driving simulator study focusing on driver distraction.

PubMed

Papantoniou, Panagiotis

2018-04-03

The present research relies on 2 main objectives. The first is to investigate whether latent model analysis through a structural equation model can be implemented on driving simulator data in order to define an unobserved driving performance variable. Subsequently, the second objective is to investigate and quantify the effect of several risk factors including distraction sources, driver characteristics, and road and traffic environment on the overall driving performance and not in independent driving performance measures. For the scope of the present research, 95 participants from all age groups were asked to drive under different types of distraction (conversation with passenger, cell phone use) in urban and rural road environments with low and high traffic volume in a driving simulator experiment. Then, in the framework of the statistical analysis, a correlation table is presented investigating any of a broad class of statistical relationships between driving simulator measures and a structural equation model is developed in which overall driving performance is estimated as a latent variable based on several individual driving simulator measures. Results confirm the suitability of the structural equation model and indicate that the selection of the specific performance measures that define overall performance should be guided by a rule of representativeness between the selected variables. Moreover, results indicate that conversation with the passenger was not found to have a statistically significant effect, indicating that drivers do not change their performance while conversing with a passenger compared to undistracted driving. On the other hand, results support the hypothesis that cell phone use has a negative effect on driving performance. Furthermore, regarding driver characteristics, age, gender, and experience all have a significant effect on driving performance, indicating that driver-related characteristics play the most crucial role in overall driving performance. The findings of this study allow a new approach to the investigation of driving behavior in driving simulator experiments and in general. By the successful implementation of the structural equation model, driving behavior can be assessed in terms of overall performance and not through individual performance measures, which allows an important scientific step forward from piecemeal analyses to a sound combined analysis of the interrelationship between several risk factors and overall driving performance.

Objectively measured physical activity has a negative but weak association with academic performance in children and adolescents.

PubMed

Esteban-Cornejo, Irene; Tejero-González, Carlos M; Martinez-Gomez, David; Cabanas-Sánchez, Verónica; Fernández-Santos, Jorge R; Conde-Caveda, Julio; Sallis, James F; Veiga, Oscar L

2014-11-01

There is an emerging body of evidence on the potential effects of regular physical activity on academic performance. The aim of this study was to add to the debate, by examining the association between objectively measured physical activity and academic performance in a relatively large sample of children and adolescents. The Spanish UP & DOWN study is a 3-year longitudinal study designed to assess the impact, overtime, of physical activity and sedentary behaviours on health indicators. This present analysis was conducted with 1778 children and adolescents aged 6-18 years. Physical activity was objectively measured by accelerometry. Academic performance was assessed using school grades. Physical activity was inversely associated with all academic performance indicators after adjustment for potential confounders, including neonatal variables, fatness and fitness (all p < 0.05). This association became nonsignificant among quartiles of physical activity. There were only slight differences in academic performance between the lowest and the second quartile of physical activity, compared to the highest quartile, with very small effect size (d < 0.20). Objectively measured physical activity may influence academic performance during both childhood and adolescence, but this association was negative and very weak. Longitudinal and intervention studies are necessary to further our understanding. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

EEG indices correlate with sustained attention performance in patients affected by diffuse axonal injury.

PubMed

Coelli, Stefania; Barbieri, Riccardo; Reni, Gianluigi; Zucca, Claudio; Bianchi, Anna Maria

2018-06-01

The aim of this study is to assess the ability of EEG-based indices in providing relevant information about cognitive engagement level during the execution of a clinical sustained attention (SA) test in healthy volunteers and DAI (diffused axonal injury)-affected patients. We computed three continuous power-based engagement indices (P β /P α , 1/P α , and P β / (P α + P θ )) from EEG recordings in a control group (n = 7) and seven DAI-affected patients executing a 10-min Conners' "not-X" continuous performance test (CPT). A correlation analysis was performed in order to investigate the existence of relations between the EEG metrics and behavioral parameters in both the populations. P β /P α and 1/P α indices were found to be correlated with reaction times in both groups while P β / (P α + P θ ) and P β /P α also correlated with the errors rate for DAI patients. In line with previous studies, time course fluctuations revealed a first strong decrease of attention after 2 min from the beginning of the test and a final fading at the end. Our results provide evidence that EEG-derived indices extraction and evaluation during SA tasks are helpful in the assessment of attention level in healthy subjects and DAI patients, offering motivations for including EEG monitoring in cognitive rehabilitation practice. Graphical abstract Three EEG-derived indices were computed from four electrodes montages in a population of seven healthy volunteers and a group of seven DAI-affected patients. Results show a significant correlation between the time course of the indices and behavioral parameters, thus demonstrating their usefulness in monitoring mental engagement level during a sustained attention task.

A flight-test and simulation evaluation of the longitudinal final approach and landing performance of an automatic system for a light wing loading STOL aircraft equipped with wing spoilers

NASA Technical Reports Server (NTRS)

Brown, S. C.; Hardy, G. H.; Hindson, W. S.

1984-01-01

As part of a comprehensive flight-test investigation of short takeoff and landing (STOL) operating systems for the terminal systems for the terminal area, an automatic landing system has been developed and evaluated for a light wing-loading turboprop-powered aircraft. An advanced digital avionics system performed display, navigation, guidance, and control functions for the test aircraft. Control signals were generated in order to command powered actuators for all conventional controls and for a set of symmetrically driven wing spoilers. This report describes effects of the spoiler control on longitudinal autoland (automatic landing) performance. Flight-test results, with and without spoiler control, are presented and compared with available (basically, conventional takeoff and landing) performance criteria. These comparisons are augmented by results from a comprehensive simulation of the controlled aircraft that included representations of the microwave landing system navigation errors that were encountered in flight as well as expected variations in atmospheric turbulence and wind shear. Flight-test results show that the addition of spoiler control improves the touchdown performance of the automatic landing system. Spoilers improve longitudinal touchdown and landing pitch-attitude performance, particularly in tailwind conditions. Furthermore, simulation results indicate that performance would probably be satisfactory for a wider range of atmospheric disturbances than those encountered in flight. Flight results also indicate that the addition of spoiler control during the final approach does not result in any measurable change in glidepath track performance, and results in a very small deterioration in airspeed tracking. This difference contrasts with simulations results, which indicate some improvement in glidepath tracking and no appreciable change in airspeed tracking. The modeling problem in the simulation that contributed to this discrepancy with flight was not resolved.

Effect of accreditation on the quality of chronic disease management: a comparative observational study.

PubMed

van Doorn-Klomberg, Arna L; Braspenning, Jozé C C; Wolters, René J; Bouma, Margriet; Wensing, Michel

2014-11-04

Practice accreditation is widely used to assess and improve quality of healthcare providers. Little is known about its effectiveness, particularly in primary care. In this study we examined the effect of accreditation on quality of care regarding diabetes, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). A comparative observational study with two cohorts was performed. We included 138 Dutch family practices that participated in the national accreditation program for primary care. A first cohort of 69 practices was measured at start and completion of a 3-year accreditation program. A second cohort of 69 practices was included and measured simultaneously with the final measurement of the first cohort. In separate multilevel regression analyses, we compared both within-group changes in the first cohort and between-groups differences at follow-up (first cohort) and start (second cohort). Outcome measures consisted of 24 systematically developed indicators of quality of care in targeted chronic diseases. In the within-group comparison, we found improvements on 6 indicators related to diabetes (feet examination, cholesterol measurement, lipid lowering medication prescription) and COPD (spirometry performance, stop smoking advice). In the between-groups comparison we found that first cohort practices performed better on 4 indicators related to diabetes (cholesterol outcome) and CVD (blood pressure outcome, smoke status registration, glucose measurement). Improvements of the quality of primary care for patients with chronic diseases were found, but few could be attributed to the accreditation program. Further development of accreditation is needed to enhance its effectiveness on chronic disease management.

Humidifier Development and Applicability to the Next Generation Portable Life Support System

NASA Technical Reports Server (NTRS)

Conger, Bruce C.; Barnes, Bruce G.; Sompayrac, Robert G.; Paul, Heather L.

2011-01-01

A development effort at the NASA Johnson Space Center investigated technologies to determine whether a humidifier would be required in the Portable Life Support System (PLSS) envisioned for future exploration missions. The humidifier has been included in the baseline PLSS schematic since performance testing of the Rapid Cycle Amine (RCA) indicates that the RCA over-dries the ventilation gas stream. Performance tests of a developmental humidifier unit and commercial off-the-shelf (COTS) units were conducted in December 2009. Following these tests, NASA revisited the need for a humidifier via system analysis. Results of this investigation indicate that it is feasible to meet humidity requirements without the humidifier if other changes are made to the PLSS ventilation loop and the Liquid Cooling and Ventilation Garment (LCVG).

Evaporating Spray in Supersonic Streams Including Turbulence Effects

NASA Technical Reports Server (NTRS)

Balasubramanyam, M. S.; Chen, C. P.

2006-01-01

Evaporating spray plays an important role in spray combustion processes. This paper describes the development of a new finite-conductivity evaporation model, based on the two-temperature film theory, for two-phase numerical simulation using Eulerian-Lagrangian method. The model is a natural extension of the T-blob/T-TAB atomization/spray model which supplies the turbulence characteristics for estimating effective thermal diffusivity within the droplet phase. Both one-way and two-way coupled calculations were performed to investigate the performance of this model. Validation results indicate the superiority of the finite-conductivity model in low speed parallel flow evaporating sprays. High speed cross flow spray results indicate the effectiveness of the T-blob/T-TAB model and point to the needed improvements in high speed evaporating spray modeling.

Performance determinants of fixed gear cycling during criteriums.

PubMed

Babault, Nicolas; Poisson, Maxime; Cimadoro, Guiseppe; Cometti, Carole; Païzis, Christos

2018-06-17

Nowadays, fixed gear competitions on outdoor circuits such as criteriums are regularly organized worldwide. To date, no study has investigated this alternative form of cycling. The purpose of the present study was to examine fixed gear performance indexes and to characterize physiological determinants of fixed gear cyclists. This study was carried out in two parts. Part 1 (n = 36) examined correlations between performance indexes obtained during a real fixed gear criterium (time trial, fastest laps, averaged lap time during races, fatigue indexes) and during a sprint track time trial. Part 2 (n = 9) examined correlations between the recorded performance indexes and some aerobic and anaerobic performance outputs (VO 2max , maximal aerobic power, knee extensor and knee flexor maximal voluntary torque, vertical jump height and performance during a modified Wingate test). Results from Part 1 indicated significant correlations between fixed gear final performance (i.e. average lap time during the finals) and single lap time (time trial, fastest lap during races and sprint track time trial). In addition, results from Part 2 revealed significant correlations between fixed gear performance and aerobic indicators (VO 2max and maximal aerobic power). However, no significant relationship was obtained between fixed gear cycling and anaerobic qualities such as strength. Similarly to traditional cycling disciplines, we concluded that fixed gear cycling is mainly limited by aerobic capacity, particularly criteriums final performance. However, specific skills including technical competency should be considered.

Robust tracking control of a magnetically suspended rigid body

NASA Technical Reports Server (NTRS)

Lim, Kyong B.; Cox, David E.

1994-01-01

This study is an application of H-infinity and micro-synthesis for designing robust tracking controllers for the Large Angle Magnetic Suspension Test Facility. The modeling, design, analysis, simulation, and testing of a control law that guarantees tracking performance under external disturbances and model uncertainties is investigated. The type of uncertainties considered and the tracking performance metric used is discussed. This study demonstrates the tradeoff between tracking performance at low frequencies and robustness at high frequencies. Two sets of controllers were designed and tested. The first set emphasized performance over robustness, while the second set traded off performance for robustness. Comparisons of simulation and test results are also included. Current simulation and experimental results indicate that reasonably good robust tracking performance can be attained for this system using multivariable robust control approach.

Effect of time span and task load on pilot mental workload

NASA Technical Reports Server (NTRS)

Berg, S. L.; Sheridan, T. B.

1986-01-01

Two sets of simulations designed to examine how a pilot's mental workload is affected by continuous manual-control activity versus discrete mental tasks that included the length of time between receiving an assignment and executing it are described. The first experiment evaluated two types of measures: objective performance indicators and subjective ratings. Subjective ratings for the two missions were different, but the objective performance measures were similar. In the second experiments, workload levels were increased and a second performance measure was taken. Mental workload had no influence on either performance-based workload measure. Subjective ratings discriminated among the scenarios and correlated with performance measures for high-workload flights. The number of mental tasks performed did not influence error rates, although high manual workloads did increase errors.

Non-obstetrical indications for cesarean section: a state-of-the-art review.

PubMed

Venturella, Roberta; Quaresima, Paola; Micieli, Mariella; Rania, Erika; Palumbo, Annarita; Visconti, Federica; Zullo, Fulvio; Di Carlo, Costantino

2018-07-01

To propose an evidence-based review on the most frequent indications for Cesarean section (CS) given by specialists in disciplines other than Obstetrics and Gynecology, with the aim of increasing consciousness about the available data in the literature and the guidelines recommendations about topics that are not frequently managed by obstetricians and gynecologists. We analyzed hospital discharge data regarding deliveries occurred in a 10-year study period in our department to obtain the prevalence and the list of the most recurrent non-obstetrical indications for CS. A search was performed in PubMed, the Cochrane Library, SCOPUS, Web of Science and Ovid MEDLINE and only studies published in English from 1950 to 2017 were included. For indications for which no systematic reviews existed, we included the best available evidence, including guidelines of non-obstetrics scientific societies or organizations, RCTs, non-randomized controlled clinical trials, case-control studies, cohort studies, and case series. The rising rate of CS registered in the recent years is not justified by reduction in maternal--fetal risk or perinatal outcomes and often reflects inappropriate clinical behaviour and a wrong tendency that assimilates CS as a defensive practice. In a relevant percentage of cases, the indication to CS is given by specialists in other disciplines, even when specific guidelines do not give clear recommendation about the route of delivery. To refuse non-obstetrical indications for CS, when scientific support is lacking, could be a useful and safe strategy to further reduce the rate of unnecessary CS.

Experience from a multi-country initiative to improve the monitoring of selected reproductive health indicators in Africa.

PubMed

Barreix, Maria; Tunçalp, Özge; Mutombo, Namuunda; Adegboyega, Ayotunde A; Say, Lale

2017-05-01

Universal access to sexual and reproductive health remains part of the unfinished business of global development in Africa. To achieve it, health interventions should be monitored using programmatic indicators. WHO's Strengthening Measurement of Reproductive Health Indicators in Africa initiative, implemented in Ghana, Nigeria, Kenya, Uganda, and Zimbabwe, aimed to improve national information systems for routine monitoring of reproductive health indicators. Participating countries developed action plans employing a two-pronged strategy: (1) revising, standardizing, and harmonizing existing reproductive health indicators captured through routine information-systems; and (2) building data-collection capacity through training and supervision at select pilot sites. Country teams evaluated existing and new indicators, and outlined barriers to strengthening routine measurement. Activities included updating abortion-care guidelines (spontaneous and induced abortions), providing training on laws surrounding induced abortions, and improving feedback mechanisms. The country teams updated monitoring and evaluation frameworks, and attempted to build recording/reporting capacity in selected pilot areas. Barriers to implementing the initiative that were encountered included restrictive induced-abortion laws, staff turn-over, and administrative delays, including low capacity among healthcare staff and competing priorities for staff time. The areas identified for further improvement were up-scaling programs to a national level, creating scorecards to record data, increasing collaborations with the private sector, conducting related costing exercises, and performing ex-post evaluations. © 2017 World Health Organization; licensed by Wiley on behalf of International Federation of Gynecology and Obstetrics.

Patient- and family-centered performance measures focused on actionable processes of care for persistent and chronic critical illness: protocol for a systematic review.

PubMed

Rose, Louise; Istanboulian, Laura; Allum, Laura; Burry, Lisa; Dale, Craig; Hart, Nicholas; Kydonaki, Claire; Ramsay, Pam; Pattison, Natalie; Connolly, Bronwen

2017-04-17

Approximately 5 to 10% of critically ill patients transition from acute critical illness to a state of persistent and in some cases chronic critical illness. These patients have unique and complex needs that require a change in the clinical management plan and overall goals of care to a focus on rehabilitation, symptom relief, discharge planning, and in some cases, end-of-life care. However, existing indicators and measures of care quality, and tools such as checklists, that foster implementation of best practices, may not be sufficiently inclusive in terms of actionable processes of care relevant to these patients. Therefore, the aim of this systematic review is to identify the processes of care, performance measures, quality indicators, and outcomes including reports of patient/family experience described in the current evidence base relevant to patients with persistent or chronic critical illness and their family members. Two authors will independently search from inception to November 2016: MEDLINE, Embase, CINAHL, Web of Science, the Cochrane Library, PROSPERO, the Joanna Briggs Institute and the International Clinical Trials Registry Platform. We will include all study designs except case series/reports of <10 patients describing their study population (aged 18 years and older) using terms such as persistent critical illness, chronic critical illness, and prolonged mechanical ventilation. Two authors will independently perform data extraction and complete risk of bias assessment. Our primary outcome is to determine actionable processes of care and interventions deemed relevant to patients experiencing persistent or chronic critical illness and their family members. Secondary outcomes include (1) performance measures and quality indicators considered relevant to our population of interest and (2) themes related to patient and family experience. We will use our systematic review findings, with data from patient, family member and clinician interviews, and a subsequent consensus building process to inform the development of quality metrics and tools to measure processes of care, outcomes and experience for patients experiencing persistent or chronic critical illness and their family members. PROSPERO CRD42016052715.

Staff Satisfaction with Administration as a Measure of Consumer Satisfaction.

ERIC Educational Resources Information Center

Tanguma, Jesus; Luster, Jane Nell

The school district in this study, "Special School District" (SSD), is under the administration of the Louisiana State Department of education and thus classified as a Louisiana state agency required to conform to the mandate that state agencies have performance indicators, including one for customer satisfaction. For the SSD, customer…

Effects of Early Leader-Member Exchange Perceptions on Academic Outcomes

ERIC Educational Resources Information Center

Jacques, Paul H.; Garger, John; Thomas, Michael; Vracheva, Veselina

2012-01-01

This study tested a series of hypotheses linking college support and quality of student-instructor relations with outcomes including student efficacy, social connectedness with peers, expectancies and academic performance. Early quality of exchanges with the instructor using Leader-Member Exchange theory was found to be a key indicator of academic…

Determining a Model to Predict Hispanic Preservice Teachers' Success on the Texas Examination of Educator Standards

ERIC Educational Resources Information Center

Zhang, Zhidong; Telese, James

2012-01-01

In this article, we report the regression relations between preservice teachers' academic characteristics and their performance on the Texas Examination of Educator Standards. These academic characteristics include grade point average, reading ability, and critical thinking. The studies indicate that the critical thinking was the best predictor…

24 CFR 901.30 - Indicator #5, annual inspection of units and systems.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the Environmental Protection Agency; (C) Natural disasters; and (D) Units kept vacant because they... buildings and sites according to the PHA's maintenance plan, including performing the required maintenance... weight of x1. (1) Grade A: The PHA inspected all major systems at 100% of its buildings and sites...

Identity Crisis: Multiple Measures and the Identification of Schools under ESSA. Summary

ERIC Educational Resources Information Center

Policy Analysis for California Education, PACE, 2016

2016-01-01

The Every Student Succeeds Act (ESSA) requires states to develop an accountability system that includes multiple measures of student academic performance and at least one additional indicator of "School Quality or Student Success" (SQSS). To support policymaking at both the state and federal level, the authors of "Identity Crisis:…

Aerobic Digestion. Biological Treatment Process Control. Instructor's Guide.

ERIC Educational Resources Information Center

Klopping, Paul H.

This unit on aerobic sludge digestion covers the theory of the process, system components, factors that affect the process performance, standard operational concerns, indicators of steady-state operations, and operational problems. The instructor's guide includes: (1) an overview of the unit; (2) lesson plan; (3) lecture outline (keyed to a set of…

Moisture barrier properties of xylan composite films

Treesearch

Amit Saxena; Thomas J. Elder; Arthur J. Ragauskas

2011-01-01

Moisture barrier properties of films based on xylan reinforced with several cellulosic resources including nanocrystalline cellulose, acacia bleached kraft pulp fibers and softwood kraft fibers have been evaluated. Measurements of water vapor transmission rate (WVTR) were performed by a modification of the wet cup method described by ASTM E 96-95, indicating that...

Buying Your Way into College? Private Tuition and the Transition to Higher Education in Ireland

ERIC Educational Resources Information Center

Smyth, Emer

2009-01-01

A number of countries, including Ireland, have experienced a recent growth in the prevalence of "shadow education", that is, paid private tuition outside the schooling system. Previous international studies have indicated that such tuition can enhance academic performance and facilitate access to tertiary education. However, such studies…

Analyzing Virtual Physics Simulations with Tracker

ERIC Educational Resources Information Center

Claessens, Tom

2017-01-01

In the physics teaching community, Tracker is well known as a user-friendly open source video analysis software, authored by Douglas Brown. With this tool, the user can trace markers indicated on a video or on stroboscopic photos and perform kinematic analyses. Tracker also includes a data modeling tool that allows one to fit some theoretical…

Possibilities of surface coating for thermal insulation. [zirconium dioxide, titanium dioxide, and zircon coatings

NASA Technical Reports Server (NTRS)

Poeschel, E.; Weisser, G.

1979-01-01

Calculations performed for pulsating heat sources indicate a relatively thin (200-1000 micron) coating can lower temperature both inside and on the surface of a construction material. Various coating materials (including zirconium dioxide) are discussed, together with possible thermic stresses and ways to deal with the latter.

The Effects of Background Information on Standarized Test Scores.

ERIC Educational Resources Information Center

Feeley, Joan T.; Wepner, Shelley B.

A study was conducted to determine the effects of exposure to the topics included on the comprehension subtest of the Nelson-Denny Reading Test (ND), Form F, on college freshmen's performance on the test. In addition, the study investigated whether those students with background information would indicate their awareness of this knowledge on a…

Use of Accountability Indicators to Evaluate Elementary School Principal Performance

ERIC Educational Resources Information Center

Byun-Kitayama, Chiae

2012-01-01

Recently, the federal government has pressured states to add student growth data as a part of the evaluation system. State legislatures in New York and Colorado have passed legislation to revamp teacher and principal evaluation to include student growth data. Numerous researchers acknowledged the critical impact of school principals on student…

Preaching to the Choir: Are the Commission's Recommendations Already Applied?

ERIC Educational Resources Information Center

Maggino, Filomena; Ruviglioni, Elena

2011-01-01

As we have seen, the Commission's final report outlines a comprehensive framework by defining some guidelines by: (a) identifying the limits of GDP as an indicator of economic performance and social progress, including measurement problems; (b) considering what additional information might be required for the production of more relevant social…

Proficiency Verification Systems (PVS): Skills Indices for Language Arts. Technical Note.

ERIC Educational Resources Information Center

Humes, Ann

The procedures undertaken in developing and organizing skills indexes for use in coding elementary school language arts textbooks to determine what is actually taught are presented in this paper. The outlined procedures included performing a preliminary analysis on four language arts textbooks to compile an extensive list of skills and performance…

Results-Based Financing in Mozambique's Central Medical Store: A Review After 1 Year.

PubMed

Spisak, Cary; Morgan, Lindsay; Eichler, Rena; Rosen, James; Serumaga, Brian; Wang, Angela

2016-03-01

Public health commodity supply chains are typically weak in low-income countries, partly because they have many disparate yet interdependent functions and components. Approaches to strengthening supply chains in such settings have often fallen short-they address technical weaknesses, but not the incentives that motivate staff to perform better. We reviewed the first year of a results-based financing (RBF) program in Mozambique, which began in January 2013. The program aimed to improve the performance of the central medical store-Central de Medicamentos e Artigos Medicos (CMAM)-by realigning incentives. We completed in-depth interviews and focus group discussions with 33 key informants, including representatives from CMAM and donor agencies, and collected quantitative data on performance measures and use of funds. The RBF agreement linked CMAM performance payments to quarterly results on 5 performance indicators related to supply planning, distribution planning, and warehouse management. RBF is predicated on the theory that a combination of carrot and stick-i.e., shared financial incentives, plus increased accountability for results-will spur changes in behavior. Important design elements: (1) indicators were measured against quarterly targets, and payments were made only for indicators that met those targets; (2) targets were set based on documented performance, at levels that could be reasonably attained, yet pushed for improvement; (3) payment was shared with and dependent on all staff, encouraging teamwork and collaboration; (4) results were validated by verifiable data sources; and (5) CMAM had discretion over how to use the funds. We found that CMAM's performance continually improved over baseline and that CMAM achieved many of its performance targets, for example, timely submission of quarterly supply and distribution planning reports. Warehouse indicators, such as inventory management and order fulfillment, proved more challenging but were nonetheless positive. By linking payments to periodic verified results, and giving CMAM discretion over how to spend the funds, the RBF agreement motivated the workforce; focused attention on results; strengthened data collection; encouraged teamwork and innovation; and ultimately strengthened the central supply chain. Policy makers and program managers can use performance incentives to catalyze and leverage existing investments. To further strengthen the approach, such incentive programs can shift attention from quantity to quality indicators, improve verification processes, and aim to institutionalize the approach. © Mukuria et al.

Results-Based Financing in Mozambique’s Central Medical Store: A Review After 1 Year

PubMed Central

Spisak, Cary; Morgan, Lindsay; Eichler, Rena; Rosen, James; Serumaga, Brian; Wang, Angela

2016-01-01

ABSTRACT Background: Public health commodity supply chains are typically weak in low-income countries, partly because they have many disparate yet interdependent functions and components. Approaches to strengthening supply chains in such settings have often fallen short—they address technical weaknesses, but not the incentives that motivate staff to perform better. Methods: We reviewed the first year of a results-based financing (RBF) program in Mozambique, which began in January 2013. The program aimed to improve the performance of the central medical store—Central de Medicamentos e Artigos Medicos (CMAM)—by realigning incentives. We completed in-depth interviews and focus group discussions with 33 key informants, including representatives from CMAM and donor agencies, and collected quantitative data on performance measures and use of funds. Implementation: The RBF agreement linked CMAM performance payments to quarterly results on 5 performance indicators related to supply planning, distribution planning, and warehouse management. RBF is predicated on the theory that a combination of carrot and stick—i.e., shared financial incentives, plus increased accountability for results—will spur changes in behavior. Important design elements: (1) indicators were measured against quarterly targets, and payments were made only for indicators that met those targets; (2) targets were set based on documented performance, at levels that could be reasonably attained, yet pushed for improvement; (3) payment was shared with and dependent on all staff, encouraging teamwork and collaboration; (4) results were validated by verifiable data sources; and (5) CMAM had discretion over how to use the funds. Findings: We found that CMAM’s performance continually improved over baseline and that CMAM achieved many of its performance targets, for example, timely submission of quarterly supply and distribution planning reports. Warehouse indicators, such as inventory management and order fulfillment, proved more challenging but were nonetheless positive. By linking payments to periodic verified results, and giving CMAM discretion over how to spend the funds, the RBF agreement motivated the workforce; focused attention on results; strengthened data collection; encouraged teamwork and innovation; and ultimately strengthened the central supply chain. Conclusion: Policy makers and program managers can use performance incentives to catalyze and leverage existing investments. To further strengthen the approach, such incentive programs can shift attention from quantity to quality indicators, improve verification processes, and aim to institutionalize the approach. PMID:27016552

Scaling of Ion Thrusters to Low Power

NASA Technical Reports Server (NTRS)

Patterson, Michael J.; Grisnik, Stanley P.; Soulas, George C.

1998-01-01

Analyses were conducted to examine ion thruster scaling relationships in detail to determine performance limits, and lifetime expectations for thruster input power levels below 0.5 kW. This was motivated by mission analyses indicating the potential advantages of high performance, high specific impulse systems for small spacecraft. The design and development status of a 0.1-0.3 kW prototype small thruster and its components are discussed. Performance goals include thruster efficiencies on the order of 40% to 54% over a specific impulse range of 2000 to 3000 seconds, with a lifetime in excess of 8000 hours at full power. Thruster technologies required to achieve the performance and lifetime targets are identified.

Analysis and methodology for aeronautical systems technology program planning

NASA Technical Reports Server (NTRS)

White, M. J.; Gershkoff, I.; Lamkin, S.

1983-01-01

A structured methodology was developed that allows the generation, analysis, and rank-ordering of system concepts by their benefits and costs, indicating the preferred order of implementation. The methodology is supported by a base of data on civil transport aircraft fleet growth projections and data on aircraft performance relating the contribution of each element of the aircraft to overall performance. The performance data are used to assess the benefits of proposed concepts. The methodology includes a computer program for performing the calculations needed to rank-order the concepts and compute their cumulative benefit-to-cost ratio. The use of the methodology and supporting data is illustrated through the analysis of actual system concepts from various sources.

Status of the NEXT Ion Engine Wear Test

NASA Technical Reports Server (NTRS)

Soulas, George C.; Domonkos, Matthew T.; Kamhawi, Hani; Patterson, Michael J.; Gardner, Michael M.

2003-01-01

The status of the NEXT 2000 hour wear test is presented. This test is being conducted with a 40 cm engineering model ion engine, designated EM1, at a beam current higher than listed on the NEXT throttle table. Pretest performance assessments demonstrated that EM1 satisfies all thruster performance requirements. As of 7/3/03, the ion engine has accumulated 406 hours of operation at a thruster input power of 6.9 kW. Overall ion engine performance, which includes thrust, thruster input power, specific impulse, and thrust efficiency, has been steady to date with no indications of performance degradation. Images of the downstream discharge cathode, neutralizer, and accelerator aperture surfaces have exhibited no significant erosion to date.

Effects of chemical equilibrium on turbine engine performance for various fuels and combustor temperatures

NASA Technical Reports Server (NTRS)

Tran, Donald H.; Snyder, Christopher A.

1992-01-01

A study was performed to quantify the differences in turbine engine performance with and without the chemical dissociation effects for various fuel types over a range of combustor temperatures. Both turbojet and turbofan engines were studied with hydrocarbon fuels and cryogenic, nonhydrocarbon fuels. Results of the study indicate that accuracy of engine performance decreases when nonhydrocarbon fuels are used, especially at high temperatures where chemical dissociation becomes more significant. For instance, the deviation in net thrust for liquid hydrogen fuel can become as high as 20 percent at 4160 R. This study reveals that computer central processing unit (CPU) time increases significantly when dissociation effects are included in the cycle analysis.

Children's construction task performance and spatial ability: controlling task complexity and predicting mathematics performance.

PubMed

Richardson, Miles; Hunt, Thomas E; Richardson, Cassandra

2014-12-01

This paper presents a methodology to control construction task complexity and examined the relationships between construction performance and spatial and mathematical abilities in children. The study included three groups of children (N = 96); ages 7-8, 10-11, and 13-14 years. Each group constructed seven pre-specified objects. The study replicated and extended previous findings that indicated that the extent of component symmetry and variety, and the number of components for each object and available for selection, significantly predicted construction task difficulty. Results showed that this methodology is a valid and reliable technique for assessing and predicting construction play task difficulty. Furthermore, construction play performance predicted mathematical attainment independently of spatial ability.

Evaluation of Student Performance through a Multidimensional Finite Mixture IRT Model.

PubMed

Bacci, Silvia; Bartolucci, Francesco; Grilli, Leonardo; Rampichini, Carla

2017-01-01

In the Italian academic system, a student can enroll for an exam immediately after the end of the teaching period or can postpone it; in this second case the exam result is missing. We propose an approach for the evaluation of a student performance throughout the course of study, accounting also for nonattempted exams. The approach is based on an item response theory model that includes two discrete latent variables representing student performance and priority in selecting the exams to take. We explicitly account for nonignorable missing observations as the indicators of attempted exams also contribute to measure the performance (within-item multidimensionality). The model also allows for individual covariates in its structural part.

Reverse total shoulder arthroplasty

PubMed Central

Familiari, Filippo; Rojas, Jorge; Nedim Doral, Mahmut; Huri, Gazi; McFarland, Edward G.

2018-01-01

Since the introduction of reverse total shoulder arthroplasty (RTSA) in 1987 (in Europe) and 2004 (in the United States), the number of RTSAs performed annually has increased. Although the main indication for RTSA has been rotator cuff tears, indications have expanded to include several shoulder conditions, many of which involve dysfunction of the rotator cuff. RTSA complications have been reported to affect 19% to 68% of patients and include acromial fracture, haematoma, infection, instability, mechanical baseplate failure, neurological injury, periprosthetic fracture and scapular notching. Current controversies in RTSA include optimal baseplate positioning, humeral neck-shaft angle (135° versus 155°), glenosphere placement (medial, lateral or bony increased offset RTSA) and subscapularis repair. Improvements in prosthesis design, surgeon experience and clinical results will need to occur to optimize this treatment for many shoulder conditions. Cite this article: EFORT Open Rev 2018;3:58–69 DOI: 10.1302/2058-5241.3.170044 PMID:29657846

Workload and time management in central cancer registries: baseline data and implication for registry staffing.

PubMed

Chapman, Susan A; Mulvihill, Linda; Herrera, Carolina

2012-01-01

The Workload and Time Management Survey of Central Cancer Registries was conducted in 2011 to assess the amount of time spent on work activities usually performed by cancer registrars. A survey including 39 multi-item questions,together with a work activities data collection log, was sent by email to the central cancer registry (CCR) manager in each of the 50 states and the District of Columbia. Twenty-four central cancer registries (47%) responded to the survey.Results indicate that registries faced reductions in budgeted staffing from 2008-2009. The number of source records and total cases were important indicators of workload. Four core activities, including abstracting at the registry, visual editing,case consolidation, and resolving edit reports, accounted for about half of registry workload. We estimate an average of 12.4 full-time equivalents (FTEs) are required to perform all cancer registration activities tracked by the survey; however,estimates vary widely by registry size. These findings may be useful for registries as a benchmark for their own registry workload and time-management data and to develop staffing guidelines.

A Survey of Managers' Access to Key Performance Indicators via HIS: The Case of Iranian Teaching Hospitals.

PubMed

Ahmadi, Maryam; Khorrami, Farid; Dehnad, Afsaneh; Golchin, Mohammad H; Azad, Mohsen; Rahimi, Shafei

2018-01-01

The challenges of using health information systems in developing countries are different from developed countries for various reasons such as infrastructure and data culture of organizations. The aim of this study is to assess managers' access to key performance indicators (KPI) via Hospital Information System (HIS) in teaching hospitals of Iran. All managers (Census method) of the four teaching hospitals affiliated to Hormozgan University of Medical Sciences (HUMS) were included in this study. KPIs which are linked to the strategic objectives of organizations were adopted from the strategic plan of HUMS. The questionnaire used in this study included three categories: Financial, Human Resources and clinical. One-sample t-test was used and the significant difference score was calculated for the acceptable level. We found that HIS cannot facilitate access to KPIs for managers in the main categories, but it was effective in two subcategories of income (p = 0.314) and salary (P = 0.289)). A study of barriers to the use of managers of HIS in hospitals is suggested.

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

Shull, D.

This report documents the initial feasibility tests performed using a commercial acoustic emission instrument for the purpose of detecting beetles in Department of Energy 9975 shipping packages. The device selected for this testing was a commercial handheld instrument and probe developed for the detection of termites, weevils, beetles and other insect infestations in wooden structures, trees, plants and soil. The results of two rounds of testing are presented. The first tests were performed by the vendor using only the hand-held instrument’s indications and real-time operator analysis of the audio signal content. The second tests included hands-free positioning of the instrumentmore » probe and post-collection analysis of the recorded audio signal content including audio background comparisons. The test results indicate that the system is promising for detecting the presence of drugstore beetles, however, additional work would be needed to improve the ease of detection and to automate the signal processing to eliminate the need for human interpretation. Mechanisms for hands-free positioning of the probe and audio background discrimination are also necessary for reliable detection and to reduce potential operator dose in radiation environments.« less

Workload and Time Management in Central Cancer Registries: Baseline Data and Implication for Registry Staffing

PubMed Central

Chapman, Susan A.; Mulvihill, Linda; Herrera, Carolina

2015-01-01

The Workload and Time Management Survey of Central Cancer Registries was conducted in 2011 to assess the amount of time spent on work activities usually performed by cancer registrars. A survey including 39 multi-item questions, together with a work activities data collection log, was sent by email to the central cancer registry (CCR) manager in each of the 50 states and the District of Columbia. Twenty-four central cancer registries (47%) responded to the survey. Results indicate that registries faced reductions in budgeted staffing from 2008–2009. The number of source records and total cases were important indicators of workload. Four core activities, including abstracting at the registry, visual editing, case consolidation, and resolving edit reports, accounted for about half of registry workload. We estimate an average of 12.4 full-time equivalents (FTEs) are required to perform all cancer registration activities tracked by the survey; however, estimates vary widely by registry size. These findings may be useful for registries as a benchmark for their own registry workload and time-management data and to develop staffing guidelines. PMID:23493024

Identifying and quantifying heterogeneity in high content analysis: application of heterogeneity indices to drug discovery.

PubMed

Gough, Albert H; Chen, Ning; Shun, Tong Ying; Lezon, Timothy R; Boltz, Robert C; Reese, Celeste E; Wagner, Jacob; Vernetti, Lawrence A; Grandis, Jennifer R; Lee, Adrian V; Stern, Andrew M; Schurdak, Mark E; Taylor, D Lansing

2014-01-01

One of the greatest challenges in biomedical research, drug discovery and diagnostics is understanding how seemingly identical cells can respond differently to perturbagens including drugs for disease treatment. Although heterogeneity has become an accepted characteristic of a population of cells, in drug discovery it is not routinely evaluated or reported. The standard practice for cell-based, high content assays has been to assume a normal distribution and to report a well-to-well average value with a standard deviation. To address this important issue we sought to define a method that could be readily implemented to identify, quantify and characterize heterogeneity in cellular and small organism assays to guide decisions during drug discovery and experimental cell/tissue profiling. Our study revealed that heterogeneity can be effectively identified and quantified with three indices that indicate diversity, non-normality and percent outliers. The indices were evaluated using the induction and inhibition of STAT3 activation in five cell lines where the systems response including sample preparation and instrument performance were well characterized and controlled. These heterogeneity indices provide a standardized method that can easily be integrated into small and large scale screening or profiling projects to guide interpretation of the biology, as well as the development of therapeutics and diagnostics. Understanding the heterogeneity in the response to perturbagens will become a critical factor in designing strategies for the development of therapeutics including targeted polypharmacology.

Evaluation of empowerment model on indicators of metabolic control in patients with type 2 diabetes, a randomized clinical trial study.

PubMed

Ebrahimi, Hossein; Sadeghi, Mahdi; Amanpour, Farzaneh; Vahedi, Hamid

2016-04-01

Diabetes education is a major subject in achieving optimal glycemic control. Effective empowerment approach can be beneficial for improving patients' health. The aim of this study was to evaluate the effect of empowerment model on indicators of metabolic control in patients with type 2 diabetes. a randomized controlled trial of 103 patients with type 2 diabetes were randomly assigned to either the intervention (empowerment approach training) or the control group (conventional training) 2014. Empowerment approach training were performed for the experimental group for eight weeks. Data collection tool included demographic information form and indicators of metabolic control checklist. Analysis was performed by one-way analysis of variance, chi-square test, paired t-test, independent t-test and multiple linear regression. Before the intervention, two groups were homogeneous in terms of demographic variables, glycosylated hemoglobin (HbA1C), and other indicators of metabolic control. After the intervention, average HbA1C and other metabolic indicators except for LDL showed significant differences in the experimental group compared to the control group. study results indicated the positive effects of applying the empowerment model on the metabolic control indicators. Therefore, applying this model is recommended to nurses and the relevant authorities in order to improve clinical outcomes in diabetic patients. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

A meta-analysis of self-monitoring on reading performance of K-12 students.

PubMed

Guzman, Guadalupe; Goldberg, Taryn S; Swanson, H Lee

2018-03-01

The published single-case design (SCD) research (N = 19 articles) on self-monitoring and reading performance was synthesized. The following inclusion criteria were used: (a) the study must have been peer-reviewed, (b) implemented an intervention targeting student self-monitoring of reading skills, (c) included data on at least 1 reading outcome, (d) included visual representation of the data, and (f) the study must have used an SCD to assess the topic of interest. A total of 67 participants, 45 males and 22 females, ranging in age from 7:8 -18:7 were included in the current meta-analysis. Ethnicity was reported for 42 students: 23 were Caucasian, 12 were African American, and 7 were Latino/Hispanic. Studies were compared with those meeting What Works Clearinghouse (WWC) standards and those not meeting standards. The Tau-U effect size (ES) method was the main calculation method used; however, Phi ES estimates are included for comparison purposes. Results indicated that self-monitoring had an overall significant large positive effect on the reading performance of K-12 students, Tau-U = 0.79, 95% confidence interval (CI) [0.64, 0.93], p < .0001. However, self-monitoring for studies that met WWC criteria yielded a larger overall positive ES, Tau-U = 0.93, 95% CI [0.79, 1.07], p < .0001. Although the current meta-analysis is limited to peer-reviewed SCD studies, the findings provide support for self-monitoring as an evidence-based reading intervention for students in Grades K-12. Furthermore, findings indicate that larger ES values were identified when consolidating studies based on WWC guidelines as compared with consolidating across all studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Perceptions on evaluative and formative functions of external supervision of Rwandan primary healthcare facilities: A qualitative study.

PubMed

Schriver, Michael; Cubaka, Vincent Kalumire; Itangishaka, Sylvere; Nyirazinyoye, Laetitia; Kallestrup, Per

2018-01-01

External supervision of primary healthcare facilities in low- and middle-income countries often has a managerial main purpose in which the role of support for professional development is unclear. To explore how Rwandan primary healthcare supervisors and providers (supervisees) perceive evaluative and formative functions of external supervision. Qualitative, exploratory study. Focus group discussions: three with supervisors, three with providers, and one mixed (n = 31). Findings were discussed with individual and groups of supervisors and providers. Evaluative activities occupied providers' understanding of supervision, including checking, correcting, marking and performance-based financing. These were presented as sources of motivation, that in self-determination theory indicate introjected regulation. Supervisors preferred to highlight their role in formative supervision, which may mask their own and providers' uncontested accounts that systematic performance evaluations predominated supervisors' work. Providers strongly requested larger focus on formative and supportive functions, voiced as well by most supervisors. Impact of performance evaluation on motivation and professional development is discussed. While external supervisors intended to support providers' professional development, our findings indicate serious problems with this in a context of frequent evaluations and performance marking. Separating the role of supporter and evaluator does not appear as the simple solution. If external supervision is to improve health care services, it is essential that supervisors and health centre managers are competent to support providers in a way that transparently accounts for various performance pressures. This includes delivery of proper formative supervision with useful feedback, maintaining an effective supervisory relationship, as well as ensuring providers are aware of the purpose and content of evaluative and formative supervision functions.

Simulation of dyslexia. How literacy and cognitive skills can help distinguish college students with dyslexia from malingerers

PubMed Central

de Bree, Elise H.; de Jong, Peter F.

2018-01-01

Academic accommodations associated with a diagnosis of dyslexia might be incentives for college students without reading or spelling difficulties to feign dyslexia and obtain the diagnosis unfairly. In the current study we examined malingering practices by comparing the performance of college students instructed to malinger dyslexia (n = 28) to that of students actually diagnosed with dyslexia (n = 16). We also included a control group of students without reading and spelling difficulties (n = 28). The test battery included tasks tapping literacy skills as well as underlying cognitive skills associated with literacy outcomes. These tasks are commonly used in diagnosing dyslexia. We examined patterns in the performance of malingerers across tasks and tested whether malingerers could be identified based on their performance on a limited number of tasks. Results indicated that malingerers scored significantly lower than students with dyslexia on reading and spelling skills; i.e., the core characteristics of dyslexia. Especially reading performance was extremely low and not in line with students’ age and level of education. Findings for underlying cognitive skills were mixed. Overall, malingerers scored lower than students with dyslexia on tasks tapping mainly speed, whereas the two groups did not differ on tasks reflecting mainly accuracy. Based on word and pseudoword reading and letter and digit naming, the three groups could be distinguished with reasonable sensitivity and specificity. In all, results indicate that college students seem to understand on which tasks they should feign dyslexia, but tend to exaggerate difficulties on these tasks to the point where diagnosticians should mistrust performance. PMID:29782515

Linking performance benchmarking of refinery process chemicals to refinery key performance indicators

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

Cook, J.M.; Nieman, L.D.

In 1977 Solomon Associates, Inc. issued its first study of refining in the US entitled, Comparative Performance Analysis for Fuel Product Refineries, most commonly referred to as the Solomon Study, or the Fuels Study. In late 1993, both the Water and Waste Water Management, and Petroleum Divisions of Nalco Chemical Company came to the same conclusion; that they must have a better understanding of the Solomon Study process, and have some input to this system of measurement. The authors first approached Solomon Associates with the idea that a specific study should be done of specialty chemicals used in the refinery.more » They felt that this would result in two studies, one for water treatment applications, and one for process. The water treatment study came first, and was completed in 1993 with the United States Petroleum Refineries Water Treatment Performance Analysis for Operating Year 1993. The process study, entitled United States Petroleum Refinery Process Treatment Performance Analysis for Operating Years 1994--95 will be issued in the 2nd quarter of this year by Nalco/Exxon Energy Chemicals, L.P, which includes the combined resources of the former Petroleum Division of Nalco Chemical Company (including the petroleum related portions of most of its overseas companies), and the petroleum related specialty chemical operations of Exxon Chemical on a global basis. What follows is a recap of the process study focus, some examples of output, and comment on both the linkage to key refinery operating indicators, as well as the perception of the effect of such measurement on the supplier relationship of the future.« less

Prospective memory performance in individuals with Parkinson's disease who have mild cognitive impairment.

PubMed

Costa, Alberto; Peppe, Antonella; Zabberoni, Silvia; Serafini, Francesca; Barban, Francesco; Scalici, Francesco; Caltagirone, Carlo; Carlesimo, Giovanni Augusto

2015-09-01

Prospective memory (PM) is the ability to keep in memory and realize future intentions. We aimed at investigating whether in Parkinson's disease (PD) PM deficits are related to mild cognitive impairment (MCI). Other aims were to investigate the cognitive abilities underlying PM performance, and the association between PM performance and measures of daily living functioning. The study included 15 PD patients with single domain MCI, 15 with multiple domain MCI, 17 PD patients without cognitive disorders (PDNC) and 25 healthy controls (HCs). All subjects were administered a PM procedure that included focal (PM cue is processed in the ongoing task) and nonfocal (PM cue is not processed in the ongoing task) conditions. PD patients were administered an extensive neuropsychological battery and scales to assess daily living abilities. PD patients with MCI (both single and multiple domains) showed lower accuracy on all PM conditions than both HC and PDNC patients. This was predicted by their scores on shifting indices. Conversely, PM accuracy of PDNC patients was comparable to HCs. Regression analyses revealed that PD patients' PM performance significantly predicted scores on daily living scales Conclusions: Results suggest that PM efficiency is not tout-court reduced in PD patients, but it specifically depends on the presence of MCI. Moreover, decreased executive functioning, but not episodic memory failure, accounts for a significant proportion of variance in PM performance. Finally, PM accuracy indices were found to be associated with measures of global daily living functioning and management of medication. (c) 2015 APA, all rights reserved).

Evaluation of a Modified User Guide for Hearing Aid Management.

PubMed

Caposecco, Andrea; Hickson, Louise; Meyer, Carly; Khan, Asaduzzaman

2016-01-01

This study investigated if a hearing aid user guide modified using best practice principles for health literacy resulted in superior ability to perform hearing aid management tasks, compared with the user guide in the original form. This research utilized a two-arm study design to compare the original manufacturer's user guide with a modified user guide for the same hearing aid--an Oticon Acto behind-the-ear aid with an open dome. The modified user guide had a lower reading grade level (4.2 versus 10.5), used a larger font size, included more graphics, and had less technical information. Eighty-nine adults ages 55 years and over were included in the study; none had experience with hearing aid use or management. Participants were randomly assigned either the modified guide (n = 47) or the original guide (n = 42). All participants were administered the Hearing Aid Management test, designed for this study, which assessed their ability to perform seven management tasks (e.g., change battery) with their assigned user guide. The regression analysis indicated that the type of user guide was significantly associated with performance on the Hearing Aid Management test, adjusting for 11 potential covariates. In addition, participants assigned the modified guide required significantly fewer prompts to perform tasks and were significantly more likely to perform four of the seven tasks without the need for prompts. The median time taken by those assigned the modified guide was also significantly shorter for three of the tasks. Other variables associated with performance on the Hearing Aid Management test were health literacy level, finger dexterity, and age. Findings indicate that the need to design hearing aid user guides in line with best practice principles of health literacy as a means of facilitating improved hearing aid management in older adults.

Association between pornography use and sexual risk behaviors in adult consumers: a systematic review.

PubMed

Harkness, Emily L; Mullan, Barbara; Mullan, Barbara M; Blaszczynski, Alex

2015-02-01

The purpose of this review was to determine whether an association exists between sexual risk behaviors and pornography consumption. Consumption of pornography is common, yet research examining its link with sexual risk behaviors is in its infancy. Indicators of sexual risk behavior, including unsafe sex practices and a higher number of sexual partners, have been linked to poor health outcomes. A systematic literature search was performed using Medline, PsycINFO, Web of Knowledge, Pubmed, and CINAHL. Studies were included if they assessed the association between pornography use and indicators of sexual risk behaviors in an adult population. A total of 17 were included in the review, and all were assessed for research standards using the Quality Index Scale. For both Internet pornography and general pornography, links with greater unsafe sex practices and number of sexual partners were identified. Limitations of the literature, including low external validity and poor study design, restrict the generalizability of the findings. Accordingly, replication and more rigorous methods are recommended for future research.

ANALYSING PERFORMANCE ASSESSMENT IN PUBLIC SERVICES: HOW USEFUL IS THE CONCEPT OF A PERFORMANCE REGIME?

PubMed

Martin, Steve; Nutley, Sandra; Downe, James; Grace, Clive

2016-03-01

Approaches to performance assessment have been described as 'performance regimes', but there has been little analysis of what is meant by this concept and whether it has any real value. We draw on four perspectives on regimes - 'institutions and instruments', 'risk regulation regimes', 'internal logics and effects' and 'analytics of government' - to explore how the concept of a multi-dimensional regime can be applied to performance assessment in public services. We conclude that the concept is valuable. It helps to frame comparative and longitudinal analyses of approaches to performance assessment and draws attention to the ways in which public service performance regimes operate at different levels, how they change over time and what drives their development. Areas for future research include analysis of the impacts of performance regimes and interactions between their visible features (such as inspections, performance indicators and star ratings) and the veiled rationalities which underpin them.

Exploring the associations between drug side-effects and therapeutic indications.

PubMed

Wang, Fei; Zhang, Ping; Cao, Nan; Hu, Jianying; Sorrentino, Robert

2014-10-01

Drug therapeutic indications and side-effects are both measurable patient phenotype changes in response to the treatment. Inferring potential drug therapeutic indications and identifying clinically interesting drug side-effects are both important and challenging tasks. Previous studies have utilized either chemical structures or protein targets to predict indications and side-effects. In this study, we compared drug therapeutic indication prediction using various information including chemical structures, protein targets and side-effects. We also compared drug side-effect prediction with various information sources including chemical structures, protein targets and therapeutic indication. Prediction performance based on 10-fold cross-validation demonstrates that drug side-effects and therapeutic indications are the most predictive information source for each other. In addition, we extracted 6706 statistically significant indication-side-effect associations from all known drug-disease and drug-side-effect relationships. We further developed a novel user interface that allows the user to interactively explore these associations in the form of a dynamic bipartitie graph. Many relationship pairs provide explicit repositioning hypotheses (e.g., drugs causing postural hypotension are potential candidates for hypertension) and clear adverse-reaction watch lists (e.g., drugs for heart failure possibly cause impotence). All data sets and highly correlated disease-side-effect relationships are available at http://astro.temple.edu/∼tua87106/druganalysis.html. Copyright © 2014 Elsevier Inc. All rights reserved.

Number comparison and number ordering as predictors of arithmetic performance in adults: Exploring the link between the two skills, and investigating the question of domain-specificity.

PubMed

Morsanyi, Kinga; O'Mahony, Eileen; McCormack, Teresa

2017-12-01

Recent evidence has highlighted the important role that number-ordering skills play in arithmetic abilities, both in children and adults. In the current study, we demonstrated that number comparison and ordering skills were both significantly related to arithmetic performance in adults, and the effect size was greater in the case of ordering skills. Additionally, we found that the effect of number comparison skills on arithmetic performance was mediated by number-ordering skills. Moreover, performance on comparison and ordering tasks involving the months of the year was also strongly correlated with arithmetic skills, and participants displayed similar (canonical or reverse) distance effects on the comparison and ordering tasks involving months as when the tasks included numbers. This suggests that the processes responsible for the link between comparison and ordering skills and arithmetic performance are not specific to the domain of numbers. Finally, a factor analysis indicated that performance on comparison and ordering tasks loaded on a factor that included performance on a number line task and self-reported spatial thinking styles. These results substantially extend previous research on the role of order processing abilities in mental arithmetic.

Episodic memory change in late adulthood: generalizability across samples and performance indices.

PubMed

Dixon, Roger A; Wahlin, Ake; Maitland, Scott B; Hultsch, David F; Hertzog, Christopher; Bäckman, Lars

2004-07-01

Younger adults recall more information from episodic memory tasks than do older adults. Because longitudinal studies are rare and often incompatible, the extent of actual late-life memory change is not well established. We assemble two different longitudinal samples of normal older adults, each of which is tested twice at a 3-year interval, using a large battery of episodic memory indicators. Together, two-wave data from both the Victoria Longitudinal Study in Canada (n = 400) and the Kungsholmen Project in Sweden (n = 168) cover a 40-year span of adulthood, ranging from 54 to 94 years of age. Principal memory tasks include categorizable word lists, story recall, and random word lists, as well as indicators of cognitive support. Overall, an examination of performance on sets of common and complementary episodic tasks reveals that, for both samples, actual 3-year changes are modest and that, when decline occurs, it is gradual. The exception-greater decline for more supported tasks-suggests that these may be especially sensitive to late-life changes.

Optimization of planar self-collimating photonic crystals.

PubMed

Rumpf, Raymond C; Pazos, Javier J

2013-07-01

Self-collimation in photonic crystals has received a lot of attention in the literature, partly due to recent interest in silicon photonics, yet no performance metrics have been proposed. This paper proposes a figure of merit (FOM) for self-collimation and outlines a methodical approach for calculating it. Performance metrics include bandwidth, angular acceptance, strength, and an overall FOM. Two key contributions of this work include the performance metrics and identifying that the optimum frequency for self-collimation is not at the inflection point. The FOM is used to optimize a planar photonic crystal composed of a square array of cylinders. Conclusions are drawn about how the refractive indices and fill fraction of the lattice impact each of the performance metrics. The optimization is demonstrated by simulating two spatially variant self-collimating photonic crystals, where one has a high FOM and the other has a low FOM. This work gives optical designers tremendous insight into how to design and optimize robust self-collimating photonic crystals, which promises many applications in silicon photonics and integrated optics.