NASA Astrophysics Data System (ADS)
Aldowaisan, Tariq; Allahverdi, Ali
2016-05-01
This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and update of the PEOs. For each PEO an assessment process is employed where performance measures are defined along with target attainment levels. Results from assessment tools are compared with the target attainment levels to measure performance with regard to the PEOs. The assessment indicates that the results meet or exceed the target attainment levels of the PEOs' performance measures.
Audit feedback on reading performance of screening mammograms: An international comparison.
Hofvind, S; Bennett, R L; Brisson, J; Lee, W; Pelletier, E; Flugelman, A; Geller, B
2016-09-01
Providing feedback to mammography radiologists and facilities may improve interpretive performance. We conducted a web-based survey to investigate how and why such feedback is undertaken and used in mammographic screening programmes. The survey was sent to representatives in 30 International Cancer Screening Network member countries where mammographic screening is offered. Seventeen programmes in 14 countries responded to the survey. Audit feedback was aimed at readers in 14 programmes, and facilities in 12 programmes. Monitoring quality assurance was the most common purpose of audit feedback. Screening volume, recall rate, and rate of screen-detected cancers were typically reported performance measures. Audit reports were commonly provided annually, but more frequently when target guidelines were not reached. The purpose, target audience, performance measures included, form and frequency of the audit feedback varied amongst mammographic screening programmes. These variations may provide a basis for those developing and improving such programmes. © The Author(s) 2016.
Guildford, Beth J; Jacobs, Clair M; Daly-Eichenhardt, Aisling; Scott, Whitney; McCracken, Lance M
2016-01-01
Physical functioning is a recommended outcome domain for pain management programmes. It can be assessed by self-report and by direct assessment of performance. Although physical performance measures may provide unique and useful information about patient functioning over and above self-report measures, it is not entirely clear which of the many possible performances to assess. This study investigated a battery of three directly assessed physical performance measures and their relationship to three currently used self-report measures of general health and functioning. The three performance measures were sensitive to treatment; patients performed significantly better on all three measures following completion of the pain management programme. The three performance measures were shown to represent a single underlying dimension, and there was a significant degree of overlap between them. The performance measures were shown to be relevant in explaining variation in the self-report measures, as well as to offer a clinically relevant different dimension of assessment to self-report. Future research could focus on developing performance-based measures that capture quality of movement and that are sensitive to relevant processes of therapeutic change. PMID:28386404
Auditing emergency management programmes: Measuring leading indicators of programme performance.
Tomsic, Heather
Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.
Developing information literacy: a key to evidence-based nursing.
Shorten, A; Wallace, M C; Crookes, P A
2001-06-01
This report describes the evaluation of a curriculum-integrated programme designed to help students develop an awareness of the nursing literature, the skills to locate and retrieve it, and skills required in its evaluation; in other words'information literacy'. Positive changes in student performance on objective measures of information-literacy skills were revealed as well as a significant increase in the levels of confidence of the student in performing those skills. Students who had undertaken the information-literacy programme ('programme' students) performed better on a range of objective measures of information literacy, as well as reporting higher levels of confidence in these skills, than students who had not participated in the programme ('non-programme' students). Evaluation of this programme provides evidence of the potential usefulness of a curriculum-integrated approach for the development of information-literacy skills within nursing education. With these underlying skills, students will be better equipped to consolidate and extend their key information-literacy skills to include research appreciation and application. These are vital for effective lifelong learning and a prerequisite to evidence-based practice.
NASA Astrophysics Data System (ADS)
Wang, Yonggang; Kuang, Jie; Liu, Chong; Cao, Qiang; Li, Deng
2017-03-01
A high performance multi-channel time-to-digital converter (TDC) is implemented in a Xilinx Zynq-7000 field programmable gate array (FPGA). It can be flexibly configured as either 32 TDC channels with 9.9 ps time-interval RMS precision, 16 TDC channels with 6.9 ps RMS precision, or 8 TDC channels with 5.8 ps RMS precision. All TDCs have a 380 M Samples/second measurement throughput and a 2.63 ns measurement dead time. The performance consistency and temperature dependence of TDC channels are also evaluated. Because Zynq-7000 FPGA family integrates a feature-rich dual-core ARM based processing system and 28 nm Xilinx programmable logic in a single device, the realization of high performance TDCs on it will make the platform more widely used in time-measuring related applications.
Lee, John Tayu; Netuveli, Gopalakrishnan; Majeed, Azeem; Millett, Christopher
2011-01-01
The Quality and Outcomes Framework (QOF), a major pay-for-performance programme, was introduced into United Kingdom primary care in April 2004. The impact of this programme on disparities in health care remains unclear. This study examines the following questions: has this pay for performance programme improved the quality of care for coronary heart disease, stroke and hypertension in white, black and south Asian patients? Has this programme reduced disparities in the quality of care between these ethnic groups? Did general practices with different baseline performance respond differently to this programme? Retrospective cohort study of patients registered with family practices in Wandsworth, London during 2007. Segmented regression analysis of interrupted time series was used to take into account the previous time trend. Primary outcome measures were mean systolic and diastolic blood pressure, and cholesterol levels. Our findings suggest that the implementation of QOF resulted in significant short term improvements in blood pressure control. The magnitude of benefit varied between ethnic groups with a statistically significant short term reduction in systolic BP in white and black but not in south Asian patients with hypertension. Disparities in risk factor control were attenuated only on few measures and largely remained intact at the end of the study period. Pay for performance programmes such as the QOF in the UK should set challenging but achievable targets. Specific targets aimed at reducing ethnic disparities in health care may also be needed.
Lindblom, Hanna; Waldén, Markus; Hägglund, Martin
2012-10-01
The objective of the present randomised controlled trial was to study the effect of a neuromuscular warm-up programme on performance tests in youth female football. Four youth female football teams with players aged 12-16 years were randomised into an intervention group and control group. The intervention was a 15-min neuromuscular warm-up programme carried out twice a week during the 11-week study period. Baseline and follow-up measurements of performance were made indoors and included the star excursion balance test, a countermovement jump test, a triple-hop for distance test, a modified Illinois agility test, and 10- and 20-m sprint tests. Fifty-two players (intervention 28; control 24) took part in baseline measurements, and after dropout, 41 players (intervention 23; control 18) were included for analysis. Minor positive changes were seen in the control group compared to the intervention group for a sub-score of the star excursion balance test (P < 0.05) and in the modified Illinois agility test (P < 0.05). No improvement was seen in the intervention group from baseline to follow-up. The study showed that a neuromuscular warm-up programme carried out during 11 weeks did not improve performance in youth female football. This could indicate that the programme does not contain sufficient stimulus to improve performance. A low player attendance at training sessions, and low specificity between exercises in the warm-up programme and the evaluated performance tests may also contribute to the lack of effect. I.
Wallis, Jason A; Webster, Kate E; Levinger, Pazit; Fong, Cynthia; Taylor, Nicholas F
2014-01-01
To determine if a pre-operative group rehabilitation programme can improve arthritis self-efficacy for people with severe hip and knee osteoarthritis. Single group, repeated measures design: 4-week baseline phase followed by a 6-week intervention phase of water exercise, and education with self-management strategies. The primary outcome was arthritis self-efficacy. The secondary outcomes were measures of pain (WOMAC), activity limitation (WOMAC), activity performance (30 s chair stand test, 10 m walk test) and health-related quality of life (EuroQol). Twenty participants (10 knee osteoarthritis and 10 hip osteoarthritis) with a mean age of 71 years (SD 7) attended 92% (SD 10%) of the scheduled sessions. All measures demonstrated baseline stability between two time points for measurements at week 1 and measurements at week 4. After the 6-week intervention programme there were no significant improvements for arthritis self-efficacy. There was a 12% increase for fast walking speed (mean increase of 0.14 m/s, 95% CI 0.07, 0.22). There were no significant improvements for other secondary outcomes. A pre-operative water-based exercise and educational programme did not improve arthritis self-efficacy, self-reported pain and activity limitation, and health-related quality of life for people with hip and knee osteoarthritis who were candidates for joint replacement. While there was a significant increase in one measure of activity performance (walking speed), these findings suggest the current programme may be of little value. Implications for Rehabilitation This pre-operative group rehabilitation programme for people with severe hip and knee osteoarthritis did not change arthritis self-efficacy, pain, activity limitation and health-related quality of life. This programme may have little value in preparing people for joint replacement surgery. The optimal pre-operative programme requires further design and investigation.
Schindler, Victoria P
2010-09-01
The purpose of this study was to assess the effectiveness of a client-centred, occupation-based occupational therapy programme for individuals with psychiatric diagnoses. The study took place in a college campus. A pre-test/post-test design was used. There were 38 participants which included college students and community members who desired to attend college, work and/or address life skill goals. The Canadian Occupational Performance Measure (COPM) was used as a pre- and post-test measure. Goals were based on problems identified in the COPM, reflected academic, vocational, life skill, and leisure goals, and were systematically addressed weekly through activities developed by the participant and a graduate occupational therapy student who acted as a mentor. The Participant Overall Satisfaction Scale was completed by each participant. A case study was used to describe the programme in more depth. The results support that the client-centred, occupation-based occupational therapy programme increased client scores on satisfaction and performance of occupational performance problems identified on the COPM. Further research is recommended to explore how client-centred occupational therapy programmes can be effective in improving academic, vocational and life skill goals. Copyright 2010 John Wiley & Sons, Ltd.
ERIC Educational Resources Information Center
Curtis, Elana; Wikaire, Erena; Jiang, Yannan; McMillan, Louise; Loto, Robert; Fonua, Sonia; Herbert, Rowan; Hori, Melissa; Ko, Teri; Newport, Rochelle; Salter, David; Wiles, Janine; Airini; Reid, Papaarangi
2017-01-01
Bridging/foundation programmes are often provided by tertiary institutions to increase equity in access and academic performance of students from under-served communities. Little empirical evidence exists to measure the effectiveness of these bridging/foundation programmes on undergraduate academic outcomes. This research identifies the predictive…
ERIC Educational Resources Information Center
Yang, Wenhsien
2015-01-01
This study investigates learners' performance in a Taiwanese tertiary content and language integrated learning (CLIL) programme. Learners' English proficiency was measured immediately after entering the programme and before their industrial placement, i.e. after two years. As in previously reported cases, the learners showed a significant…
Creating meaningful business continuity management programme metrics.
Strong, Brian
2010-11-01
The popular axiom, 'what gets measured gets done', is often applied in the quality management and continuous improvement disciplines. This truism is also useful to business continuity practitioners as they continually strive to prove the value of their organisation's investment in a business continuity management (BCM) programme. BCM practitioners must also remain relevant to their organisations as executives focus on the bottom line and maintaining stakeholder confidence. It seems that executives always find a way, whether in a hallway or elevator, to ask BCM professionals about the company's level of readiness. When asked, they must be ready with an informed response. The establishment of a process to measure business continuity programme performance and organisational readiness has emerged as a key component of US Department of Homeland Security 'Voluntary Private Sector Preparedness (PS-Prep) Program' standards where the overarching goal is to improve private sector preparedness for disasters and emergencies. The purpose of this paper is two-fold: to introduce continuity professionals to best practices that should be considered when developing a BCM metrics programme as well as providing a case study of how a large health insurance company researched, developed and implemented a process to measure BCM programme performance and company readiness.
NASA Astrophysics Data System (ADS)
Kirby, Nicola Frances; Dempster, Edith Roslyn
2014-11-01
The Foundation Programme of the Centre for Science Access at the University of KwaZulu-Natal, South Africa provides access to tertiary science studies to educationally disadvantaged students who do not meet formal faculty entrance requirements. The low number of students proceeding from the programme into mainstream is of concern, particularly given the national imperative to increase participation and levels of performance in tertiary-level science. An attempt was made to understand foundation student performance in a campus of this university, with the view to identifying challenges and opportunities for remediation in the curriculum and processes of selection into the programme. A classification and regression tree analysis was used to identify which variables best described student performance. The explanatory variables included biographical and school-history data, performance in selection tests, and socio-economic data pertaining to their year in the programme. The results illustrate the prognostic reliability of the model used to select students, raise concerns about the inefficiency of school performance indicators as a measure of students' academic potential in the Foundation Programme, and highlight the importance of accommodation arrangements and financial support for student success in their access year.
Banks, Kevin; Meaburn, Anthony; Phelan, Elaine
2013-01-01
To determine whether the clinical competencies of musculoskeletal outpatient physiotherapists improve if they participate in an annual in-service education programme designed around clinical practice needs. A within-subject, without-control, experimental, pre-test post-test study. Clinical and educational facilities of Doncaster and Bassetlaw Hospitals NHS Foundation Trust and locality-based outpatient facilities. Participants were 37 specialist musculoskeletal outpatient physiotherapists (band 6 and 7), working for Doncaster and Bassetlaw Hospitals NHS Foundation Trust. Participants completed three separate modules of in-service education through an academic year, based on learning outcomes identified from observation and performance rating of their clinical competencies. Each module lasted 7 hours, with supporting clinical assistance sessions and self-directed learning time. The primary outcome measure was a (participant) performance rating (from novice to expert) of 20 clinical competencies scored by experienced clinical educators before and after completion of the in-service education programme. A secondary, qualitative outcome measure (a purpose-made, semi-structured questionnaire) given after the programme explored participants' experiences and perceptions of the in-service education programme. Seven competencies were identified as the focus of the programme because their performance ratings were the lowest. All seven of these competencies improved following the programme. Communication scores improved by 6%, clinical reasoning by 4%, functional analysis of movement by 6%, use of research in practice by 4%, and critical appraisal of evidence by 4.6%. Performance of structural differentiation and the range of manual handling skills demonstrated were the only competencies to show a statistically significant improvement of 14.6% and 12%, respectively (p≤0.025(. Thematic analysis of the questionnaires revealed that 96% of respondents felt that their practice had changed positively over the year because of the programme. Providing a structured and bespoke in-service education programme over an academic year may help to improve the rating of clinical competencies and give participants the perception that their clinical practice has changed because of the programme.
Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Williams, Susan B; Byrne, Karin N; LoGiudice, Dina; Lautenschlager, Nicola T; Dodd, Karen J
2013-05-01
To evaluate the feasibility and safety of a home-based exercise programme for people with Alzheimer's disease, and to provide preliminary evidence of programme effectiveness in improving balance and mobility and reducing falls risk. A randomized controlled trial. Community. Forty people with mild to moderate Alzheimer's disease (mean age 81.9, SD 5.72; 62.5% female). Participants were randomized to a six-month home-based individually tailored balance, strengthening and walking exercise programme (physiotherapist) or a six-month home-based education programme (control) (occupational therapist). Both programmes provided six home-visits and five follow-up phone calls. Balance, mobility, falls and falls risk were measured at baseline and programme completion. Intention-to-treat analysis using a generalized linear model with group allocation as a predictor variable was performed to evaluate programme effectiveness. Feasibility and adverse events were systematically recorded at each contact. Fifty-eight per cent of the exercise group finished the programme, completing an average of 83% of prescribed sessions, with no adverse events reported. Functional Reach improved significantly (P = 0.002) in the exercise group (mean (SD), 2.28 (4.36)) compared to the control group (-2.99 (4.87)). Significant improvement was also observed for the Falls Risk for Older People - Community score (P = 0.008) and trends for improvement on several other balance, mobility, falls and falls risk measures for the exercise group compared to the control group. The exercise programme was feasible and safe and may help improve balance and mobility performance and reduce falls risk in people with Alzheimer's disease.
Minimum detectable dose as a measure of bioassay programme capability.
Carbaugh, E H
2003-01-01
This paper suggests that minimum detectable dose (MDD) be used to describe the capability of bioassay programmes for which intakes are expected to be rare. This allows expression of the capability in units that correspond directly to primary dose limits. The concept uses the well established analytical statistic minimum detectable amount (MDA) as the starting point, and assumes MDA detection at a prescribed time post-intake. The resulting dose can then be used as an indication of the adequacy or capability of the programme for demonstrating compliance with the performance criteria. MDDs can be readily tabulated or plotted to demonstrate the effectiveness of different types of monitoring programmes. The inclusion of cost factors for bioassay measurements can allow optimisation.
Withy, Kelley M; Lee, Wayde; Renger, Ralph F
2007-11-01
Successful substance abuse treatment requires many changes in behavior, attitude and skills. Culturally tailored approaches to substance abuse treatment have shown initial success, but are not yet accepted as best practice models. In order to document programme effectiveness of a new culturally tailored substance abuse treatment programme on the rural island of Molokai, Hawaii, the authors worked to develop a multi-level evaluation plan to measure behavior changes occurring after participation in activities targeting identified causes of substance abuse in the population of interest. The authors compiled interview results to develop a map of identified causes of substance abuse in the community studied. Strategic planning then identified the specific activities aimed at impacting identified root causes. A literature review was performed to document the effectiveness of such activities. An evaluation plan was developed to measure programme impact on antecedent conditions contributing to substance use in this community. Prioritized causes of substance abuse in the target group included low self esteem, lack of self identity and life plan, and limited communication and conflict resolution skills. Activities targeting these conditions included cultural activities, group counseling, and individual counseling. Literature to support the benefit of addressing these factors was uncovered, and evaluation methodology was developed to measure changes in behaviors, attitudes, and practices, as a measure of programme success. While programme evaluation data is still being collected, the authors have demonstrated a sound foundation for programme activities, and designed methodology for collecting meaningful data to measure programme effectiveness at changing important root causes of substance abuse in a rural Native Hawaiian community.
de Kok, Mascha; Frotscher, Caroline N A; van der Weijden, Trudy; Kessels, Alfons G H; Dirksen, Carmen D; van de Velde, Cornelis J H; Roukema, Jan A; Bell, Antoine V R J; van der Ent, Fred W; von Meyenfeldt, Maarten F
2007-07-02
Whereas ultra-short stay (day care or 24 hour hospitalisation) following breast cancer surgery was introduced in the US and Canada in the 1990s, it is not yet common practice in Europe. This paper describes the design of the MaDO study, which involves the implementation of ultra short stay admission for patients after breast cancer surgery, and evaluates whether the targets of the implementation strategy are reached. The ultra short stay programme and the applied implementation strategy will be evaluated from the economic perspective. The MaDO study is a pre-post-controlled multi-centre study, that is performed in four hospitals in the Netherlands. It includes a pre and post measuring period of six months each with six months of implementation in between in at least 40 patients per hospital per measurement period. Primary outcome measure is the percentage of patients treated in ultra short stay. Secondary endpoints are the percentage of patients treated according to protocol, degree of involvement of home care nursing, quality of care from the patient's perspective, cost-effectiveness of the ultra short stay programme and cost-effectiveness of the implementation strategy. Quality of care will be measured by the QUOTE-breast cancer instrument, cost-effectiveness of the ultra short stay programme will be measured by means of the EuroQol (administered at four time-points) and a cost book for patients. Cost-effectiveness analysis will be performed from a societal perspective. Cost-effectiveness of the implementation strategy will be measured by determination of the costs of implementation activities. This study will reveal barriers and facilitators for implementation of the ultra short stay programme. Moreover, the results of the study will provide information about the cost-effectiveness of the ultra short stay programme and the implementation strategy. Current Controlled Trials ISRCTN77253391.
Measuring the Success of an Academic Development Programme: A Statistical Analysis
ERIC Educational Resources Information Center
Smith, L. C.
2009-01-01
This study uses statistical analysis to estimate the impact of first-year academic development courses in microeconomics, statistics, accountancy, and information systems, offered by the University of Cape Town's Commerce Academic Development Programme, on students' graduation performance relative to that achieved by mainstream students. The data…
The value of health screening in music schools and conservatoires.
Clark, Terry; Williamon, Aaron; Redding, Emma
2013-04-01
Interest in musicians' health and well-being is growing, reflected by increasing numbers of investigations into the physicality and psychology of musical performance. Within sport and dance, screening and profiling programmes, especially of the musculoskeletal system, have furthered understanding on not only physical and psychological capabilities and demands but also musculoskeletal injury mechanisms and susceptibility. This article engages with questions relating to the development and delivery of musician-specific health screening programmes. Effective screening can offer a variety of benefits for musicians, providing informed recommendations for sustaining performance-related fitness across educational and professional contexts. Employing an interdisciplinary approach when developing screening programmes is essential, as is the ecological appropriateness of the measures used. The implications inherent in delivering and sustaining successful screening programmes in schools and conservatoires are discussed.
Clinical experience with a chronic pain management programme in Hong Kong Chinese patients.
Man, Alice K Y; Chu, M C; Chen, P P; Ma, M; Gin, Tony
2007-10-01
To describe experience with a chronic pain management programme in Hong Kong Chinese patients. Prospective study. Regional hospital, Hong Kong. Patients with chronic pain who participated in the first six Comprehensive Out-patient Pain Engagement programmes between 2002 and 2005. Comprehensive Out-patient Pain Engagement is a 14-day structured, multidisciplinary out-patient programme conducted over 6 weeks. It includes pain education, cognitive re-conceptualisation, training in communication skills and coping strategies, graded physical exercises and functional activities training. It aims to improve patient function and quality of life, despite persistent pain. Changes in scores from baseline values after joining the programme, with respect to several assessment tools. These included the following: visual analogue pain scale, Pain Catastrophizing Scale, Patient Self-efficacy Questionnaire, Canadian Occupational Performance Measure, Medical Outcome Survey-Short Form 36 Questionnaire, and duration of physical tolerances, medication utilisation, and work status records. Forty-five patients were available for analysis. After the Comprehensive Out-patient Pain Engagement programme, improvements in Medical Outcome Survey-Short Form 36 Questionnaire (role physical and vitality), Pain Catastrophizing Scale, Patient Self-efficacy Questionnaire, and Canadian Occupational Performance Measure were demonstrated (P<0.05). The duration of standing and sitting tolerances increased (P<0.05). An improvement in employment rate was also evident (P=0.01). The initial results of our management programme in Chinese patients with chronic pain are encouraging. This type of programme should be promoted more widely in this group of patients, as it appears to improve physical function, psychological well-being, and productivity.
Horizontal schools-based health programme in rural Kenya.
Bogie, James; Eder, Ben; Magnus, Dan; Amonje, Onguko David; Gant, Martina
2017-09-01
Primary school children in low-income countries are at risk of many diseases and poor health affects attendance, cognition and ability to learn. Developing school health and nutrition strategies has been extensively highlighted as a global priority, with a particular focus on complex programme design. However, such programmes are relatively untested in low-income settings. We implemented a complex school health and nutrition programme in two schools in Western Kenya over 3 years. There were numerous elements covering health policy, skills-based health education, infrastructure and disease prevention. A local non-governmental organisation, with involvement from local government and the community, performed programme implementation. Height-for-age, weight-for-age,height-for-weight, anaemia prevalence, academic performance and school attendance were the primary outcome measures. The programme improved nutrition, academic performance and anaemia prevalence. The number of underweight children fell from 20% to 11% (OR 0.51 95% CI 0.39 to 0.68 p=<0.01) and stunting prevalence fell from 29.9% to 20% (OR 0.59 95% CI 0.50 to 0.68 p=<0.01). Academic performance improved with a 74% reduction in odds of failing assessments (OR 0.26 95% CI 0.22 to 0.29 p=<0.01). Anaemia prevalence fell from 17.2% to 11%. The programme showed an increase in low body mass index prevalence and no effect on school attendance, the reasons for which are unclear. These results are encouraging and demonstrate that complex schools health programmes can lead to positive gains in health, nutrition and importantly academic performance. There is a need for further evaluation of comprehensive school health interventions in poor communities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Pitt, Victoria; Powis, David; Levett-Jones, Tracy; Hunter, Sharyn
2014-05-01
Research conducted primarily with psychology and medical students has highlighted that personal qualities play an important role in students' academic performance. In nursing there has been limited investigation of the relationship between personal qualities and performance. Yet, reports of student incivility and a lack of compassion have prompted appeals to integrate the assessment of personal qualities into pre-registration nursing student selection. Before this can be done research is needed to explore the influence of students' personal qualities on programme performance and progression. This study explores the relationships between students' personal qualities and their academic and clinical performance, behaviours and progression through a pre-registration nursing programme in Australia. This longitudinal descriptive correlational study was undertaken with a sample of Australian pre-registration nursing students (n=138). Students' personal qualities were assessed using three personal qualities assessment (PQA) instruments. Outcome measures included grades in nursing theory and clinical courses, yearly grade point average, final clinical competency, progression (completion), class attendance and levels of life event stress. Significant correlations were found between academic performance and PQA scores for self-control, resilience and traits of aloofness, confidence and involvement. Final clinical competence was predicted by confidence and self-control scores. Students with higher empathy had higher levels of life event stress in their first year and class attendance had a positive correlation with self-control. Completing the programme in three years was weakly predicted by the measure of resilience. No difference was noted between extreme or non-extreme scorers on the PQA scales with respect to performance or progression. This sample of students' personal qualities was found to influence their academic and clinical performance and their ability to complete a pre-registration programme in three years. However, further research is required with larger cohorts to confirm the use of personal qualities assessment during selection. © 2013.
Quality Differences of Higher Education and Its Determinants in a Less-Developed Country
ERIC Educational Resources Information Center
Sarmiento Espinel, Jaime Andrés; Silva Arias, Adriana Carolina; Van Gameren, Edwin
2015-01-01
Two key measures to determine the quality of higher education are the performance of students and the accreditation of a programme's quality. We analyse the difference in the distributions of the student's scores in a standardised test of economics knowledge between accredited and non-accredited undergraduate economics programmes in a…
Use of herd management programmes to improve the reproductive performance of dairy cattle.
McDougall, S; Heuer, C; Morton, J; Brownlie, T
2014-05-01
There has been a long history of herd health and production management programmes in many dairy industries around the world, but evidence for the efficacy of such programmes is limited. In response to a perceived decline in fertility of dairy cows, a herd reproductive management programme (InCalf) was introduced in New Zealand in 2007. This programme uses a management cycle approach that includes an assessment of the current herd status, identification of areas for improvement, development of a plan, implementation of this plan and finally a review process. The programme uses facilitators who work with farmers either in a one-to-one manner or in a formalised group setting that involves a series of meetings over a 12-month period (the farmer action group). The hypothesis that involvement in a reproductive management programme would improve herd reproductive performance was tested using a herd-level controlled randomised study (the National Herd Fertility Study) involving herds in four geographic regions of New Zealand over 2 years. Within each region, herds were ranked on the basis of the 6-week in-calf rate (i.e. the proportion of the herd pregnant in the first 6 weeks of the seasonal breeding programme) in the year preceding commencement of the study and then randomly assigned to be involved in a farmer action group or left as untreated controls. The key outcome variable of the study was the 6-week in-calf rate. Pregnancy diagnosis was undertaken at 12 weeks after the start of the seasonal breeding programme, which allowed determination of conception dates and hence calculation of the 6-week in-calf rate. Additional measurements including heifer live weight and body condition score (pre-calving and pre-mating) were undertaken to test whether treatment resulted in measurable changes in some of the key determinants of herd reproductive performance. Involvement in the farmer action group of InCalf resulted in a 2 percentage point increase in the 6-week in-calf rate (P=0.05). The following additional observations were made in herds involved in the farmer action group relative to control herds: heifers had live weight closer to target; the pre-mating body condition score of cows was higher; and oestrous detection rates were higher. It was concluded that involvement in this herd reproductive management programme improved reproductive outcomes in this New Zealand study. However, to achieve substantial improvements in herd reproductive performance at the regional or national level a greater response to the programme and a high uptake of such programmes is required, as well as use of other industry-level tools such as genetic management programmes.
Long-term observations of tropospheric ozone: GAW Measurement Guidelines
NASA Astrophysics Data System (ADS)
Tarasova, Oksana; Galbally, Ian E.; Schultz, Martin G.
2013-04-01
The Global Atmosphere Watch (GAW) Programme of the World Meteorological Organization (WMO) coordinates long-term observations of the chemical composition and physical properties of the atmosphere which are relevant for understanding of atmospheric chemistry and climate change. Atmospheric observations of reactive gases (tropospheric ozone, carbon monoxide, volatile organic compounds and nitrogen oxides) coordinated by the GAW Programme complement local and regional scale air quality monitoring efforts. As part of the GAW quality assurance (QA) system detailed measurement guidelines for atmospheric trace species are developed by international expert teams at irregular intervals. The most recent report focuses on continuous in-situ measurements of ozone in the troposphere, performed in particular at continental or island sites with altitudes ranging from sea level to mountain tops. Data Quality Objectives (DQOs) are defined for different applications of the data (e.g. trend analysis and verification of global model forecasts). These DQOs include a thorough discussion of the tolerable level of measurement uncertainty and data completeness. The guidelines present the best practices and practical arrangements adopted by the GAW Programme in order to enable the GAW station network to approach or achieve the defined tropospheric ozone DQOs. The document includes information on the selection of station and measurement locations, required skills and training of staff, recommendations on the measurement technique and the necessary equipment to perform highest quality measurements, rules for conducting the measurements, preparing the data and archiving them, and more. Much emphasis is given to discussions about how to ensure the quality of the data through tracing calibrations back to primary standards, proper calibration and data analysis, etc. In the GAW Programme the QA system is implemented through Central Facilities (Central Calibration Laboratories, World and Regional Calibration Centers and World Data Centers), Scientific Advisory Groups and GAW Training and Education Center. These bodies support primary standards, provide calibration and data archiving facilities, coordinate comparison campaigns, perform stations audit, provide documentation and training of personnel.
Giusi, G; Giordano, O; Scandurra, G; Rapisarda, M; Calvi, S; Ciofi, C
2016-04-01
Measurements of current fluctuations originating in electron devices have been largely used to understand the electrical properties of materials and ultimate device performances. In this work, we propose a high-sensitivity measurement setup topology suitable for the automatic and programmable Direct-Current (DC), Capacitance-Voltage (CV), and gate-drain low frequency noise characterization of field effect transistors at wafer level. Automatic and programmable operation is particularly useful when the device characteristics relax or degrade with time due to optical, bias, or temperature stress. The noise sensitivity of the proposed topology is in the order of fA/Hz(1/2), while DC performances are limited only by the source and measurement units used to bias the device under test. DC, CV, and NOISE measurements, down to 1 pA of DC gate and drain bias currents, in organic thin film transistors are reported to demonstrate system operation and performances.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Giusi, G.; Giordano, O.; Scandurra, G.
Measurements of current fluctuations originating in electron devices have been largely used to understand the electrical properties of materials and ultimate device performances. In this work, we propose a high-sensitivity measurement setup topology suitable for the automatic and programmable Direct-Current (DC), Capacitance-Voltage (CV), and gate-drain low frequency noise characterization of field effect transistors at wafer level. Automatic and programmable operation is particularly useful when the device characteristics relax or degrade with time due to optical, bias, or temperature stress. The noise sensitivity of the proposed topology is in the order of fA/Hz{sup 1/2}, while DC performances are limited only bymore » the source and measurement units used to bias the device under test. DC, CV, and NOISE measurements, down to 1 pA of DC gate and drain bias currents, in organic thin film transistors are reported to demonstrate system operation and performances.« less
Hill, Keith D; LoGiudice, Dina; Lautenschlager, Nicola T; Said, Catherine M; Dodd, Karen J; Suttanon, Plaiwan
2009-07-16
Balance dysfunction and falls are common problems in later stages of dementia. Exercise is a well-established intervention to reduce falls in cognitively intact older people, although there is limited randomised trial evidence of outcomes in people with dementia. The primary objective of this study is to evaluate whether a home-based balance exercise programme improves balance performance in people with mild to moderate severity Alzheimer's disease. Two hundred and fourteen community dwelling participants with mild to moderate severity Alzheimer's disease will be recruited for the randomised controlled trial. A series of laboratory and clinical measures will be used to evaluate balance and mobility performance at baseline. Participants will then be randomized to receive either a balance training home exercise programme (intervention group) from a physiotherapist, or an education, information and support programme from an occupational therapist (control group). Both groups will have six home visits in the six months following baseline assessment, as well as phone support. All participants will be re-assessed at the completion of the programme (after six months), and again in a further six months to evaluate sustainability of outcomes. The primary outcome measures will be the Limits of Stability (a force platform measure of balance) and the Step Test (a clinical measure of balance). Secondary outcomes include other balance and mobility measures, number of falls and falls risk measures, cognitive and behavioural measures, and carer burden and quality of life measures. Assessors will be blind to group allocation. Longitudinal change in balance performance will be evaluated in a sub-study, in which the first 64 participants of the control group with mild to moderate severity Alzheimer's disease, and 64 age and gender matched healthy participants will be re-assessed on all measures at initial assessment, and then at 6, 12, 18 and 24 months. By introducing a balance programme at an early stage of the dementia pathway, when participants are more likely capable of safe and active participation in balance training, there is potential that balance performance will be improved as dementia progresses, which may reduce the high falls risk at this later stage. If successful, this approach has the potential for widespread application through community based services for people with mild to moderate severity Alzheimer's disease. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12608000040369).
Chen, Bob; Mok, Damon; Lee, Winson C C; Lam, Wing Kai
2015-02-01
To examine the effect of a high-intensity stepwise conditioning programme combined with multiple recovery measures on physical fitness, agility, and knee pain symptoms of an injured player. A single case study. University-based conditioning training laboratory. One 26-year-old male world-class badminton player (height, 190.0 cm; weight, 79.3 kg; left dominant hand; playing experience, 16 years; former world champion) with patellar tendinosis and calcification of his left knee. The player received seven conditioning sessions over three weeks. During the programme, there was a gradual increase in training duration and load across sessions while cold therapy, manual stretches and massage were administered after each session to minimise inflammation. The training outcome was evaluated with three different testing methods: standard step test, badminton-specific agility test, and tension-pain rating. The conditioning programme reduced knee pain symptoms and improved actual performance and cardiopulmonary fitness during the agility task. The player was able to return to sport and compete within a month. A high-intensity stepwise conditioning programme improved the physical fitness while sufficient recovery measures minimised any possible undesirable effects and promoted faster return to elite level competition. Copyright © 2014 Elsevier Ltd. All rights reserved.
A low power, low noise Programmable Analog Front End (PAFE) for biopotential measurements.
Adimulam, Mahesh Kumar; Divya, A; Tejaswi, K; Srinivas, M B
2017-07-01
A low power Programmable Analog Front End (PAFE) for biopotential measurements is presented in this paper. The PAFE circuit processes electrocardiogram (ECG), electromyography (EMG) and electroencephalogram (EEG) signals with higher accuracy. It consists mainly of improved transconductance programmable gain instrumentational amplifier (PGIA), programmable high pass filter (PHPF), and second order low pass filter (SLPF). A 15-bit programmable 5-stage successive approximation analog-to-digital converter (SAR-ADC) is implemented for improving the performance, whose power consumption is reduced due to multiple stages and by OTA/Comparator sharing technique between the stages. The power consumption is further reduced by operating the analog portion of PAFE on 0.5V supply voltage and digital portion on 0.3V supply voltage generated internally through a voltage regulator. The proposed low power PAFE has been fabricated in 180nm standard CMOS process. The performance parameters of PAFE in 15-bit mode are found to be, gain of 31-70 dB, input referred noise of 1.15 μVrms, CMRR of 110 dB, PSRR of 104 dB, and signal-to-noise distortion ratio (SNDR) of 83.5dB. The power consumption of the design is 1.1 μW @ 0.5 V supply voltage and it occupies a core silicon area of 1.2 mm 2 .
El-Gilany, A-H; El-Shaer, S; Khashaba, E; El-Dakroory, S A; Omar, N
2017-06-01
A quasi-experimental study was performed on 20 technicians working in the Faculty of Medicine, Mansoura University, Egypt. The knowledge, attitude, and practice (KAP) of laboratory technicians was measured before and two months after enrolling them in an intervention programme about laboratory best practice procedures. The programme addressed laboratory safety and medical waste management. The assessment was performed using a validated Arabic self-administered questionnaire. Pre- and post-intervention scores were compared using non-parametric tests. There are significant increases in the scores of KAP after implementation of the training programme. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Williams, Sian A; Gucciardi, Daniel F; Bear, Natasha; Gibson, Noula
2018-01-01
Introduction Children with cerebral palsy (CP) and other neurodevelopmental disabilities often receive a home programme of exercises to assist in reaching their therapy goals. Adherence to exercise programmes is necessary to attain the level of practice required to achieve goals; however, adherence can be difficult to accomplish. In this paper, we describe the protocol for a randomised controlled trial to evaluate the effectiveness of delivering a home exercise programme to school-age children with disabilities using Physitrack, an online exercise prescription tool with a website or app interface. Methods and analysis Participants aged 6–17 years, with CP or other neurodevelopmental disabilities, receiving community physiotherapy services in Western Australia, will be recruited. Participants will be stratified by age and functional mobility and randomised to either the intervention group, who will complete an 8-week home exercise programme using Physitrack, or the control group, who will complete an 8-week exercise programme without Physitrack. Researcher blinding to group allocation, and participant blinding to outcome, will be maintained. The primary outcome measures are adherence to the home exercise programme with weekly collection of home exercise logs; achievement of individualised goals by phone interview before and after intervention; and correctness of exercise performance by collection and analysis of videos of participants performing home exercises. Secondary outcome measures include enjoyment of physical activity, confidence to complete exercise programme, preferred method of delivery of programme and usability of Physitrack. A sample size of 58 participants will be necessary to see an effect on home programme adherence. Data will be analysed using the intention-to-treat principle. Ethics and dissemination Ethical approval was obtained from Curtin University Human Research Ethics Committee in July 2016 (10391). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at scientific conferences. Trial registration number ACTRN12616000743460; Pre-results. PMID:29362255
Hill, K; Fearn, M; Williams, S; Mudge, L; Walsh, C; McCarthy, P; Walsh, M; Street, A
2010-01-01
Adults with haemophilia and other bleeding disorders often develop lower limb musculoskeletal problems associated with bleeds into joints and muscles, which may affect balance performance and increase likelihood of falling. The aim of this study was to evaluate the effectiveness of an individualized balance and strength home exercise programme on improving balance and related outcomes for adults with haemophilia and other bleeding disorders. Twenty male adults with haemophilia and other bleeding disorders (mean age 39.4 years, 95% CI = 33.7-45.1) were recruited to participate. They underwent a comprehensive clinical and force platform assessment of balance and related measures. Based on assessment findings, the assessing physiotherapist provided an individualized home exercise programme of balance, strengthening and walking exercises. Re-assessment occurred after the 4-month exercise programme. Twelve participants (60%) completed the programme and were re-assessed. There were no safety problems or dropouts associated with the exercise programme aggravating joint status. Although there were no statistically significant changes in any of the measures (adjusted for multiple comparisons), there were improvements of between 5% and 22% on 10 of the 16 measures, with the Neurocom modified Clinical Test of Sensory Interaction on Balance (P = 0.036) and Timed Sit to Stand (P = 0.064) approaching significance. A tailored home exercise programme targeting balance, strengthening and walking is feasible for adults with haemophilia and other bleeding disorders. These results suggest that positive physical outcomes including improved balance and mobility may be achieved with this type of programme.
Kampshoff, Caroline S; Buffart, Laurien M; Schep, Goof; van Mechelen, Willem; Brug, Johannes; Chinapaw, Mai J M
2010-11-30
Preliminary studies suggest that physical exercise interventions can improve physical fitness, fatigue and quality of life in cancer patients after completion of chemotherapy. Additional research is needed to rigorously test the effects of exercise programmes among cancer patients and to determine optimal training intensity accordingly. The present paper presents the design of a randomized controlled trial evaluating the effectiveness and cost-effectiveness of a high intensity exercise programme compared to a low-to-moderate intensity exercise programme and a waiting list control group on physical fitness and fatigue as primary outcomes. After baseline measurements, cancer patients who completed chemotherapy are randomly assigned to either a 12-week high intensity exercise programme or a low-to-moderate intensity exercise programme. Next, patients from both groups are randomly assigned to immediate training or a waiting list (i.e. waiting list control group). After 12 weeks, patients of the waiting list control group start with the exercise programme they have been allocated to.Both interventions consist of equal bouts of resistance and endurance interval exercises with the same frequency and duration, but differ in training intensity. Additionally, patients of both exercise programmes are counselled to improve compliance and achieve and maintain an active lifestyle, tailored to their individual preferences and capabilities.Measurements will be performed at baseline (t = 0), 12 weeks after randomization (t = 1), and 64 weeks after randomization (t = 2). The primary outcome measures are cardiorespiratory fitness and muscle strength assessed by means of objective performance indicators, and self-reported fatigue. Secondary outcome measures include health-related quality of life, self-reported physical activity, daily functioning, body composition, mood and sleep disturbances, and return to work. In addition, compliance and satisfaction with the interventions will be evaluated. Potential moderation by pre- and post-illness lifestyle, health and exercise-related attitudes, beliefs and motivation will also be assessed. Finally, the cost-effectiveness of both exercise interventions will be evaluated. This randomized controlled trial will be a rigorous test of effects of exercise programmes for cancer patients after chemotherapy, aiming to contribute to evidence-based practice in cancer rehabilitation programmes. This study is registered at the Netherlands Trial Register (NTR2153).
Searchfield, Grant D; Linford, Tania; Kobayashi, Kei; Crowhen, David; Latzel, Matthias
2018-03-01
To compare preference for and performance of manually selected programmes to an automatic sound classifier, the Phonak AutoSense OS. A single blind repeated measures study. Participants were fit with Phonak Virto V90 ITE aids; preferences for different listening programmes were compared across four different sound scenarios (speech in: quiet, noise, loud noise and a car). Following a 4-week trial preferences were reassessed and the users preferred programme was compared to the automatic classifier for sound quality and hearing in noise (HINT test) using a 12 loudspeaker array. Twenty-five participants with symmetrical moderate-severe sensorineural hearing loss. Participant preferences of manual programme for scenarios varied considerably between and within sessions. A HINT Speech Reception Threshold (SRT) advantage was observed for the automatic classifier over participant's manual selection for speech in quiet, loud noise and car noise. Sound quality ratings were similar for both manual and automatic selections. The use of a sound classifier is a viable alternative to manual programme selection.
Rahman, Nadia; Vinayakarao, Latha; Pathak, Sangeeta; Minden, Dawn; Melson, Louise; Vitue, Ella; Pradhan, A
2017-03-01
The objective was to assess the feedback from a quality improvement training programme to reduce obstetric anal sphincter injuries (OASIS). Training sessions were organised that included evidence-based information on OASIS risk factors and training on models to measure perineal body length (PBL), perform episiotomies with standard and 60° fixed angle scissors (EPISCISSORS-60®), and measure post-delivery episiotomy suture angles with protractor transparencies. Feedback forms using a Likert scale (1-4) were completed and analysed. The setting was an evidence-based quality improvement programme (Strategy for Using Practical aids for Prevention of OASIS, Recording episiotomies and clinician Training [SUPPORT]) at two National Health Service (NHS) Hospitals in the UK. The participants were midwives and doctors attending the SUPPORT training programme RESULTS: All of the participants (100 %) would recommend the training programme to a friend or colleague. 92 % felt that the training session improved their knowledge of the impact of PBL and perineal distension and their knowledge of the relationship between episiotomy angle and OASIS "a lot" or "somewhat". Based on this feedback, we recommend the addition of the knowledge content of the SUPPORT programme to other centres providing perineal assessment and repair courses.
Paillard, T; Lafont, C; Costes-Salon, M C; Rivière, D; Dupui, P
2004-10-01
This work analyses the short-term physiological and neurophysiological effects of a brisk walking programme in ageing, healthy, active men. Twenty-one men 63 to 72 years of age were recruited and separated into 2 groups. One group performed a walking programme (WP) (n = 11) and another served as control (C) group (n = 10). The walking programme lasted for twelve weeks and included five sessions per week. Several parameters were assessed before and after the programme for the WP group. The same tests were performed (separated by twelve weeks) in group C. During each assessment, the subjects were put through static and dynamic balance tests, spatio-temporal gait analysis, body composition measurements and determination of aerobic capacity and bone mineral density. The statistic analysis showed a significant improvement in dynamic balance performance, especially in lateral sway when the subjects kept their eyes open, an increase of VO(2) max and loss of fat mass in the WP group. However, no alterations appeared in spatiotemporal gait characteristics, static balance performance, lean mass or bone mineral density (total body and hip). According to these results, this walking programme may have positive effects on preventing ageing subjects from falling.
Dalkin, Sonia; Gibbons, Elizabeth; Wright, Judy; Valderas, Jose Maria; Meads, David; Black, Nick
2017-01-01
Objectives Internationally, there has been considerable debate about the role of data in supporting quality improvement in health care. Our objective was to understand how, why and in what circumstances the feedback of aggregated patient-reported outcome measures data improved patient care. Methods We conducted a realist synthesis. We identified three main programme theories underlying the use of patient-reported outcome measures as a quality improvement strategy and expressed them as nine ‘if then’ propositions. We identified international evidence to test these propositions through searches of electronic databases and citation tracking, and supplemented our synthesis with evidence from similar forms of performance data. We synthesized this evidence through comparing the mechanisms and impact of patient-reported outcome measures and other performance data on quality improvement in different contexts. Results Three programme theories were identified: supporting patient choice, improving accountability and enabling providers to compare their performance with others. Relevant contextual factors were extent of public disclosure, use of financial incentives, perceived credibility of the data and the practicality of the results. Available evidence suggests that patients or their agents rarely use any published performance data when selecting a provider. The perceived motivation behind public reporting is an important determinant of how providers respond. When clinicians perceived that performance indicators were not credible but were incentivized to collect them, gaming or manipulation of data occurred. Outcome data do not provide information on the cause of poor care: providers needed to integrate and interpret patient-reported outcome measures and other outcome data in the context of other data. Lack of timeliness of performance data constrains their impact. Conclusions Although there is only limited research evidence to support some widely held theories of how aggregated patient-reported outcome measures data stimulate quality improvement, several lessons emerge from interventions sharing the same programme theories to help guide the increasing use of these measures. PMID:29260592
Thacker, K K; Kaste, L M; Homsi, K D; LeHew, C W
2016-11-01
To assess oral cancer prevention and early detection curricula in Illinois associate-degree dental hygiene programmes and highlight global health applications. An email invitation was sent to each Illinois associate-degree granting dental hygiene programme's oral cancer contact to participate in a survey via a SurveyMonkey™ link to a 21-item questionnaire. Questions elicited background information on each programme and inquired about curriculum and methods used for teaching oral cancer prevention and early detection. Eight of the 12 (67%) programmes responded. Three (37.5%) reported having a specific oral cancer curriculum. Five (62.5%) require students to perform examinations for signs and symptoms of oral cancer at each clinic visit. Variations exist across the programmes in the number of patients each student sees annually and the number of oral cancer examinations each student performs before graduation. Seven programmes (87.5%) conduct early detection screening in community settings. All programmes included risk assessment associated with tobacco. All other risk factors measured were treated inconsistently. Significant differences in training and experience were reported across Illinois dental hygiene programmes. Training is neither standardized nor uniformly comprehensive. Students' preparation for delivering prevention and early detection services to their patients could be strengthened to ensure competence including reflection of risk factors and behaviours in a global context. Regular review of curricular guidelines and programme content would help dental hygienists meet the expectations of the Crete Declaration on Oral Cancer Prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
[Effects of a programme of aquatic Ai Chi exercise in patients with fibromyalgia. A pilot study].
Perez-De la Cruz, Sagrario; Lambeck, Johan
2015-01-16
Fibromyalgia is rheumathological disease a combination of physical, psychological and social limitations. The aim of the present study is to determinate the benefits of Ai Chi program on quality of life, depression and pain. An experimental study was performed with 20 fibromyalgia patients two different cities. Outcome measures were functional capacity (Fibromyalgia Impact Questionnaire), pain (Visual Analogue Scale) and quality of life (Short Form-36). Measures were performed at baseline and after ten weeks post-intervention. After ten weeks of treatment, the results showed significant reduction (p < 0,05) in virtually all outcome measures. An Ai Chi aquatic therapy programme contributes to reduce pain and improve quality of life as well as physical and mental health in patients with fibromyalgia.
NASA Astrophysics Data System (ADS)
Statham, P.; Llovet, X.; Duncumb, P.
2012-03-01
We have assessed the reliability of different Monte Carlo simulation programmes using the two available Bastin-Heijligers databases of thin-film measurements by EPMA. The MC simulation programmes tested include Curgenven-Duncumb MSMC, NISTMonte, Casino and PENELOPE. Plots of the ratio of calculated to measured k-ratios ("kcalc/kmeas") against various parameters reveal error trends that are not apparent in simple error histograms. The results indicate that the MC programmes perform quite differently on the same dataset. However, they appear to show a similar pronounced trend with a "hockey stick" shape in the "kcalc/kmeas versus kmeas" plots. The most sophisticated programme PENELOPE gives the closest correspondence with experiment but still shows a tendency to underestimate experimental k-ratios by 10 % for films that are thin compared to the electron range. We have investigated potential causes for this systematic behaviour and extended the study to data not collected by Bastin and Heijligers.
Rutten, Geert M; Harting, Janneke; Bartholomew, L Kay; Schlief, Angelique; Oostendorp, Rob A B; de Vries, Nanne K
2013-05-25
Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme's effectiveness and the fidelity, acceptability and feasibility of its implementation. A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines' main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen's d). Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (-15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme's multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence. To assess its value, the programme needs to be tested in a randomized controlled trial.
A novel sleep optimisation programme to improve athletes' well-being and performance.
Van Ryswyk, Emer; Weeks, Richard; Bandick, Laura; O'Keefe, Michaela; Vakulin, Andrew; Catcheside, Peter; Barger, Laura; Potter, Andrew; Poulos, Nick; Wallace, Jarryd; Antic, Nick A
2017-03-01
To improve well-being and performance indicators in a group of Australian Football League (AFL) players via a six-week sleep optimisation programme. Prospective intervention study following observations suggestive of reduced sleep and excessive daytime sleepiness in an AFL group. Athletes from the Adelaide Football Club were invited to participate if they had played AFL senior-level football for 1-5 years, or if they had excessive daytime sleepiness (Epworth Sleepiness Scale [ESS] >10), measured via ESS. An initial education session explained normal sleep needs, and how to achieve increased sleep duration and quality. Participants (n = 25) received ongoing feedback on their sleep, and a mid-programme education and feedback session. Sleep duration, quality and related outcomes were measured during week one and at the conclusion of the six-week intervention period using sleep diaries, actigraphy, ESS, Pittsburgh Sleep Quality Index, Profile of Mood States, Training Distress Scale, Perceived Stress Scale and the Psychomotor Vigilance Task. Sleep diaries demonstrated an increase in total sleep time of approximately 20 min (498.8 ± 53.8 to 518.7 ± 34.3; p < .05) and a 2% increase in sleep efficiency (p < 0.05). There was a corresponding increase in vigour (p < 0.001) and decrease in fatigue (p < 0.05). Improvements in measures of sleep efficiency, fatigue and vigour indicate that a sleep optimisation programme may improve athletes' well-being. More research is required into the effects of sleep optimisation on athletic performance.
Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool
2018-01-16
Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.
Qayumi, A K; Kurihara, Y; Imai, M; Pachev, G; Seo, H; Hoshino, Y; Cheifetz, R; Matsuura, K; Momoi, M; Saleem, M; Lara-Guerra, H; Miki, Y; Kariya, Y
2004-10-01
This study aimed to compare the effects of computer-assisted, text-based and computer-and-text learning conditions on the performances of 3 groups of medical students in the pre-clinical years of their programme, taking into account their academic achievement to date. A fourth group of students served as a control (no-study) group. Participants were recruited from the pre-clinical years of the training programmes in 2 medical schools in Japan, Jichi Medical School near Tokyo and Kochi Medical School near Osaka. Participants were randomly assigned to 4 learning conditions and tested before and after the study on their knowledge of and skill in performing an abdominal examination, in a multiple-choice test and an objective structured clinical examination (OSCE), respectively. Information about performance in the programme was collected from school records and students were classified as average, good or excellent. Student and faculty evaluations of their experience in the study were explored by means of a short evaluation survey. Compared to the control group, all 3 study groups exhibited significant gains in performance on knowledge and performance measures. For the knowledge measure, the gains of the computer-assisted and computer-assisted plus text-based learning groups were significantly greater than the gains of the text-based learning group. The performances of the 3 groups did not differ on the OSCE measure. Analyses of gains by performance level revealed that high achieving students' learning was independent of study method. Lower achieving students performed better after using computer-based learning methods. The results suggest that computer-assisted learning methods will be of greater help to students who do not find the traditional methods effective. Explorations of the factors behind this are a matter for future research.
Computer-aided programming for message-passing system; Problems and a solution
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wu, M.Y.; Gajski, D.D.
1989-12-01
As the number of processors and the complexity of problems to be solved increase, programming multiprocessing systems becomes more difficult and error-prone. Program development tools are necessary since programmers are not able to develop complex parallel programs efficiently. Parallel models of computation, parallelization problems, and tools for computer-aided programming (CAP) are discussed. As an example, a CAP tool that performs scheduling and inserts communication primitives automatically is described. It also generates the performance estimates and other program quality measures to help programmers in improving their algorithms and programs.
Optimizing performance by improving core stability and core strength.
Hibbs, Angela E; Thompson, Kevin G; French, Duncan; Wrigley, Allan; Spears, Iain
2008-01-01
Core stability and core strength have been subject to research since the early 1980s. Research has highlighted benefits of training these processes for people with back pain and for carrying out everyday activities. However, less research has been performed on the benefits of core training for elite athletes and how this training should be carried out to optimize sporting performance. Many elite athletes undertake core stability and core strength training as part of their training programme, despite contradictory findings and conclusions as to their efficacy. This is mainly due to the lack of a gold standard method for measuring core stability and strength when performing everyday tasks and sporting movements. A further confounding factor is that because of the differing demands on the core musculature during everyday activities (low load, slow movements) and sporting activities (high load, resisted, dynamic movements), research performed in the rehabilitation sector cannot be applied to the sporting environment and, subsequently, data regarding core training programmes and their effectiveness on sporting performance are lacking. There are many articles in the literature that promote core training programmes and exercises for performance enhancement without providing a strong scientific rationale of their effectiveness, especially in the sporting sector. In the rehabilitation sector, improvements in lower back injuries have been reported by improving core stability. Few studies have observed any performance enhancement in sporting activities despite observing improvements in core stability and core strength following a core training programme. A clearer understanding of the roles that specific muscles have during core stability and core strength exercises would enable more functional training programmes to be implemented, which may result in a more effective transfer of these skills to actual sporting activities.
Kok, Maryse C; Kane, Sumit S; Tulloch, Olivia; Ormel, Hermen; Theobald, Sally; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; de Koning, Korrie A M
2015-03-07
Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors intersect to influence CHW performance. A systematic review with a narrative analysis was conducted to identify contextual factors influencing performance of CHWs. We searched six databases for quantitative, qualitative, and mixed-methods studies that included CHWs working in promotional, preventive or curative primary health care services in LMICs. We differentiated CHW performance outcome measures at two levels: CHW level and end-user level. Ninety-four studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programmes. Thematic coding was conducted and evidence on five main categories of contextual factors influencing CHW performance was synthesized. Few studies had the influence of contextual factors on CHW performance as their primary research focus. Contextual factors related to community (most prominently), economy, environment, and health system policy and practice were found to influence CHW performance. Socio-cultural factors (including gender norms and values and disease related stigma), safety and security and education and knowledge level of the target group were community factors that influenced CHW performance. Existence of a CHW policy, human resource policy legislation related to CHWs and political commitment were found to be influencing factors within the health system policy context. Health system practice factors included health service functionality, human resources provisions, level of decision-making, costs of health services, and the governance and coordination structure. All contextual factors can interact to shape CHW performance and affect the performance of CHW interventions or programmes. Research on CHW programmes often does not capture or explicitly discuss the context in which CHW interventions take place. This synthesis situates and discusses the influence of context on CHW and programme performance. Future health policy and systems research should better address the complexity of contextual influences on programmes. This insight can help policy makers and programme managers to develop CHW interventions that adequately address and respond to context to optimise performance.
Ngo, Diana K L; Sherry, Tisamarie B; Bauhoff, Sebastian
2017-02-01
Pay-for-performance (P4P) programmes have been introduced in numerous developing countries with the goal of increasing the provision and quality of health services through financial incentives. Despite the popularity of P4P, there is limited evidence on how providers achieve performance gains and how P4P affects health system quality by changing structural inputs. We explore these two questions in the context of Rwanda's 2006 national P4P programme by examining the programme's impact on structural quality measures drawn from international and national guidelines. Given the programme's previously documented success at increasing institutional delivery rates, we focus on a set of delivery-specific and more general structural inputs. Using the programme's quasi-randomized roll-out, we apply multivariate regression analysis to short-run facility data from the 2007 Service Provision Assessment. We find positive programme effects on the presence of maternity-related staff, the presence of covered waiting areas and a management indicator and a negative programme effect on delivery statistics monitoring. We find no effects on a set of other delivery-specific physical resources, delivery-specific human resources, delivery-specific operations, general physical resources and general human resources. Using mediation analysis, we find that the positive input differences explain a small and insignificant fraction of P4P's impact on institutional delivery rates. The results suggest that P4P increases provider availability and facility operations but is only weakly linked with short-run structural health system improvements overall. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
FPGA-Based X-Ray Detection and Measurement for an X-Ray Polarimeter
NASA Technical Reports Server (NTRS)
Gregory, Kyle; Hill, Joanne; Black, Kevin; Baumgartner, Wayne
2013-01-01
This technology enables detection and measurement of x-rays in an x-ray polarimeter using a field-programmable gate array (FPGA). The technology was developed for the Gravitational and Extreme Magnetism Small Explorer (GEMS) mission. It performs precision energy and timing measurements, as well as rejection of non-x-ray events. It enables the GEMS polarimeter to detect precisely when an event has taken place so that additional measurements can be made. The technology also enables this function to be performed in an FPGA using limited resources so that mass and power can be minimized while reliability for a space application is maximized and precise real-time operation is achieved. This design requires a low-noise, charge-sensitive preamplifier; a highspeed analog to digital converter (ADC); and an x-ray detector with a cathode terminal. It functions by computing a sum of differences for time-samples whose difference exceeds a programmable threshold. A state machine advances through states as a programmable number of consecutive samples exceeds or fails to exceed this threshold. The pulse height is recorded as the accumulated sum. The track length is also measured based on the time from the start to the end of accumulation. For track lengths longer than a certain length, the algorithm estimates the barycenter of charge deposit by comparing the accumulator value at the midpoint to the final accumulator value. The design also employs a number of techniques for rejecting background events. This innovation enables the function to be performed in space where it can operate autonomously with a rapid response time. This implementation combines advantages of computing system-based approaches with those of pure analog approaches. The result is an implementation that is highly reliable, performs in real-time, rejects background events, and consumes minimal power.
A pilot quality assurance scheme for diabetic retinopathy risk reduction programmes.
Garvican, L; Scanlon, P H
2004-10-01
We describe a pilot study of measurement of quality assurance targets for diabetic retinopathy screening and performance comparison between 10 existing services, in preparation for the roll-out of the national programme. In 1999 the UK National Screening Committee approved proposals for a national diabetic retinopathy risk reduction programme, including recommendations for quality assurance, but implementation was held pending publication of the National Service Framework for Diabetes. Existing services requested the authors to perform a pilot study of a QA scheme, indicating willingness to contribute data for comparison. Objectives and quality standards were developed, following consultation with diabetologists, ophthalmologists and retinal screeners. Services submitted 2001/2 performance data, in response to a questionnaire, for anonymization, central analysis and comparison. The 17 quality standards encompass all aspects of the programme from identification of patients to timeliness of treatment. Ten programmes took part, submitting all the data available. All returns were incomplete, but especially so from the optometry-based schemes. Eight or more services demonstrated they could reach the minimum level in only five of the 17 standards. Thirty per cent could not provide coverage data. All were running behind. Reasons for difficulties in obtaining data and/or failing to achieve standards included severe under-funding and little previous experience of QA. Information systems were limited and incompatible between diabetes and eye units, and there was a lack of co-ordinated management of the whole programme. Quality assurance is time-consuming, expensive and inadequately resourced. The pilot study identified priorities for local action. National programme implementation must involve integral quality assurance mechanisms from the outset.
Impact of dose calibrators quality control programme in Argentina
NASA Astrophysics Data System (ADS)
Furnari, J. C.; de Cabrejas, M. L.; del C. Rotta, M.; Iglicki, F. A.; Milá, M. I.; Magnavacca, C.; Dima, J. C.; Rodríguez Pasqués, R. H.
1992-02-01
The national Quality Control (QC) programme for radionuclide calibrators started 12 years ago. Accuracy and the implementation of a QC programme were evaluated over all these years at 95 nuclear medicine laboratories where dose calibrators were in use. During all that time, the Metrology Group of CNEA has distributed 137Cs sealed sources to check stability and has been performing periodic "checking rounds" and postal surveys using unknown samples (external quality control). An account of the results of both methods is presented. At present, more of 65% of the dose calibrators measure activities with an error less than 10%.
[Financial incentives for quality improvement].
Belicza, Eva; Evetovits, Tamás
2010-05-01
Policy makers and payers of health care services devote increasing attention to improve quality of services by incentivising health care providers. These--so called--pay for performance (P4P) programmes have so far been introduced in few countries only and evidence on their effectiveness is still scarce. Therefore we do not know yet which instruments of these programmes are most effective and efficient in improving quality. The P4P systems implemented so far in primary care and in integrated delivery systems use indicators for measurement of performance and the basis for rewards. These indicators are mostly process indicators, but there are some outcome indicators as well. The desired quality improvement effects are most likely to be achieved with programmes that provide seizable financial rewards and cover the extra cost of quality improvement efforts as well. Administration of the programme has to be fully transparent and clear to all involved. It has to be based on scientific evidence and supported with sufficient dedicated funding. Conducting pilot studies is a precondition for large scale implementation.
Effectiveness of a Video-Feedback and Questioning Programme to Develop Cognitive Expertise in Sport
García-González, Luis; Moreno, M. Perla; Moreno, Alberto; Gil, Alexander; del Villar, Fernando
2013-01-01
The importance within sport expertise of cognitive factors has been emphasised in many research studies. Adaptations that take place in athletes’ long-term memories are going to condition their decision-making and performance, and training programmes must be developed that improve these adaptations. In our study, we provide a tactical-cognitive training programme based on video-feedback and questioning in order to improve tactical knowledge in tennis players and verify its effect when transferred to athletes’ decision-making. 11 intermediate tennis players participated in this study (12.9±0.7 years old), distributed into two groups (experimental, n = 5; control, n = 6). Tactical knowledge was measured by problem representation and strategy planning with a verbal protocol. Decision-making was measured by a systematic observation instrument. Results confirm the effectiveness of a combination of video-feedback and questioning on cognitive expertise, developing adaptations in long-term memory that produce an improvement in the quality of tactical knowledge (content, sophistication and structure). This, in turn, is transferred to the athletes’ decision-making capacity, leading to a higher percentage of successful decisions made during game play. Finally, we emphasise the need to develop effective programmes to develop cognitive expertise and improve athletes' performance, and include it in athletes’ formative stages. PMID:24340012
Do the physiotherapy results make us happy in a case with ‘happy puppet’ (Angelman) syndrome?
Kara, Ozgun Kaya; Mutlu, Akmer; Gunel, Mintaze Kerem; Haliloglu, Goknur
2010-01-01
This study aimed to investigate the benefits of physiotherapy programme in a patient with Angelman syndrome (AS) during a follow-up of 3 years. Assessments included: disability level with gross motor function classification systems, gross motor function with gross motor function measurement (GMFM), balance with Berg Balance Scale, motor performance with gross motor performance measurement (GMPM) and tonus assessment with Modified Ashworth Scale. Physiotherapy programme was performed during 36 months, 3 days per week by physical therapist according to Neurodevelopmental Treatment approach. During the 36 months, GMFM increased from 11.46% to 70.82% and GMPM increased from 1.25% to 70.25%. This case report is the first study about the effectiveness of physiotherapy with medium-term follow-up in a child with AS. Physiotherapy results make us happy in this particular patient with ‘happy puppet’ syndrome. PMID:22802472
Differing effects of two synthetic phonics programmes on early reading development.
Shapiro, Laura R; Solity, Jonathan
2016-06-01
Synthetic phonics is the widely accepted approach for teaching reading in English: Children are taught to sound out the letters in a word then blend these sounds together. We compared the impact of two synthetic phonics programmes on early reading. Children received Letters and Sounds (L&S; 7 schools) which teaches multiple letter-sound mappings or Early Reading Research (ERR; 10 schools) which teaches only the most consistent mappings plus frequent words by sight. We measured phonological awareness (PA) and reading from school entry to the end of the second (all schools) or third school year (4 ERR, 3 L&S schools). Phonological awareness was significantly related to all reading measures for the whole sample. However, there was a closer relationship between PA and exception word reading for children receiving the L&S programme. The programmes were equally effective overall, but their impact on reading significantly interacted with school-entry PA: Children with poor PA at school entry achieved higher reading attainments under ERR (significant group difference on exception word reading at the end of the first year), whereas children with good PA performed equally well under either programme. The more intensive phonics programme (L&S) heightened the association between PA and exception word reading. Although the programmes were equally effective for most children, results indicate potential benefits of ERR for children with poor PA. We suggest that phonics programmes could be simplified to teach only the most consistent mappings plus frequent words by sight. © 2015 The British Psychological Society.
Suligowska, Klaudia; Czarniak, Piotr; Krawczyk, Michał; Szcześniak, Przemysław; Król, Ewa; Kusiak, Aida; Sabiniewicz, Robert; Wierzba, Tomasz; Utracka, Alicja; Urban, Magdalena; Wytrykowska, Anna; Pakalska, Anna; Drewek, Konrad; Giczewska, Anna; Popowski, Piotr; Wrotkowska, Magdalena; Marczulin, Joanna; Bochniak, Mariusz
2016-01-01
Introduction The study involved preparing and implementation a model of complex screening programme for adolescents and comparison of anthropometric examinations between the population of the SOPKARD-Junior programme and representative sample of Polish children in the same age. Material and methods The screening programme in 14–15 year old pupils (n = 282) included: anthropometric, blood pressure, echocardiographic, electrocardiographic, carotid arteries, kidney and thyroid ultrasound examinations, as well as respiratory, dental and masticatory system, orthopaedic, psychological and psychiatric assessment. Blood and urine tests were also performed. The results of anthropometric examinations from the SOPKARD-Junior and OLAF programmes were used for comparative analysis. Results Statistically significant (p < 0.001) differences between young people from Sopot and their peers in the general Polish population were found in height (+3.61 cm for boys), body mass (+5.19 kg for boys and +3.99 kg for girls), body mass index (+0.99 kg/m2 for boys and +1.33 kg/m2 for girls), waist circumference (+4.52 cm for boys and +4.52 cm for girls) and hip circumference (+2.51 cm for boys). The highest attendance rate was achieved for examinations performed in school (e.g. anthropometric and blood pressure measurements – n = 268; 95%) and the lowest for the echocardiograpy performed in local hospital (n = 133; 47%). The mean score of the programme quality (scale 1–6) assessed by children was 4.63. Conclusions The SOPKARD-Junior programme represents an attempt to develop a model of screening assessments for teenagers in Poland. Preliminary results of the SOPKARD-Junior programme indicate small differences in the biological development of Sopot youth in comparison with their peers from Polish population of the OLAF programme. The high attendance rate on research conducted at the school indicate that proposed health examinations in adolescents are acceptable and feasible. PMID:29379531
Suligowska, Klaudia; Czarniak, Piotr; Krawczyk, Michał; Szcześniak, Przemysław; Król, Ewa; Kusiak, Aida; Sabiniewicz, Robert; Wierzba, Tomasz; Utracka, Alicja; Urban, Magdalena; Wytrykowska, Anna; Pakalska, Anna; Drewek, Konrad; Giczewska, Anna; Popowski, Piotr; Wrotkowska, Magdalena; Marczulin, Joanna; Bochniak, Mariusz; Zdrojewski, Tomasz
2018-01-01
The study involved preparing and implementation a model of complex screening programme for adolescents and comparison of anthropometric examinations between the population of the SOPKARD-Junior programme and representative sample of Polish children in the same age. The screening programme in 14-15 year old pupils ( n = 282) included: anthropometric, blood pressure, echocardiographic, electrocardiographic, carotid arteries, kidney and thyroid ultrasound examinations, as well as respiratory, dental and masticatory system, orthopaedic, psychological and psychiatric assessment. Blood and urine tests were also performed. The results of anthropometric examinations from the SOPKARD-Junior and OLAF programmes were used for comparative analysis. Statistically significant ( p < 0.001) differences between young people from Sopot and their peers in the general Polish population were found in height (+3.61 cm for boys), body mass (+5.19 kg for boys and +3.99 kg for girls), body mass index (+0.99 kg/m 2 for boys and +1.33 kg/m 2 for girls), waist circumference (+4.52 cm for boys and +4.52 cm for girls) and hip circumference (+2.51 cm for boys). The highest attendance rate was achieved for examinations performed in school (e.g. anthropometric and blood pressure measurements - n = 268; 95%) and the lowest for the echocardiograpy performed in local hospital ( n = 133; 47%). The mean score of the programme quality (scale 1-6) assessed by children was 4.63. The SOPKARD-Junior programme represents an attempt to develop a model of screening assessments for teenagers in Poland. Preliminary results of the SOPKARD-Junior programme indicate small differences in the biological development of Sopot youth in comparison with their peers from Polish population of the OLAF programme. The high attendance rate on research conducted at the school indicate that proposed health examinations in adolescents are acceptable and feasible.
Bustamante, Arturo Vargas
2011-10-01
This study investigates household out-of-pocket healthcare expenditures (OPH) and preventive care utilization (PHU) to compare federal and state healthcare provider performance in villages targeted by conditional cash transfer (CCT) programmes in poor rural areas of Mexico. Lower OPH and higher PHU are indicative of better performance in the study setting. Log-linear and probit regression models were used to compare outcomes in households from treatment and control villages reached by federal and state healthcare providers. In treatment villages, eligible households receive cash grants from the CCT programme. In control villages, eligible households do not receive cash grants from the CCT programme at the time of the survey. Families who live in treatment villages reported lower OPH (-52.5% for federal and -46.2% for state clinics) and higher PHU (21% for federal and 20% for state clinics) regardless of clinic setting. As the reduction in OPH is higher in areas reached by the federal clinics, it implies better performance from this healthcare delivery system. Additionally, federal clinic outcomes were also more homogeneous because OPH are not significantly different between treatment and control villages. Alternative measures such as drug and physician expenditures, diabetes and hypertension tests and nutritional-supplement receipt confirmed these findings. Mexico has two healthcare delivery systems that cater to identical rural populations. The better-funded and more centralized federal system is more effective at providing health care in poor rural villages of Mexico regardless of CCT participation. State clinics in villages targeted by the CCT programme, however, perform significantly better. © 2011 Blackwell Publishing Ltd.
A Robust Strategy for Total Ionizing Dose Testing of Field Programmable Gate Arrays
NASA Technical Reports Server (NTRS)
Wilcox, Edward; Berg, Melanie; Friendlich, Mark; Lakeman, Joseph; KIm, Hak; Pellish, Jonathan; LaBel, Kenneth
2012-01-01
We present a novel method of FPGA TID testing that measures propagation delay between flip-flops operating at maximum speed. Measurement is performed on-chip at-speed and provides a key design metric when building system-critical synchronous designs.
Eaton, David J; Tyler, Justine; Backshall, Alex; Bernstein, David; Carver, Antony; Gasnier, Anne; Henderson, Julia; Lee, Jonathan; Patel, Rushil; Tsang, Yatman; Yang, Huiqi; Zotova, Rada; Wells, Emma
2017-03-01
External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems. Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array. A total of 54 measurement sessions were performed between May 2014 and June 2016 at 28 UK institutions, reflecting the different combinations of planning and delivery systems used at each institution. Average ratio of measured output between auditor and host was 1.002±0.006. Average point dose agreement for clinical plans was -0.3±1.8%. Average (and 95% lower confidence intervals) of gamma pass rates at 2%/2mm, 3%/2mm and 3%/3mm respectively were: 92% (80%), 96% (90%) and 98% (94%). Moderately significant differences were seen between fixed gantry angle and rotational IMRT, and between combination of planning systems and linac manufacturer, but not between anatomical treatment site or beam energy. An external audit programme has been implemented for universal and efficient credentialing of IMRT treatments in clinical trials. Good agreement was found between measured and expected doses, with few outliers, leading to a simple table of optimal and mandatory tolerances for approval of dosimetry audit results. Feedback was given to some centres leading to improved clinical practice. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
Does the UKCAT predict performance on exit from medical school? A national cohort study
Cleland, J A; Ayansina, D; Nicholson, S
2016-01-01
Objectives Most UK medical programmes use aptitude tests during student selection, but large-scale studies of predictive validity are rare. This study assesses the UK Clinical Aptitude Test (UKCAT: http://www.ukcat.ac.uk), and 4 of its subscales, along with individual and contextual socioeconomic background factors, as predictors of performance during, and on exit from, medical school. Methods This was an observational study of 6294 medical students from 30 UK medical programmes who took the UKCAT from 2006 to 2008, for whom selection data from the UK Foundation Programme (UKFPO), the next stage of UK medical education training, were available in 2013. We included candidate demographics, UKCAT (cognitive domains; total scores), UKFPO Educational Performance Measure (EPM) and national exit situational judgement test (SJT). Multilevel modelling was used to assess relationships between variables, adjusting for confounders. Results The UKCAT—as a total score and in terms of the subtest scores—has significant predictive validity for performance on the UKFPO EPM and SJT. UKFPO performance was also affected positively by female gender, maturity, white ethnicity and coming from a higher social class area at the time of application to medical school An inverse pattern was seen for a contextual measure of school, with those attending fee-paying schools performing significantly more weakly on the EPM decile, the EPM total and the total UKFPO score, but not the SJT, than those attending other types of school. Conclusions This large-scale study, the first to link 2 national databases—UKCAT and UKFPO, has shown that UKCAT is a predictor of medical school outcome. The data provide modest supportive evidence for the UKCAT's role in student selection. The conflicting relationships of socioeconomic contextual measures (area and school) with outcome adds to wider debates about the limitations of these measures, and indicates the need for further research. PMID:27855088
An evaluation of the problem-solving ability of diplomates from a comprehensive nursing programme.
Makhathini, J T; Uys, L R
1996-10-01
The aim of this South African study was to obtain a measurement of the problem-solving ability of diplomates from a basic nursing programme with this skill included in its programme objectives. The problem-solving skills of diplomates from this programme were compared with those of first years to determine if there is an improvement in the problem-solving skills. A comparison was also made with a different basic programmes not claiming to teach problem-solving. The research design selected for this study was the ex post facto design. Data were collected using the Triple Jump Method which is an interview technique. The findings suggested that the level of the problem-solving skills of the comprehensive nursing programme diplomate is not satisfactory. There was, however, some improvement in the problem-solving ability from the first to the fourth year. The level of performance of the fourth years was slightly higher than that of the third years of the three-year nursing programme, who were used as the control group. Recommendations on selection teaching and evaluation of students, as well as further research, were made.
Stenhouse, Rosie; Snowden, Austyn; Young, Jenny; Carver, Fiona; Carver, Hannah; Brown, Norrie
2016-08-01
Reports of poor nursing care have focused attention on values based selection of candidates onto nursing programmes. Values based selection lacks clarity and valid measures. Previous caring experience might lead to better care. Emotional intelligence (EI) might be associated with performance, is conceptualised and measurable. To examine the impact of 1) previous caring experience, 2) emotional intelligence 3) social connection scores on performance and retention in a cohort of first year nursing and midwifery students in Scotland. A longitudinal, quasi experimental design. Adult and mental health nursing, and midwifery programmes in a Scottish University. Adult, mental health and midwifery students (n=598) completed the Trait Emotional Intelligence Questionnaire-short form and Schutte's Emotional Intelligence Scale on entry to their programmes at a Scottish University, alongside demographic and previous caring experience data. Social connection was calculated from a subset of questions identified within the TEIQue-SF in a prior factor and Rasch analysis. Student performance was calculated as the mean mark across the year. Withdrawal data were gathered. 598 students completed baseline measures. 315 students declared previous caring experience, 277 not. An independent-samples t-test identified that those without previous caring experience scored higher on performance (57.33±11.38) than those with previous caring experience (54.87±11.19), a statistically significant difference of 2.47 (95% CI, 0.54 to 4.38), t(533)=2.52, p=.012. Emotional intelligence scores were not associated with performance. Social connection scores for those withdrawing (mean rank=249) and those remaining (mean rank=304.75) were statistically significantly different, U=15,300, z=-2.61, p$_amp_$lt;0.009. Previous caring experience led to worse performance in this cohort. Emotional intelligence was not a useful indicator of performance. Lower scores on the social connection factor were associated with withdrawal from the course. Copyright © 2016 Elsevier Ltd. All rights reserved.
Aboalshamat, Khalid; Hou, Xiang-Yu; Strodl, Esben
2015-08-19
Psychological distress is well-documented worldwide among medical and dental students. Few studies have assessed the impact of self-development coaching programs on the students' psychological health. The aim of the study was to evaluate the effect of a self-development coaching programme on the psychological health and academic performance of preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia. Four-hundred and twenty-two participants (n = 422, 20-22 years) fulfilled the study requirements and were invited into a parallel-randomised controlled trial that was partially blinded. Participants were stratified by faculty, gender, and academic year, and then randomised. A total of 156 students participated in the intervention group (IG) and 163 students participated in the control group (CG). The IG received the selfdevelopment programme, involving skills and strategies aimed to improve students' psychological health and academic performance, through a two-day workshop. Meanwhile, the CG attended an active placebo programme focussing on theoretical information that was delivered through a five-hour workshop. Both programmes were conducted by the same presenter during Week 1 of the second semester of the 2012-2013 academic year. Data were gathered immediately before (T1), one week after (T2) and five weeks (T3) after the intervention. Psychological health was measured using the Depression Anxiety Stress Scale (DASS-21), the General Self-Efficacy (GSE), and the Satisfaction With Life Scale (SWLS). Academic performance was measured using students' academic weighted grades (WG). Student cognitive and emotional perceptions of the intervention were measured using the Credibility/Expectancy Questionnaire (CEQ). Data from 317 students, who completed the follow ups, were analysed across the three time periods (IG, n = 155; CG, n = 162). The baseline variables and demographic data of the IG and CG were not significantly different. The IG showed short-term significant reductions in depression and anxiety in compared to CG from T1 to T2. The short-term changes in stress, GSE and SWLS of the IG were not significantly different from those of the CG. While both groups showed a significant change on most of the psychological variables from T1 to T3, no significant differences were found between the groups in this period. In addition, no significant difference was found in WG between the IG and CG after the intervention. No harms relevant to the intervention were reported. The investigated self-development coaching programme showed only a short-term improvement on depression and anxiety compared with an active control. There was no effect of the intervention on academic performance. ACTRN12614000896673.
Chinese Responses to Shanghai's Performance in PISA
ERIC Educational Resources Information Center
Tan, Charlene
2017-01-01
This article analyses the public responses in China to Shanghai's performance in the 2012 Programme for International Student Assessment (PISA). Based on data obtained from media accounts and other materials published between 2013 and 2016, the research findings show that the responses in China are generally reflective, measured and self-critical.…
Low-Latency Embedded Vision Processor (LLEVS)
2016-03-01
26 3.2.3 Task 3 Projected Performance Analysis of FPGA- based Vision Processor ........... 31 3.2.3.1 Algorithms Latency Analysis ...Programmable Gate Array Custom Hardware for Real- Time Multiresolution Analysis . ............................................... 35...conduct data analysis for performance projections. The data acquired through measurements , simulation and estimation provide the requisite platform for
Making Sense of the Performance (Dis)Advantage for Immigrant Students across Canada
ERIC Educational Resources Information Center
Volante, Louis; Klinger, Don; Bilgili, Özge; Siegel, Melissa
2017-01-01
International achievement measures such as the Programme for International Student Assessment (PISA) have traditionally reported a significant gap between non-migrant and immigrant student groups--a result that is often referred to as the "immigrant performance disadvantage". This article examines first- and second-generation immigrant…
NASA Astrophysics Data System (ADS)
Pauline, Ong; Taib, Hariati; AzwirAzlan, Mohd; Fitriah Nasir, Nurul; Azham Azmi, Mohd; Salleh, Saliha Md; Zain, Badrul Aisham Md; Mahzan, Shahruddin; Hafeez Zainulabidin, Muhd; Ahmad, Sufizar; Rahman, Nasrull Abd; Ngali, Zamani; Rahman, Hamimah Abd
2017-01-01
Universiti Tun Hussein Onn Malaysia (UTHM) is the 15th of the 20 public universities established in Malaysia. UTHM consists of eight faculties. One of them is the Faculty of Mechanical and Manufacturing Engineering (FKMP). The programme offered - Bachelor of Mechanical Engineering with Honours (BDD), undergoes continuous auditing and accreditation by the Engineering Accreditation Council (EAC). To fulfill the requirement for accreditation, EAC requires the faculty to assess and evaluate the programme learning outcomes’ (PLOs) attainment of the graduates, such that all graduates are targeted to achieve the performance indicator (PI) upon graduation. This paper discusses the methods developed by the FKMP for PLOs’ measurement and evaluation. Two approaches are utilized in this regards, (i) the direct assessment based on students’ performance in courses, and (ii) the indirect assessment based the industrial and graduates’ perception. The PLOs’ attainment for graduates of cohort 2010-2012 are analysed in this study. Consolidation data shows that the PI for majority of the PLOs are achieved, indicating that the programme offered complies with the standard expected by different stakeholders.
Ali, K; Zahra, D; Tredwin, C
2017-11-01
To compare the academic performance of graduate-entry and direct school leavers in an undergraduate dental programme. This study examined the results of students in applied dental knowledge (ADK) progress tests conducted during two academic years. A mixed model analysis of variance (ANOVA) was conducted to compare the performance of graduate-entry and direct school leavers. ADK was treated as a repeated measures variable, and the outcome variable of interest was percentage score on the ADK. The results show statistically significant main effects for ADK [F (1,113) = 61.58, P < 0.001, η 2 p = 0.35], Cohort [F (1,113) = 88.57, P < 0.001, η 2 p = 0.44] and Entry [F (1,113) = 11.31, P = 0.001, η 2 p = 0.09]. That is, students do better on each subsequent test (main effect of ADK), students in later years of the programme perform better than those in earlier years (main effect of cohort), and graduate-entry students outperform direct school leavers. This is the first study to explore the differences in the academic performance of graduate-entry and direct school leavers in an undergraduate dental programme. The results show that the academic performance of graduate students was better than the direct school leavers in years 2 and 3. Further research is required to compare the performance of students longitudinally across the entire duration of undergraduate dental programmes and evaluate whether this difference persists throughout. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Hansen, Tina; Elholm Madsen, Esben; Sørensen, Annette
2016-01-01
In order to enhance the quality of the data collected in a multicentre validation study of a revised Danish version of the McGill Ingestive Skills Assessment (MISA), the authors developed a rater training programme. The purpose of the present study was to evaluate the effect of the training on scoring performance and scale-specific expertise amongst raters. During 2 days of rater training, 81 occupational therapists (OTs) were qualified to observe and score dysphagic clients' mealtime performance according to the criteria of 36 MISA-items. The training effects were evaluated pre- to post-training using percentage exact agreement (PA) of scored MISA items of a case-vignette and a Likert scale self-report of scale-specific expertise. PA increased significantly from pre- to post-training (Z = -4.404, p < 0.001), although items for which the case-vignette reflected deficient mealtime performance appeared most difficult to score. The OTs scale-specific expertise improved significantly (knowledge: Z = -7.857, p < 0.001 and confidence: Z = -7.838, p < 0.001). Rater training improved OTs scoring performance when using the Danish MISA as well as their perceived scale-specific expertise. Future rater training should emphasis the items identified as those most difficult to score. Additionally, further studies addressing different training approaches and durations are warranted. When occupational therapists (OTs) use the McGill Ingestive Skills Assessment (MISA) they observe, interpret and record occupational performance of dysphagic clients participating in a meal. This is a highly complex task, which might introduce unwanted variability in measurement scores. A 2-day rater training programme was developed and this builds on the findings of several studies. These suggest that combinations of different training methods tend to yield the most effective results. Participation in the newly developed training programme on how to administer the MISA significantly reduces unwanted variability in measurement scores and improves OTs' competency. The training programme could be used in undergraduate and postgraduate dysphagia education initiatives to help OTs understanding of the content and the scoring criteria for each aspect of occupational performance during a meal, thus developing observation skills as well as recognizing and avoiding the most common errors in measurement scores.
A simple laser locking system based on a field-programmable gate array.
Jørgensen, N B; Birkmose, D; Trelborg, K; Wacker, L; Winter, N; Hilliard, A J; Bason, M G; Arlt, J J
2016-07-01
Frequency stabilization of laser light is crucial in both scientific and industrial applications. Technological developments now allow analog laser stabilization systems to be replaced with digital electronics such as field-programmable gate arrays, which have recently been utilized to develop such locking systems. We have developed a frequency stabilization system based on a field-programmable gate array, with emphasis on hardware simplicity, which offers a user-friendly alternative to commercial and previous home-built solutions. Frequency modulation, lock-in detection, and a proportional-integral-derivative controller are programmed on the field-programmable gate array and only minimal additional components are required to frequency stabilize a laser. The locking system is administered from a host-computer which provides comprehensive, long-distance control through a versatile interface. Various measurements were performed to characterize the system. The linewidth of the locked laser was measured to be 0.7 ± 0.1 MHz with a settling time of 10 ms. The system can thus fully match laser systems currently in use for atom trapping and cooling applications.
A simple laser locking system based on a field-programmable gate array
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jørgensen, N. B.; Birkmose, D.; Trelborg, K.
Frequency stabilization of laser light is crucial in both scientific and industrial applications. Technological developments now allow analog laser stabilization systems to be replaced with digital electronics such as field-programmable gate arrays, which have recently been utilized to develop such locking systems. We have developed a frequency stabilization system based on a field-programmable gate array, with emphasis on hardware simplicity, which offers a user-friendly alternative to commercial and previous home-built solutions. Frequency modulation, lock-in detection, and a proportional-integral-derivative controller are programmed on the field-programmable gate array and only minimal additional components are required to frequency stabilize a laser. The lockingmore » system is administered from a host-computer which provides comprehensive, long-distance control through a versatile interface. Various measurements were performed to characterize the system. The linewidth of the locked laser was measured to be 0.7 ± 0.1 MHz with a settling time of 10 ms. The system can thus fully match laser systems currently in use for atom trapping and cooling applications.« less
Bryk, Flavio Fernandes; Dos Reis, Amir Curcio; Fingerhut, Deborah; Araujo, Thomas; Schutzer, Marcela; Cury, Ricardo de Paula Leite; Duarte, Aires; Fukuda, Thiago Yukio
2016-05-01
The objective of this study was to evaluate whether women with knee osteoarthritis performing a rehabilitation programme consisting of low-load exercises combined with PVO exhibited the same results in changes in quadriceps strength, pain relief, and functional improvement when compared to women receiving a programme consisting of high-load exercises without PVO. Thirty-four women (mean age, 61 years) with a diagnosis of knee osteoarthritis were randomly assigned to a conventional or occlusion group. The women in the conventional group (n = 17) performed a 6-week quadriceps strengthening and stretching programme using a load around 70 % of the 1-repetition maximum (RM). The women in the occlusion group (n = 17) performed the same programme, however, only using a load around 30 % of the 1-RM, while PVO was induced. The PVO was achieved using a pressure cuff applied to the upper third of the thigh and inflated to 200 mmHg during the quadriceps exercise. An 11-point Numerical Pain Rating Scale (NPRS), the Lequesne questionnaire, the Timed-Up and Go (TUG) test, and muscle strength measurement using a hand-held dynamometer were used as outcome measures at baseline (pretreatment) and at the end of the 6-week of treatment. Pain, using the NPRS, was also assessed when performing the quadriceps exercises during the exercise sessions. At baseline, demographic, strength, pain, and functional assessment data were similar between groups. Patients from both the conventional and occlusion groups had a higher level of function (Lequesne and TUG test), less pain (NPRS), and higher quadriceps strength at the 6-week evaluation when compared to baseline (all P < 0.05). However, the between-group analysis showed no differences for all outcomes variables at posttreatment (n.s.). Patients in the occlusion group experienced less anterior knee discomfort during the treatment sessions than those in the high-load exercise group (P < 0.05). A rehabilitation programme that combined PVO to low-load exercise resulted in similar benefits in pain, function, and quadriceps strength than a programme using high-load conventional exercise in patients with knee osteoarthritis. However, the use of PVO combined with low-load exercise resulted in less anterior knee pain during the training sessions. I.
Esculier, Jean-Francois; Vaudrin, Joanie; Bériault, Patrick; Gagnon, Karine; Tremblay, Louis E
2012-02-01
To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.
ERIC Educational Resources Information Center
Ortega-Maldonado, Alberto; Salanova, Marisa
2018-01-01
This study explores the predictive relationships between psychological capital (PsyCap), meaning-focused coping, satisfaction and performance among undergraduate students. Six hundred and eighty two (n = 682) college students from 29 different academic programmes completed an academic well-being survey, which included measures of PsyCap, coping…
Chuter, V H; de Jonge, X A K Janse; Thompson, B M; Callister, R
2015-03-01
Poor core stability is linked to a range of musculoskeletal pathologies and core-strengthening programmes are widely used as treatment. Treatment outcomes, however, are highly variable, which may be related to the method of delivery of core strengthening programmes. We investigated the effect of identical 8 week core strengthening programmes delivered as either supervised or home-based on measures of core stability. Participants with poor core stability were randomised into three groups: supervised (n=26), home-based (n=26) or control (n=26). Primary outcomes were the Sahrmann test and the Star Excursion Balance Test (SEBT) for dynamic core stability and three endurance tests (side-bridge, flexor and Sorensen) for static core stability. The exercise programme was devised and supervised by an exercise physiologist. Analysis of covariance on the change from baseline over the 8 weeks showed that the supervised group performed significantly better on all core stability measures than both the home-based and control group. The home-based group produced significant improvements compared to the control group in all static core stability tests, but not in most of the dynamic core stability tests (Sahrmann test and two out of three directions of the SEBT). Our results support the use of a supervised core-strengthening programme over a home-based programme to maximise improvements in core stability, especially in its dynamic aspects. Based on our findings in healthy individuals with low core stability, further research is recommended on potential therapeutic benefits of supervised core-strengthening programmes for pathologies associated with low core stability. ACTRN12613000233729. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Impact of pass/fail grading on medical students' well-being and academic outcomes.
Spring, Laura; Robillard, Diana; Gehlbach, Lorrie; Simas, Tiffany A Moore
2011-09-01
Many medical schools are currently undergoing curriculum reform. When considering the means by which students will be evaluated in a revised curriculum, the need to reduce the prevalences of depression and anxiety associated with academic stress must be weighed against the importance of academic outcomes. Pass/fail evaluation, as compared with tiered grading, is commonly presented as a means to adequately assess student performance while minimising stress and anxiety. The purpose of this literature review was to determine the impact of pass/fail grading on medical student well-being and academic outcomes. A systematic search was performed of the available literature published between January 1980 and August 2010, using the PubMed, Ovid Medline, Ovid PsycINFO and ERIC databases. Eligible papers assessed the impact of pass/fail grading on medical student well-being, academic outcomes or both. Academic outcomes included but were not limited to objective measures, such as performance on the US Medical Licensing Examination, and subjective measures, such as student desirability by residency programmes. Reference lists in identified papers were searched and all identified papers were run through a citation index. Four papers met the inclusion criteria for both well-being and academic outcomes. An additional five papers met the inclusion criteria for academic outcomes only. The four papers that focused on well-being reported improvement in specified areas. No significant difference was identified in any of the five papers examining objective academic outcomes or in those papers that examined the quality of residency programmes attained. Results from two studies suggested that some programme directors believe pass/fail grading creates disadvantages for students in attaining a residency, whereas a third study yielded mixed results about its impact on residency attainment. Student well-being is enhanced and objective academic performance is not adversely affected by a pass/fail evaluation system, but students' ability to obtain a desired residency programme may be hindered by individual programme directors' preferences for tiered grading systems. There is an overall paucity of literature on this topic and additional study is needed. © Blackwell Publishing Ltd 2011.
NASA Astrophysics Data System (ADS)
Cucu, Daniela; Woods, Mike
2008-08-01
The paper aims to present a practical approach for testing laboratories to ensure the quality of their test results. It is based on the experience gained in assessing a large number of testing laboratories, discussing with management and staff, reviewing results obtained in national and international PTs and ILCs and exchanging information in the EA laboratory committee. According to EN ISO/IEC 17025, an accredited laboratory has to implement a programme to ensure the quality of its test results for each measurand. Pre-analytical, analytical and post-analytical measures shall be applied in a systematic manner. They shall include both quality control and quality assurance measures. When designing the quality assurance programme a laboratory should consider pre-analytical activities (like personnel training, selection and validation of test methods, qualifying equipment), analytical activities ranging from sampling, sample preparation, instrumental analysis and post-analytical activities (like decoding, calculation, use of statistical tests or packages, management of results). Designed on different levels (analyst, quality manager and technical manager), including a variety of measures, the programme shall ensure the validity and accuracy of test results, the adequacy of the management system, prove the laboratory's competence in performing tests under accreditation and last but not least show the comparability of test results. Laboratory management should establish performance targets and review periodically QC/QA results against them, implementing appropriate measures in case of non-compliance.
Joseph, Jean Paul; Jerome, Gregory; Lambert, Wesler; Almazor, Patrick; Cupidon, Colette Eugene; Hirschhorn, Lisa R
2015-07-01
Although the central role of quality to achieve targeted population health goals is widely recognized, how to spread the capacity to measure and improve quality across programmes has not been widely studied. We describe the successful leveraging of expertise and framework of a national HIV quality improvement programme to spread capacity and improve quality across a network of clinics in HIV and other targeted areas of healthcare delivery in rural Haiti.The work was led by Zamni LaSante, a Haitian nongovernment organization and its sister organization, Partners In Health working in partnership with the Haitian Ministry of Health in the Plateau Central and Lower Artibonite regions in 12 public sector facilities.Data included routinely collected organizational assessments of facility quality improvement capacity, national HIV performance measures and Zamni LaSante programme records.We found that facility quality improvement capacity increased with spread from HIV to other areas of inpatient and outpatient care, including tuberculosis (TB), maternal health and inpatient services in all 12 supported healthcare facilities. A significant increase in the quality of HIV care was also seen in most areas, including CD4 monitoring, TB screening, HIV treatment (all P < 0.01) and nutritional assessment and prevention of mother-to-child transmission (both P < .05), with an increase in average facility performance from 39 to 72% (P < .01).In conclusion, using a diagonal approach to leverage a national vertical programme for wider benefit resulted in accelerated change in professional culture and increased capacity to spread quality improvement activities across facilities and areas of healthcare delivery. This led to improvement within and beyond HIV care and contributed to the goal of quality of care for all.
Aldehag, Anna; Jonsson, Hans; Lindblad, Jan; Kottorp, Anders; Ansved, Tor; Kierkegaard, Marie
2013-10-01
To investigate the effects of a hand-training programme on grip, pinch and wrist force, manual dexterity and activities of daily living, in adults with myotonic dystrophy type 1 (DM1). In this randomised controlled trial with a crossover design, 35 adults with DM1 were, after stratification for grip force, assigned by lot to two groups. Group A started with 12 weeks of hand training, while group B had no intervention. After a wash-out period of 12 weeks, where none received training, the order was reversed. The Grippit® was used as primary outcome measure and the hand-held Microfet2™ myometer, the Purdue Pegboard, the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS) were secondary outcome measures. Assessments were performed before and after training and control periods, i.e. four times altogether. Ten persons dropped out and 13 had acceptable adherence. Intention-to-treat analyses revealed significant intervention effects for isometric wrist flexor force (p = 0.048), and for COPM performance (p = 0.047) and satisfaction (p = 0.027). On an individual level, improvements were in general showed after a training period. The hand-training programme had positive effects on wrist flexor force and self-perception of occupational performance, and of satisfaction with performance. No evident detrimental effects were shown. Myotonic dystrophy type 1 (DM1) is a slowly progressive neuromuscular disease characterised by myotonia and muscle weakness and wasting. People with DM1 are often concerned about their ability to carry out ADL and to participate in, e.g. work, sports and hobbies when they gradually become weaker. This pilot study showed that a hand-training programme improved wrist flexor force and self-perception and satisfaction of occupational performance. Resistance training of hand muscles with a silicon-based putty can be a therapy option for people with DM1 in clinical practise.
2011-01-01
Background The Czech Breast Cancer Screening Programme (CBCSP) was initiated in September 2002 by establishing a network of accredited centres. The aim of this article is to describe progress in the programme quality over time after the inception of the organised programme. Methods The CBCSP is monitored using an information system consisting of three principal components: 1) the national cancer registry, 2) a screening registry collecting data on all screening examinations, further assessments and final diagnoses at accredited programme centres, and 3) administrative databases of healthcare payers. Key performance indicators from the European Guidelines have been adopted for continuous monitoring. Results Breast cancer incidence in the Czech Republic has steadily been increasing, however with a growing proportion of less advanced stages. The mortality rate has recently stabilised. The screening registry includes 2,083,285 records on screening episodes between 2002 and 2008. In 2007-2008, 51% of eligible women aged 45-69 were screened. In 2008, the detection rates were 6.1 and 3.7 per 1,000 women in initial and subsequent screening respectively. Corresponding recall rates are 3.9% and 2.2%, however, it is necessary to pay attention to further assessment performed during the screening visits. Benign to malignant open biopsy ratio was 0.1. Of invasive cases detected in screening, 35.6% was less than 10 mm in diameter. Values of early performance indicators, as measured by both crude and standardized estimates, are generally improving and fulfil desirable targets set by European Guidelines. Conclusions Mammography screening in the Czech Republic underwent successful transformation from opportunistic prevention to an organised programme. Values of early indicators confirm continuous improvement in different aspects of process quality. Further stimulation of participation through invitation system is necessary to exploit the full potential of screening mammography at the population level. PMID:21554747
[Work place health promotion programmes of the statutory German Pension Insurance].
Meffert, C; Mittag, O; Jäckel, W H
2013-12-01
In 2009, the amendment of § 31 Abs. 1 Nr. 2 SGB VI gave the German Pension Insurance the opportunity to provide outpatient medical treatments for insured people who have an occupation with particularly high risk of health. Ever since, the German Pension Insurance has developed various work place prevention programmes, which have been implemented as pilot projects. This article aims at systematically recording and comparatively analyzing these programmes in a synopsis which meets the current state of knowledge. We developed an 8 page questionnaire focusing on work place prevention programmes by the German Pension Insurance. This questionnaire was sent to people in charge of all programmes known to us. All programmes have been drafted -across indications. They are aiming at insured people who already suffer from first health disorders but who are not in imminent need of rehabilitation. However, the concrete target groups at which the specific programmes are aimed differ (shift workers, nurses, elderly employees). Another difference between the various programmes is the setting (in- or outpatients) as well as the duration. All programmes are using existing structures offered by the German Pension Insurance. They provide measures in pension insurance owned rehabilitation centers. It would be desirable to link these performances with internal work place health promotion and offers of other social insurances. © Georg Thieme Verlag KG Stuttgart · New York.
2013-01-01
Background Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme’s effectiveness and the fidelity, acceptability and feasibility of its implementation. Methods A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines’ main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen’s d). Results Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (−15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme’s multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. Conclusions The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence. To assess its value, the programme needs to be tested in a randomized controlled trial. PMID:23705912
DOT National Transportation Integrated Search
1982-01-01
The Detailed Station Model (DSM) provides operational and performance measures of alternative station configurations and management policies with respect to vehicle and passenger capabilities. It provides an analytic tool to support tradeoff studies ...
Herzer, Kurt R; Niessen, Louis; Constenla, Dagna O; Ward, William J; Pronovost, Peter J
2014-01-01
Objective To assess the cost-effectiveness of a multifaceted quality improvement programme focused on reducing central line-associated bloodstream infections in intensive care units. Design Cost-effectiveness analysis using a decision tree model to compare programme to non-programme intensive care units. Setting USA. Population Adult patients in the intensive care unit. Costs Economic costs of the programme and of central line-associated bloodstream infections were estimated from the perspective of the hospital and presented in 2013 US dollars. Main outcome measures Central line-associated bloodstream infections prevented, deaths averted due to central line-associated bloodstream infections prevented, and incremental cost-effectiveness ratios. Probabilistic sensitivity analysis was performed. Results Compared with current practice, the programme is strongly dominant and reduces bloodstream infections and deaths at no additional cost. The probabilistic sensitivity analysis showed that there was an almost 80% probability that the programme reduces bloodstream infections and the infections’ economic costs to hospitals. The opportunity cost of a bloodstream infection to a hospital was the most important model parameter in these analyses. Conclusions This multifaceted quality improvement programme, as it is currently implemented by hospitals on an increasingly large scale in the USA, likely reduces the economic costs of central line-associated bloodstream infections for US hospitals. Awareness among hospitals about the programme's benefits should enhance implementation. The programme's implementation has the potential to substantially reduce morbidity, mortality and economic costs associated with central line-associated bloodstream infections. PMID:25256190
Kilding, Andrew E; Tunstall, Helen; Kuzmic, Dejan
2008-01-01
There is a paucity of evidence regarding the use of injury prevention programmes for preadolescents participating in sport. "The 11 "injury prevention programme was developed by FIFA's medical research centre (F-MARC) to help reduce the risk of injury in football players aged 14 years and over. The aim of this study was to determine the suitability and effectiveness of "The 11 "for younger football players. Twenty-four [12 experimental (EXP), 12 control (CON)] young football players (age 10.4 ± 1.4 yr) participated. The EXP group followed "The 11 "training programme 5 days per week, for 6 weeks, completing all but one of the 10 exercises. Prior to, and after the intervention, both EXP and CON groups performed a battery of football-specific physical tests. Changes in performance scores within each group were compared using independent t-tests (p ≤ 0.05). Feedback was also gathered on the young players' perceptions of "The 11". No injuries occurred during the study in either group. Compliance to the intervention was 72%. Measures of leg power (3 step jump and counter-movement jump) increased significantly (3.4 and 6.0% respectively, p < 0.05). Speed over 20 m improved by 2% (p < 0.05). Most players considered "The 11 "beneficial but not enjoyable in the prescribed format. Given the observed improvements in the physical abilities and the perceived benefits of "The 11", it would appear that a modified version of the programme is appropriate and should be included in the training of young football players, for both physical development and potential injury prevention purposes, as well as to promote fair play. To further engage young football players in such a programme, some modification to "The 11 "should be considered. Key pointsChildren who participate in recreational and competitive sports, especially football, are susceptible to injury.There is a need for the design and assessment of injury prevention programmes for children.The 11 "improves essential physical performance characteristics and has the potential to reduce the risk of injury.It may be prudent to implement a 'child-friendly' version of "The 11", to enhance long-term programme adherence and to ensure progressive physical development of players.
Kilding, Andrew E; Tunstall, Helen; Kuzmic, Dejan
2008-01-01
There is a paucity of evidence regarding the use of injury prevention programmes for preadolescents participating in sport. “The 11 ”injury prevention programme was developed by FIFA’s medical research centre (F-MARC) to help reduce the risk of injury in football players aged 14 years and over. The aim of this study was to determine the suitability and effectiveness of “The 11 ”for younger football players. Twenty-four [12 experimental (EXP), 12 control (CON)] young football players (age 10.4 ± 1.4 yr) participated. The EXP group followed “The 11 ”training programme 5 days per week, for 6 weeks, completing all but one of the 10 exercises. Prior to, and after the intervention, both EXP and CON groups performed a battery of football-specific physical tests. Changes in performance scores within each group were compared using independent t-tests (p ≤ 0.05). Feedback was also gathered on the young players’ perceptions of “The 11”. No injuries occurred during the study in either group. Compliance to the intervention was 72%. Measures of leg power (3 step jump and counter-movement jump) increased significantly (3.4 and 6.0% respectively, p < 0.05). Speed over 20 m improved by 2% (p < 0.05). Most players considered “The 11 ”beneficial but not enjoyable in the prescribed format. Given the observed improvements in the physical abilities and the perceived benefits of “The 11”, it would appear that a modified version of the programme is appropriate and should be included in the training of young football players, for both physical development and potential injury prevention purposes, as well as to promote fair play. To further engage young football players in such a programme, some modification to “The 11 ”should be considered. Key pointsChildren who participate in recreational and competitive sports, especially football, are susceptible to injury.There is a need for the design and assessment of injury prevention programmes for children.The 11 ”improves essential physical performance characteristics and has the potential to reduce the risk of injury.It may be prudent to implement a ‘child-friendly’ version of “The 11”, to enhance long-term programme adherence and to ensure progressive physical development of players. PMID:24149898
Managing patient deterioration: assessing teamwork and individual performance.
Cooper, Simon; Cant, Robyn; Porter, Jo; Missen, Karen; Sparkes, Louise; McConnell-Henry, Tracy; Endacott, Ruth
2013-05-01
To assess the ability of rural Australian nurse teams to manage deteriorating patients. This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Knowledge in relation to patient deterioration management varied (mean 63%, range 27-100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17-83%, SD 14.03) with significantly higher levels in younger participants (r=-0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.
Cervical cancer screening in Europe: Quality assurance and organisation of programmes.
Elfström, K Miriam; Arnheim-Dahlström, Lisen; von Karsa, Lawrence; Dillner, Joakim
2015-05-01
Cervical screening programmes have reduced cervical cancer incidence and mortality but the level of success is highly variable between countries. Organisation of programmes is essential for equity and cost-effectiveness. However, there are differences in effectiveness, also among organised programmes. In order to identify the key organisational components that determine effectiveness, we performed a Europe-wide survey on the current status of organisation and organised quality assurance (QA) measures in cervical cancer prevention programmes, as well as organisation-associated costs. A comprehensive questionnaire was developed through systematic review of literature and existing guidelines. The survey was sent to programme organisers, Ministries of Health and experts in 34 European Union (EU) and European Free Trade Agreement (EFTA) countries. Detailed aspects of programme organisation, quality assurance, monitoring, evaluation and corresponding line-item costs were recorded. Documentation of programme guidelines, protocols and publications was requested. Twenty-nine of 34 countries responded. The results showed that organised efforts for QA, monitoring and evaluation were carried out to a differing extent and were not standardised, making it difficult to compare the cost-effectiveness of organisation and QA strategies. Most countries found it hard to estimate the costs associated with launching and operating the organised programme. To our knowledge, this is the first questionnaire to request detailed information on the actual organisation and QA of programmes. The results of this survey can be used as a basis for further development of standardised guidelines on organisation and QA of cervical cancer screening programmes in Europe. Copyright © 2015 Elsevier Ltd. All rights reserved.
Keogh, Justin W; Rice, John; Taylor, Denise; Kilding, Andrew
2014-06-01
Most exercise studies for older adults have been university- or hospital-based. Little is known about the benefits and factors influencing long-term participation in community-based exercise programmes, especially in New Zealand. To quantify the objective benefits, participant perceptions and retention rates of a New Zealand community-based exercise programme for adults (60 years or older). Study 1 involved assessing the benefits of 12 weeks' training on a convenience sample of 62 older adults commencing the never2old Active Ageing programme. Study 2 assessed the perceptions of 150 current participants on a variety of programme components that could act as barriers or facilitators to continued engagement. Study 3 assessed the retention rates of 264 participants in the programme over a two-year period. Significant improvements in many physical functional scores were observed in Study 1 (5-30 percentile points; p<0.05). Questionnaire responses from participants in Study 2 indicated many perceived benefits (positive responses from 67-95% on various questions) and that core components of the programme were rated very highly (64-99% on various components). Retention rates were high, with Study 3 finding 57% of participants still engaging in the programme at the end of the two-year period. A community-based exercise programme for older adults can improve many objective and subjective measures of physical fitness and functional performance and have good retention rates. General practitioners and other allied health professionals in New Zealand should consider promoting programmes, such as the never2old Active Ageing programme, to their older patients.
Malátová, Renata; Rokytová, Jitka; Stumbauer, Jan
2013-08-01
Dorsal pain caused by spine dysfunctions belongs to most frequent chronic illnesses. The muscles of the deep stabilising spine system work as a single functional unit where a dysfunction of only one muscle causes dysfunction of the whole system. Non-invasive, objective and statistically measurable evaluation of the condition of deep stabilising spine system has been made possible by the construction of muscular dynamometer. The aim of our work has been the assessment of deep stabilising spine system by diaphragm test and muscular dynamometer measurements. Based on an initial examination, a 6-week intervention programme was established including instructions on physiological body posture and correct basic body stabilisation for the given exercises and muscle strengthening. Consecutive measurements are then compared with the initial ones. It was presumed that a smaller number of the tested subjects would be able to correctly activate the deep stabilising spine system muscles before the intervention programme when compared to those after the intervention programme. A positive change of 87% has been found. It is clear that if a person actively approaches the programme, then positive adaptation changes on the deep stabilising spine system are seen only after 6 weeks. With the muscular dynamometer, activation of deep stabilising spine system can be objectively measured. Changes between the initial condition of a subject and the difference after some exercise or rehabilitation are especially noticeable. Also, the effect of given therapy or correct performance of the exercise can be followed and observed.
Hetzel, Manuel W; Iteba, Nelly; Makemba, Ahmed; Mshana, Christopher; Lengeler, Christian; Obrist, Brigit; Schulze, Alexander; Nathan, Rose; Dillip, Angel; Alba, Sandra; Mayumana, Iddy; Khatib, Rashid A; Njau, Joseph D; Mshinda, Hassan
2007-06-29
Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health) impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services.
Physical education, school physical activity, school sports and academic performance
Trudeau, François; Shephard, Roy J
2008-01-01
Background The purpose of this paper is to review relationships of academic performance and some of its determinants to participation in school-based physical activities, including physical education (PE), free school physical activity (PA) and school sports. Methods Linkages between academic achievement and involvement in PE, school PA and sport programmes have been examined, based on a systematic review of currently available literature, including a comprehensive search of MEDLINE (1966 to 2007), PSYCHINFO (1974 to 2007), SCHOLAR.GOOGLE.COM, and ERIC databases. Results Quasi-experimental data indicate that allocating up to an additional hour per day of curricular time to PA programmes does not affect the academic performance of primary school students negatively, even though the time allocated to other subjects usually shows a corresponding reduction. An additional curricular emphasis on PE may result in small absolute gains in grade point average (GPA), and such findings strongly suggest a relative increase in performance per unit of academic teaching time. Further, the overwhelmingly majority of such programmes have demonstrated an improvement in some measures of physical fitness (PF). Cross-sectional observations show a positive association between academic performance and PA, but PF does not seem to show such an association. PA has positive influences on concentration, memory and classroom behaviour. Data from quasi-experimental studies find support in mechanistic experiments on cognitive function, pointing to a positive relationship between PA and intellectual performance. Conclusion Given competent providers, PA can be added to the school curriculum by taking time from other subjects without risk of hindering student academic achievement. On the other hand, adding time to "academic" or "curricular" subjects by taking time from physical education programmes does not enhance grades in these subjects and may be detrimental to health. PMID:18298849
Vocational training and employability: Evaluation evidence from Romania.
Popescu, Madalina Ecaterina; Roman, Monica
2018-04-01
This study evaluates the direct effects of vocational training, which is a popular active labour market policy in a European developing country such as Romania. Since the available official statistical microdata were insufficient to conduct reliable impact evaluations, the main findings were obtained through a counterfactual impact evaluation using newly produced micro survey data. Moreover, the research provides a heterogeneity analysis of groups of trainees, in order to identify the categories for which the programme performs best. The main results reveal that the training measure has a positive, but modest impact upon employability in Romania: participation increases employment chances properly controlled by 15%. It is most successful for women and for people living in urban areas. Measures for increasing the impacts of the vocational training programme in Romania are identified in terms of better targeting and profiling the trainees and closer adjustment of the programme to the specific needs of the labour market. Copyright © 2017 Elsevier Ltd. All rights reserved.
Estimating the coverage of mental health programmes: a systematic review.
De Silva, Mary J; Lee, Lucy; Fuhr, Daniela C; Rathod, Sujit; Chisholm, Dan; Schellenberg, Joanna; Patel, Vikram
2014-04-01
The large treatment gap for people suffering from mental disorders has led to initiatives to scale up mental health services. In order to track progress, estimates of programme coverage, and changes in coverage over time, are needed. Systematic review of mental health programme evaluations that assess coverage, measured either as the proportion of the target population in contact with services (contact coverage) or as the proportion of the target population who receive appropriate and effective care (effective coverage). We performed a search of electronic databases and grey literature up to March 2013 and contacted experts in the field. Methods to estimate the numerator (service utilization) and the denominator (target population) were reviewed to explore methods which could be used in programme evaluations. We identified 15 735 unique records of which only seven met the inclusion criteria. All studies reported contact coverage. No study explicitly measured effective coverage, but it was possible to estimate this for one study. In six studies the numerator of coverage, service utilization, was estimated using routine clinical information, whereas one study used a national community survey. The methods for estimating the denominator, the population in need of services, were more varied and included national prevalence surveys case registers, and estimates from the literature. Very few coverage estimates are available. Coverage could be estimated at low cost by combining routine programme data with population prevalence estimates from national surveys.
Nakamura, Masakazu; Iso, Hiroyasu; Kitamura, Akihiko; Imano, Hironori; Noda, Hiroyuki; Kiyama, Masahiko; Sato, Shinichi; Yamagishi, Kazumasa; Nishimura, Kunihiro; Nakai, Michikazu; Vesper, Hubert W; Teramoto, Tamio; Miyamoto, Yoshihiro
2016-11-01
Background The US Centers for Disease Control and Prevention ensured adequate performance of the routine triglycerides methods used in Japan by a chromotropic acid reference measurement procedure used by the Centers for Disease Control and Prevention lipid standardization programme as a reference point. We examined standardized data to clarify the performance of routine triglycerides methods. Methods The two routine triglycerides methods were the fluorometric method of Kessler and Lederer and the enzymatic method. The methods were standardized using 495 Centers for Disease Control and Prevention reference pools with 98 different concentrations ranging between 0.37 and 5.15 mmol/L in 141 survey runs. The triglycerides criteria for laboratories which perform triglycerides analyses are used: accuracy, as bias ≤5% from the Centers for Disease Control and Prevention reference value and precision, as measured by CV, ≤5%. Results The correlation of the bias of both methods to the Centers for Disease Control and Prevention reference method was: y (%bias) = 0.516 × (Centers for Disease Control and Prevention reference value) -1.292 ( n = 495, R 2 = 0.018). Triglycerides bias at medical decision points of 1.13, 1.69 and 2.26 mmol/L was -0.71%, -0.42% and -0.13%, respectively. For the combined precision, the equation y (CV) = -0.398 × (triglycerides value) + 1.797 ( n = 495, R 2 = 0.081) was used. Precision was 1.35%, 1.12% and 0.90%, respectively. It was shown that triglycerides measurements at Osaka were stable for 36 years. Conclusions The epidemiologic laboratory in Japan met acceptable accuracy goals for 88.7% of all samples, and met acceptable precision goals for 97.8% of all samples measured through the Centers for Disease Control and Prevention lipid standardization programme and demonstrated stable results for an extended period of time.
Nakamura, Masakazu; Iso, Hiroyasu; Kitamura, Akihiko; Imano, Hironori; Noda, Hiroyuki; Kiyama, Masahiko; Sato, Shinichi; Yamagishi, Kazumasa; Nishimura, Kunihiro; Nakai, Michikazu; Vesper, Hubert W; Teramoto, Tamio; Miyamoto, Yoshihiro
2017-01-01
Background The US Centers for Disease Control and Prevention ensured adequate performance of the routine triglycerides methods used in Japan by a chromotropic acid reference measurement procedure used by the Centers for Disease Control and Prevention lipid standardization programme as a reference point. We examined standardized data to clarify the performance of routine triglycerides methods. Methods The two routine triglycerides methods were the fluorometric method of Kessler and Lederer and the enzymatic method. The methods were standardized using 495 Centers for Disease Control and Prevention reference pools with 98 different concentrations ranging between 0.37 and 5.15 mmol/L in 141 survey runs. The triglycerides criteria for laboratories which perform triglycerides analyses are used: accuracy, as bias ≤5% from the Centers for Disease Control and Prevention reference value and precision, as measured by CV, ≤5%. Results The correlation of the bias of both methods to the Centers for Disease Control and Prevention reference method was: y (%bias) = 0.516 × (Centers for Disease Control and Prevention reference value) −1.292 (n = 495, R2 = 0.018). Triglycerides bias at medical decision points of 1.13, 1.69 and 2.26 mmol/L was −0.71%, −0.42% and −0.13%, respectively. For the combined precision, the equation y (CV) = −0.398 × (triglycerides value) + 1.797 (n = 495, R2 = 0.081) was used. Precision was 1.35%, 1.12% and 0.90%, respectively. It was shown that triglycerides measurements at Osaka were stable for 36 years. Conclusions The epidemiologic laboratory in Japan met acceptable accuracy goals for 88.7% of all samples, and met acceptable precision goals for 97.8% of all samples measured through the Centers for Disease Control and Prevention lipid standardization programme and demonstrated stable results for an extended period of time. PMID:26680645
Development of an active structure flight experiment
NASA Astrophysics Data System (ADS)
Manning, R. A.; Wyse, R. E.; Schubert, S. R.
1993-02-01
The design and development of the Air Force and TRW's Advanced Control Technology Experiment (ACTEX) flight experiment is described in this paper. The overall objective of ACTEX is to provide an active structure trailblazer which will demonstrate the compatibility of active structures with operational spacecraft performance and lifetime measures. At the heart of the experiment is an active tripod driven by a digitally-programmable analog control electronics subsystem. Piezoceramic sensors and actuators embedded in a graphite epoxy host material provide the sensing and actuation mechanism for the active tripod. Low noise ground-programmable electronics provide a virtually unlimited number of control schemes that can be implemented in the space environment. The flight experiment program provides the opportunity to gather performance, reliability, adaptability, and lifetime performance data on vibration suppression hardware for the next generation of DoD and NASA spacecraft.
Juhel-Gaugain, M; McEvoy, J D; VanGinkel, L A
2000-12-01
The experimental design of a material certification programme is described. The matrix reference materials (RMs) comprised chlortetracycline (CTC)-containing and CTC-free lyophilised porcine liver, kidney and muscle produced under the European Commission's Standards Measurements and Testing (SMT) programme. The aim of the certification programme was to determine accurately and precisely the concentration of CTC and 4-epi-chlortetracycline (epi-CTC) contained in the RMs. A multi-laboratory approach was used to certify analyte concentrations. Participants (n = 19) were instructed to strictly adhere to previously established guidelines. Following the examination of analytical performance criteria, statistical manipulation of results submitted by 13 laboratories, (6 withdrew) allowed an estimate to be made of the true value of the analyte content. The Nalimov test was used for detection of outlying results. The Cochran and Bartlett tests were employed for testing the homogeneity of variances. The normality of results distribution was tested according to the Kolmogorov-Smirnov-Lilliefors test. One-way analysis of variance (ANOVA) was employed to calculate the within and between-laboratory standard deviations, the overall mean and confidence interval for the CTC and epi-CTC content of each of the RMs. Certified values were within or very close to the target concentration ranges specified in the SMT contract. These studies have demonstrated the successful production and certification of CTC-containing and CTC-free porcine RMs.
High-performance reconfigurable coincidence counting unit based on a field programmable gate array.
Park, Byung Kwon; Kim, Yong-Su; Kwon, Osung; Han, Sang-Wook; Moon, Sung
2015-05-20
We present a high-performance reconfigurable coincidence counting unit (CCU) using a low-end field programmable gate array (FPGA) and peripheral circuits. Because of the flexibility guaranteed by the FPGA program, we can easily change system parameters, such as internal input delays, coincidence configurations, and the coincidence time window. In spite of a low-cost implementation, the proposed CCU architecture outperforms previous ones in many aspects: it has 8 logic inputs and 4 coincidence outputs that can measure up to eight-fold coincidences. The minimum coincidence time window and the maximum input frequency are 0.47 ns and 163 MHz, respectively. The CCU will be useful in various experimental research areas, including the field of quantum optics and quantum information.
Cost-effectiveness of a comprehensive programme for drug-resistant tuberculosis in China.
Fitzpatrick, Christopher; Hui, Zhang; Lixia, Wang; Renzhong, Li; Yunzhou, Ruan; Mingting, Chen; Yanlin, Zhao; Jin, Zhao; Wei, Su; Caihong, Xu; Cheng, Chen; Alston, Timothy; Yan, Qu; Chengfei, Lv; Yunting, Fu; Shitong, Huan; Qiang, Sun; Scano, Fabio; Chin, Daniel P; Floyd, Katherine
2015-11-01
To investigate the cost-effectiveness of a comprehensive programme for drug-resistant tuberculosis launched in four sites in China in 2011. In 2011-2012, we reviewed the records of 172 patients with drug-resistant tuberculosis who enrolled in the comprehensive programme and we collected relevant administrative data from hospitals and China's public health agency. For comparison, we examined a cohort of 81 patients who were treated for drug-resistant tuberculosis in 2006-2009. We performed a cost-effectiveness analysis, from a societal perspective, that included probabilistic uncertainty. We measured early treatment outcomes based on three-month culture results and modelled longer-term outcomes to facilitate estimation of the comprehensive programme's cost per disability-adjusted life-year (DALY) averted. The comprehensive programme cost 8837 United States dollars (US$) per patient treated. Low enrolment rates meant that some fixed costs were higher, per patient, than expected. Although the comprehensive programme appeared 30 times more costly than the previous one, it resulted in greater health benefits. The comprehensive programme, which cost US$ 639 (95% credible interval: 112 to 1322) per DALY averted, satisfied the World Health Organization's criterion for a very cost-effective intervention. The comprehensive programme, which included rapid screening, standardized care and financial protection, improved individual outcomes for MDR tuberculosis in a cost-effective manner. To support post-2015 global heath targets, the comprehensive programme should be expanded to non-residents and other areas of China.
A self-timed multipurpose delay sensor for Field Programmable Gate Arrays (FPGAs).
Osuna, Carlos Gómez; Ituero, Pablo; López-Vallejo, Marisa
2013-12-20
This paper presents a novel self-timed multi-purpose sensor especially conceived for Field Programmable Gate Arrays (FPGAs). The aim of the sensor is to measure performance variations during the life-cycle of the device, such as process variability, critical path timing and temperature variations. The proposed topology, through the use of both combinational and sequential FPGA elements, amplifies the time of a signal traversing a delay chain to produce a pulse whose width is the sensor's measurement. The sensor is fully self-timed, avoiding the need for clock distribution networks and eliminating the limitations imposed by the system clock. One single off- or on-chip time-to-digital converter is able to perform digitization of several sensors in a single operation. These features allow for a simplified approach for designers wanting to intertwine a multi-purpose sensor network with their application logic. Employed as a temperature sensor, it has been measured to have an error of ±0.67 °C, over the range of 20-100 °C, employing 20 logic elements with a 2-point calibration.
A Self-Timed Multipurpose Delay Sensor for Field Programmable Gate Arrays (FPGAs)
Osuna, Carlos Gómez; Ituero, Pablo; López-Vallejo, Marisa
2014-01-01
This paper presents a novel self-timed multi-purpose sensor especially conceived for Field Programmable Gate Arrays (FPGAs). The aim of the sensor is to measure performance variations during the life-cycle of the device, such as process variability, critical path timing and temperature variations. The proposed topology, through the use of both combinational and sequential FPGA elements, amplifies the time of a signal traversing a delay chain to produce a pulse whose width is the sensor's measurement. The sensor is fully self-timed, avoiding the need for clock distribution networks and eliminating the limitations imposed by the system clock. One single off- or on-chip time-to-digital converter is able to perform digitization of several sensors in a single operation. These features allow for a simplified approach for designers wanting to intertwine a multi-purpose sensor network with their application logic. Employed as a temperature sensor, it has been measured to have an error of ±0.67 °C, over the range of 20–100 °C, employing 20 logic elements with a 2-point calibration. PMID:24361927
A programmable broadband low frequency active vibration isolation system for atom interferometry.
Tang, Biao; Zhou, Lin; Xiong, Zongyuan; Wang, Jin; Zhan, Mingsheng
2014-09-01
Vibration isolation at low frequency is important for some precision measurement experiments that use atom interferometry. To decrease the vibrational noise caused by the reflecting mirror of Raman beams in atom interferometry, we designed and demonstrated a compact stable active low frequency vibration isolation system. In this system, a digital control subsystem is used to process and feedback the vibration measured by a seismometer. A voice coil actuator is used to control and cancel the motion of a commercial passive vibration isolation platform. With the help of field programmable gate array-based control subsystem, the vibration isolation system performed flexibly and accurately. When the feedback is on, the intrinsic resonance frequency of the system will change from 0.8 Hz to about 0.015 Hz. The vertical vibration (0.01-10 Hz) measured by the in-loop seismometer is reduced by an additional factor of up to 500 on the basis of a passive vibration isolation platform, and we have proved the performance by adding an additional seismometer as well as applying it in the atom interferometry experiment.
How long does it take to become fit?
Pearn, J
1980-01-01
To become fit an individual must generate optimal muscle strength and must develop cardiopulmonary reserve, or stamina. Physical fitness programmes require motivation, a graded series of appropriately designed exercises, and scientific surveillance. Motivation and efficiency in fitness programmes depends on early positive feedback to participants, confirming that stamina and strength are developing. A practical field experiment was performed to determine the minimum time that healthy young adults require to reach an initial plateau in objective measures of fitness. Fifty male university undergraduates were studied during an annual volunteer military training camp. Thirty had volunteered to take part in the fitness programme; the remaining 20 had initially rejected the offer but underwent the programme as part of their military training and acted as unmotivated controls. All the subjects became fit within 14 days of starting training, with objective improvement in both absolute strength and pulse recovery times. Non-motivated individuals, training with motivated individuals for 20 minutes each day, can therefore achieve levels of fitness indistinguishable from those of healthy highly motivated subjects. Fitness programmes must be carefully supervised, however, with medical examinations for those about to undergo vigorous exercise. PMID:7437862
ERIC Educational Resources Information Center
Mateju, Petr; Smith, Michael L.
2015-01-01
This article examines gender gaps in academic performance (grades in mathematics and reading) between boys and girls of ninth-grade elementary schools in the Czech Republic. Our analysis is based on 2003 data from the Programme for International Student Assessment, encompassing the academic performance and family background of ninth-grade pupils.…
TROPOMI on ESA's Sentinel 5p ready for launch and use
NASA Astrophysics Data System (ADS)
de Vries, Johan; Voors, Robert; Ording, Barend; Dingjan, Jos; Veefkind, Pepijn; Ludewig, Antje; Kleipool, Quintus; Hoogeveen, Ruud; Aben, Ilse
2016-08-01
TROPOMI is the single instrument on ESA's Sentinel 5 precursor satellite to be launched in October 2016. TROPOMI will measure the atmospheric constituents absorbing in the UV-SWIR wavelength range, being O3, NO2, SO2, CH4, CO, CH2O, and aerosol properties. TROPOMI is a sun back-scatter instrument in the line of SCIAMACHY and OMI with 4 spectrometer bands and a spectral resolution of 0.25 - 0.5 nm. Following the earlier sensors, firstly the spatial resolution is improved by a factor 6 (OMI) to 7 x 7 km2 and at the same time the sensitivity by an order of magnitude. The paper discusses the instrument performances as acquired from on-ground performance / calibration measurements. For the calibration an extremely condensed measurement campaign of 4 months 24/7 measurements was performed with virtually no slack and still gathering all of the data necessary from on-ground measurements. Given the fact that the trace gas signals and their variation in the measured spectra can be quite small, calibration is crucial to get accurate results and this illustrates that TROPOMI is a highly success driven and efficient programme. TROPOMI / Sentinel-5p bridges the data streams from on one hand OMI and SCIAMACHY and on the other hand the future Sentinel-5. It is the first of a series of satellites from the Copernicus programme devoted to air quality and will soon be ready for use.
The accountability of clinical education: its definition and assessment.
Murray, E; Gruppen, L; Catton, P; Hays, R; Woolliscroft, J O
2000-10-01
Medical education is not exempt from increasing societal expectations of accountability. Competition for financial resources requires medical educators to demonstrate cost-effective educational practice; health care practitioners, the products of medical education programmes, must meet increasing standards of professionalism; the culture of evidence-based medicine demands an evaluation of the effect educational programmes have on health care and service delivery. Educators cannot demonstrate that graduates possess the required attributes, or that their programmes have the desired impact on health care without appropriate assessment tools and measures of outcome. To determine to what extent currently available assessment approaches can measure potentially relevant medical education outcomes addressing practitioner performance, health care delivery and population health, in order to highlight areas in need of research and development. Illustrative publications about desirable professional behaviour were synthesized to obtain examples of required competencies and health outcomes. A MEDLINE search for available assessment tools and measures of health outcome was performed. There are extensive tools for assessing clinical skills and knowledge. Some work has been done on the use of professional judgement for assessing professional behaviours; scholarship; and multiprofessional team working; but much more is needed. Very little literature exists on assessing group attributes of professionals, such as clinical governance, evidence-based practice and workforce allocation, and even less on examining individual patient or population health indices. The challenge facing medical educators is to develop new tools, many of which will rely on professional judgement, for assessing these broader competencies and outcomes.
Implementing the Rock Challenge: Teacher Perspectives on a Performing Arts Programme
ERIC Educational Resources Information Center
Jones, Mathew; Murphy, Simon; Salmon, Debra; Kimberlee, Richard; Orme, Judy
2004-01-01
The Rock Challenge is a school-based performing arts programme that aims to promote healthy lifestyles amongst secondary school students. This paper reports on teacher perspectives on the implementation of The Rock Challenge in nine English schools. This study highlights how performing arts programmes, such as The Rock Challenge, are unlikely to…
Individualized follow up programme and early discharge in term neonates.
De Carolis, Maria Pia; Cocca, Carmen; Valente, Elisabetta; Lacerenza, Serafina; Rubortone, Serena Antonia; Zuppa, Antonio Alberto; Romagnoli, Costantino
2014-07-15
Early discharge of mother/neonate dyad has become a common practice, and its effects are measured by readmission rates. We evaluated the safety of early discharge followed by an individualized Follow-up programme and the efficacy in promoting breastfeeding initiation and duration. During a nine-month period early discharge followed by an early targeted Follow-up was carried out in term neonates in the absence of weight loss <10% or hyperbilirubinaemia at risk of treatment. Follow-up visits were performed at different timepoints with a specific flow-chart according to both bilirubin levels and weight loss at discharge. During the study period early discharge was performed in 419 neonates and Follow-up was carried out in 408 neonates (97.4%). No neonates required readmission for hyperbilirubinaemia and dehydration during the first 28 days of life. Breastfeeding rate was 90.6%, 75.2%, 41.5% at 30, 90 and 180 days of life, respectively. A six-month phone interview was performed for 383 neonates (93.8%) and satisfaction of parents about early discharge was high in 345 cases (90.1%). Early discharge in association with an individualized Follow-up programme resulted safe for the neonate and effective for breastfeeding initation and duration.
Huang, Chen-Yu; Keall, Paul; Rice, Adam; Colvill, Emma; Ng, Jin Aun; Booth, Jeremy T
2017-09-01
Inter-fraction and intra-fraction motion management methods are increasingly applied clinically and require the development of advanced motion platforms to facilitate testing and quality assurance program development. The aim of this study was to assess the performance of a 5 degrees-of-freedom (DoF) programmable motion platform HexaMotion (ScandiDos, Uppsala, Sweden) towards clinically observed tumor motion range, velocity, acceleration and the accuracy requirements of SABR prescribed in AAPM Task Group 142. Performance specifications for the motion platform were derived from literature regarding the motion characteristics of prostate and lung tumor targets required for real time motion management. The performance of the programmable motion platform was evaluated against (1) maximum range, velocity and acceleration (5 DoF), (2) static position accuracy (5 DoF) and (3) dynamic position accuracy using patient-derived prostate and lung tumor motion traces (3 DoF). Translational motion accuracy was compared against electromagnetic transponder measurements. Rotation was benchmarked with a digital inclinometer. The static accuracy and reproducibility for translation and rotation was <0.1 mm or <0.1°, respectively. The accuracy of reproducing dynamic patient motion was <0.3 mm. The motion platform's range met the need to reproduce clinically relevant translation and rotation ranges and its accuracy met the TG 142 requirements for SABR. The range, velocity and acceleration of the motion platform are sufficient to reproduce lung and prostate tumor motion for motion management. Programmable motion platforms are valuable tools in the investigation, quality assurance and commissioning of motion management systems in radiation oncology.
Pereira, Michelle Jessica; Coombes, Brooke Kaye; Comans, Tracy Anne; Johnston, Venerina
2015-06-01
The aim of this study is to investigate the effects of onsite workplace health-enhancing physical activity (HEPA) programmes on worker productivity. The PROSPERO registration number is CRD42014008750. A search for controlled trials or randomised controlled trials (RCTs) that investigated the effects of onsite workplace HEPA programmes on productivity levels of working adults was performed. Risk of bias of included studies was assessed, and the inter-rater reliability of the quality assessment was analysed. Qualitative synthesis of available evidence is presented. Eight studies were included in the review. There is consistent evidence that onsite workplace HEPA programmes do not reduce levels of sick leave. There appears to be inconsistent evidence of the impact of onsite workplace HEPA programmes on worker productivity. A high-quality study of an onsite combination (aerobic, strengthening and flexibility) HEPA regime and a moderate-quality study of a Tai Chi programme improved worker productivity measured with questionnaires in female laundry workers and older female nurses, respectively. Two high-quality studies and four moderate-quality studies did not show benefit. Studies that showed benefit were mainly those designed with productivity measures as primary outcomes, delivered to occupations involved with higher physical loads, and had higher compliance and programme intensity. The small number of studies and the lack of consistency among studies limited further analyses. There is inconsistent evidence that onsite workplace HEPA programmes improve self-reported worker productivity. Future high-quality RCTs of onsite workplace HEPA programmes should be designed around productivity outcomes, target at-risk groups and investigate interventions of sufficient intensity. High attendance with improved recording is needed to achieve significant results in augmenting worker productivity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Reed, Casey A; Ford, Kevin R; Myer, Gregory D; Hewett, Timothy E
2012-08-01
Core stability training, operationally defined as training focused to improve trunk and hip control, is an integral part of athletic development, yet little is known about its direct relation to athletic performance. This systematic review focuses on identification of the association between core stability and sports-related performance measures. A secondary objective was to identify difficulties encountered when trying to train core stability with the goal of improving athletic performance. A systematic search was employed to capture all articles related to athletic performance and core stability training that were identified using the electronic databases MEDLINE, CINAHL and SPORTDiscus™ (1982-June 2011). A systematic approach was used to evaluate 179 articles identified for initial review. Studies that performed an intervention targeted toward the core and measured an outcome related to athletic or sport performances were included, while studies with a participant population aged 65 years or older were excluded. Twenty-four in total met the inclusionary criteria for review. Studies were evaluated using the Physical Therapy Evidence Database (PEDro) scale. The 24 articles were separated into three groups, general performance (n = 8), lower extremity (n = 10) and upper extremity (n = 6), for ease of discussion. In the majority of studies, core stability training was utilized in conjunction with more comprehensive exercise programmes. As such, many studies saw improvements in skills of general strengths such as maximum squat load and vertical leap. Surprisingly, not all studies reported measurable increases in specific core strength and stability measures following training. Additionally, investigations that targeted the core as the primary goal for improved outcome of training had mixed results. Core stability is rarely the sole component of an athletic development programme, making it difficult to directly isolate its affect on athletic performance. The population biases of some studies of athletic performance also confound the results. Targeted core stability training provides marginal benefits to athletic performance. Conflicting findings and the lack of a standardization for measurement of outcomes and training focused to improve core strength and stability pose difficulties. Because of this, further research targeted to determine this relationship is necessary to better understand how core strength and stability affect athletic performance.
van Vugt, Jeroen L A; Levolger, Stef; Gharbharan, Arvind; Koek, Marcel; Niessen, Wiro J; Burger, Jacobus W A; Willemsen, Sten P; de Bruin, Ron W F; IJzermans, Jan N M
2017-04-01
The association between body composition (e.g. sarcopenia or visceral obesity) and treatment outcomes, such as survival, using single-slice computed tomography (CT)-based measurements has recently been studied in various patient groups. These studies have been conducted with different software programmes, each with their specific characteristics, of which the inter-observer, intra-observer, and inter-software correlation are unknown. Therefore, a comparative study was performed. Fifty abdominal CT scans were randomly selected from 50 different patients and independently assessed by two observers. Cross-sectional muscle area (CSMA, i.e. rectus abdominis, oblique and transverse abdominal muscles, paraspinal muscles, and the psoas muscle), visceral adipose tissue area (VAT), and subcutaneous adipose tissue area (SAT) were segmented by using standard Hounsfield unit ranges and computed for regions of interest. The inter-software, intra-observer, and inter-observer agreement for CSMA, VAT, and SAT measurements using FatSeg, OsiriX, ImageJ, and sliceOmatic were calculated using intra-class correlation coefficients (ICCs) and Bland-Altman analyses. Cohen's κ was calculated for the agreement of sarcopenia and visceral obesity assessment. The Jaccard similarity coefficient was used to compare the similarity and diversity of measurements. Bland-Altman analyses and ICC indicated that the CSMA, VAT, and SAT measurements between the different software programmes were highly comparable (ICC 0.979-1.000, P < 0.001). All programmes adequately distinguished between the presence or absence of sarcopenia (κ = 0.88-0.96 for one observer and all κ = 1.00 for all comparisons of the other observer) and visceral obesity (all κ = 1.00). Furthermore, excellent intra-observer (ICC 0.999-1.000, P < 0.001) and inter-observer (ICC 0.998-0.999, P < 0.001) agreement for all software programmes were found. Accordingly, excellent Jaccard similarity coefficients were found for all comparisons (mean ≥ 0.964). FatSeg, OsiriX, ImageJ, and sliceOmatic showed an excellent agreement for CSMA, VAT, and SAT measurements on abdominal CT scans. Furthermore, excellent inter-observer and intra-observer agreement were achieved. Therefore, results of studies using these different software programmes can reliably be compared. © 2016 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.
Levolger, Stef; Gharbharan, Arvind; Koek, Marcel; Niessen, Wiro J.; Burger, Jacobus W.A.; Willemsen, Sten P.; de Bruin, Ron W.F.
2016-01-01
Abstract Background The association between body composition (e.g. sarcopenia or visceral obesity) and treatment outcomes, such as survival, using single‐slice computed tomography (CT)‐based measurements has recently been studied in various patient groups. These studies have been conducted with different software programmes, each with their specific characteristics, of which the inter‐observer, intra‐observer, and inter‐software correlation are unknown. Therefore, a comparative study was performed. Methods Fifty abdominal CT scans were randomly selected from 50 different patients and independently assessed by two observers. Cross‐sectional muscle area (CSMA, i.e. rectus abdominis, oblique and transverse abdominal muscles, paraspinal muscles, and the psoas muscle), visceral adipose tissue area (VAT), and subcutaneous adipose tissue area (SAT) were segmented by using standard Hounsfield unit ranges and computed for regions of interest. The inter‐software, intra‐observer, and inter‐observer agreement for CSMA, VAT, and SAT measurements using FatSeg, OsiriX, ImageJ, and sliceOmatic were calculated using intra‐class correlation coefficients (ICCs) and Bland–Altman analyses. Cohen's κ was calculated for the agreement of sarcopenia and visceral obesity assessment. The Jaccard similarity coefficient was used to compare the similarity and diversity of measurements. Results Bland–Altman analyses and ICC indicated that the CSMA, VAT, and SAT measurements between the different software programmes were highly comparable (ICC 0.979–1.000, P < 0.001). All programmes adequately distinguished between the presence or absence of sarcopenia (κ = 0.88–0.96 for one observer and all κ = 1.00 for all comparisons of the other observer) and visceral obesity (all κ = 1.00). Furthermore, excellent intra‐observer (ICC 0.999–1.000, P < 0.001) and inter‐observer (ICC 0.998–0.999, P < 0.001) agreement for all software programmes were found. Accordingly, excellent Jaccard similarity coefficients were found for all comparisons (mean ≥ 0.964). Conclusions FatSeg, OsiriX, ImageJ, and sliceOmatic showed an excellent agreement for CSMA, VAT, and SAT measurements on abdominal CT scans. Furthermore, excellent inter‐observer and intra‐observer agreement were achieved. Therefore, results of studies using these different software programmes can reliably be compared. PMID:27897414
Lee, James W.; Thundat, Thomas G.
2005-06-14
An apparatus and method for performing nucleic acid (DNA and/or RNA) sequencing on a single molecule. The genetic sequence information is obtained by probing through a DNA or RNA molecule base by base at nanometer scale as though looking through a strip of movie film. This DNA sequencing nanotechnology has the theoretical capability of performing DNA sequencing at a maximal rate of about 1,000,000 bases per second. This enhanced performance is made possible by a series of innovations including: novel applications of a fine-tuned nanometer gap for passage of a single DNA or RNA molecule; thin layer microfluidics for sample loading and delivery; and programmable electric fields for precise control of DNA or RNA movement. Detection methods include nanoelectrode-gated tunneling current measurements, dielectric molecular characterization, and atomic force microscopy/electrostatic force microscopy (AFM/EFM) probing for nanoscale reading of the nucleic acid sequences.
HÖner, Oliver; Votteler, Andreas; Schmid, Markus; Schultz, Florian; Roth, Klaus
2015-01-01
The utilisation of motor performance tests for talent identification in youth sports is discussed intensively in talent research. This article examines the reliability, differential stability and validity of the motor diagnostics conducted nationwide by the German football talent identification and development programme and provides reference values for a standardised interpretation of the diagnostics results. Highly selected players (the top 4% of their age groups, U12-U15) took part in the diagnostics at 17 measurement points between spring 2004 and spring 2012 (N = 68,158). The heterogeneous test battery measured speed abilities and football-specific technical skills (sprint, agility, dribbling, ball control, shooting, juggling). For all measurement points, the overall score and the speed tests showed high internal consistency, high test-retest reliability and satisfying differential stability. The diagnostics demonstrated satisfying factorial-related validity with plausible and stable loadings on the two empirical factors "speed" and "technical skills". The score, and the technical skills dribbling and juggling, differentiated the most among players of different performance levels and thus showed the highest criterion-related validity. Satisfactory psychometric properties for the diagnostics are an important prerequisite for a scientifically sound rating of players' actual motor performance and for the future examination of the prognostic validity for success in adulthood.
Early interventions for youths at high risk for bipolar disorder: a developmental approach.
Benarous, Xavier; Consoli, Angèle; Milhiet, Vanessa; Cohen, David
2016-03-01
In recent decades, ongoing research programmes on primary prevention and early identification of bipolar disorder (BD) have been developed. The aim of this article is to review the principal forms of evidence that support preventive interventions for BD in children and adolescents and the main challenges associated with these programmes. We performed a literature review of the main computerised databases (MEDLINE, PUBMED) and a manual search of the literature relevant to prospective and retrospective studies of prodromal symptoms, premorbid stages, risk factors, and early intervention programmes for BD. Genetic and environmental risk factors of BD were identified. Most of the algorithms used to measure the risk of developing BD and the early interventions programmes focused on the familial risk. The prodromal signs varied greatly and were age dependent. During adolescence, depressive episodes associated with genetic or environmental risk factors predicted the onset of hypomanic/manic episodes over subsequent years. In prepubertal children, the lack of specificity of clinical markers and difficulties in mood assessment were seen as impeding preventive interventions at these ages. Despite encouraging results, biomarkers have not thus far been sufficiently validated in youth samples to serve as screening tools for prevention. Additional longitudinal studies in youths at high risk of developing BD should include repeated measures of putative biomarkers. Staging models have been developed as an integrative approach to specify the individual level of risk based on clinical (e.g. prodromal symptoms and familial history of BD) and non-clinical (e.g. biomarkers and neuroimaging) data. However, there is still a lack of empirically validated studies that measure the benefits of using these models to design preventive intervention programmes.
Hetzel, Manuel W; Iteba, Nelly; Makemba, Ahmed; Mshana, Christopher; Lengeler, Christian; Obrist, Brigit; Schulze, Alexander; Nathan, Rose; Dillip, Angel; Alba, Sandra; Mayumana, Iddy; Khatib, Rashid A; Njau, Joseph D; Mshinda, Hassan
2007-01-01
Background Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. Project The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health) impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. Conclusion The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services. PMID:17603898
Reuter, I.; Mehnert, S.; Sammer, G.; Oechsner, M.; Engelhardt, M.
2012-01-01
Mild cognitive impairment, especially executive dysfunction might occur early in the course of Parkinson's disease. Cognitive training is thought to improve cognitive performance. However, transfer of improvements achieved in paper and pencil tests into daily life has been difficult. The aim of the current study was to investigate whether a multimodal cognitive rehabilitation programme including physical exercises might be more successful than cognitive training programmes without motor training. 240 PD-patients were included in the study and randomly allocated to three treatment arms, group A cognitive training, group B cognitive training and transfer training and group C cognitive training, transfer training and psychomotor and endurance training. The primary outcome measure was the ADAS-Cog. The secondary outcome measure was the SCOPA-Cog. Training was conducted for 4 weeks on a rehabilitation unit, followed by 6 months training at home. Caregivers received an education programme. The combination of cognitive training using paper and pencil and the computer, transfer training and physical training seems to have the greatest effect on cognitive function. Thus, patients of group C showed the greatest improvement on the ADAS-Cog and SCOPA-COG and were more likely to continue with the training programme after the study. PMID:23008772
Demarzo, Marcelo; Montero-Marin, Jesus; Puebla-Guedea, Marta; Navarro-Gil, Mayte; Herrera-Mercadal, Paola; Moreno-González, Sergio; Calvo-Carrión, Sandra; Bafaluy-Franch, Laura; Garcia-Campayo, Javier
2017-01-01
Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted. Clinical Trials.gov Registration ID: NCT02643927.
Demarzo, Marcelo; Montero-Marin, Jesus; Puebla-Guedea, Marta; Navarro-Gil, Mayte; Herrera-Mercadal, Paola; Moreno-González, Sergio; Calvo-Carrión, Sandra; Bafaluy-Franch, Laura; Garcia-Campayo, Javier
2017-01-01
Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted. Clinical Trials.gov Registration ID: NCT02643927 PMID:28848465
Estimating the coverage of mental health programmes: a systematic review
De Silva, Mary J; Lee, Lucy; Fuhr, Daniela C; Rathod, Sujit; Chisholm, Dan; Schellenberg, Joanna; Patel, Vikram
2014-01-01
Background The large treatment gap for people suffering from mental disorders has led to initiatives to scale up mental health services. In order to track progress, estimates of programme coverage, and changes in coverage over time, are needed. Methods Systematic review of mental health programme evaluations that assess coverage, measured either as the proportion of the target population in contact with services (contact coverage) or as the proportion of the target population who receive appropriate and effective care (effective coverage). We performed a search of electronic databases and grey literature up to March 2013 and contacted experts in the field. Methods to estimate the numerator (service utilization) and the denominator (target population) were reviewed to explore methods which could be used in programme evaluations. Results We identified 15 735 unique records of which only seven met the inclusion criteria. All studies reported contact coverage. No study explicitly measured effective coverage, but it was possible to estimate this for one study. In six studies the numerator of coverage, service utilization, was estimated using routine clinical information, whereas one study used a national community survey. The methods for estimating the denominator, the population in need of services, were more varied and included national prevalence surveys case registers, and estimates from the literature. Conclusions Very few coverage estimates are available. Coverage could be estimated at low cost by combining routine programme data with population prevalence estimates from national surveys. PMID:24760874
FPGA Implementation of Generalized Hebbian Algorithm for Texture Classification
Lin, Shiow-Jyu; Hwang, Wen-Jyi; Lee, Wei-Hao
2012-01-01
This paper presents a novel hardware architecture for principal component analysis. The architecture is based on the Generalized Hebbian Algorithm (GHA) because of its simplicity and effectiveness. The architecture is separated into three portions: the weight vector updating unit, the principal computation unit and the memory unit. In the weight vector updating unit, the computation of different synaptic weight vectors shares the same circuit for reducing the area costs. To show the effectiveness of the circuit, a texture classification system based on the proposed architecture is physically implemented by Field Programmable Gate Array (FPGA). It is embedded in a System-On-Programmable-Chip (SOPC) platform for performance measurement. Experimental results show that the proposed architecture is an efficient design for attaining both high speed performance and low area costs. PMID:22778640
NASA Astrophysics Data System (ADS)
Abdelazim, S.; Santoro, D.; Arend, M.; Moshary, F.; Ahmed, S.
2011-11-01
A field deployable all-fiber eye-safe Coherent Doppler LIDAR is being developed at the Optical Remote Sensing Lab at the City College of New York (CCNY) and is designed to monitor wind fields autonomously and continuously in urban settings. Data acquisition is accomplished by sampling lidar return signals at 400 MHz and performing onboard processing using field programmable gate arrays (FPGAs). The FPGA is programmed to accumulate signal information that is used to calculate the power spectrum of the atmospherically back scattered signal. The advantage of using FPGA is that signal processing will be performed at the hardware level, reducing the load on the host computer and allowing for 100% return signal processing. An experimental setup measured wind speeds at ranges of up to 3 km.
2009-01-01
Background Physical activity programmes can help to prevent functional decline in the elderly. Until now, such programmes use to target either on healthy community-dwelling seniors or on elderly living in special residences or care institutions. Sedentary or frail people, however, are difficult to reach when they live in their own homes. The general practitioner's (GP) practice offers a unique opportunity to acquire these people for participation in activity programmes. We conceptualised a multidimensional home-based exercise programme that shall be delivered to the target group through cooperation between GPs and exercise therapists. In order to prepare a randomised controlled trial (RCT), a feasibility study is being conducted. Methods The study is designed as a single arm interventional trial. We plan to recruit 90 patients aged 70 years and above through their GPs. The intervention lasts 12 weeks and consists of physical activity counselling, a home-exercise programme, and exercise consultations provided by an exercise therapist in the GP's practice and via telephone. The exercise programme consists of two main components: 1. a combination of home-exercises to improve strength, flexibility and balance, 2. walking for exercise to improve aerobic capacity. Primary outcome measures are: appraisal by GP, undesirable events, drop-outs, adherence. Secondary outcome measures are: effects (a. motor tests: timed-up-and-go, chair rising, grip strength, tandem stand, tandem walk, sit-and-reach; b. telephone interview: PRISCUS-Physical Activity Questionnaire, Short Form-8 Health Survey, three month recall of frequency of falls, Falls Efficacy Scale), appraisal by participant, exercise performance, focus group discussion. Data analyses will focus on: 1. decision-making concerning the conduction of a RCT, 2. estimation of the effects of the programme, detection of shortcomings and identification of subgroups with contrary results, 3. feedback to participants and to GPs. Conclusion A new cooperation between GPs and exercise therapists to approach community-dwelling seniors and to deliver a home-exercise programme is object of research with regard to feasibility and acceptance. In case of success, an RCT should examine the effects of the programme. A future implementation within primary medical care may take advantage from the flexibility of the programme. Trial registration Current Controlled Trials ISRCTN58562962. PMID:19686587
Preventing childhood obesity in Asia: an overview of intervention programmes.
Uijtdewilligen, L; Waters, C N; Müller-Riemenschneider, F; Lim, Y W
2016-11-01
The rapid economic growth in Asia in the past few decades has contributed to the global increase in childhood obesity prevalence. Yet, little is known about obesity prevention efforts in this region. This systematic review provides an overview of child obesity prevention programmes in Asia. Searches were performed in six electronic databases. Out of 4,234 studies, 17 were included, among them 11 controlled trials (of which five were randomized). Only one study was published before 2007. Identified studies were predominantly conducted in China and Thailand and targeted primary school children in a school setting. Most studies implemented different programmes, frequently targeting behavioural modification through nutrition/health education lectures and/or physical activity sessions. Programme effects related to obesity outcome measures were mixed. Most substantial effects were found for outcomes such as improved health knowledge and/or favourable lifestyle practices. The relatively small number of relevant publications in Asia highlights the need for scientific evaluations of existing and future programmes. This will help ensure the implementation and dissemination of evidence-based approaches that have been proven to be effective in the Asian context. Targeting preschool settings and applying a comprehensive multisectoral approach may increase the effectiveness and sustainability of childhood obesity prevention programmes. © 2016 World Obesity.
McDowell, Kathryn; O'Neill, Brenda; Blackwood, Bronagh; Clarke, Chris; Gardner, Evie; Johnston, Paul; Kelly, Michaeline; McCaffrey, John; Mullan, Brian; Murphy, Sally; Trinder, T John; Lavery, Gavin; McAuley, Daniel F; Bradley, Judy M
2017-07-01
To investigate the effectiveness of a 6-week exercise programme in patients discharged home following critical illness compared with standard care. Multicentre prospective phase II randomised controlled trial, with blinded outcome assessment after hospital discharge, following the 6-week intervention and at 6 months. 60 patients (30 per group) aged ≥18 years, mechanically ventilated >96 hours, and not in other rehabilitation, that is, cardiac or pulmonary rehabilitation programmes. Participants in the intervention group completed an individually tailored (personalised) exercise programme. Primary outcome measure was SF-36 physical functioning following the intervention. Secondary outcomes included a range of performance-based and patient-reported measures. Improvements in the primary outcome did not differ significantly between groups (mean difference (95% CI) 3.0 (-2.2 to 8.2), p=0.26). The intervention group showed significant improvement compared with the control group (mean difference (95% CI)) in SF-36 role physical (6.6 (0.73 to 12.5), p=0.03); incremental shuttle walk test (83.1 m (8.3 to 157.9), p=0.03); functional limitations profile (-4.8 (-8.7 to -0.9), p=0.02); self-efficacy to exercise (2.2 (0.8 to 3.7), p=0.01) and readiness to exercise (1.3 (0.8 to 1.9), p<0.001). These improvements were not sustained at 6 months except readiness to exercise. Improvements in all other secondary outcome measures were not significant. There was no statistically significant difference in the primary outcome measure of self-reported physical function following this 6-week exercise programme. Secondary outcome results will help inform future studies. NCT01463579. (results), https://clinicaltrials.gov/. 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/.
Are Full-Time MBAs Performing?
ERIC Educational Resources Information Center
Rowland, Caroline Ann; Hall, Roger David
2012-01-01
Full-time MBA students amount to about one-third of the 26,000 students enrolled on MBA programmes at UK universities. The programmes have become increasingly international in student composition and concerns have been expressed about performance, quality and comparability between programmes. Research into predictors of MBA success has been…
2014-01-01
Background Comprehensive rehabilitation, involving health professionals from various disciplines, is widely used as an adjunct to pharmacological and surgical treatment in people with rheumatic diseases. However, the evidence for the clinical- and cost-effectiveness of such interventions is limited, and the majority of those who receive rehabilitation are back to their initial health status six to 12 months after discharge. Methods/design To evaluate the goal attainment, health effects and cost-effectiveness of a new rehabilitation programme compared to current traditional rehabilitation programmes for people with rheumatic diseases, a stepped-wedge cluster randomized trial will be performed. Patients admitted for rehabilitation at six centres in the south-eastern part of Norway will be invited to participate. In the trial, six participating centres will switch from a control (current rehabilitation programme) to an intervention phase (the new rehabilitation programme) in a randomized order. Supported by recent research, the new programme will be a supplement to the existing programme at each centre, and will comprise four elements designed to enhance and support lifestyle changes introduced in the rehabilitation period: structured goal-planning, motivational interviewing, a self-help booklet and four follow-up telephone calls during the first five months following discharge. The primary outcome will be health-related quality of life and goal attainment, as measured by the Patient Generated Index directly before and after the rehabilitation stay, as well as after six and 12 months. Secondary outcomes will include self-reported pain, fatigue, a global assessment of disease activity and motivation for change (measured on 11-point numeric ratings scales), health-related quality of life as measured by the Short Form 36 Health Survey (SF-36) and utility assessed by the SF6D utility index. The main analysis will be on an intention to treat basis and will assess the clinical- and cost-effectiveness of the structured goal planning and tailored follow-up rehabilitation programme for patients with rheumatic diseases. Discussion The findings will constitute an important contribution to more cost-effective- and evidence-based rehabilitation services for people with rheumatic diseases. Trial registration ISRCTN91433175. PMID:24886382
The report explains the basic concepts of in-stack opacity as measured by in-stack opacity monitors. Also included are calculator programs that model the performance of venturi scrubbers and electrostatic precipitators. The effect of particulate control devices on in-stack opacit...
Postirradiation Effects In Integrated Circuits
NASA Technical Reports Server (NTRS)
Shaw, David C.; Barnes, Charles E.
1993-01-01
Two reports discuss postirradiation effects in integrated circuits. Presents examples of postirradiation measurements of performances of integrated circuits of five different types: dual complementary metal oxide/semiconductor (CMOS) flip-flop; CMOS analog multiplier; two CMOS multiplying digital-to-analog converters; electrically erasable programmable read-only memory; and semiconductor/oxide/semiconductor octal buffer driver.
ERIC Educational Resources Information Center
Vodounon, Maurice A.
2006-01-01
The primary purpose of the study was to determine if a treatment that concentrates on building programs from previously written modules can improve the decomposition processes of novice programmers in the C++ programming language and, hence, programming performance. For purposes of performance analysis, a subsample of 23 students was divided into…
ERIC Educational Resources Information Center
Dinis da Costa, Patrícia; Araújo, Luísa
2016-01-01
The analyses presented in this report indicate that in several Member States (MS) 15-year-old students in vocational-oriented programmes (VET) perform better in digital reading than in print reading in PISA 2012. When differentiated by programme of study--VET versus general education programmes--VET students perform better in digital than in print…
Expert opinions and scientific evidence for colonoscopy key performance indicators.
Rees, Colin J; Bevan, Roisin; Zimmermann-Fraedrich, Katharina; Rutter, Matthew D; Rex, Douglas; Dekker, Evelien; Ponchon, Thierry; Bretthauer, Michael; Regula, Jaroslaw; Saunders, Brian; Hassan, Cesare; Bourke, Michael J; Rösch, Thomas
2016-12-01
Colonoscopy is a widely performed procedure with procedural volumes increasing annually throughout the world. Many procedures are now performed as part of colorectal cancer screening programmes. Colonoscopy should be of high quality and measures of this quality should be evidence based. New UK key performance indicators and quality assurance standards have been developed by a working group with consensus agreement on each standard reached. This paper reviews the scientific basis for each of the quality measures published in the UK standards. 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/.
Mirzazadeh, Azim; Gandomkar, Roghayeh; Hejri, Sara Mortaz; Hassanzadeh, Gholamreza; Koochak, Hamid Emadi; Golestani, Abolfazl; Jafarian, Ali; Jalili, Mohammad; Nayeri, Fatemeh; Saleh, Narges; Shahi, Farhad; Razavi, Seyed Hasan Emami
2016-02-01
The purpose of this study was to utilize the Context, Input, Process and Product (CIPP) evaluation model as a comprehensive framework to guide initiating, planning, implementing and evaluating a revised undergraduate medical education programme. The eight-year longitudinal evaluation study consisted of four phases compatible with the four components of the CIPP model. In the first phase, we explored the strengths and weaknesses of the traditional programme as well as contextual needs, assets, and resources. For the second phase, we proposed a model for the programme considering contextual features. During the process phase, we provided formative information for revisions and adjustments. Finally, in the fourth phase, we evaluated the outcomes of the new undergraduate medical education programme in the basic sciences phase. Information was collected from different sources such as medical students, faculty members, administrators, and graduates, using various qualitative and quantitative methods including focus groups, questionnaires, and performance measures. The CIPP model has the potential to guide policy makers to systematically collect evaluation data and to manage stakeholders' reactions at each stage of the reform in order to make informed decisions. However, the model may result in evaluation burden and fail to address some unplanned evaluation questions.
The value of mentorship in medical education.
Dalgaty, Faith; Guthrie, Greg; Walker, Heather; Stirling, Kevin
2017-04-01
The transition from senior medical student to working safely and effectively as a new junior doctor is one of the biggest challenges that a new graduate will face. In 2014 the General Medical Council published The state of medical education and practice in the UK, reporting that some new doctors continue to struggle with increased responsibilities. We classify these instances as a 'performance gap', describing occasions in clinical practice where an individual exceeds their performance capacity. The Medical Mentorship Programme addressed identified performance gaps through a structured curriculum of simulation-based education and facilitated clinical practice. Programme content was based on the experiences of the authors and their peers in graduating from their undergraduate training programme and becoming junior doctors. A questionnaire was disseminated to junior doctors in their first clinical rotation. The questionnaire asked doctors to describe instances where they experienced a performance gap. These data informed the development of the Medical Mentorship Programme. The effect of this programme was then evaluated via focus group discussion. The Medical Mentorship Programme has been shown to be an effective conduit for supporting the transfer of learning needed to address performance gaps in students. The programme increased the confidence of students in preparation for clinical practice and allowed junior doctors to reflect on their professional development. The programme combined complementary teaching techniques - mentorship, simulation and direct clinical experience - to aid the professional development of both students and mentors. Some new doctors continue to struggle with increased responsibilities. © 2016 John Wiley & Sons Ltd.
Belgacem, Bénédicte; Auclair, Candy; Fedor, Marie-Christine; Brugnon, David; Blanquet, Marie; Tournilhac, Olivier; Gerbaud, Laurent
2013-12-01
The French setting, including laws and guidelines, advocates greater involvement of informal caregivers in the care of cancer patients to protect the caregivers from depression, distress, and a decrease in their quality of life. This study aimed to assess the efficacy of a caregiver educational programme by measuring two outcomes: patients' and caregivers' quality of life and caregivers' burden. A multicentre randomised controlled trial was performed in six oncology wards in French hospitals. Eligible patients had a cancer, a main caregiver, allowed their caregivers' involvement, and received an inclusion agreement by a doctor/psychologist dyad. The experimental group participated in an educational programme performed by nurses to improve their skills in meal support, nursing care, welfare care, or symptom management. The SF36 and the Zarit burden scales were used to measure quality of life and caregivers' burden at the beginning and at the end of the study. 67 patients were randomised and 33 were included in the experimental group. Evolution scores, which measured the difference between baseline and final scores, showed an improvement in patients' and caregivers' quality of life and an alleviated burden for experimental group caregivers. An educational programme for caregivers encourages the involvement of patients, informal caregivers and health-care providers in a triangular relationship which enhances the quality of life of patients and caregivers alike and decreases caregivers' burden. Care organisation should therefore be rethought as a triangular relationship between patients, caregivers and health-care providers, with nurses as the mainstay. Copyright © 2013 Elsevier Ltd. All rights reserved.
Rural poverty reduction through centrally sponsored schemes.
Saxena, N C
2007-10-01
This paper discusses the evolving profile of poverty in India and reviews the national performance of selected anti-poverty programmes between 1997-1998 and 2005. For each programme, it outlines the budgetary allocation principle used for the States and districts and analyzes budgetary performance over the period. The main objective is to explore the extent to which the anti-poverty programmes are reaching their target groups effectively. Finally, it identifies the specific factors responsible for under-performance and provides a set of recommendations for policy makers and programme implementers which could help improve the outcomes of the schemes.
Shields, Nora; Taylor, Nicholas F; Fernhall, Bo
2010-03-25
Muscle strength is important for young people with Down syndrome as they make the transition to adulthood, because their workplace activities typically emphasise physical rather than cognitive skills. Muscle strength is reduced up to 50% in people with Down syndrome compared to their peers without disability. Progressive resistance training improves muscle strength and endurance in people with Down syndrome. However, there is no evidence on whether it has an effect on work task performance or physical activity levels. The aim of this study is to investigate if a student-led community-based progressive resistance training programme can improve these outcomes in adolescents and young adults with Down syndrome. A randomised controlled trial will compare progressive resistance training with a control group undertaking a social programme. Seventy adolescents and young adults with Down syndrome aged 14-22 years and mild to moderate intellectual disability will be randomly allocated to the intervention or control group using a concealed method. The intervention group will complete a 10-week, twice a week, student-led progressive resistance training programme at a local community gymnasium. The student mentors will be undergraduate physiotherapy students. The control group will complete an arts/social programme with a student mentor once a week for 90 minutes also for 10 weeks to control for the social aspect of the intervention. Work task performance (box stacking, pail carry), muscle strength (1 repetition maximum for chest and leg press) and physical activity (frequency, duration, intensity over 7-days) will be assessed at baseline (Week 0), following the intervention (Week 11), and at 3 months post intervention (Week 24) by an assessor blind to group allocation. Data will be analysed using ANCOVA with baseline measures as covariates. This paper outlines the study protocol for a randomised controlled trial on the effects of progressive resistance training on work task performance and physical activity for adolescents and young adults with Down syndrome. The intervention addresses the impairment of muscle weakness which may improve work task performance and help to increase physical activity levels. Australian New Zealand Clinical Trials Registry ACTRN12609000938202.
Yuen, Hon Keung; Mueller, Kris; Mayor, Ellise; Azuero, Andres
2011-12-01
The purpose of this mixed methods study was to evaluate the effect of participation in the "Seasoned Arts At the Samford for You" (SAASY) programme, which included a 6-week acting class and four public performances, on the psychological well-being and health-related quality of life of older adults. Twelve older adults with chronic conditions from a low-income senior apartment and a senior living community participated in the programme. The acting class, led by two professional artists, met for a 2-hour class weekly for six weeks. Participants completed the General Well-being Schedule (GWBS) and the 36-Item Short-Form Health Survey (SF-36) both at the beginning of the programme and one month after the programme ended. In addition, participants were individually interviewed to explore the perceived impact of the theatre programme on their well-being. Participants reported a significantly higher score in the GWBS and on the physical but not on the mental component summary of the SF-36 at post-SAASY programme. Content analysis of the interview transcripts revealed that participants attained an improved sense of self-worth and self-advocacy and overcame self-imposed limitations. Results showed improvement in psychological well-being and health-related quality of life, most notably in the physical health component of SF-36 after participating in the programme. Practice implications for occupational therapists using drama as a creative leisure occupation to promote health among older adults with chronic conditions may involve analysis of participants' occupational profile, identification of deficit areas and adaptation of the acting programme content to meet specific needs and goals. The present study used a pretest and post test one group design that has numerous inherent limitations that affect the ability to make valid inferences from study findings. A more rigorous research design with a wait-listed control group and collection of outcome measures immediately after the acting class as well as at three months follow-up is essential in validating the present findings. Outcome measures used in future studies to evaluate the health benefits of a theatre programme should focus on ameliorating the effects of disease on disability (such as functional mobility, everyday cognitive function and activities of daily living) in addition to prevention. Copyright © 2011 John Wiley & Sons, Ltd.
Influence of aquatic training on the motor performance of patients with haemophilic arthropathy.
Vallejo, L; Pardo, A; Gomis, M; Gallach, J E; Pérez, S; Querol, F
2010-01-01
Thirteen patients with haemophilia A took part in this study voluntarily. They underwent an aquatic training programme over a 9-week period (27 sessions; three sessions per week; 1 h per session). Their motor performance was assessed by the following cardio-respiratory and mechanical variables before and after the training programme: oxygen uptake (VO(2), mL min(-1)), relative oxygen uptake (rel VO(2), mL min(-1).kg(-1)), carbon dioxide (CO(2), mL min(-1)), respiratory quotient (R), heart rate (bpm) and the distance covered in 12 min (the Cooper test, m). Nine patients successfully completed the intervention and measurement protocols without bleeding or other adverse events. After the proposed training programme, significant differences between the pre-test and post-test were observed. Patients' aerobic capacity increased considerably, and their oxygen uptake improved by 51.51% (P < 0.05), while their relative oxygen uptake went up by 37.73% (P < 0.05). Their mechanical capacity also increased considerably (14.68%, P < 0.01). Our results suggest that 27 specially designed aquatic training sessions for our patients with haemophilia A had a positive effect on their motor performance and considerably improved their aerobic and mechanical capacity without causing adverse effects.
Rejman, Marek; Bilewski, Marek; Szczepan, Stefan; Klarowicz, Andrzej; Rudnik, Daria; Maćkała, Krzysztof
2017-01-01
The aim of this study was to analyse changes taking place within selected kinematic parameters of the swimming start, after completing a six-week plyometric training, assuming that the take-off power training improves its effectiveness. The experiment included nine male swimmers. In the pre-test the swimmers performed three starts focusing on the best performance. Next, a plyometric training programme, adapted from sprint running, was introduced in order to increase a power of the lower extremities. The programme entailed 75 minute sessions conducted twice a week. Afterwards, a post-test was performed, analogous to the pre-test. Spatio-temporal structure data of the swimming start were gathered from video recordings of the swimmer above and under water. Impulses triggered by the plyometric training contributed to a shorter start time (the main measure of start effectiveness) and glide time as well as increasing average take-off, flight and glide velocities including take-off, entry and glide instantaneous velocities. The glide angle decreased. The changes in selected parameters of the swimming start and its confirmed diagnostic values, showed the areas to be susceptible to plyometric training and suggested that applied plyometric training programme aimed at increasing take-off power enhances the effectiveness of the swimming start.
Psychosocial components of cardiac recovery and rehabilitation attendance
King, K; Humen, D; Smith, H; Phan, C; Teo, K
2001-01-01
OBJECTIVE—To examine the relations between demographic factors, specific psychosocial factors, and cardiac rehabilitation attendance. DESIGN—Cohort, repeated measures design. SETTING—A large tertiary care centre in western Canada PATIENTS—304 consecutive consenting patients discharged following acute myocardial infarction and/or coronary artery bypass graft surgery. MAIN OUTCOME MEASURES—The Jenkins self-efficacy expectation scales and activity checklists of behaviour performance for maintaining health and role resumption, modified version of the self-motivation inventory, and the shortened social support scale. RESULTS—Those who had higher role resumption behaviour performance scores at two weeks after discharge were significantly less likely to attend cardiac rehabilitation programmes. At six months after discharge, those who attended cardiac rehabilitation demonstrated higher health maintenance self-efficacy expectation and behaviour performance scores. Health maintenance self-efficacy expectation and behaviour performance improved over time. Women reported less social support but showed greater improvement in health maintenance self-efficacy expectation. Changes in self-efficacy scores were unrelated to—but changes in health maintenance behaviour performance scores were strongly associated with—cardiac rehabilitation attendance. CONCLUSIONS—Cardiac patients and practitioners may have misconceptions about the mandate and potential benefits of rehabilitation programmes. Patients who resumed role related activities early and more completely apparently did not see the need to "rehabilitate" while those who attended cardiac rehabilitation programmes enhanced their secondary prevention behaviours. Keywords: self-efficacy; motivation; social support; cardiac recovery; cardiac rehabilitation PMID:11179268
Effects of a preceptorship programme on turnover rate, cost, quality and professional development.
Lee, Tso-Ying; Tzeng, Wen-Chii; Lin, Chia-Huei; Yeh, Mei-Ling
2009-04-01
The purpose of the present study was to design a preceptorship programme and to evaluate its effects on turnover rate, turnover cost, quality of care and professional development. A high turnover rate of nurses is a common global problem. How to improve nurses' willingness to stay in their jobs and reduce the high turnover rate has become a focus. Well-designed preceptorship programmes could possibly decrease turnover rates and improve professional development. A quasi-experimental research design was used. First, a preceptorship programme was designed to establish the role and responsibilities of preceptors in instructing new nurses. Second, a quasi-experimental design was used to evaluate the preceptorship programme. Data on new nurses' turnover rate, turnover cost, quality of nursing care, satisfaction of preceptor's teaching and preceptor's perception were measured. After conducting the preceptorship programme, the turnover rate was 46.5% less than the previous year. The turnover cost was decreased by US$186,102. Additionally, medication error rates made by new nurses dropped from 50-0% and incident rates of adverse events and falls decreased. All new nurses were satisfied with preceptor guidance. The preceptorship programme effectively lowered the turnover rate of new nurses, reduced turnover costs and enhanced the quality of nursing care, especially by reducing medication error incidents. Positive feedback about the programme was received from new nurses. Study findings may offer healthcare administrators another option for retaining new nurses, controlling costs, improving quality and fostering professional development. In addition, incentives and effective support from the organisation must be considered when preceptors perform preceptorship responsibilities.
Community engagement: outcomes for occupational therapy students, faculty and clients.
Schindler, Victoria P
2014-06-01
Students in health care professions, including occupational therapy, are required to develop knowledge, skills and attitudes in mental health and research. Persons diagnosed with a mental illness, a learning disability or an autism-spectrum disorder desire to achieve goals in higher education and employment. Faculty in health care programmes strives to meet professional goals and accreditation and institution requirements for teaching, service and scholarship. The Bridge Program, a programme based on principles of community engagement, was developed to meet the needs of these three stakeholders. The objective of this paper is to provide programme description and outcomes of the effectiveness of the Bridge Program for all three stakeholders. This uses mixed methods research design including descriptive and quantitative and qualitative one-group pre-test-post-test designs. Instruments consisted of the Occupational Therapy Student and Mental Health Population Scale and the Canadian Occupational Performance Measure. Quantitative results support that graduate occupational therapy students gained research and clinical skills (n = 100; p = .000); clients increased performance and satisfaction toward goals (n = 113; p = .000) and faculty (n = 1) achieved goals related to teaching, service and scholarship. Programmes based on principles of community engagement can address the needs of the community, can provide outcomes that advance knowledge about community practice and can result in benefits for all stakeholders. This paper is limited to generalization and instrumentation and recommends an ongoing evaluation of other community engagement programmes involving all stakeholders in the future research. Copyright © 2014 John Wiley & Sons, Ltd.
Innovative strategies for a successful SLMTA country programme: The Rwanda story
Sebasirimu, Sabin; Gatabazi, John B.; Ruzindana, Emmanuel; Kayobotsi, Claver; Linde, Mary K.; Mazarati, Jean B.; Ntagwabira, Edouard; Serumondo, Janvier; Dahourou, Georges A.; Gatei, Wangeci; Muvunyi, Claude M.
2014-01-01
Background In 2009, to improve the performance of laboratories and strengthen healthcare systems, the World Health Organization Regional Office for Africa (WHO AFRO) and partners launched two initiatives: a laboratory quality improvement programme called Strengthening Laboratory Management Toward Accreditation (SLMTA), and what is now called the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA). Objectives This study describes the achievements of Rwandan laboratories four years after the introduction of SLMTA in the country, using the SLIPTA scoring system to measure laboratory progress. Methods Three cohorts of five laboratories each were enrolled in the SLMTA programme in 2010, 2011 and 2013. The cohorts used SLMTA workshops, improvement projects, mentorship and quarterly performance-based financing incentives to accelerate laboratory quality improvement. Baseline, exit and follow-up audits were conducted over a two-year period from the time of enrolment. Audit scores were used to categorise laboratory quality on a scale of zero (< 55%) to five (95% – 100%) stars. Results At baseline, 14 of the 15 laboratories received zero stars with the remaining laboratory receiving a two-star rating. At exit, five laboratories received one star, six received two stars and four received three stars. At the follow-up audit conducted in the first two cohorts approximately one year after exit, one laboratory scored two stars, five laboratories earned three stars and four laboratories, including the National Reference Laboratory, achieved four stars. Conclusion Rwandan laboratories enrolled in SLMTA showed improvement in quality management systems. Sustaining the gains and further expansion of the SLMTA programme to meet country targets will require continued programme strengthening. PMID:29043189
Empirical Investigation of Predictors of Success in an MBA Programme
ERIC Educational Resources Information Center
Gupta, Atul; Turek, Joseph
2015-01-01
Purpose: The twofold purpose of this study was to determine if selected variables were predictors of: student performance in the MBA programme; and student performance on the MBA MFT exam. Design/methodology/approach: This study focuses on MBA graduates at a US university who have successfully completed the entire programme requirements. Real…
Development of a framework of quality assurance practices for a radon passive dosemeter service.
D'Alessandro, M; Leonardi, F; Tonnarini, S; Trevisi, R; Veschetti, M
2010-06-01
Etched track detectors are widely used for the detection of radon and its decay products. The reliability of radon measurement performed with such devices requires that laboratories producing analytical data are able to provide results of the required quality. The need for uniform results from laboratories at an international level therefore requires the implementation of a quality assurance programme, the harmonization of criteria, sampling procedures, calculations and the reporting of results, agreed on the basis of fundamental principles and international standards. The quality assurance programme described here is the first step on the way to ISO/IEC 17025 certification for the RI-RN (ISPESL) laboratory.
Nilsagård, Ylva E; Forsberg, Anette S; von Koch, Lena
2013-02-01
The use of interactive video games is expanding within rehabilitation. The evidence base is, however, limited. Our aim was to evaluate the effects of a Nintendo Wii Fit® balance exercise programme on balance function and walking ability in people with multiple sclerosis (MS). A multi-centre, randomised, controlled single-blinded trial with random allocation to exercise or no exercise. The exercise group participated in a programme of 12 supervised 30-min sessions of balance exercises using Wii games, twice a week for 6-7 weeks. Primary outcome was the Timed Up and Go test (TUG). In total, 84 participants were enrolled; four were lost to follow-up. After the intervention, there were no statistically significant differences between groups but effect sizes for the TUG, TUGcognitive and, the Dynamic Gait Index (DGI) were moderate and small for all other measures. Statistically significant improvements within the exercise group were present for all measures (large to moderate effect sizes) except in walking speed and balance confidence. The non-exercise group showed statistically significant improvements for the Four Square Step Test and the DGI. In comparison with no intervention, a programme of supervised balance exercise using Nintendo Wii Fit® did not render statistically significant differences, but presented moderate effect sizes for several measures of balance performance.
2010-01-01
Background Kenya has experienced a number of retail sector initiatives aimed at improving access to antimalarial medicines. This study explored stakeholders' perceptions of the role of private medicine retailers (PMRs), the value and feasibility of programme goals, perceived programme impact, factors influencing implementation and recommendations in three districts of Kenya. Methods This study was part of a larger evaluation of PMR programmes, including quantitative and qualitative components. The qualitative research was conducted to assess implementation processes and actors' experiences in the programmes, through focus group discussions with trained PMRs and mothers of children under five years, and in-depth interviews with programme managers, trainers and co-trainers. Results PMRs were perceived to provide rapid cheap treatment for non-serious conditions and used as a deliberate and continuously evaluated choice between different treatment sources. All stakeholders supported programme goals and most PMRs described increased customer satisfaction, more rational purchasing of medicine stock and increased medicine sales after participation. Factors undermining programme implementation included a lack of MoH resources to train and monitor large numbers of PMRs, the relative instability of outlets, medicines stocked and retail personnel, the large number of proprietary brands and financial challenges to retailers in stocking antimalarial medicines, and their customers in buying them. Unambiguous national support and a broad range of strategies are important to strengthen the feasibility of change in OTC antimalarial use. Conclusions Understanding the context and implementation processes of PMR programmes and the perspectives of key actors are critical to identifying measures to support their effective implementation. Financial barriers underlie many described challenges, with important implications for policies on subsidies in this sector. In spite of barriers to implementation, increased exposure to programme activities promoted trust and improved relationships between PMRs and their clients and trainers, strengthening feasibility of such interventions. Public information can strengthen PMR training programmes by engaging local communities and may facilitate performance monitoring of PMRs by their clients. PMID:20181234
Rowa, Yvonne; Abuya, Timothy O; Mutemi, Wilfred K; Ochola, Sam; Molyneux, Sassy; Marsh, Vicki
2010-02-24
Kenya has experienced a number of retail sector initiatives aimed at improving access to antimalarial medicines. This study explored stakeholders' perceptions of the role of private medicine retailers (PMRs), the value and feasibility of programme goals, perceived programme impact, factors influencing implementation and recommendations in three districts of Kenya. This study was part of a larger evaluation of PMR programmes, including quantitative and qualitative components. The qualitative research was conducted to assess implementation processes and actors' experiences in the programmes, through focus group discussions with trained PMRs and mothers of children under five years, and in-depth interviews with programme managers, trainers and co-trainers. PMRs were perceived to provide rapid cheap treatment for non-serious conditions and used as a deliberate and continuously evaluated choice between different treatment sources. All stakeholders supported programme goals and most PMRs described increased customer satisfaction, more rational purchasing of medicine stock and increased medicine sales after participation. Factors undermining programme implementation included a lack of MoH resources to train and monitor large numbers of PMRs, the relative instability of outlets, medicines stocked and retail personnel, the large number of proprietary brands and financial challenges to retailers in stocking antimalarial medicines, and their customers in buying them. Unambiguous national support and a broad range of strategies are important to strengthen the feasibility of change in OTC antimalarial use. Understanding the context and implementation processes of PMR programmes and the perspectives of key actors are critical to identifying measures to support their effective implementation. Financial barriers underlie many described challenges, with important implications for policies on subsidies in this sector. In spite of barriers to implementation, increased exposure to programme activities promoted trust and improved relationships between PMRs and their clients and trainers, strengthening feasibility of such interventions. Public information can strengthen PMR training programmes by engaging local communities and may facilitate performance monitoring of PMRs by their clients.
Comparison of two training programmes on paramedic-delivered CPR performance.
Govender, Kevin; Sliwa, Karen; Wallis, Lee; Pillay, Yugan
2016-05-01
To compare CPR performance in two groups of paramedics who received CPR training from two different CPR training programmes. Conducted in June 2014 at the Hamad Medical Corporation Ambulance Service, the national ambulance service of the State of Qatar, the CPR performances of 149 new paramedic recruits were evaluated after they had received training from either a traditional CPR programme or a tailored CPR programme. Both programmes taught the same content but differed in the way in which this content was delivered to learners. Exclusive to the tailored programme was mandatory precourse work, continuous assessments, a locally developed CPR instructional video and pedagogical activities tailored to the background education and learner style preferences of paramedics. At the end of each respective training programme, a single examiner who was blinded to the type of training paramedics had received, rated them as competent or non-competent on basic life support skills, condition specific skills, specific overall skills and non-technical skills during a simulated out-of-hospital cardiac arrest (OHCA) assessment. Paramedics who received CPR training with the tailored programme were rated competent 70.9% of the time, compared with paramedics who attended the traditional programme and who achieved this rating 7.9% of the time (p<0.001). Specific improvements were seen in the time required to detect cardiac arrest, chest compression quality, and time to first monitored rhythm and delivered shock. In an OHCA scenario, CPR performance rated as competent was significantly higher when training was received using a tailored CPR programme. 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/
A Low-Cost CMOS Programmable Temperature Switch
Li, Yunlong; Wu, Nanjian
2008-01-01
A novel uncalibrated CMOS programmable temperature switch with high temperature accuracy is presented. Its threshold temperature Tth can be programmed by adjusting the ratios of width and length of the transistors. The operating principles of the temperature switch circuit is theoretically explained. A floating gate neural MOS circuit is designed to compensate automatically the threshold temperature Tth variation that results form the process tolerance. The switch circuit is implemented in a standard 0.35 μm CMOS process. The temperature switch can be programmed to perform the switch operation at 16 different threshold temperature Tths from 45—120°C with a 5°C increment. The measurement shows a good consistency in the threshold temperatures. The chip core area is 0.04 mm2 and power consumption is 3.1 μA at 3.3V power supply. The advantages of the temperature switch are low power consumption, the programmable threshold temperature and the controllable hysteresis. PMID:27879871
Odhiambo, Fredrick; Buff, Ann M; Moranga, Collins; Moseti, Caroline M; Wesongah, Jesca Okwara; Lowther, Sara A; Arvelo, Wences; Galgalo, Tura; Achia, Thomas O; Roka, Zeinab G; Boru, Waqo; Chepkurui, Lily; Ogutu, Bernhards; Wanja, Elizabeth
2017-09-13
Malaria accounts for ~21% of outpatient visits annually in Kenya; prompt and accurate malaria diagnosis is critical to ensure proper treatment. In 2013, formal malaria microscopy refresher training for microscopists and a pilot quality-assurance (QA) programme for malaria diagnostics were independently implemented to improve malaria microscopy diagnosis in malaria low-transmission areas of Kenya. A study was conducted to identify factors associated with malaria microscopy performance in the same areas. From March to April 2014, a cross-sectional survey was conducted in 42 public health facilities; 21 were QA-pilot facilities. In each facility, 18 malaria thick blood slides archived during January-February 2014 were selected by simple random sampling. Each malaria slide was re-examined by two expert microscopists masked to health-facility results. Expert results were used as the reference for microscopy performance measures. Logistic regression with specific random effects modelling was performed to identify factors associated with accurate malaria microscopy diagnosis. Of 756 malaria slides collected, 204 (27%) were read as positive by health-facility microscopists and 103 (14%) as positive by experts. Overall, 93% of slide results from QA-pilot facilities were concordant with expert reference compared to 77% in non-QA pilot facilities (p < 0.001). Recently trained microscopists in QA-pilot facilities performed better on microscopy performance measures with 97% sensitivity and 100% specificity compared to those in non-QA pilot facilities (69% sensitivity; 93% specificity; p < 0.01). The overall inter-reader agreement between QA-pilot facilities and experts was κ = 0.80 (95% CI 0.74-0.88) compared to κ = 0.35 (95% CI 0.24-0.46) between non-QA pilot facilities and experts (p < 0.001). In adjusted multivariable logistic regression analysis, recent microscopy refresher training (prevalence ratio [PR] = 13.8; 95% CI 4.6-41.4), ≥5 years of work experience (PR = 3.8; 95% CI 1.5-9.9), and pilot QA programme participation (PR = 4.3; 95% CI 1.0-11.0) were significantly associated with accurate malaria diagnosis. Microscopists who had recently completed refresher training and worked in a QA-pilot facility performed the best overall. The QA programme and formal microscopy refresher training should be systematically implemented together to improve parasitological diagnosis of malaria by microscopy in Kenya.
The Effects of Isolated and Integrated ‘Core Stability’ Training on Athletic Performance Measures
Reed, Casey A.; Ford, Kevin R.; Myer, Gregory D.; Hewett, Timothy E.
2014-01-01
Background Core stability training, operationally defined as training focused to improve trunk and hip control, is an integral part of athletic development, yet little is known about its direct relation to athletic performance. Objective This systematic review focuses on identification of the association between core stability and sports-related performance measures. A secondary objective was to identify difficulties encountered when trying to train core stability with the goal of improving athletic performance. Data sources A systematic search was employed to capture all articles related to athletic performance and core stability training that were identified using the electronic databases MEDLINE, CINAHL and SPORTDiscus™ (1982-June2011). Study selection A systematic approach was used to evaluate 179 articles identified for initial review. Studies that performed an intervention targeted toward the core and measured an outcome related to athletic or sport performances were included, while studies with a participant population aged 65 years or older were excluded. Twenty-four in total met the inclusionary criteria for review. Study appraisal and synthesis methods Studies were evaluated using the Physical Therapy Evidence Database (PEDro) scale. The 24 articles were separated into three groups, general performance (n = 8), lower extremity (n = 10) and upper extremity (n = 6), for ease of discussion. Results In the majority of studies, core stability training was utilized in conjunction with more comprehensive exercise programmes. As such, many studies saw improvements in skills of general strengths such as maximum squat load and vertical leap. Surprisingly, not all studies reported measurable increases in specific core strength and stability measures following training. Additionally, investigations that targeted the core as the primary goal for improved outcome of training had mixed results. Limitations Core stability is rarely the sole component of an athletic development programme, making it difficult to directly isolate its affect on athletic performance. The population biases of some studies of athletic performance also confound the results. Conclusions Targeted core stability training provides marginal benefits to athletic performance. Conflicting findings and the lack of a standardization for measurement of outcomes and training focused to improve core strength and stability pose difficulties. Because of this, further research targeted to determine this relationship is necessary to better understand how core strength and stability affect athletic performance. PMID:22784233
Enhancing Entrepreneurial Self-Efficacy through Vocational Entrepreneurship Education Programmes
ERIC Educational Resources Information Center
Maritz, Alex; Brown, Chris
2013-01-01
The purpose of this study is to report the results of a longitudinal evaluation of a vocational entrepreneurship education programme (EEP) using entrepreneurial self-efficacy (ESE) measures. An empirical, mixed methods longitudinal and effectuation scale was used to measure ESE scores. Results indicate that participation in the programme had a…
Institutions, Culture and Background: The School Performance of Immigrant Students
ERIC Educational Resources Information Center
Murat, Marina; Frederic, Patrizio
2015-01-01
Programme for International Student Assessment data from 29 countries was used to measure immigrant school gaps (differences in scores between immigrants and natives) in relation to various potentially correlated factors. Results show that negative gaps are concentrated in the European Union; in the South, they are mainly correlated with school…
The Employability Advantage: Embedding Skills through a University-Wide Language Programme
ERIC Educational Resources Information Center
Cervi-Wilson, Tiziana; Brick, Billy
2016-01-01
As the employment of graduates appears among the performance indicators of institutions in higher education, universities are focussing more and more upon the development of employability related skills to enhance students' prospects in the job market. All UK universities are measured on the first jobs that their students acquire after graduation.…
Promoting Students' Paragraph Writing Using EDMODO: An Action Research
ERIC Educational Resources Information Center
Al-Naibi, Is'haq; Maryem Al-Jabri; Al-Kalbani, Iman
2018-01-01
This paper reports the findings of an action research that was carried out to measure the effectiveness of integrating a social networking website "Edmodo" in students' writing performance in an EFL classroom at Arab Open University (Oman Branch). The participants were 25 students studying English in the Foundation Programme. Along with…
Expanding Educational Access in Eastern Turkey: A New Initiative
ERIC Educational Resources Information Center
O'Dwyer, John; Aksit, Necmi; Sands, Margaret
2010-01-01
The Eastern Anatolian project extends opportunity and access to quality education. The study examines the selection and learning systems adopted within the framework of gender equity, family background and higher order skills. Performance data on a range of selection measures and the initial programme are analysed. Results show that selection was…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gaede, S; Jordan, K; Western University, London, ON
Purpose: To present a customized programmable moving insert for the ArcCHECK™ phantom that can, in a single delivery, check both entrance dosimetry, while simultaneously verifying the delivery of respiratory-gated VMAT. Methods: The cylindrical motion phantom uses a computer-controlled stepping motor to move an insert inside a stationery sleeve. Insert motion is programmable and can include rotational motion in addition to linear motion along the axis of the cylinder. The sleeve fits securely in the bore of the ArcCHECK™. Interchangeable inserts, including an A1SL chamber, optically-stimulated luminescence dosimeters, radiochromic film, or 3D gels, allow this combination to be used for commissioning,more » routine quality assurance, and patient-specific dosimetric verification of respiratory-gated VMAT. Before clinical implementation, the effect of a moving insert on the ArcCHECK™ measurements was considered. First, the measured dose to the ArcCHECK™ containing multiple inserts in the static position was compared to the calculated dose during multiple VMAT treatment deliveries. Then, dose was measured under both sinusoidal and real-patient motion conditions to determine any effect of the moving inserts on the ArcCHECK™ measurements. Finally, dose was measured during gated VMAT delivery to the same inserts under the same motion conditions to examine any effect of various beam “on-and-off” and dose rate ramp “up-and-down”. Multiple comparisons between measured and calculated dose to different inserts were also considered. Results: The pass rate for the static delivery exceeded 98% for all measurements (3%/3mm), suggesting a valid setup for entrance dosimetry. The pass rate was not altered for any measurement delivered under motion conditions. A similar Result was observed under gated VMAT conditions, including agreement of measured and calculated dose to the various inserts. Conclusion: Incorporating a programmable moving insert within the ArcCHECK™ phantom provides an efficient verification of respiratory-gated VMAT delivery that is useful during commissioning, routine quality assurance, and patient-specific dose verification. Prototype phantom development and testing was performed in collaboration with Modus Medical Devices Inc. (London, ON). No financial support was granted.« less
Oral language skills intervention in pre-school-a cautionary tale.
Haley, Allyson; Hulme, Charles; Bowyer-Crane, Claudine; Snowling, Margaret J; Fricke, Silke
2017-01-01
While practitioners are increasingly asked to be mindful of the evidence base of intervention programmes, evidence from rigorous trials for the effectiveness of interventions that promote oral language abilities in the early years is sparse. To evaluate the effectiveness of a language intervention programme for children identified as having poor oral language skills in preschool classes. A randomized controlled trial was carried out in 13 UK nursery schools. In each nursery, eight children (N = 104, mean age = 3 years 11 months) with the poorest performance on standardized language measures were selected to take part. All but one child were randomly allocated to either an intervention (N = 52) or a waiting control group (N = 51). The intervention group received a 15-week oral language programme in addition to their standard nursery curriculum. The programme was delivered by trained teaching assistants and aimed to foster vocabulary knowledge, narrative and listening skills. Initial results revealed significant differences between the intervention and control group on measures of taught vocabulary. No group differences were found on any standardized language measure; however, there were gains of moderate effect size in listening comprehension. The study suggests that an intervention, of moderate duration and intensity, for small groups of preschool children successfully builds vocabulary knowledge, but does not generalize to non-taught areas of language. The findings strike a note of caution about implementing language interventions of moderate duration in preschool settings. The findings also highlight the importance of including a control group in intervention studies. © 2016 Royal College of Speech and Language Therapists.
Leadership training to improve nurse retention.
Wallis, Allan; Kennedy, Kathy I
2013-05-01
This paper discusses findings from an evaluation of a training programme designed to promote collaborative, team-based approaches to improve nurse retention within health care organizations. A year-long leadership training programme was designed and implemented to develop effective teams that could address retention challenges in a diverse set of organizations in Colorado ranging from public, private to non-profit. An evaluation, based on a combination of participant observation, group interviews, and the use of standardized tests measuring individual emotional intelligence and team dynamics was conducted to assess the effectiveness of the training programme. What role do the emotional intelligence of individual members and organizational culture play in team effectiveness? Out of five teams participating in the training programme, two performed exceptionally well, one experienced moderate success and two encountered significant problems. Team dynamics were significantly affected by the emotional intelligence of key members holding supervisory positions and by the existing culture and structure of the participating organizations. Team approaches to retention hold promise but require careful development and are most likely to work where organizations have a collaborative problem-solving environment. © 2012 Blackwell Publishing Ltd.
ERIC Educational Resources Information Center
Kirby, Nicola F.; Dempster, Edith R.
2015-01-01
In South Africa, foundation programmes are a well-established alternative access route to tertiary science study for educationally disadvantaged students. Student access to, and performance in, one such foundation programme has been researched by the authors seeking opportunities to improve student retention. The biology module in particular has…
Anding, Kirsten; Bär, Thomas; Trojniak-Hennig, Joanna; Kuchinke, Simone; Krause, Rolfdieter; Rost, Jan M; Halle, Martin
2015-08-27
Long-term studies regarding the effect of a structured physical exercise programme (SPEP) during haemodialysis (HD) assessing compliance and clinical benefit are scarce. A single-centre clinical trial, non-randomised, investigating 46 patients with HD (63.2 ± 16.3 years, male/female 24/22, dialysis vintage 4.4 years) performing an SPEP over 5 years. The SPEP (twice/week for 60 min during haemodialysis) consisted of a combined resistance (8 muscle groups) and endurance (supine bicycle ergometry) training. Exercise intensity was continuously adjusted to improvements of performance testing. Changes in endurance and resistance capacity, physical functioning and quality of life (QoL) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years. Average power per training session, maximal strength tests (maximal exercise repetitions/min), three performance-based tests for physical function, SF36 for QoL were assessed in the beginning and every 6 months thereafter. 78% of the patients completed the programme after 1 year and 43% after 5 years. Participants were divided--according to adherence to the programme--into three groups: (1) high adherence group (HA, >80% of 104 training sessions within 12 months), (2) moderate adherence (MA, 60-80%), and 3. Low adherence group (LA, <60%)) with HA and MA evaluated quantitatively. One-year follow-up data revealed significant (p<0.05) improvement for both groups in all measured parameters: exercise capacity (HA: 55%, MA: 45%), strength (HA: >120%, MA: 40-50%), QoL in three scores of SF36 subscales and physical function in the three tests taken between 11% and 31%. Moreover, a quantitative correlation analysis revealed a close association (r=0.8) between large improvement of endurance capacity and weak physical condition (HA). The exercise programme described improves physical function significantly and can be integrated into a HD routine with a high long-term adherence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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.
NASA Astrophysics Data System (ADS)
Jing, Hailong; Su, Xianyu; You, Zhisheng
2017-03-01
A uniaxial three-dimensional shape measurement system with multioperation modes for different modulation algorithms is proposed. To provide a general measurement platform that satisfies the specific measurement requirements in different application scenarios, a measuring system with multioperation modes based on modulation measuring profilometry (MMP) is presented. Unlike the previous solutions, vertical scanning by focusing control of an electronic focus (EF) lens is implemented. The projection of a grating pattern is based on a digital micromirror device, which means fast phase-shifting with high precision. A field programmable gate array-based master control center board acts as the coordinator of the MMP system; it harmonizes the workflows, such as grating projection, focusing control of the EF lens, and fringe pattern capture. Fourier transform, phase-shifting technique, and temporary Fourier transform are used for modulation analysis in different operation modes. The proposed system features focusing control, speed, programmability, compactness, and availability. This paper details the principle of MMP for multioperation modes and the design of the proposed system. The performances of different operation modes are analyzed and compared, and a work piece with steep holes is measured to verify this multimode MMP system.
Paramedir: A Tool for Programmable Performance Analysis
NASA Technical Reports Server (NTRS)
Jost, Gabriele; Labarta, Jesus; Gimenez, Judit
2004-01-01
Performance analysis of parallel scientific applications is time consuming and requires great expertise in areas such as programming paradigms, system software, and computer hardware architectures. In this paper we describe a tool that facilitates the programmability of performance metric calculations thereby allowing the automation of the analysis and reducing the application development time. We demonstrate how the system can be used to capture knowledge and intuition acquired by advanced parallel programmers in order to be transferred to novice users.
NASA Astrophysics Data System (ADS)
Benveniste, J.; Cotton, D.; Moreau, T.; Raynal, M.; Varona, E.; Cipollini, P.; Cancet, M.; Martin, F.; Fenoglio-Marc, L.; Naeije, M.; Fernandes, J.; Lazaro, C.; Restano, M.; Ambrózio, A.
2017-12-01
The ESA Sentinel-3 satellite, launched in February 2016 as a part of the Copernicus programme, is the second satellite to operate a SAR mode altimeter. The Sentinel 3 Synthetic Aperture Radar Altimeter (SRAL) is based on the heritage from Cryosat-2, but this time complemented by a Microwave Radiometer (MWR) to provide a wet troposphere correction, and operating at Ku and C-Bands to provide an accurate along-track ionospheric correction. The SRAL is operated in SAR mode over the whole ocean and promises increased performance w.r.t. conventional altimetry. SCOOP (SAR Altimetry Coastal & Open Ocean Performance) is a project funded under the ESA SEOM (Scientific Exploitation of Operational Missions) Programme Element, started in September 2015, to characterise the expected performance of Sentinel-3 SRAL SAR mode altimeter products, in the coastal zone and open-ocean, and then to develop and evaluate enhancements to the baseline processing scheme in terms of improvements to ocean measurements. There is also a work package to develop and evaluate an improved Wet Troposphere correction for Sentinel-3, based on the measurements from the on-board MWR, further enhanced mostly in the coastal and polar regions using third party data, and provide recommendations for use. In this presentation we present results from the SCOOP project that demonstrate the excellent performance of SRAL in terms of measurement precision, and we illustrate the development and testing of new processing approaches designed specifically to improve performance close to the coast. The SCOOP test data sets and relevant documentation are available to external researchers on application to the project team. At the end of the project recommendations for further developments and implementations will be provided through a scientific roadmap.
Measuring informed choice in population-based reproductive genetic screening: a systematic review
Ames, Alice Grace; Metcalfe, Sylvia Ann; Archibald, Alison Dalton; Duncan, Rony Emily; Emery, Jon
2015-01-01
Genetic screening and health-care guidelines recommend that programmes should facilitate informed choice. It is therefore important that accurate measures of informed choice are available to evaluate such programmes. This review synthesises and appraises measures used to evaluate informed choice in population-based genetic screening programmes for reproductive risk. Databases were searched for studies offering genetic screening for the purpose of establishing reproductive risk to an adult population sample, in which aspects of informed choice were measured. Studies were included if, at a minimum, measures of uptake of screening and knowledge were used. Searches identified 1462 citations and 76 studies were reviewed in full text; 34 studies met the inclusion criteria. Over 20 different measures of informed choice were used. Many measures lacked adequate validity and reliability data. This systematic review will inform future evaluation of informed choice in population genetic screening programmes. PMID:24848746
NASA Astrophysics Data System (ADS)
Tho, Siew Wei; Chan, Ka Wing; Yeung, Yau Yuen
2015-10-01
In this study, a new physics education programme is specifically developed for a famous theme park in Hong Kong to provide community-based science learning to her visitors, involving her three newly constructed rides. We make innovative use of digital technologies in this programme and incorporate a rigorous evaluation of the learning effectiveness of the programme. A total of around 200 students from nine local secondary schools participated in both the physics programme and its subsequent evaluation which consists of a combination of research and assessment tools, including pre- and post-multiple-choice tests, a questionnaire survey and an interview as specifically developed for this programme, or adopted from some well-accepted research instruments. Based on the evaluation of students' academic performance, there are two educationally significant findings on enhancing the students' physics learning: (a) traditionally large gender differences in physics performance and interest of learning are mostly eliminated; and (b) a less-exciting ride called the aviator (instead of the most exciting roller-coaster ride) can induce the largest learning effect (or gain in academic performance) amongst teenagers. Besides, findings from the questionnaire survey and interviews of participants are reported to reveal their views, perceptions, positive and negative comments or feedback on this programme which could provide valuable insights for future development of other similar community-based programmes.
Hepperger, Caroline; Gföller, Peter; Hoser, Christian; Ulmer, Hanno; Fischer, Felix; Schobersberger, Wolfgang; Fink, Christian
2017-11-01
Improvements in pain, function and sports activity are the main goals of patients following total knee arthroplasty (TKA). Participation in sports has become an increasingly important contributor to patients' quality of life (QoL). Hiking is one of the most popular summer activities among elderly people in alpine regions. Consequently, this randomized controlled trial investigates the impact of a 3-month guided hiking programme on patients' functional abilities and QoL following TKA. It was hypothesized that patients who participate in this programme would demonstrate improvements in functional and QoL parameters compared with a control group. Forty-eight TKA patients were included and randomized into either the intervention group (IG; n = 25) or the control group (CG; n = 23). The IG participated in a 3-month hiking programme (2-3 times a week), whereas the CG performed activities of daily living. The stair climb test (SCT), QoL questionnaires and isokinetic force measurements were completed at three time points (i.e. pre-test, post-test, retention-test). ANOVAs for repeated measurements were conducted for the SCT results. The Friedman test and the Mann-Whitney U test were performed for the QoL parameters. After the 3-month hiking programme, the IG achieved faster overall walking times on the SCT. The time decreased from 4.3 ± 0.6 s (pre-test) to 3.6 ± 0.4 s (post-test) for the stair ascent (p = 0.060) and from 3.6 ± 0.6 s (pre-test) to 3.2 ± 0.5 s (post-test) for the stair descent (p = 0.036). The IG showed significant improvement on some of the subscales of the Knee Injury and Osteoarthritis Outcome Score from pre-test to retention-test (p < 0.01). In the CG, no significant changes were observed (n.s.). The results indicate moderate improvement in the functional abilities and QoL of TKA patients who participated in a 3-month guided hiking programme compared with the patients in the CG. Hiking did not have any acute detrimental effects on the TKA patients during this study period. II.
The Cockcroft difference: an analysis of the impact of a nursing leadership development programme.
Chappell, Kate K; Willis, Leah
2013-03-01
Identifying impact areas of nursing leadership development programmes is needed to determine if there are measureable effects on participants. These impact areas help to identify measures to substantiate the benefits of nursing leadership programmes for organization leaders making decisions about support and implementation of such opportunities for their emerging leaders. Using mixed qualitative/quantitative methods, the impact of a nursing leadership development programme, the Amy V. Cockcroft Fellowship, is examined to determine if there are measureable influences. Themes of four areas of impact: improved conflict resolution/negotiation skills, communication skills, personal development and career action or change were identified through content analysis. These themes provide the basis for creating measureable indicators for nursing organizations to use in determining the value of nursing leadership development programmes such as the Amy V. Cockcroft Fellowship. Based on the findings established in this research article, nurse managers can focus on developing themselves and their peer groups through nursing leadership development programmes to prepare for leading in the present and future healthcare environment. © 2012 Blackwell Publishing Ltd.
Neutron and photon shielding benchmark calculations by MCNP on the LR-0 experimental facility.
Hordósy, G
2005-01-01
In the framework of the REDOS project, the space-energy distribution of the neutron and photon flux has been calculated over the pressure vessel simulator thickness of the LR-0 experimental reactor, Rez, Czech Republic. The results calculated by the Monte Carlo code MCNP4C are compared with the measurements performed in the Nuclear Research Institute, Rez. The spectra have been measured at the barrel, in front of, inside and behind the pressure vessel in different configurations. The neutron measurements were performed in the energy range 0.1-10 MeV. This work has been done in the frame of the 5th Frame Work Programme of the European Community 1998-2002.
Man, David Wai Kwong; Poon, Wai Sang; Lam, Chow
2013-01-01
People with traumatic brain injury (TBI) often experience cognitive deficits in attention, memory, executive functioning and problem-solving. The purpose of the present research study was to examine the effectiveness of an artificial intelligent virtual reality (VR)-based vocational problem-solving skill training programme designed to enhance employment opportunities for people with TBI. This was a prospective randomized controlled trial (RCT) comparing the effectiveness of the above programme with that of the conventional psycho-educational approach. Forty participants with mild (n = 20) or moderate (n = 20) brain injury were randomly assigned to each training programme. Comparisons of problem-solving skills were performed with the Wisconsin Card Sorting Test, the Tower of London Test and the Vocational Cognitive Rating Scale. Improvement in selective memory processes and perception of memory function were found. Across-group comparison showed that the VR group performed more favourably than the therapist-led one in terms of objective and subjective outcome measures and better vocational outcomes. These results support the potential use of a VR-based approach in memory training in people with MCI. Further VR applications, limitations and future research are described.
Parekh, Sanjoti; Bush, Robert; Cook, Susan; Grant, Phillipa
2015-11-01
The purpose of this study is to evaluate an educational programme, 'Diabetes Connect: Connecting Professions', which was developed to enhance communication across primary care networks, to support best practice in clinical interventions and progress multidisciplinary team work to benefit patients in diabetes care. A total of 26 workshops were successfully delivered for 309 primary care professionals across the state of Queensland in Australia from November 2011. It consists of two separate, but complementary training elements: a series of online clinical education training modules and state-wide interprofessional learning workshops developed to enhance professional competencies. The evaluation design included completion of online surveys by the participants at two time points: first upon registering for the online modules or workshops; second, one week after attending a workshop. The survey included questions to evaluate the change in role performance measures. Overall, significant increases in participants' current knowledge, perceived ability to adopt this knowledge at work and willingness to change professional behaviour in the short term were observed. The study suggests that for maximum benefit both, workshop and online training, should be combined and made available widely. Future programmes should use a randomised trial design to test the delivery model.
Nevin, Jonpaul; Waldron, Mark; Patterson, Stephen; Smith, Paul; Price, Mike; Hunt, Alex
2018-03-20
The aim of the present study was to investigate the effects of an 8-week concurrent strength and endurance training programme in comparison to endurance training only on several key determinants of hand cycling performance. Five H4 and five H3 classified hand cyclists with at least one year's hand cycling training history consented to participate in the study. Subjects underwent a battery of tests to establish body mass, body composition, VO2peak, maximum aerobic power, gross mechanical efficiency, maximal upper body strength, and 30 km time trial performance. Subjects were matched into pairs based upon 30 km time trial performance and randomly allocated to either a concurrent strength and endurance or endurance training only, intervention group. Following an 8-week training programme based upon a conjugated block periodisation model, subjects completed a second battery of tests. A mixed model, 2-way analysis of variance (ANOVA) revealed no significant changes between groups. However, the calculation of effect sizes (ES) revealed that both groups demonstrated a positive improvement in most physiological and performance measures with subjects in the concurrent group demonstrating a greater magnitude of improvement in body composition (ES -0.80 vs. -0.22) maximal aerobic power (ES 0.97 vs. 0.28), gross mechanical efficiency (ES 0.87 vs. 0.63), bench press 1 repetition maximum (ES 0.53 vs. 0.33), seated row 1 repetition maximum (ES 1.42 vs. 0.43), and 30 km time trial performance (ES -0.66 vs. -0.30). In comparison to endurance training only, an 8-week concurrent training intervention based upon a conjugated block periodisation model appears to be a more effective training regime for improving the performance capabilities of hand cyclists.
Steunebrink, Mirjam; Zwerver, Johannes; Brandsema, Ruben; Groenenboom, Petra; van den Akker-Scheek, Inge; Weir, Adam
2013-01-01
To assess if continuous topical glyceryl trinitrate (GTN) treatment improves outcome in patients with chronic patellar tendinopathy when compared with eccentric training alone. Randomised double-blind, placebo-controlled clinical trial comparing a 12-week programme of using a GTN or placebo patch in combination with eccentric squats on a decline board. Measurements were performed at baseline, 6, 12 and 24 weeks. Primary outcome measure was the Victorian Institute of Sports Assessment-Patella (VISA-P) questionnaire. Secondary outcome measures were patient satisfaction and pain scores during sports. Generalised estimated equation was used to analyse the treatment, time and treatment×time effect. Analyses were performed following the intention-to-treat principle. VISA-P scores for both groups improved over the study period to 75.0±16.2 and 80.7±22.1 at 24 weeks. Results showed a significant effect for time (p<0.01) but no effect for treatment×time (p=0.80). Mean Visual Analogue Scores pain scores during sports for both groups increased over the study period to 6.6±3 and 7.8±3.1. Results showed a significant effect for time (p<0.01) but no effect for treatment×time (p=0.38). Patient satisfaction showed no difference between GTN and placebo groups (p=0.25) after 24 weeks, but did show a significant difference over time (p=0.01). Three patients in the GTN group reported some rash. It seems that continuous topical GTN treatment in addition to an eccentric exercise programme does not improve clinical outcome compared to placebo patches and an eccentric exercise programme in patients with chronic patellar tendinopathy.
Dejaco, Beate; Habets, Bas; van Loon, Corné; van Grinsven, Susan; van Cingel, Robert
2017-07-01
To investigate the effectiveness of isolated eccentric versus conventional exercise therapy in patients with rotator cuff tendinopathy. Thirty-six patients with rotator cuff tendinopathy, diagnosed by an orthopaedic surgeon, were included and randomly allocated to an isolated eccentric exercise (EE) group (n = 20, mean age = 50.2 ± 10.8 years) or a conventional exercise (CG) group (n = 16, mean age = 48.6 ± 12.3 years). Both groups fulfilled a 12-week daily home-based exercise programme and received a total amount of nine treatment sessions. The Constant Murley score was used to evaluate both objective (e.g. range of motion and strength) and subjective measures (e.g. pain and activities of daily living). A visual analogue scale (VAS) was used to evaluate pain during daily activities. As secondary outcomes, shoulder range of motion and isometric abduction strength in 45° in the scapular plane were evaluated. All measurements were taken at baseline, at 6, 12 and 26 weeks. After 26 weeks, both groups showed a significant increase in the Constant Murley score and a significant decrease in VAS scores. No difference was found between the groups, for any of the evaluated outcome measures. A 12-week-isolated eccentric training programme of the rotator cuff is beneficial for shoulder function and pain after 26 weeks in patients with rotator cuff tendinopathy. However, it is no more beneficial than a conventional exercise programme for the rotator cuff and scapular muscles. Based on the results, clinicians should take into account that performing two eccentric exercises twice a day is as effective as performing six concentric/eccentric exercises once a day in patients with rotator cuff tendinopathy.
Nicolopoulou, E P; Ztoupis, I N; Karabetsos, E; Gonos, I F; Stathopulos, I A
2015-04-01
The second round of an interlaboratory comparison scheme on radio frequency electromagnetic field measurements has been conducted in order to evaluate the overall performance of laboratories that perform measurements in the vicinity of mobile phone base stations and broadcast antenna facilities. The participants recorded the electric field strength produced by two high frequency signal generators inside an anechoic chamber in three measurement scenarios with the antennas transmitting each time different signals at the FM, VHF, UHF and GSM frequency bands. In each measurement scenario, the participants also used their measurements in order to calculate the relative exposure ratios. The results were evaluated in each test level calculating performance statistics (z-scores and En numbers). Subsequently, possible sources of errors for each participating laboratory were discussed, and the overall evaluation of their performances was determined by using an aggregated performance statistic. A comparison between the two rounds proves the necessity of the scheme. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Adini, Bruria; Goldberg, Avishay; Cohen, Robert; Bar-Dayan, Yaron
2012-04-01
This study investigated the relationship between training programmes for pandemic flu and level of knowledge of health-care professionals with performance in an avian flu exercise. Training programmes of all general hospitals in Israel for managing a pandemic influenza were evaluated. Spearman's ρ correlation was used to analyse the relationship between training scores and level of knowledge of medical personnel with performance in an avian flu exercise. Hospital preparedness levels were evaluated at two time points and Wilcoxon signed-rank test was used to determine if overall preparedness scores improved over time. Evaluation of training programmes for pandemic influenza showed high to very high scores in most hospitals (mean 85, SD 22). Significant correlations between training and performance in the exercise were noted for: implementation of training programmes 0.91, P = 0.000; designating personnel for training 0.87, P = 0.000; content of training 0.61, P = 0.001; and training materials 0.36, P = 0.05. Overall reliability of the evaluation scores was 0.82 and reliability for two of the sub-scales was: implementation of the programme 0.78; and designating personnel for training 0.37. No significant correlation was found between level of knowledge and performance in the exercise. Training programmes for hospital personnel for pandemic flu have a significant role in improving performance in case of pandemic flu. The key component of the training programme appears to be the implementation of the programme. Use of knowledge tests should be further investigated, as they do not appear to correlate with the level of emergency preparedness for pandemic influenza.
Brown, A K; Liu-Ambrose, T; Tate, R; Lord, S R
2009-08-01
To determine the effect of a general group-based exercise programme on cognitive performance and mood among seniors without dementia living in retirement villages. Randomised controlled trial. Four intermediate care and four self-care retirement village sites in Sydney, Australia. 154 seniors (19 men, 135 women; age range 62 to 95 years), who were residents of intermediate care and self-care retirement facilities. Participants were randomised to one of three experimental groups: (1) a general group-based exercise (GE) programme composed of resistance training and balance training exercises; (2) a flexibility exercise and relaxation technique (FR) programme; or (3) no-exercise control (NEC). The intervention groups (GE and FR) participated in 1-hour exercise classes twice a week for a total period of 6 months. Using standard neuropsychological tests, we assessed cognitive performance at baseline and at 6-month re-test in three domains: (1) fluid intelligence; (2) visual, verbal and working memory; and (3) executive functioning. We also assessed mood using the Geriatric Depression Scale (GDS) and the Positive and Negative Affect Schedule (PANAS). The GE programme significantly improved cognitive performance of fluid intelligence compared with FR or NEC. There were also significant improvements in the positive PANAS scale within both the GE and FR groups and an indication that the two exercise programmes reduced depression in those with initially high GDS scores. Our GE programme significantly improved cognitive performance of fluid intelligence in seniors residing in retirement villages compared with our FR programme and the NEC group. Furthermore, both group-based exercise programmes were beneficial for certain aspects of mood within the 6-month intervention period.
Patient level cost of diabetes self-management education programmes: an international evaluation
Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan
2017-01-01
Objectives The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Setting Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Participants Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary and secondary measures Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. Results We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. Conclusions This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. PMID:28583913
Chowdhury, Shubhajit Roy
2012-04-01
The paper reports of a Field Programmable Gate Array (FPGA) based embedded system for detection of QRS complex in a noisy electrocardiogram (ECG) signal and thereafter differential diagnosis of tachycardia and tachyarrhythmia. The QRS complex has been detected after application of entropy measure of fuzziness to build a detection function of ECG signal, which has been previously filtered to remove power line interference and base line wander. Using the detected QRS complexes, differential diagnosis of tachycardia and tachyarrhythmia has been performed. The entire algorithm has been realized in hardware on an FPGA. Using the standard CSE ECG database, the algorithm performed highly effectively. The performance of the algorithm in respect of QRS detection with sensitivity (Se) of 99.74% and accuracy of 99.5% is achieved when tested using single channel ECG with entropy criteria. The performance of the QRS detection system has been compared and found to be better than most of the QRS detection systems available in literature. Using the system, 200 patients have been diagnosed with an accuracy of 98.5%.
Cluster randomised control trial for cricket injury prevention programme (CIPP): a protocol paper.
Soomro, Najeebullah; Chua, Nina; Freeston, Jonathan; Ferdinands, Rene E D; Sanders, Ross
2017-09-28
Injury prevention programmes (IPPs) are effective in reducing injuries among adolescent team sports. However, there is no validated cricket-specific IPP despite the high incidence of musculoskeletal injuries among amateur cricketers. To evaluate whether a cricket injury prevention programme (CIPP) as a pretraining warm-up or post-training cool-down can reduce injury rates in amateur cricket players. CIPP is a cluster randomised controlled trial which includes 36 male amateur club teams having cricket players aged 14-40 years to be randomly assigned to three study arms: warm-up, cool-down and control (n=12 teams, 136 players in each arm). The intervention groups will perform 15 min CIPP either as a pretraining warm-up or a post-training cool-down. The primary outcome measure will be injury incidence per 1000 player hours and the secondary outcome measures will be whether IPP as a warm-up is better than IPP as a cool-down, and the adherence to the intervention. ACTRN 1261700047039. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Hammond, A; Lincoln, N; Sutcliffe, L
1999-05-01
Joint protection (JP) is a self-management technique widely taught to people with rheumatoid arthritis (RA). JP education aims to enable people with RA to reduce pain, inflammation, joint stress and reduce risks of deformity through using assistive devices and alternative movement patterns of affected joints to perform everyday activities. Previous studies evaluating JP education methods common in the UK have identified JP adherence is poor. A group education programme was developed using the Health Belief Model and Self-efficacy Theory. Strategies used to maximise JP adherence included goal-setting, contracting, modelling, homework programmes, motor learning theory, recall enhancing methods and mental practice. A crossover trial (n = 35) was conducted. Adherence with JP was measured using an objective observational test (the Joint Protection Behaviour Assessment). Significant improvements in use of JP were recorded at 12 and 24 weeks post-education (P < 0.01). No significant changes in measures of pain, functional disability, grip strength, self-efficacy or helplessness occurred post-education, although this may have been due to the small sample size recruited. In conclusion, JP adherence can be facilitated through the use of educational-behavioural strategies, suggesting this approach should be more widely adopted in clinical practice.
Programme Evaluation: Maintaining Quality in Higher Education
ERIC Educational Resources Information Center
Loots, A.
2008-01-01
The evaluation of educational or social programmes is paramount for establishing success or impact in higher education. Evaluation questions about programme goals (e.g. better performance of first-year students) or about the quality of programme strategies (design and implementation) and effectiveness of delivery (coordinator inputs and…
Peabody, John W; Shimkhada, Riti; Quimbo, Stella; Solon, Orville; Javier, Xylee; McCulloch, Charles
2014-01-01
Improving clinical performance using measurement and payment incentives, including pay for performance (or P4P), has, so far, shown modest to no benefit on patient outcomes. Our objective was to assess the impact of a P4P programme on paediatric health outcomes in the Philippines. We used data from the Quality Improvement Demonstration Study. In this study, the P4P intervention, introduced in 2004, was randomly assigned to 10 community district hospitals, which were matched to 10 control sites. At all sites, physician quality was measured using Clinical Performance Vignettes (CPVs) among randomly selected physicians every 6 months over a 36-month period. In the hospitals randomized to the P4P intervention, physicians received bonus payments if they met qualifying scores on the CPV. We measured health outcomes 4–10 weeks after hospital discharge among children 5 years of age and under who had been hospitalized for diarrhoea and pneumonia (the two most common illnesses affecting this age cohort) and had been under the care of physicians participating in the study. Health outcomes data collection was done at baseline/pre-intervention and 2 years post-intervention on the following post-discharge outcomes: (1) age-adjusted wasting, (2) C-reactive protein in blood, (3) haemoglobin level and (4) parental assessment of child’s health using general self-reported health (GSRH) measure. To evaluate changes in health outcomes in the control vs intervention sites over time (baseline vs post-intervention), we used a difference-in-difference logistic regression analysis, controlling for potential confounders. We found an improvement of 7 and 9 percentage points in GSRH and wasting over time (post-intervention vs baseline) in the intervention sites relative to the control sites (P ≤ 0.001). The results from this randomized social experiment indicate that the introduction of a performance-based incentive programme, which included measurement and feedback, led to improvements in two important child health outcomes. PMID:24134922
NASA Astrophysics Data System (ADS)
Yu, Haijun; Li, Guofu; Duo, Liping; Jin, Yuqi; Wang, Jian; Sang, Fengting; Kang, Yuanfu; Li, Liucheng; Wang, Yuanhu; Tang, Shukai; Yu, Hongliang
2015-02-01
A user-friendly data acquisition and control system (DACS) for a pulsed chemical oxygen -iodine laser (PCOIL) has been developed. It is implemented by an industrial control computer,a PLC, and a distributed input/output (I/O) module, as well as the valve and transmitter. The system is capable of handling 200 analogue/digital channels for performing various operations such as on-line acquisition, display, safety measures and control of various valves. These operations are controlled either by control switches configured on a PC while not running or by a pre-determined sequence or timings during the run. The system is capable of real-time acquisition and on-line estimation of important diagnostic parameters for optimization of a PCOIL. The DACS system has been programmed using software programmable logic controller (PLC). Using this DACS, more than 200 runs were given performed successfully.
Mohanan, Manoj; Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos
2017-05-01
To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme - the World Health Partners' Sky Program. We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers' performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. The programme did not significantly improve health-care providers' knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up.
Mikó, Ibolya; Szerb, Imre; Szerb, Anna; Poor, Gyula
2017-02-01
To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. A total of 100 osteoporotic women - at least with one osteoporotic fracture - aged 65 years old and above. Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group ( p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.
NASA Astrophysics Data System (ADS)
Alkhaddar, R. A.; Phipps, D.; Morgan, R.; Karci, B.; Hordesseux, J.
2007-07-01
This project is part of a programme aimed at reducing water consumption. Power showers are water inefficient, but in order to persuade the user to accept a lower water use it will be necessary to sustain the "shower experience" to maintain user satisfaction. Previous work has indicated that users' requirements include temperature stability, adequate water volume and distribution, and skin pressure, all of which are substantially controlled by the showerhead. In the present phase of the project several commercially available domestic showerheads have been examined to determine pressure-volume characteristics, radial spray distributions at different flow rates, direct and indirect measures of "skin pressure" and measurements of vertical temperature profiles. Part of the practical work at LJMU has supported extensive theoretical studies by CFD carried out by staff at Arup (consulting engineers) for the Market Transformation Programme. A future phase will study user satisfaction in their own homes where user satisfaction will be surveyed and linked to the physical performance of the shower.
Diemer, J; Quétel, C R; Taylor, P D P
2002-09-01
The contribution of the Institute for Reference Materials and Measurements to the certification of the B, Cd, Cu, Mg, and Pb content of a synthetic water sample used in Comparison 12 of the International Measurement Evaluation Programme (IMEP-12) is described. The aim of the IMEP programme is to demonstrate objectively the degree of equivalence and quality of chemical measurements of individual laboratories on the international scene by comparing them with reference ranges traceable to the SI (Système International d'Unités). IMEP is organized in support of European Union policies and helps to improve the traceability of values produced by field chemical measurement laboratories. The analytical procedure used to establish the reference values for the B, Cd, Cu, Mg, and Pb content of the IMEP-12 sample is based on inductively coupled plasma-isotope-dilution mass spectrometry (ICP-IDMS) applied as a primary method of measurement. The measurements performed for the IMEP-12 study are described in detail. Focus is on the element boron, which is particularly difficult to analyze by ICP-MS because of potential problems of low sensitivity, high mass discrimination, memory effects, and abundance sensitivity. For each of the certified amount contents presented here a total uncertainty budget was calculated using the method of propagation of uncertainties according to ISO (International Organization for Standardization) and Eurachem guidelines. For all investigated elements with concentrations in the low micro g kg(-1) and mg kg(-1) range (corresponding to pmol kg(-1) to the high micro mol kg(-1) level), SI-traceable reference values with relative expanded uncertainties ( k=2) of less than 2 % were obtained.
Neuropsychological predictors of clinical outcome in opiate addiction.
Passetti, F; Clark, L; Mehta, M A; Joyce, E; King, M
2008-04-01
A growing literature supports a role for neurocognitive deficits such as impaired decision-making in the development and maintenance of addictive behaviour. On the basis of these findings, it has been suggested that measures of neurocognitive functioning may be applied to the task of predicting clinical outcome in drug addiction. This in turn may have relevance for differentiating treatment based on individual patient needs. To explore this hypothesis we obtained neurocognitive measures of planning, impulsivity and decision-making from 37 opiate dependent individuals within 6 weeks of starting a community drug treatment programme and we followed them up 3 months into the programme. Performance on two tests of decision-making, but not on tests of planning, motor inhibition, reflection impulsivity or delay discounting, was found to predict abstinence from illicit drugs at 3 months with high specificity and moderate sensitivity. In particular, two thirds of the participants performing normally on the Cambridge Gamble Task and the Iowa Gambling Task, but none of those impaired on both, were abstinent from illicit drugs at follow up. Other neuropsychological, psychiatric or psychosocial factors measured in this sample did not explain this finding. The results are discussed in terms of the brain circuitry involved and the potential implications for the planning of treatment services for opiate dependence.
Dückers, Michel L A; Thormar, Sigridur B; Juen, Barbara; Ajdukovic, Dean; Newlove-Eriksson, Lindy; Olff, Miranda
2018-01-01
Disasters can have an enormous impact on the health and well-being of those affected. Internationally, governments and service providers are often challenged to address complex psychosocial problems. Ideally, the potentially broad range of support activities include a coherent, high-quality mental health and psychosocial support (MHPSS) programme. We present a theory-driven quantitative analysis of the quality of 40 MHPSS programmes, mostly implemented in European disaster settings. The objective is to measure quality domains recognized as relevant in the literature and to empirically test associations. During the EU project "Operationalizing Psychosocial Support in Crisis" (OPSIC) an evaluation survey was designed and developed for this purpose and completed by 40 MHPSS programme coordinators involved in different mass emergencies and disasters. We analysed the survey data in two steps. Firstly, we used the data to operationalize quality domains of a MHPSS programme, tested constructs and assessed their internal consistency reliability. A total of 26 out of 44 survey items clustered into three of the four domains identified within the theoretical framework: "planning and delivery system" (Cronbach's alpha 0.82); "general evaluation criteria" (Cronbach's alpha 0.82); and "essential psychosocial principles" (Cronbach's alpha 0.75). "Measures and interventions applied", theoretically a potential fourth domain, could not be confirmed to empirically cluster together. Secondly, several models with associations between domains and measures and interventions were tested and compared. The model with the best fit suggests that in MHPSS programmes with a higher planning and delivery systems score, a larger number of measures and interventions from evidence-informed guidelines are applied. In such programmes, coordinators are more positive about general evaluation criteria and the realization of essential psychosocial principles. Moreover, the analyses showed that some measures and interventions are more likely to be applied in programmes with more evolved planning and delivery systems, yet for most measures and interventions the likelihood of being applied is not linked to planning and delivery system status, nor to coordinator perceptions concerning psychosocial principles and evaluation criteria. Further research is necessary to validate and expand the findings and to learn more about success factors and obstacles for MHPSS programme implementation.
Homma, Satoki; Imamura, Haruhiko; Nakamura, Toru; Fujimura, Kaori; Ito, Yoshihiro; Maeda, Yuji; Kaneko, Ikuyo
2016-01-01
We performed a comparative study of a health education programme that was delivered either through one-way communication with printed media, or through interactive videophone interviews. We aimed to ascertain which mode of counselling, when used in combination with telemonitoring, is more effective at lifestyle modification intended to improve health status. Participants, who were residents of Kurihara city in Miyagi prefecture, Japan, were randomized into two groups: one group received individualized monthly documented reports (n = 33; 22 females; average age: 67.2 years), and the other received interactive videophone communication (n = 35; 22 females; average age: 65.1 years) for three months. Telemonitoring was conducted on both groups, using a pedometer, weighing scale and a sphygmomanometer. Pre- and post-intervention, anthropometric measurements and blood tests were performed; the participants also completed self-administered questionnaires. The two groups showed similar degrees of health status improvement and satisfaction levels. However, the participants in the videophone group were more aware of improvements in their lifestyles than were the participants in the document group. The individualized printed communication programme was less time-consuming compared to videophone communication. Further studies are needed to formulate a balanced protocol for a counselling-cum-telemonitoring programme that provides optimal health improvement and cost performance with the available human resources. © The Author(s) 2015.
Linden, Ariel; Adams, John L; Roberts, Nancy
2006-04-01
Although disease management (DM) has been in existence for over a decade, there is still much uncertainty as to its effectiveness in improving health status and reducing medical cost. The main reason is that most programme evaluations typically follow weak observational study designs that are subject to bias, most notably selection bias and regression to the mean. The regression discontinuity (RD) design may be the best alternative to randomized studies for evaluating DM programme effectiveness. The most crucial element of the RD design is its use of a 'cut-off' score on a pre-test measure to determine assignment to intervention or control. A valuable feature of this technique is that the pre-test measure does not have to be the same as the outcome measure, thus maximizing the programme's ability to use research-based practice guidelines, survey instruments and other tools to identify those individuals in greatest need of the programme intervention. Similarly, the cut-off score can be based on clinical understanding of the disease process, empirically derived, or resource-based. In the RD design, programme effectiveness is determined by a change in the pre-post relationship at the cut-off point. While the RD design is uniquely suitable for DM programme evaluation, its success will depend, in large part, on fundamental changes being made in the way DM programmes identify and assign individuals to the programme intervention.
Tan, Thiam-Chye; Tan, Kim-Teng; Tee, John Cs
2007-09-01
The delivery of optimal and safe medical care is critical in healthcare. The traditional practice of "See one, do one and teach one" residency training programme is no longer acceptable. In the past, there was no structured residency training programme in our hospital. There were several cases of organ injuries from surgeries performed by the residents. In 2005, we conducted a pilot study to organise a structured teaching, education, surgical accreditation and assessment (TESA) residency programme for 15 residents in the Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital. We performed a written questionnaire survey of the residents on the new programme and patients' expectation (n = 2926) as subjective outcomes in the 1-year follow-up. We also studied the complication rates of all minor and major surgeries performed by the residents in 2004 and 2005 as an objective outcome. All the residents (n = 15) surveyed supported the TESA programme. Patients' expectation improved significantly from 71% in 2004 (n = 1559) to 83% in 2005 (n = 1367) (P = 0.03). There were 10,755 surgeries in 2004 and 10,558 surgeries in 2005 performed by our residents, with 6 cases (5.6%) of organ injuries in 2004 compared to 3 cases (2.8%) in 2005. This reduction was not statistically significant. The TESA residency programme in our hospital has an impact on the delivery of optimal and safe medical care while ensuring the training of residents to be competent specialists.
Using quantum process tomography to characterize decoherence in an analog electronic device
NASA Astrophysics Data System (ADS)
Ostrove, Corey; La Cour, Brian; Lanham, Andrew; Ott, Granville
The mathematical structure of a universal gate-based quantum computer can be emulated faithfully on a classical electronic device using analog signals to represent a multi-qubit state. We describe a prototype device capable of performing a programmable sequence of single-qubit and controlled two-qubit gate operations on a pair of voltage signals representing the real and imaginary parts of a two-qubit quantum state. Analog filters and true-RMS voltage measurements are used to perform unitary and measurement gate operations. We characterize the degradation of the represented quantum state with successive gate operations by formally performing quantum process tomography to estimate the equivalent decoherence channel. Experimental measurements indicate that the performance of the device may be accurately modeled as an equivalent quantum operation closely resembling a depolarizing channel with a fidelity of over 99%. This work was supported by the Office of Naval Research under Grant No. N00014-14-1-0323.
[Lack of correlation between performances in a simulator and in reality].
Konge, Lars; Bitsch, Mikael
2010-12-13
Simulation-based training provides obvious benefits for patients and doctors in education. Frequently, virtual reality simulators are expensive and evidence for their efficacy is poor, particularly as a result of studies with poor methodology and few test participants. In medical simulated training- and evaluation programmes it is always a question of transfer to the real clinical world. To illustrate this problem a study comparing the test performance of persons on a bowling simulator with their performance in a real bowling alley was conducted. Twenty-five test subjects played two rounds of bowling on a Nintendo Wii and 25 days later on a real bowling alley. Correlations of the scores in the first and second round (test-retest-reliability) and of the scores on the simulator and in reality (criterion validation) were studied and there was tested for any difference between female and male performance. The intraclass correlation coefficient equalled 0.76, i.e. the simulator fairly accurately measured participant performance. In contrast to this there was absolutely no correlation between participants' real bowling abilities and their scores on the simulator (Pearson's r = 0.06). There was no significant difference between female and male abilities. Simulation-based testing and training must be based on evidence. More studies are needed to include an adequate number of subjects. Bowling competence should not be based on Nintendo Wii measurements. Simulated training- and evaluation programmes should be validated before introduction, to ensure consistency with the real world.
Boggan, Joel C; Cheely, George; Shah, Bimal R; Heffelfinger, Randy; Springall, Deanna; Thomas, Samantha M; Zaas, Aimee; Bae, Jonathan
2014-09-01
Systematically engaging residents in large programs in quality improvement (QI) is challenging. To coordinate a shared QI project in a large residency program using an online tool. A web-based QI tool guided residents through a 2-phase evaluation of performance of foot examinations in patients with diabetes. In phase 1, residents completed reviews of health records with online data entry. Residents were then presented with personal performance data relative to peers and were prompted to develop improvement plans. In phase 2, residents again reviewed personal performance. Rates of performance were compared at the program and clinic levels for each phase, with data presented for residents. Acceptability was measured by the number of residents completing each phase. Feasibility was measured by estimated faculty, programmer, and administrator time and costs. Seventy-nine of 86 eligible residents (92%) completed improvement plans and reviewed 1471 patients in phase 1, whereas 68 residents (79%) reviewed 1054 patient charts in phase 2. Rates of performance of examination increased significantly between phases (from 52% to 73% for complete examination, P < .001). Development of the tool required 130 hours of programmer time. Project analysis and management required 6 hours of administrator and faculty time monthly. An online tool developed and implemented for program-wide QI initiatives successfully engaged residents to participate in QI activities. Residents using this tool demonstrated improvement in a selected quality target. This tool could be adapted by other graduate medical education programs or for faculty development.
NASA Astrophysics Data System (ADS)
Kirby, Nicola F.; Dempster, Edith R.
2015-12-01
In South Africa, foundation programmes are a well-established alternative access route to tertiary science study for educationally disadvantaged students. Student access to, and performance in, one such foundation programme has been researched by the authors seeking opportunities to improve student retention. The biology module in particular has been recognised to place students at risk of failing the foundation programme, thereby reducing throughput into mainstream science programmes. This study uses decision tree analysis to provide a detailed description of foundation biology student performance so that points of weakness and opportunities for remedial action may be pinpointed. While students' alternative-entry selection scores have previously been found to most effectively account for performance in the programme as a whole, no similar positive relationship was identified for any subgroup of students in the foundation biology module. Conversely, academic language proficiency in the medium of instruction (English), formerly found to play no role in overall student performance, was revealed as primary in explaining achievement in foundation biology, most adversely affecting students rendered particularly vulnerable by an additional academic and/or socio-economic disadvantage. A pass in the stand-alone foundation academic literacy module did not necessarily correspond to a pass in biology. Compromised by educational disadvantage, compounded by a mismatch in programme selection criteria and inadequate academic literacy support, discipline-specific, fundamental literacy development in the biology curriculum is proposed to enable students towards epistemic access in the module. Pending this intervention, formal access to mainstream study is unlikely for the foundation students most at risk of failure.
Fitzgerald, Diarmaid; Foody, John; Kelly, Dan; Ward, Tomas; Markham, Charles; McDonald, John; Caulfield, Brian
2007-01-01
This paper describes the design and development of a computer game for instructing an athlete through a series of prescribed rehabilitation exercises. In an attempt to prevent or treat musculoskeletal type injuries along with trying to improve physical performance, athletes are prescribed exercise programmes by appropriately trained specialists. Typically athletes are shown how to perform each exercise in the clinic following examination but they often have no way of knowing if their technique is correct while they are performing their home exercise programme. We describe a system that allows an automatic audit of this activity. Our system utilises ten inertial motion tracking sensors incorporated in a wearable body suit which allows a bluetooth connection from a root hub to a laptop/computer. Using our specifically designed software programme, the athlete can be instructed and analysed as he/she performs the individually tailored exercise programme and a log is recorded of the time and performance level of each exercise completed. We describe a case study that illustrates how a clinician can at a later date review the athletes progress and subsequently alter the exercise programme as they see fit.
Bertozzi, Lucia; Villafañe, Jorge H; Capra, Francesco; Reci, Marsida; Pillastrini, Paolo
2015-03-01
The objectives of this study were to determine the effectiveness of a programme of prevention exercises conducted in a corporate environment in poultry industry slaughterers suffering from musculoskeletal disorders. Forty workers, 70% female (mean ± SD age: 44.4 ± 8.4 years) were consecutively, in an alternative way, assigned to one of two groups receiving either set of 10 sessions (experimental or control group). The experimental group followed an exercise programme for a period of five weeks and a protocol of home exercises. The control group performed the exercise protocol only at home. The Roland Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI) to measure disability, the Visual Analogue Scale (VAS) score and the Pain Drawing to measure pain were used as outcome evaluations. A significant effect of time interaction (all P <0.001 and; F = 40.673; F = 33.907 and F = 25.447) existed for lumbar VAS, RMDQ and ODI immediately after the intervention (all P < 0.006). No significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. This study shows that a programme of prevention exercises may have a positive effect in improving musculoskeletal disorders of slaughterhouse workers. Pain decreased in the lumbar region, and there was an almost significant reduction in disability. Copyright © 2014 John Wiley & Sons, Ltd.
Francis, Linda; Dunt, David; Cadilhac, Dominique A
2016-01-01
Objectives Programmes to address chronic disease are a focus of governments worldwide. Despite growth in ‘implementation science’, there is a paucity of knowledge regarding the best means to measure sustainability. The aim of this review was to summarise current practice for measuring sustainability outcomes of chronic disease health programmes, providing guidance for programme planners and future directions for the academic field. Settings A scoping review of the literature spanning 1985–2015 was conducted using MEDLINE, CINAHL, PsychINFO and The Cochrane Library limited to English language and adults. Main search terms included chronic disease, acute care, sustainability, institutionalisation and health planning. A descriptive synthesis was required. Settings included primary care, hospitals, mental health centres and community health. Participants Programmes included preventing or managing chronic conditions including diabetes, heart disease, depression, respiratory disease, cancer, obesity, dental hygiene and multiple chronic diseases. Primary and secondary outcome measures Outcome measures included clarifying a sustainability definition, types of methodologies used, timelines for assessment, criteria levels to determine outcomes and how methodology varies between intervention types. Results Among 153 abstracts retrieved, 87 were retained for full article review and 42 included in the qualitative synthesis. Five definitions for sustainability outcome were identified with ‘maintenance of programme activities’ most frequent. Achieving sustainability was dependent on inter-relationships between various organisational and social contexts supporting a broad scale approach to evaluation. An increasing trend in use of mixed methods designs over multiple time points to determine sustainability outcomes was found. Conclusions Despite the importance and investment in chronic disease programmes, few studies are undertaken to measure sustainability. Methods to evaluate sustainability are diverse with some emerging patterns in measurement found. Use of mixed methods approaches over multiple time points may serve to better guide measurement of sustainability. Consensus on aspects of standardised measurement would promote the future possibility of meta-analytic syntheses. PMID:27246000
Benefits of ESA Gravity-Related Hands-on Programmes for University Students' Careers
NASA Astrophysics Data System (ADS)
Callens, Natacha; Ha, Lily; Galeone, Piero
2016-10-01
The Education Office of the European Space Agency (ESA) offers university students, from ESA Member and Cooperating States, the opportunity to perform investigations in physical sciences, life sciences, and technology, under different gravity conditions through three educational programmes. The "Fly Your Thesis!" (FYT) programme makes use of parabolic flights and the "Drop Your Thesis!" (DYT) programme utilizes a drop tower as microgravity carriers, while the "Spin Your Thesis!" (SYT) programme uses a large centrifuge to create hypergravity. To date, more than hundred university students had the chance to participate in the design, development, and performance of one or more experiments during dedicated campaigns. In the following paper, we examine demographics of past participants of the ESA Education Office gravity-related opportunities over the past seven years and evaluate the benefits of these educational programmes for the participants' studies and careers. Student teams that participated in one of the programmes between 2009 and 2013 were contacted to fill in a questionnaire. The feedback from the students demonstrate significant benefits extending far beyond the primary educational objectives of these programmes.
A new broadband square law detector. [microwave radiometers
NASA Technical Reports Server (NTRS)
Reid, M. S.; Gardner, R. A.; Stelzried, C. T.
1975-01-01
A broadband constant law detector was developed for precision power measurements, radio metric measurements, and other applications. It has a wide dynamic range and an accurate square law response. Other desirable characteristics, which are all included in a single compact unit, are: (1) high-level dc output with immunity to ground loop problems; (2) fast response times; (3) ability to insert known time constants; and (4) good thermal stability. The detector and its performance are described in detail. The detector can be operated in a programmable system with a ten-fold increase in accuracy. The use and performance of the detector in a noise-adding radiometer system is also discussed.
A cost-effective measurement-device-independent quantum key distribution system for quantum networks
NASA Astrophysics Data System (ADS)
Valivarthi, Raju; Zhou, Qiang; John, Caleb; Marsili, Francesco; Verma, Varun B.; Shaw, Matthew D.; Nam, Sae Woo; Oblak, Daniel; Tittel, Wolfgang
2017-12-01
We experimentally realize a measurement-device-independent quantum key distribution (MDI-QKD) system. It is based on cost-effective and commercially available hardware such as distributed feedback lasers and field-programmable gate arrays that enable time-bin qubit preparation and time-tagging, and active feedback systems that allow for compensation of time-varying properties of photons after transmission through deployed fiber. We examine the performance of our system, and conclude that its design does not compromise performance. Our demonstration paves the way for MDI-QKD-based quantum networks in star-type topology that extend over more than 100 km distance.
Barben, Jürg; Castellani, Carlo; Dankert-Roelse, Jeannette; Gartner, Silvia; Kashirskaya, Nataliya; Linnane, Barry; Mayell, Sarah; Munck, Anne; Sands, Dorota; Sommerburg, Olaf; Pybus, Simon; Winters, Victoria; Southern, Kevin W
2017-03-01
Newborn screening (NBS) for cystic fibrosis (CF) is a well-established public health strategy with international standards. The aim of this study was to provide an update on NBS for CF in Europe and assess performance against the standards. Questionnaires were sent to key workers in each European country. In 2016, there were 17 national programmes, 4 countries with regional programmes and 25 countries not screening in Europe. All national programmes employed different protocols, with IRT-DNA the most common strategy. Five countries were not using DNA analysis. In addition, the processing and structure of programmes varied considerably. Most programmes were achieving the ECFS standards with respect to timeliness, but were less successful with respect to sensitivity and specificity. There has been a steady increase in national CF NBS programmes across Europe with variable strategies and outcomes that reflect the different approaches. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
Hislop, M D; Stokes, K A; Williams, S; McKay, C D; England, M; Kemp, S P T
2016-01-01
Background Injuries to youth rugby players have become an increasingly prominent health concern, highlighting the importance of developing and implementing appropriate preventive strategies. A growing body of evidence from other youth sports has demonstrated the efficacy of targeted exercise regimens to reduce injury risk. However, studies have yet to investigate the effect of such interventions in youth contact sport populations like rugby union. Objective To determine the efficacy of an evidence-based movement control exercise programme compared with a sham exercise programme to reduce injury risk in youth rugby players. Exercise programme compliance between trial arms and the effect of coach attitudes on compliance will also be evaluated. Setting School rugby coaches in England will be the target of the researcher intervention, with the effects of the injury prevention programmes being measured in male youth players aged 14–18 years in school rugby programmes over the 2015–2016 school winter term. Methods A cluster-randomised controlled trial with schools randomly allocated to either a movement control exercise programme or a sham exercise programme, both of which are coach-delivered. Injury measures will derive from field-based injury surveillance, with match and training exposure and compliance recorded. A questionnaire will be used to evaluate coach attitudes, knowledge, beliefs and behaviours both prior to and on the conclusion of the study period. Outcome measures Summary injury measures (incidence, severity and burden) will be compared between trial arms, as will the influence of coach attitudes on compliance and injury burden. Additionally, changes in these outcomes through using the exercise programmes will be evaluated. Trial registration number ISRTCNN13422001. PMID:27900148
San-Juan, R; Manuel, O; Hirsch, H H; Fernández-Ruiz, M; López-Medrano, F; Comoli, P; Caillard, S; Grossi, P; Aguado, J M
2015-06-01
There is limited clinical evidence on the utility of the monitoring of Epstein-Barr virus (EBV) DNAemia in the pre-emptive management of post-transplant lymphoproliferative disease (PTLD) in solid organ transplant (SOT) recipients. We investigated current preventive measures against EBV-related PTLD through a web-based questionnaire sent to 669 SOT programmes in 35 European countries. This study was performed on behalf of the ESGICH study group from the European Society of Clinical Microbiology and Infectious Diseases. A total of 71 SOT programmes from 15 European countries participated in the study. EBV serostatus of the recipient is routinely obtained in 69/71 centres (97%) and 64 (90%) have access to EBV DNAemia assays. EBV monitoring is routinely used in 85.9% of the programmes and 77.4% reported performing pre-emptive treatment for patients with significant EBV DNAemia levels. Pre-emptive treatment for EBV DNAemia included reduction of immunosuppression in 50.9%, switch to mammalian target of rapamycin inhibitors in 30.9%, and use of rituximab in 14.5% of programmes. Imaging by whole-body 18-fluoro-deoxyglucose positron emission tomography (FDG-PET) is used in 60.9% of centres to rule out PTLD and complemented computer tomography is used in 50%. In 10.9% of centres, FDG-PET is included in the first-line diagnostic workup in patients with high-risk EBV DNAemia. Despite the lack of definitive evidence, EBV load measurements are frequently used in Europe to guide diagnostic workup and pre-emptive reduction of immunosuppression. We need prospective and controlled studies to define the impact of EBV monitoring in reducing the risk of PTLD in SOT recipients. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos
2017-01-01
Abstract Objective To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme – the World Health Partners’ Sky Program. Methods We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers’ performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. Findings The programme did not significantly improve health-care providers’ knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Conclusion Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up. PMID:28479635
Aryankhesal, Aidin; Sheldon, Trevor A; Mannion, Russell; Mahdipour, Saeade
2015-07-01
Performance measurement systems are increasingly used to reward and improve provider performance. However, such initiatives may also inadvertently induce a range of unintended and dysfunctional side-effects. This study explores the unintended and adverse consequences induced by the Iranian national hospital grading programme, which incorporates financial incentives for meeting nationally defined standards. We interviewed key informants across four key groups with a legitimate interest in healthcare performance: four purposively selected hospitals; four health insurance organizations; the Iranian hospital accreditation body; and one grading agency. The transcribed interviews and field notes were analysed thematically, and subsequently, member checking was conducted. Seven dysfunctional consequences were identified: misrepresentation of data by hospitals; increased anxiety and stress among hospital employees; tunnel vision; financial pressures on poorly graded hospitals; incentives to purchase unnecessary equipment; erosion of public trust; and restricting access to hospital services by patients. These were caused by the way the grading system was implemented: poor standards of audit; the way in which the audit process was conducted; and the timing of audits. The pay for performance element of the grading system and the focus on structural aspects in the standards made improvement in grading particularly difficult for those hospitals that had been assessed as under-performing. Although the Iranian hospital grading system has resulted in a significant increase in the adoption of national standards, it has nevertheless induced a range of perverse outcomes. To mitigate these requires further refinement and recalibration of the system. © The Author(s) 2015.
Johne's disease: a successful eradication programme in a dairy goat herd.
Gavin, William G; Porter, Catherine A; Hawkins, Nathan; Schofield, Michael J; Pollock, John M
2018-04-28
This retrospective analysis and report describes the successful eradication and posteradication surveillance programme for Johne's disease ( Mycobacterium avium subspecies paratuberculosis (MAP)) in a closed herd of dairy goats. In 1994, MAP's presence in the goat herd was first suspected through individual annual serological screening and then subsequently confirmed through faecal culture and histopathology in 1997 when implementation of a more aggressive programme of testing and eradication of the diseased animals began. This programme included frequent serological screening of all adult goats using ELISA and agar gel immunodiffusion assays. Faecal cultures for bacteria were performed on suspect or positive animals and for all goats found dead or euthanased, and tissues were submitted for histopathology and acid-fast staining. Additional disease eradication measures included maintaining a closed herd and minimising faecal-oral transmission of MAP. Following a more aggressive testing regimen and euthanasia of goats with positive faecal culture, the herd was first considered free of MAP in 2003 and has remained free to the present day. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Kemp, Joanne L; Schache, Anthony G; Makdissi, Michael; Sims, Kevin J; Crossley, Kay M
2013-07-01
This study investigated tests of hip muscle strength and functional performance. The specific objectives were to: (i) establish intra- and inter-rater reliability; (ii) compare differences between dominant and non-dominant limbs; (iii) compare agonist and antagonist muscle strength ratios; (iv) compare differences between genders; and (v) examine relationships between hip muscle strength, baseline measures and functional performance. Reliability study and cross-sectional analysis of hip strength and functional performance. In healthy adults aged 18-50years, normalised hip muscle peak torque and functional performance were evaluated to: (i) establish intra-rater and inter-rater reliability; (ii) analyse differences between limbs, between antagonistic muscle groups and genders; and (iii) associations between strength and functional performance. Excellent reliability (intra-rater ICC=0.77-0.96; inter-rater ICC=0.82-0.95) was observed. No difference existed between dominant and non-dominant limbs. Differences in strength existed between antagonistic pairs of muscles: hip abduction was greater than adduction (p<0.001) and hip ER was greater than IR (p<0.001). Men had greater ER strength (p=0.006) and hop for distance (p<0.001) than women. Strong associations were observed between measures of hip muscle strength (except hip flexion) and age, height, and functional performance. Deficits in hip muscle strength or functional performance may influence hip pain. In order to provide targeted rehabilitation programmes to address patient-specific impairments, and determine when individuals are ready to return to physical activity, clinicians are increasingly utilising tests of hip strength and functional performance. This study provides a battery of reliable, clinically applicable tests which can be used for these purposes. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Patient level cost of diabetes self-management education programmes: an international evaluation.
Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan
2017-06-04
The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Field-programmable beam reconfiguring based on digitally-controlled coding metasurface
NASA Astrophysics Data System (ADS)
Wan, Xiang; Qi, Mei Qing; Chen, Tian Yi; Cui, Tie Jun
2016-02-01
Digital phase shifters have been applied in traditional phased array antennas to realize beam steering. However, the phase shifter deals with the phase of the induced current; hence, it has to be in the path of each element of the antenna array, making the phased array antennas very expensive. Metamaterials and/or metasurfaces enable the direct modulation of electromagnetic waves by designing subwavelength structures, which opens a new way to control the beam scanning. Here, we present a direct digital mechanism to control the scattered electromagnetic waves using coding metasurface, in which each unit cell loads a pin diode to produce binary coding states of “1” and “0”. Through data lines, the instant communications are established between the coding metasurface and the internal memory of field-programmable gate arrays (FPGA). Thus, we realize the digital modulation of electromagnetic waves, from which we present the field-programmable reflective antenna with good measurement performance. The proposed mechanism and functional device have great application potential in new-concept radar and communication systems.
Digitally Programmable Analogue Circuits for Sensor Conditioning Systems
Zatorre, Guillermo; Medrano, Nicolás; Sanz, María Teresa; Aldea, Concepción; Calvo, Belén; Celma, Santiago
2009-01-01
This work presents two current-mode integrated circuits designed for sensor signal preprocessing in embedded systems. The proposed circuits have been designed to provide good signal transfer and fulfill their function, while minimizing the load effects due to building complex conditioning architectures. The processing architecture based on the proposed building blocks can be reconfigured through digital programmability. Thus, sensor useful range can be expanded, changes in the sensor operation can be compensated for and furthermore, undesirable effects such as device mismatching and undesired physical magnitudes sensor sensibilities are reduced. The circuits were integrated using a 0.35 μm standard CMOS process. Experimental measurements, load effects and a study of two different tuning strategies are presented. From these results, system performance is tested in an application which entails extending the linear range of a magneto-resistive sensor. Circuit area, average power consumption and programmability features allow these circuits to be included in embedded sensing systems as a part of the analogue conditioning components. PMID:22412331
Joint programmes in paediatric cardiothoracic surgery: a survey and descriptive analysis.
DeCampli, William M
2011-12-01
Joint programmes, as opposed to regionalisation of paediatric cardiac care, may improve outcomes while preserving accessibility. We determined the prevalence and nature of joint programmes. We sent an online survey to 125 paediatric cardiac surgeons in the United States in November, 2009 querying the past or present existence of a joint programme, its mission, structure, function, and perceived success. A total of 65 surgeon responses from 65 institutions met the criteria for inclusion. Of the 65 institutions, 22 currently or previously conducted a joint programme. Compared with primary institutions, partner institutions were less often children's hospitals (p = 0.0004), had fewer paediatric beds (p = 0.005), and performed fewer cardiac cases (p = 0.03). Approximately 47% of partner hospitals performed fewer than 50 cases per year. The median distance range between hospitals was 41-60 miles, ranging from 5 to 1000 miles. Approximately 54% of partner hospitals had no surgeon working primarily on-site, and 31% of the programmes conducted joint conferences. Approximately 67% of the programmes limited the complexity of cases at the partner hospital, and 83% of the programmes had formal contracts between hospitals. Of the six programmes whose main mission was to increase referrals to the primary hospital, three were felt to have failed. Of the nine programmes whose mission was to increase regional quality, eight were felt to be successful. Joint programmes in paediatric cardiac surgery are common but are heterogeneous in structure and function. Programmes whose mission is to improve the quality of regional care seem more likely to succeed. Joint programmes may be a practical alternative to regionalisation to achieve better outcomes.
A demonstrator for an incoherent Doppler wind lidar receiver
NASA Astrophysics Data System (ADS)
Fabre, F.; Marini, A.; Sidler, Thomas C.; Morancais, Didier; Fongy, G.; Vidal, Ph.
2018-04-01
The knowledge of wind fields for a global terrestrial coverage and accurate altitude sampling is one of the main keys for improvement of meteorological predictions and general understanding of atmosphere behaviour. The best way to recover this information is remote sensing from space using low Earth orbit satellites. The measurement principle is to analyse the Doppler shift of the flux emitted by the space instrument and backscattered by the atmosphere. One of the most promising principle for Doppler shift measurement is the direct detection which does not need local oscillators. what significantly simplifies the design of such a space-borne receiver. ESA-ESTEC initiated at early 95' a programme called "lncoherent Doppler Wind Lidar (IDWL) technologies" for the study and bread-boarding phase. MMS won this contract proposing an original concept based on the use of a Fizeau high resolution interferometer working in the UV band. coupled with an intensified CCD. This concept is patented by MMS, as well as the special CCD timing sequence that will be depicted below. The programme begun by a study of the space-borne instrument in order to identify main constraints and define the receiver as could be for a flight model. A detailed performance model was established and parametric analysis allowed to optimise the concept in order to reach required performances. This study phase finally provided the definition of a bread-board for expected performances demonstration. Moreover, the Laser Signal Simulator (LSS) which is used to simulate the Lidar echo in term of amplitude as well as frequency modulation was defined at this step. The performances of this test support equipment are of main importance for the validation of the demonstrator design and performances. The second part of the study aimed at defining the derailed design of the demonstrator and associated test support equipment as well as initiating preliminary validation experiments on most critical technologies, like Fizeau interferometer which needs particularly high thermal stability and spectral resolution. At the end of this design phase. the test bench equipment begun to be manufactured and equipment test results preliminary assessed the study phase results. After integration, the correct operation and control of the overall test bench were assessed and performance tests were undertaken . The final conclusion of this programme aimed at updating the performance simulation software in order to refine expected performances for the future flight instrument.
Lind, Rune Rasmussen; Geertsen, Svend Sparre; Ørntoft, Christina; Madsen, Mads; Larsen, Malte Nejst; Dvorak, Jiri; Ritz, Christian; Krustrup, Peter
2018-02-01
Recent studies have shown promising effects of physical activity on cognitive function, but there is a need to investigate this link in real-life settings such as schools. Hence, the objective of the present pilot study was to investigate whether the school-based physical activity programme "FIFA 11 for Health" for Europe could improve cognitive performance in preadolescent Danish children. The pilot study used an 11-week cluster-randomised intervention study design. School classes were randomly assigned to either a control group (CG) (n = 93 children, age = 11.8, s = 0.2 years), which performed the obligatory daily school-based physical activity (5 × 45 minutes per week); or an intervention group (IG) (n = 838 children, age = 11.9, s = 0.4 years), which substituted 2 × 45 minutes per week of the daily school physical activity with the "FIFA 11 for Health" for Europe programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up. The IG improved their cognitive performance compared to the CG for psychomotor function (56, s x - = 22 ms, p < .001), attention (39, s x - = 17 ms, p = .012) and working memory (79, s x - = 35 ms, p = .020). This pilot study provides evidence that the school-based physical activity programme "FIFA 11 for Health" for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt to disentangle the effects of "FIFA 11 for Health" for Europe on cognitive performance by investigating the characteristics of the programme's physical activity.
Altun, Idiris; Yuksel, Kasim Zafer; Mert, Tufan
2017-01-01
To investigate whether programmable cerebrospinal fluid (CSF) shunts are influenced by exposure to the magnetic field and to compare the effects of magnetic field in 4 different brands of programmable CSF shunts. This experimental study was performed in the laboratory using a novel design of magnetic field. Four types of programmable CSF shunts (Miethke®, Medtronic®, Sophysa® and Codman®Hakim®) were exposed to the magnetic field generated by an apparatus consisting of Helmholtz coil for 5 minutes. In every CSF shunt, initial pressures were adjusted to 110 mm H2O and pressures after exposure to magnetic field were noted. These measurements were implemented at frequencies of 5 Hz, 20 Hz, 30 Hz, 40 Hz, 60 Hz and 80 Hz. In each type, three shunts were utilized and evaluations were made twice for every shunt. At 5, 30, 40 and 60 Hz, Groups 1, 2 and 3 had significantly higher average pressures than Group 4. At 20 and 80 Hz, Groups 1 and 2 had notably different pressure values than Groups 3 and 4. Group 3 displayed the highest pressure, while Group 4 demonstrated the lowest pressure. Exposure to magnetic fields may affect the pressures of programmable CSF shunts. However, further controlled, clinical trials are warranted to elucidate the in-vivo effects of magnetic field exposure.
A Masters Programme in Telecommunications Management--Demand-Based Curriculum Design
ERIC Educational Resources Information Center
Gharaibeh, Khaled M.; Kaylani, Hazem; Murphy, Noel; Brennan, Conor; Itradat, Awni; Al-Bataineh, Mohammed; Aloqlah, Mohammed; Salhieh, Loay; Altarazi, Safwan; Rawashdeh, Nathir; del Carmen Bas Cerdá, María; Conchado Peiró, Andrea; Al-Zoubi, Asem; Harb, Bassam; Bany Salameh, Haythem
2015-01-01
This paper presents a curriculum design approach for a Masters Programme in Telecommunications Management based on demand data obtained from surveying the needs of potential students of the proposed programme. Through online surveys disseminated at telecom companies in Jordan, it was possible to measure the demand for such a programme and to…
The SLMTA programme: Transforming the laboratory landscape in developing countries
Maruta, Talkmore; Luman, Elizabeth T.; Nkengasong, John N.
2014-01-01
Background Efficient and reliable laboratory services are essential to effective and well-functioning health systems. Laboratory managers play a critical role in ensuring the quality and timeliness of these services. However, few laboratory management programmes focus on the competencies required for the daily operations of a laboratory in resource-limited settings. This report provides a detailed description of an innovative laboratory management training tool called Strengthening Laboratory Management Toward Accreditation (SLMTA) and highlights some challenges, achievements and lessons learned during the first five years of implementation (2009–2013) in developing countries. Programme SLMTA is a competency-based programme that uses a series of short courses and work-based learning projects to effect immediate and measurable laboratory improvement, while empowering laboratory managers to implement practical quality management systems to ensure better patient care. A SLMTA training programme spans from 12 to 18 months; after each workshop, participants implement improvement projects supported by regular supervisory visits or on-site mentoring. In order to assess strengths, weaknesses and progress made by the laboratory, audits are conducted using the World Health Organization’s Regional Office for Africa (WHO AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist, which is based on International Organization for Standardization (ISO) 15189 requirements. These internal audits are conducted at the beginning and end of the SLMTA training programme. Conclusion Within five years, SLMTA had been implemented in 617 laboratories in 47 countries, transforming the laboratory landscape in developing countries. To our knowledge, SLMTA is the first programme that makes an explicit connection between the performance of specific management behaviours and routines and ISO 15189 requirements. Because of this close relationship, SLMTA is uniquely positioned to help laboratories seek accreditation to ISO 15189. PMID:26752335
Van Grootven, Bastiaan; McNicoll, Lynn; Mendelson, Daniel A; Friedman, Susan M; Fagard, Katleen; Milisen, Koen; Flamaing, Johan; Deschodt, Mieke
2018-01-01
Objective To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. Design An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). Setting Western Europe and the USA. Participants Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate). Measures Participants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method. Results In the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications. Conclusion The indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes. PMID:29549210
How Six Sigma Methodology Improved Doctors' Performance
ERIC Educational Resources Information Center
Zafiropoulos, George
2015-01-01
Six Sigma methodology was used in a District General Hospital to assess the effect of the introduction of an educational programme to limit unnecessary admissions. The performance of the doctors involved in the programme was assessed. Ishikawa Fishbone and 5 S's were initially used and Pareto analysis of their findings was performed. The results…
Visuospatial training improves elementary students' mathematics performance.
Lowrie, Tom; Logan, Tracy; Ramful, Ajay
2017-06-01
Although spatial ability and mathematics performance are highly correlated, there is scant research on the extent to which spatial ability training can improve mathematics performance. This study evaluated the efficacy of a visuospatial intervention programme within classrooms to determine the effect on students' (1) spatial reasoning and (2) mathematics performance as a result of the intervention. The study involved grade six students (ages 10-12) in eight classes. There were five intervention classes (n = 120) and three non-intervention control classes (n = 66). A specifically designed 10-week spatial reasoning programme was developed collaboratively with the participating teachers, with the intervention replacing the standard mathematics curriculum. The five classroom teachers in the intervention programme presented 20 hr of activities aimed at enhancing students' spatial visualization, mental rotation, and spatial orientation skills. The spatial reasoning programme led to improvements in both spatial ability and mathematics performance relative to the control group who received standard mathematics instruction. Our study is the first to show that a classroom-based spatial reasoning intervention improves elementary school students' mathematics performance. © 2017 The British Psychological Society.
Melhuish, Edward; Belsky, Jay; Anning, Angela; Ball, Mog; Barnes, Jacqueline; Romaniuk, Helena; Leyland, Alastair
2007-06-01
An area-based initiative, Sure Start Local Programmes (SSLPs), was established by the UK government to reduce social exclusion through improving the well-being of children aged 0-3 years and their families in disadvantaged communities; a true community intervention in that all children under four and their families in specified areas served as targets of universal services. A national evaluation examined the links between variation in programme implementation and effectiveness. Data gathered from multiple sources produced measures of implementation in terms of proficiency, services and staffing. Measures of programme impact on child/parenting outcomes derived from multilevel models, controlling for child, family and area characteristics, were identified to demonstrate programme effectiveness. Some modest linkage between programme implementation (e.g., proficiency, empowerment of parents and staff, identification of users) and effectiveness for child and parenting outcomes. Overall proficiency and specific aspects of implementation may influence effectiveness, which should guide the design of other child, family and community services.
Thøgersen-Ntoumani, Cecilie; Loughren, Elizabeth A; Duda, Joan L; Fox, Kenneth R; Kinnafick, Florence-Emilie
2010-09-27
Following an extensive recruitment campaign, a 16-week lunchtime intervention to increase walking was implemented with insufficiently physically active University employees to examine programme feasibility and the effects of the programme in increasing walking behaviour, and in improving well-being and work performance. A feasibility study in which participants were randomised to an immediate treatment or a delayed treatment control (to start at 10 weeks) group. For the first ten weeks of the intervention, participants took part in three facilitator-led group walks per week each of thirty minutes duration and were challenged to accumulate another sixty minutes of walking during the weekends. In the second phase of the intervention, the organised group walks ceased to be offered and participants were encouraged to self-organise their walks. Motivational principles were employed using contemporary motivational theory. Outcome measures (including self-reported walking, step counts, cardiovascular fitness, general and work-related well-being and work performance) were assessed at baseline, at the end of the 16-week intervention and (for some) four months after the end of the intervention. Process and outcome assessments were also taken throughout, and following, the intervention. The results of the intervention will determine the feasibility of implementing a lunchtime walking programme to increase walking behaviour, well-being and performance in sedentary employees. If successful, there is scope to implement definitive trials across a range of worksites with the aim of improving both employee and organisational health. Current Controlled Trials ISRCTN81504663.
Thormar, Sigridur B.; Juen, Barbara; Ajdukovic, Dean; Newlove-Eriksson, Lindy; Olff, Miranda
2018-01-01
Disasters can have an enormous impact on the health and well-being of those affected. Internationally, governments and service providers are often challenged to address complex psychosocial problems. Ideally, the potentially broad range of support activities include a coherent, high-quality mental health and psychosocial support (MHPSS) programme. We present a theory-driven quantitative analysis of the quality of 40 MHPSS programmes, mostly implemented in European disaster settings. The objective is to measure quality domains recognized as relevant in the literature and to empirically test associations. During the EU project “Operationalizing Psychosocial Support in Crisis” (OPSIC) an evaluation survey was designed and developed for this purpose and completed by 40 MHPSS programme coordinators involved in different mass emergencies and disasters. We analysed the survey data in two steps. Firstly, we used the data to operationalize quality domains of a MHPSS programme, tested constructs and assessed their internal consistency reliability. A total of 26 out of 44 survey items clustered into three of the four domains identified within the theoretical framework: “planning and delivery system” (Cronbach’s alpha 0.82); “general evaluation criteria” (Cronbach’s alpha 0.82); and “essential psychosocial principles” (Cronbach’s alpha 0.75). “Measures and interventions applied”, theoretically a potential fourth domain, could not be confirmed to empirically cluster together. Secondly, several models with associations between domains and measures and interventions were tested and compared. The model with the best fit suggests that in MHPSS programmes with a higher planning and delivery systems score, a larger number of measures and interventions from evidence-informed guidelines are applied. In such programmes, coordinators are more positive about general evaluation criteria and the realization of essential psychosocial principles. Moreover, the analyses showed that some measures and interventions are more likely to be applied in programmes with more evolved planning and delivery systems, yet for most measures and interventions the likelihood of being applied is not linked to planning and delivery system status, nor to coordinator perceptions concerning psychosocial principles and evaluation criteria. Further research is necessary to validate and expand the findings and to learn more about success factors and obstacles for MHPSS programme implementation. PMID:29489888
Moreno-Tapia, Sandra Veronica; Vera-Salas, Luis Alberto; Osornio-Rios, Roque Alfredo; Dominguez-Gonzalez, Aurelio; Stiharu, Ion; de Jesus Romero-Troncoso, Rene
2010-01-01
Computer numerically controlled (CNC) machines have evolved to adapt to increasing technological and industrial requirements. To cover these needs, new generation machines have to perform monitoring strategies by incorporating multiple sensors. Since in most of applications the online Processing of the variables is essential, the use of smart sensors is necessary. The contribution of this work is the development of a wireless network platform of reconfigurable smart sensors for CNC machine applications complying with the measurement requirements of new generation CNC machines. Four different smart sensors are put under test in the network and their corresponding signal processing techniques are implemented in a Field Programmable Gate Array (FPGA)-based sensor node. PMID:22163602
Moreno-Tapia, Sandra Veronica; Vera-Salas, Luis Alberto; Osornio-Rios, Roque Alfredo; Dominguez-Gonzalez, Aurelio; Stiharu, Ion; Romero-Troncoso, Rene de Jesus
2010-01-01
Computer numerically controlled (CNC) machines have evolved to adapt to increasing technological and industrial requirements. To cover these needs, new generation machines have to perform monitoring strategies by incorporating multiple sensors. Since in most of applications the online Processing of the variables is essential, the use of smart sensors is necessary. The contribution of this work is the development of a wireless network platform of reconfigurable smart sensors for CNC machine applications complying with the measurement requirements of new generation CNC machines. Four different smart sensors are put under test in the network and their corresponding signal processing techniques are implemented in a Field Programmable Gate Array (FPGA)-based sensor node.
Polarimetric Multispectral Imaging Technology
NASA Technical Reports Server (NTRS)
Cheng, L.-J.; Chao, T.-H.; Dowdy, M.; Mahoney, C.; Reyes, G.
1993-01-01
The Jet Propulsion Laboratory is developing a remote sensing technology on which a new generation of compact, lightweight, high-resolution, low-power, reliable, versatile, programmable scientific polarimetric multispectral imaging instruments can be built to meet the challenge of future planetary exploration missions. The instrument is based on the fast programmable acousto-optic tunable filter (AOTF) of tellurium dioxide (TeO2) that operates in the wavelength range of 0.4-5 microns. Basically, the AOTF multispectral imaging instrument measures incoming light intensity as a function of spatial coordinates, wavelength, and polarization. Its operation can be in either sequential, random access, or multiwavelength mode as required. This provides observation flexibility, allowing real-time alternation among desired observations, collecting needed data only, minimizing data transmission, and permitting implementation of new experiments. These will result in optimization of the mission performance with minimal resources. Recently we completed a polarimetric multispectral imaging prototype instrument and performed outdoor field experiments for evaluating application potentials of the technology. We also investigated potential improvements on AOTF performance to strengthen technology readiness for applications. This paper will give a status report on the technology and a prospect toward future planetary exploration.
Jacobs, Stephen P; Parsons, Matthew; Rouse, Paul; Parsons, John; Gunderson-Reid, Michelle
2018-04-01
Service providers and funders need ways to work together to improve services. Identifying critical performance variables provides a mechanism by which funders can understand what they are purchasing without getting caught up in restrictive service specifications that restrict the ability of service providers to meet the needs of the clients. An implementation pathway and benchmarking programme called IN TOUCH provided contracted providers of home support and funders with a consistent methodology to follow when developing and implementing new restorative approaches for service delivery. Data from performance measurement was used to triangulate the personal and social worlds of the stakeholders enabling them to develop a shared understanding of what is working and what is not. The initial implementation of IN TOUCH involved five District Health Boards. The recursive dialogue encouraged by the IN TOUCH programme supports better and more sustainable service development because performance management is anchored to agreed data that has meaning to all stakeholders. Copyright © 2017 Elsevier Ltd. All rights reserved.
Agility assessment using fuzzy logic approach: a case of healthcare dispensary.
Suresh, M; Patri, Rojalin
2017-06-09
Agile concepts are not only beneficial for manufacturing sector but also for service sector such as healthcare. However, assessment of agility has been predominantly done in manufacturing enterprises. This study demonstrates a means to measure agility of a healthcare organization by assessing agility of a university dispensary. Its contribution to the knowledge base is twofold. First, it proposes a means to measure the agility of a healthcare organization and second, it identifies the attributes that prevent agile performance and outlines the suggestive measure to enhance its agile capabilities. A case study approach has been adopted and fuzzy logic has been employed to measure the agility of the case dispensary. At first, the measures of assessment which include four enablers, fifteen criteria and forty-five attributes have been identified from the literature and rated by the experts indicating the importance of the measures in the assessment. Then, the case dispensary has been assessed on those measures by collecting observed performance rating from decision makers. At last, Fuzzy logic has been applied on the performance rating data to analyze and interpret the agile capability of the dispensary. The findings suggest that transparent information flow, adequate salary and bonuses for caregivers, reading error in medical descriptions, in house/nearby pathology laboratory services, technical up-gradation of dispensary equipments and facilities, minimization of patient throughput time and adequate training programme for safety practices are the attributes that weakens agile capability of the University dispensary. The current agility of the dispensary was found to be 'Agile' which is average in relation to the agility labels. Attributes such as transparent information flow, adequate salary and bonuses for caregivers, elimination of reading error in medical descriptions, in house/nearby pathology laboratory services, technical up-gradation of dispensary equipments and facilities, minimization of patient throughput time and adequate training programme for safety practices are extremely crucial for enhancing agile capability of a healthcare organization.
Ayyanat, Jayachandran A; Harbour, Catherine; Kumar, Sanjeev; Singh, Manjula
2018-01-05
Many interventions have attempted to increase vulnerable and remote populations' access to ORS and zinc to reduce child mortality from diarrhoea. However, the impact of these interventions is difficult to measure. From 2010 to 15, Micronutrient Initiative (MI), worked with the public sector in Bihar, India to enable community health workers to treat and report uncomplicated child diarrhoea with ORS and zinc. We describe how we estimated programme's impact on child mortality with Lives Saved Tool (LiST) modelling and data from MI's management information system (MIS). This study demonstrates that using LiST modelling and MIS data are viable options for evaluating programmes to reduce child mortality. We used MI's programme monitoring data to estimate coverage rates and LiST modelling software to estimate programme impact on child mortality. Four scenarios estimated the effects of different rates of programme scale-up and programme coverage on estimated child mortality by measuring children's lives saved. The programme saved an estimated 806-975 children under-5 who had diarrhoea during five-year project phase. Increasing ORS and zinc coverage rates to 19.8% & 18.3% respectively under public sector coverage with effective treatment would have increased the programme's impact on child mortality and could have achieved the project goal of saving 4200 children's lives during the five-year programme. Programme monitoring data can be used with LiST modelling software to estimate coverage rates and programme impact on child mortality. This modelling approach may cost less and yield estimates sooner than directly measuring programme impact with population-based surveys. However, users must be cautious about relying on modelled estimates of impact and ensure that the programme monitoring data used is complete and precise about the programme aspects that are modelled. Otherwise, LiST may mis-estimate impact on child mortality. Further, LiST software may require modifications to its built-in assumptions to capture programmatic inputs. LiST assumes that mortality rates and cause of death structure change only in response to changes in programme coverage. In Bihar, overall child mortality has decreased and diarrhoea seems to be less lethal than previously, but at present LiST does not adjust its estimates for these sorts of changes.
Wolf, Jennyfer; Mäusezahl, Daniel; Verastegui, Hector; Hartinger, Stella M
2017-07-08
This study examined measures of clean cookstove adoption after improved solid fuel stove programmes in three geographically and culturally diverse rural Andean settings and explored factors associated with these measures. A questionnaire was administered to 1200 households on stove use and cooking behaviours including previously defined factors associated with clean cookstove adoption. Logistic multivariable regressions with 16 pre-specified explanatory variables were performed for three outcomes; (1) daily improved solid fuel stove use, (2) use of liquefied petroleum gas stove and (3) traditional stove displacement. Eighty-seven percent of households reported daily improved solid fuel stove use, 51% liquefied petroleum gas stove use and 66% no longer used the traditional cookstove. Variables associated with one or more of the three outcomes are: education, age and civil status of the reporting female, household wealth and size, region, encounters of problems with the improved solid fuel stove, knowledge of somebody able to build an improved solid fuel stove, whether stove parts are obtainable in the community, and subsidy schemes. We conclude that to be successful, improved solid fuel stove programmes need to consider (1) existing household characteristics, (2) the household's need for ready access to maintenance and repair, and (3) improved knowledge at the community level.
de Moura, Bruno Pereira; Marins, João Carlos Bouzas; Franceschini, Sylvia Do Carmo Castro; Reis, Janice Sepúlveda; Amorim, Paulo Roberto Dos Santos
2015-01-01
Although exercise promotes beneficial effects in diabetic patients, some studies have questioned the degree of their importance in terms of the increase in total energy expenditure. In these studies, the decrease of physical activity levels (PAL) was referred as "compensatory effect of exercise". However, our aim was to investigate whether aerobic exercise has compensatory effects on PAL in type 2 diabetes patients. Eight volunteers (51.1 ± 8.2 years) were enrolled in a supervised exercise programme for 8 weeks (3 d · wk(-1), 50-60% of VO2 peak for 30-60 min). PAL was measured using tri-axial accelerometers in the 1st, 8th and 12th weeks. Biochemical tests, cardiorespiratory fitness, anthropometric assessment and body composition were measured in the 2nd and 11th weeks. Statistical analysis was performed using non-parametric tests (Friedman and Wilcoxon, P < 0.05). We found no significant differences in PAL between intervention periods, and participants spent the majority of their awake time in sedentary activities. However, the exercise programme generated a significant 14.8% increase in VO2 peak and a 15% reduction in fructosamine. The exercise programme had no compensatory effects on PAL in type 2 diabetes patients, but improved their cardiorespiratory fitness and glycaemic control.
Wolf, Jennyfer; Mäusezahl, Daniel; Verastegui, Hector; Hartinger, Stella M.
2017-01-01
This study examined measures of clean cookstove adoption after improved solid fuel stove programmes in three geographically and culturally diverse rural Andean settings and explored factors associated with these measures. A questionnaire was administered to 1200 households on stove use and cooking behaviours including previously defined factors associated with clean cookstove adoption. Logistic multivariable regressions with 16 pre-specified explanatory variables were performed for three outcomes; (1) daily improved solid fuel stove use, (2) use of liquefied petroleum gas stove and (3) traditional stove displacement. Eighty-seven percent of households reported daily improved solid fuel stove use, 51% liquefied petroleum gas stove use and 66% no longer used the traditional cookstove. Variables associated with one or more of the three outcomes are: education, age and civil status of the reporting female, household wealth and size, region, encounters of problems with the improved solid fuel stove, knowledge of somebody able to build an improved solid fuel stove, whether stove parts are obtainable in the community, and subsidy schemes. We conclude that to be successful, improved solid fuel stove programmes need to consider (1) existing household characteristics, (2) the household’s need for ready access to maintenance and repair, and (3) improved knowledge at the community level. PMID:28698468
NASA Astrophysics Data System (ADS)
Molenda, Michał; Ratman-Kłosińska, Izabela
2018-03-01
Many innovative environmental technologies never reach the market because they are new and cannot demonstrate a successful track record of previous applications. This fact is a serious obstacle on their way to the market. Lack of credible data on the performance of a technology causes mistrust of investors in innovations, especially from public sector, who seek effective solutions however without compromising the technical and financial risks associated with their implementation. Environmental technology verification (ETV) offers a credible, robust and transparent process that results in a third party confirmation of the claims made by the providers about the performance of the novel environmental technologies. Verifications of performance are supported by high quality, independent test data. In that way ETV as a tool helps establish vendor credibility and buyer confidence. Several countries across the world have implemented ETV in the form of national or regional programmes. ETV in the European Union was implemented as a voluntary scheme if a form of a pilot programme. The European Commission launched the Environmental Technology Pilot Programme of the European Union (EU ETV) in 2011. The paper describes the European model of ETV set up and put to operation under the Pilot Programme of Environmental Technologies Verification of the European Union. The goal, objectives, technological scope, involved entities are presented. An attempt has been made to summarise the results of the EU ETV scheme performance available for the period of 2012 when the programme has become fully operational until the first half of 2016. The study was aimed at analysing the overall organisation and efficiency of the EU ETV Pilot Programme. The study was based on the analysis of the documents the operation of the EU ETV system. For this purpose, a relevant statistical analysis of the data on the performance of the EU ETV system provided by the European Commission was carried out.
Lee, W R; Kim, H S; Park, M K; Lee, J H; Kim, K H
2012-09-01
The Thomson scattering diagnostic system is successfully installed in the Korea Superconducting Tokamak Advanced Research (KSTAR) facility. We got the electron temperature and electron density data for the first time in 2011, 4th campaign using a field programmable gate array (FPGA) based signal control board. It operates as a signal generator, a detector, a controller, and a time measuring device. This board produces two configurable trigger pulses to operate Nd:YAG laser system and receives a laser beam detection signal from a photodiode detector. It allows a trigger pulse to be delivered to a time delay module to make a scattered signal measurement, measuring an asynchronous time value between the KSTAR timing board and the laser system injection signal. All functions are controlled by the embedded processor running on operating system within a single FPGA. It provides Ethernet communication interface and is configured with standard middleware to integrate with KSTAR. This controller has operated for two experimental campaigns including commissioning and performed the reconfiguration of logic designs to accommodate varying experimental situation without hardware rebuilding.
A Reconfigurable Instrument System for Nuclear and Particle Physics Experiments
NASA Astrophysics Data System (ADS)
Sang, Ziru; Li, Feng; Jiang, Xiao; Jin, Ge
2014-04-01
We developed a reconfigurable nuclear instrument system (RNIS) that could satisfy the requirements of diverse nuclear and particle physics experiments, and the inertial confinement fusion diagnostic. Benefiting from the reconfigurable hardware structure and digital pulse processing technology, RNIS shakes off the restrictions of cumbersome crates and miscellaneous modules. It retains all the advantages of conventional nuclear instruments and is more flexible and portable. RNIS is primarily composed of a field programmable hardware board and relevant PC software. Separate analog channels are designed to provide different functions, such as amplifiers, ADC, fast discriminators and Schmitt discriminators for diverse experimental purposes. The high-performance field programmable gate array could complete high-precision time interval measurement, histogram accumulation, counting, and coincidence anticoincidence measurement. To illustrate the prospects of RNIS, a series of applications to the experiments are described in this paper. The first, for which RNIS was originally developed, involves nuclear energy spectrum measurement with a scintillation detector and photomultiplier. The second experiment applies RNIS to a G-M tube counting experiment, and in the third, it is applied to a quantum communication experiment through reconfiguration.
Ford, Paul A; Perkins, Gill; Swaine, Ian
2013-01-01
The purpose of this study was to establish whether an accumulated brisk walking programme, performed during the school day, is effective in changing body composition in primary school children aged 5-11 years. Altogether, 152 participants (79 boys and 73 girls) took part in this repeated-measures intervention study, divided into groups of walkers and controls. The walkers took part in the intervention during school time, which involved brisk walking around the school grounds for 15 min in the morning and afternoon, at least three times a week for 15 weeks. This represented an additional 90 min of moderate physical activity per week. The controls undertook their usual school day activities. Pre- and post-intervention anthropometric and body composition measures were taken. Body fat (-1.95 ± 2.6%) and fat mass (-0.49 ± 1.0 kg) were significantly reduced in the walkers after the intervention, whereas the controls showed no significant changes in these measures. Our results show that regular accumulated bouts of brisk walking during the school day can positively affect body composition in primary school children.
Lovell, Ric; Towlson, Chris; Parkin, Guy; Portas, Matt; Vaeyens, Roel; Cobley, Stephen
2015-01-01
The relative age effect (RAE) and its relationships with maturation, anthropometry, and physical performance characteristics were examined across a representative sample of English youth soccer development programmes. Birth dates of 1,212 players, chronologically age-grouped (i.e., U9's-U18's), representing 17 professional clubs (i.e., playing in Leagues 1 & 2) were obtained and categorised into relative age quartiles from the start of the selection year (Q1 = Sep-Nov; Q2 = Dec-Feb; Q3 = Mar-May; Q4 = Jun-Aug). Players were measured for somatic maturation and performed a battery of physical tests to determine aerobic fitness (Multi-Stage Fitness Test [MSFT]), Maximal Vertical Jump (MVJ), sprint (10 & 20m), and agility (T-Test) performance capabilities. Odds ratio's (OR) revealed Q1 players were 5.3 times (95% confidence intervals [CI]: 4.08-6.83) more likely to be selected than Q4's, with a particularly strong RAE bias observed in U9 (OR: 5.56) and U13-U16 squads (OR: 5.45-6.13). Multivariate statistical models identified few between quartile differences in anthropometric and fitness characteristics, and confirmed chronological age-group and estimated age at peak height velocity (APHV) as covariates. Assessment of practical significance using magnitude-based inferences demonstrated body size advantages in relatively older players (Q1 vs. Q4) that were very-likely small (Effect Size [ES]: 0.53-0.57), and likely to very-likely moderate (ES: 0.62-0.72) in U12 and U14 squads, respectively. Relatively older U12-U14 players also demonstrated small advantages in 10m (ES: 0.31-0.45) and 20m sprint performance (ES: 0.36-0.46). The data identify a strong RAE bias at the entry-point to English soccer developmental programmes. RAE was also stronger circa-PHV, and relatively older players demonstrated anaerobic performance advantages during the pubescent period. Talent selectors should consider motor function and maturation status assessments to avoid premature and unwarranted drop-out of soccer players within youth development programmes.
Lovell, Ric; Towlson, Chris; Parkin, Guy; Portas, Matt; Vaeyens, Roel; Cobley, Stephen
2015-01-01
The relative age effect (RAE) and its relationships with maturation, anthropometry, and physical performance characteristics were examined across a representative sample of English youth soccer development programmes. Birth dates of 1,212 players, chronologically age-grouped (i.e., U9’s-U18’s), representing 17 professional clubs (i.e., playing in Leagues 1 & 2) were obtained and categorised into relative age quartiles from the start of the selection year (Q1 = Sep-Nov; Q2 = Dec-Feb; Q3 = Mar-May; Q4 = Jun-Aug). Players were measured for somatic maturation and performed a battery of physical tests to determine aerobic fitness (Multi-Stage Fitness Test [MSFT]), Maximal Vertical Jump (MVJ), sprint (10 & 20m), and agility (T-Test) performance capabilities. Odds ratio’s (OR) revealed Q1 players were 5.3 times (95% confidence intervals [CI]: 4.08–6.83) more likely to be selected than Q4’s, with a particularly strong RAE bias observed in U9 (OR: 5.56) and U13-U16 squads (OR: 5.45–6.13). Multivariate statistical models identified few between quartile differences in anthropometric and fitness characteristics, and confirmed chronological age-group and estimated age at peak height velocity (APHV) as covariates. Assessment of practical significance using magnitude-based inferences demonstrated body size advantages in relatively older players (Q1 vs. Q4) that were very-likely small (Effect Size [ES]: 0.53–0.57), and likely to very-likely moderate (ES: 0.62–0.72) in U12 and U14 squads, respectively. Relatively older U12-U14 players also demonstrated small advantages in 10m (ES: 0.31–0.45) and 20m sprint performance (ES: 0.36–0.46). The data identify a strong RAE bias at the entry-point to English soccer developmental programmes. RAE was also stronger circa-PHV, and relatively older players demonstrated anaerobic performance advantages during the pubescent period. Talent selectors should consider motor function and maturation status assessments to avoid premature and unwarranted drop-out of soccer players within youth development programmes. PMID:26331852
Taha, Zahari; Musa, Rabiu Muazu; P P Abdul Majeed, Anwar; Alim, Muhammad Muaz; Abdullah, Mohamad Razali
2018-02-01
Support Vector Machine (SVM) has been shown to be an effective learning algorithm for classification and prediction. However, the application of SVM for prediction and classification in specific sport has rarely been used to quantify/discriminate low and high-performance athletes. The present study classified and predicted high and low-potential archers from a set of fitness and motor ability variables trained on different SVMs kernel algorithms. 50 youth archers with the mean age and standard deviation of 17.0 ± 0.6 years drawn from various archery programmes completed a six arrows shooting score test. Standard fitness and ability measurements namely hand grip, vertical jump, standing broad jump, static balance, upper muscle strength and the core muscle strength were also recorded. Hierarchical agglomerative cluster analysis (HACA) was used to cluster the archers based on the performance variables tested. SVM models with linear, quadratic, cubic, fine RBF, medium RBF, as well as the coarse RBF kernel functions, were trained based on the measured performance variables. The HACA clustered the archers into high-potential archers (HPA) and low-potential archers (LPA), respectively. The linear, quadratic, cubic, as well as the medium RBF kernel functions models, demonstrated reasonably excellent classification accuracy of 97.5% and 2.5% error rate for the prediction of the HPA and the LPA. The findings of this investigation can be valuable to coaches and sports managers to recognise high potential athletes from a combination of the selected few measured fitness and motor ability performance variables examined which would consequently save cost, time and effort during talent identification programme. Copyright © 2017 Elsevier B.V. All rights reserved.
Käser, Michael; Maure, Christine; Halpaap, Beatrice M M; Vahedi, Mahnaz; Yamaka, Sara; Launois, Pascal; Casamitjana, Núria
2016-05-01
Between August 2012 and April 2013 the Career Development Fellowship programme of the Special Programme for Research and Training in Tropical Diseases (World Health Organization) underwent an external evaluation to assess its past performance and determine recommendations for future programme development and continuous performance improvement. The programme provides a year-long training experience for qualified researchers from low and middle income countries at pharmaceutical companies or product development partnerships. Independent evaluators from the Swiss Tropical and Public Health Institute and the Barcelona Institute for Global Health used a results-based methodology to review the programme. Data were gathered through document review, surveys, and interviews with a range of programme participants. The final evaluation report found the Career Development Fellowship to be relevant to organizers' and programme objectives, efficient in its operations, and effective in its training scheme, which was found to address needs and gaps for both fellows and their home institutions. Evaluators found that the programme has the potential for impact and sustainability beyond the programme period, especially with the successful reintegration of fellows into their home institutions, through which newly-developed skills can be shared at the institutional level. Recommendations included the development of a scheme to support the re-integration of fellows into their home institutions post-fellowship and to seek partnerships to facilitate the scaling-up of the programme. The impact of the Professional Membership Scheme, an online professional development tool launched through the programme, beyond the scope of the Career Development Fellowship programme itself to other applications, has been identified as a positive unintended outcome. The results of this evaluation may be of interest for other efforts in the field of research capacity strengthening in LMICs or, generally, to other professional development schemes of a similar structure.
Effects of a salsa dance training on balance and strength performance in older adults.
Granacher, Urs; Muehlbauer, Thomas; Bridenbaugh, Stephanie A; Wolf, Madeleine; Roth, Ralf; Gschwind, Yves; Wolf, Irene; Mata, Rui; Kressig, Reto W
2012-01-01
Deficits in static and particularly dynamic postural control and force production have frequently been associated with an increased risk of falling in older adults. The objectives of this study were to investigate the effects of salsa dancing on measures of static/dynamic postural control and leg extensor power in seniors. Twenty-eight healthy older adults were randomly assigned to an intervention group (INT, n = 14, age 71.6 ± 5.3 years) to conduct an 8-week progressive salsa dancing programme or a control group (CON, n = 14, age 68.9 ± 4.7 years). Static postural control was measured during one-legged stance on a balance platform and dynamic postural control was obtained while walking on an instrumented walkway. Leg extensor power was assessed during a countermovement jump on a force plate. Programme compliance was excellent with participants of the INT group completing 92.5% of the dancing sessions. A tendency towards an improvement in the selected measures of static postural control was observed in the INT group as compared to the CON group. Significant group × test interactions were found for stride velocity, length and time. Post hoc analyses revealed significant increases in stride velocity and length, and concomitant decreases in stride time. However, salsa dancing did not have significant effects on various measures of gait variability and leg extensor power. Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate. Age-related deficits in measures of static and particularly dynamic postural control can be mitigated by salsa dancing in older adults. High physical activity and fitness/mobility levels of our participants could be responsible for the nonsignificant findings in gait variability and leg extensor power. Copyright © 2012 S. Karger AG, Basel.
Anding, Kirsten; Bär, Thomas; Trojniak-Hennig, Joanna; Kuchinke, Simone; Krause, Rolfdieter; Rost, Jan M; Halle, Martin
2015-01-01
Objective Long-term studies regarding the effect of a structured physical exercise programme (SPEP) during haemodialysis (HD) assessing compliance and clinical benefit are scarce. Study design A single-centre clinical trial, non-randomised, investigating 46 patients with HD (63.2±16.3 years, male/female 24/22, dialysis vintage 4.4 years) performing an SPEP over 5 years. The SPEP (twice/week for 60 min during haemodialysis) consisted of a combined resistance (8 muscle groups) and endurance (supine bicycle ergometry) training. Exercise intensity was continuously adjusted to improvements of performance testing. Changes in endurance and resistance capacity, physical functioning and quality of life (QoL) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years. Average power per training session, maximal strength tests (maximal exercise repetitions/min), three performance-based tests for physical function, SF36 for QoL were assessed in the beginning and every 6 months thereafter. Results 78% of the patients completed the programme after 1 year and 43% after 5 years. Participants were divided—according to adherence to the programme—into three groups: (1) high adherence group (HA, >80% of 104 training sessions within 12 months), (2) moderate adherence (MA, 60–80%), and 3. Low adherence group (LA, <60%)) with HA and MA evaluated quantitatively. One-year follow-up data revealed significant (p<0.05) improvement for both groups in all measured parameters: exercise capacity (HA: 55%, MA: 45%), strength (HA: >120%, MA: 40–50%), QoL in three scores of SF36 subscales and physical function in the three tests taken between 11% and 31%. Moreover, a quantitative correlation analysis revealed a close association (r=0.8) between large improvement of endurance capacity and weak physical condition (HA). Conclusions The exercise programme described improves physical function significantly and can be integrated into a HD routine with a high long-term adherence. PMID:26316654
Implementation of renal key performance indicators: promoting improved clinical practice.
Toussaint, Nigel D; McMahon, Lawrence P; Dowling, Gregory; Soding, Jenny; Safe, Maria; Knight, Richard; Fair, Kathleen; Linehan, Leanne; Walker, Rowan G; Power, David A
2015-03-01
In the Australian state of Victoria, the Renal Health Clinical Network (RHCN) of the Department of Health Victoria established a Renal Key Performance Indicator (KPI) Working Group in 2011. The group developed four KPIs related to chronic kidney disease and dialysis. A transplant working group of the RHCN developed two additional KPIs. The aim was to develop clinical indicators to measure performance of renal services to drive service improvement. A data collection and benchmarking programme was established, with data provided monthly to the Department using a purpose-designed website portal. The KPI Working Group is responsible for analysing data each quarter and ensuring indicators remain accurate and relevant. Each indicator has clear definitions and targets, and assess (i) patient education, (ii) timely creation of vascular access for haemodialysis, (iii) proportion of patients dialysing at home, (iv) incidence of dialysis-related peritonitis, (v) incidence of pre-emptive renal transplantation, and (vi) timely listing of patients for deceased donor transplantation. Most KPIs have demonstrated improved performance over time with limited gains notably in two: the proportion of patients dialysing at home (KPI 3) and timely listing patients for transplantation (KPI 6). KPI implementation has been established in Victoria for 2 years, providing performance data without additional funding. The six Victorian KPIs are measurable, relevant and modifiable, and implementation relies on enthusiasm and goodwill of physicians and nurses involved in collecting data. The KPIs require further evaluation, but adoption of a similar programme by other jurisdictions could lead to improved national outcomes. © 2014 Asian Pacific Society of Nephrology.
Boggan, Joel C.; Cheely, George; Shah, Bimal R.; Heffelfinger, Randy; Springall, Deanna; Thomas, Samantha M.; Zaas, Aimee; Bae, Jonathan
2014-01-01
Background Systematically engaging residents in large programs in quality improvement (QI) is challenging. Objective To coordinate a shared QI project in a large residency program using an online tool. Methods A web-based QI tool guided residents through a 2-phase evaluation of performance of foot examinations in patients with diabetes. In phase 1, residents completed reviews of health records with online data entry. Residents were then presented with personal performance data relative to peers and were prompted to develop improvement plans. In phase 2, residents again reviewed personal performance. Rates of performance were compared at the program and clinic levels for each phase, with data presented for residents. Acceptability was measured by the number of residents completing each phase. Feasibility was measured by estimated faculty, programmer, and administrator time and costs. Results Seventy-nine of 86 eligible residents (92%) completed improvement plans and reviewed 1471 patients in phase 1, whereas 68 residents (79%) reviewed 1054 patient charts in phase 2. Rates of performance of examination increased significantly between phases (from 52% to 73% for complete examination, P < .001). Development of the tool required 130 hours of programmer time. Project analysis and management required 6 hours of administrator and faculty time monthly. Conclusions An online tool developed and implemented for program-wide QI initiatives successfully engaged residents to participate in QI activities. Residents using this tool demonstrated improvement in a selected quality target. This tool could be adapted by other graduate medical education programs or for faculty development. PMID:26279782
Grier, Karissa; Hill, Jennie L; Reese, Felicia; Covington, Constance; Bennette, Franchennette; MacAuley, Lorien; Zoellner, Jamie
2015-10-01
Few published community garden studies have focused on low socio-economic youth living in public housing or used a community-based participatory research approach in conjunction with youth-focused community garden programmes. The objective of the present study was to evaluate the feasibility (i.e. demand, acceptability, implementation and limited-effectiveness testing) of a 10-week experiential theory-based gardening and nutrition education programme targeting youth living in public housing. In this mixed-methods feasibility study, demand and acceptability were measured using a combination of pre- and post-programme surveys and interviews. Implementation was measured via field notes and attendance. Limited-effectiveness was measured quantitatively using a pre-post design and repeated-measures ANOVA tests. Two public housing sites in the Dan River Region of south central Virginia, USA. Forty-three youth (primarily African American), twenty-five parents and two site leaders. The positive demand and acceptability findings indicate the high potential of the programme to be used and be suitable for the youth, parents and site leaders. Field notes revealed numerous implementation facilitators and barriers. Youth weekly attendance averaged 4·6 of 10 sessions. Significant improvements (P<0·05) were found for some (e.g. fruit and vegetable asking self-efficacy, overall gardening knowledge, knowledge of MyPlate recommendations), but not all limited-effectiveness measures (e.g. willingness to try fruits and vegetables, fruit and vegetable eating self-efficacy). This community-based participatory research study demonstrates numerous factors that supported and threatened the feasibility of a gardening and nutrition programme targeting youth in public housing. Lessons learned are being used to adapt and strengthen the programme for future efforts targeting fruit and vegetable behaviours.
NASA Astrophysics Data System (ADS)
Çelik, Mehmet; Hamid, Ramiz; Kuetgens, Ulrich; Yacoot, Andrew
2012-08-01
X-ray interferometry is emerging as an important tool for dimensional nanometrology both for sub-nanometre measurement and displacement. It has been used to verify the performance of the next generation of displacement measuring optical interferometers within the European Metrology Research Programme project NANOTRACE. Within this project a more detailed set of comparison measurements between the x-ray interferometer and a dual channel Fabry-Perot optical interferometer (DFPI) have been made to demonstrate the capabilities of both instruments for picometre displacement metrology. The results show good agreement between the two instruments, although some minor differences of less than 5 pm have been observed.
Electronics for a focal plane crystal spectrometer
NASA Technical Reports Server (NTRS)
Goeke, R. F.
1978-01-01
The HEAO-B program forced the usual constraints upon the spacecraft experiment electronics: high reliability, low power consumption, and tight packaging at reasonable cost. The programmable high voltage power supplies were unique in both application and simplicity of manufacture. The hybridized measurement chain is a modification of that used on the SAS-C program; the charge amplifier design in particular shows definite improvement in performance over previous work.
Lindsay, Geoff; Strand, Steve; Davis, Hilton
2011-12-30
There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP). This involved the large scale rolling out of three programmes to parents of children 8-13 years in 18 local authorities (LAs) over a 2 year period. The UK government's Department for Education allocated each programme (Incredible Years, Triple P and Strengthening Families Strengthening Communities) to six LAs which then developed systems to intervene using parenting groups. Implementation fidelity was supported by the training of group facilitators by staff of the appropriate parenting programme supplemented by supervision. Parents completed measures of parenting style, efficacy, satisfaction, and mental well-being, and also child behaviour. A total of 1121 parents completed pre- and post-course measures. There were significant improvements on all measures for each programme; effect sizes (Cohen's d) ranged across the programmes from 0.57 to 0.93 for parenting style; 0.33 to 0.77 for parenting satisfaction and self-efficacy; and from 0.49 to 0.88 for parental mental well-being. Effectiveness varied between programmes: Strengthening Families Strengthening Communities was significantly less effective than both the other two programmes in improving parental efficacy, satisfaction and mental well-being. Improvements in child behaviour were found for all programmes: effect sizes for reduction in conduct problems ranged from -0.44 to -0.71 across programmes, with Strengthening Families Strengthening Communities again having significantly lower reductions than Incredible Years. Evidence-based parenting programmes can be implemented successfully on a large scale in community settings despite the lack of concentrated and sustained support available during a controlled trial.
2011-01-01
Background There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP). This involved the large scale rolling out of three programmes to parents of children 8-13 years in 18 local authorities (LAs) over a 2 year period. Methods The UK government's Department for Education allocated each programme (Incredible Years, Triple P and Strengthening Families Strengthening Communities) to six LAs which then developed systems to intervene using parenting groups. Implementation fidelity was supported by the training of group facilitators by staff of the appropriate parenting programme supplemented by supervision. Parents completed measures of parenting style, efficacy, satisfaction, and mental well-being, and also child behaviour. Results A total of 1121 parents completed pre- and post-course measures. There were significant improvements on all measures for each programme; effect sizes (Cohen's d) ranged across the programmes from 0.57 to 0.93 for parenting style; 0.33 to 0.77 for parenting satisfaction and self-efficacy; and from 0.49 to 0.88 for parental mental well-being. Effectiveness varied between programmes: Strengthening Families Strengthening Communities was significantly less effective than both the other two programmes in improving parental efficacy, satisfaction and mental well-being. Improvements in child behaviour were found for all programmes: effect sizes for reduction in conduct problems ranged from -0.44 to -0.71 across programmes, with Strengthening Families Strengthening Communities again having significantly lower reductions than Incredible Years. Conclusions Evidence-based parenting programmes can be implemented successfully on a large scale in community settings despite the lack of concentrated and sustained support available during a controlled trial. PMID:22208676
Support for All in the UK Work Programme? Differential Payments, Same Old Problem
Rees, James; Whitworth, Adam; Carter, Elle
2014-01-01
The UK has been a high profile policy innovator in welfare-to-work provision which has led in the Coalition government's Work Programme to a fully outsourced, ‘black box’ model with payments based overwhelmingly on job outcome results. A perennial fear in such programmes is providers' incentives to ‘cream’ and ‘park’ claimants, and the Department for Work and Pensions has sought to mitigate such provider behaviours through Work Programme design, particularly via the use of claimant groups and differential pricing. In this article, we draw on a qualitative study of providers in the programme alongside quantitative analysis of published performance data to explore evidence around creaming and parking. The combination of the quantitative and qualitative evidence suggest that creaming and parking are widespread, seem systematically embedded within the Work Programme, and are driven by a combination of intense cost-pressures and extremely ambitious performance targets alongside overly diverse claimant groups and inadequately calibrated differentiated payment levels. PMID:25411516
Support for All in the UK Work Programme? Differential Payments, Same Old Problem.
Rees, James; Whitworth, Adam; Carter, Elle
2014-04-01
The UK has been a high profile policy innovator in welfare-to-work provision which has led in the Coalition government's Work Programme to a fully outsourced, 'black box' model with payments based overwhelmingly on job outcome results. A perennial fear in such programmes is providers' incentives to 'cream' and 'park' claimants, and the Department for Work and Pensions has sought to mitigate such provider behaviours through Work Programme design, particularly via the use of claimant groups and differential pricing. In this article, we draw on a qualitative study of providers in the programme alongside quantitative analysis of published performance data to explore evidence around creaming and parking. The combination of the quantitative and qualitative evidence suggest that creaming and parking are widespread, seem systematically embedded within the Work Programme, and are driven by a combination of intense cost-pressures and extremely ambitious performance targets alongside overly diverse claimant groups and inadequately calibrated differentiated payment levels.
Rudge, James W; Phuanakoonon, Suparat; Nema, K Henry; Mounier-Jack, Sandra; Coker, Richard
2010-11-01
In Papua New Guinea, investment by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) has played an important role in scaling up the response to HIV and tuberculosis (TB). As part of a series of case studies on how Global Fund-supported programmes interact with national health systems, we assessed the nature and extent of integration of the Global Fund portfolios within the national HIV and TB programmes, the integration of the HIV and TB programmes within the general health system, and system-wide effects of Global Fund support in Papua New Guinea. The study relied on a literature review and 30 interviews with key stakeholders using the Systemic Rapid Assessment Toolkit and thematic analysis. Global Fund-supported activities were found to be largely integrated, or at least coordinated, with the national HIV and TB programmes. However, this has reinforced the vertical nature of these programmes with respect to the general health system, with parallel systems established to meet the demands of programme scale-up and the performance-based nature of Global Fund investment in the weak health system context of Papua New Guinea. The more parallel functions include monitoring and evaluation, and procurement and supply chain systems, while human resources and infrastructure for service delivery are increasingly integrated at more local levels. Positive synergies of Global Fund support include engagement of civil-society partners, and a reliable supply of high-quality drugs which may have increased patient confidence in the health system. However, the severely limited and overburdened pool of human resources has been skewed towards the three diseases, both at management and service delivery levels. There is also concern surrounding the sustainability of the disease programmes, given their dependence on donors. Increasing Global Fund attention towards health system strengthening was viewed positively, but should acknowledge that system changes are slow, difficult to measure and require long-term support.
School hearing screening programme in the UK: practice and performance
Fonseca, S; Forsyth, H; Neary, W
2005-01-01
Background: Paediatric audiology services and screening programmes are currently under review. Aims and Methods: To investigate current practice and performance of the school hearing screening programme (SHSP) by means of a questionnaire. Results: SHSP was found to detect previously unrecognised hearing loss at low cost. Wide variation in practice was shown, and the majority of services had no computerised system for data collection. Conclusion: There is a need for nationally agreed protocols and quality assurance procedures. PMID:15665168
Carlier, Bouwine E; Schuring, Merel; Burdorf, Alex
2018-03-01
Purpose To evaluate the influence of an interdisciplinary re-employment programme on labour force participation and perceived health among unemployed persons with common mental health problems. In addition, the influence of entering paid employment on self-rated physical health and mental health was investigated. Methods In this quasi-experimental study with 2 years follow up, 869 persons were enrolled after referral to an interdisciplinary re-employment programme (n = 380) or regular re-employment programme (n = 489). The propensity score technique was used to account for observed differences between the intervention and control group. The intervention programme was provided by an interdisciplinary team, consisting of mental health care professionals as well as employment specialists. Mental health problems were addressed through cognitive counselling and individual tailored job-search support was provided by an employment professional. Primary outcome measures were paid employment and voluntary work. Secondary outcome measures were self-rated mental and physical health, measured by the Short Form 12 Health Survey, and anxiety and depressive symptoms, measured by the Kessler Psychological Distress Scale. Changes in labour force participation and health were examined with repeated-measures logistic regression analyses by the generalized estimating equations method. Results The interdisciplinary re-employment programme did not have a positive influence on entering employment or physical or mental health among unemployed persons with mental health problems. After 2 years, 10% of the participants of the intervention programme worked fulltime, compared to 4% of the participants of the usual programmes (adjusted OR 1.65). The observed differences in labour force participation were not statistically significant. However, among persons who entered paid employment, physical health improved (+16%) and anxiety and depressive symptoms decreased (-15%), whereas health remained unchanged among persons who continued to be unemployed. Conclusions Policies to improve population health should take into account that promoting paid employment may be an effective intervention to improve health. It is recommended to invest in interdisciplinary re-employment programmes with a first place and train approach.
Retrospective performance assessment of the draft test guideline 426 on developmental neurotoxicity.
This document was created by an international panel under the auspices of the International Programme on Chemical Safety of the World Health Programme. The purpose and intent of this retrospective performance assessment document is to review the history of the developmen...
Kalinin, Stanislav; Kühnemuth, Ralf; Vardanyan, Hayk; Seidel, Claus A M
2012-09-01
We present a fast hardware photon correlator implemented in a field-programmable gate array (FPGA) combined with a compact confocal fluorescence setup. The correlator has two independent units with a time resolution of 4 ns while utilizing less than 15% of a low-end FPGA. The device directly accepts transistor-transistor logic (TTL) signals from two photon counting detectors and calculates two auto- or cross-correlation curves in real time. Test measurements demonstrate that the performance of our correlator is comparable with the current generation of commercial devices. The sensitivity of the optical setup is identical or even superior to current commercial devices. The FPGA design and the optical setup both allow for a straightforward extension to multi-color applications. This inexpensive and compact solution with a very good performance can serve as a versatile platform for uses in education, applied sciences, and basic research.
NASA Astrophysics Data System (ADS)
Kalinin, Stanislav; Kühnemuth, Ralf; Vardanyan, Hayk; Seidel, Claus A. M.
2012-09-01
We present a fast hardware photon correlator implemented in a field-programmable gate array (FPGA) combined with a compact confocal fluorescence setup. The correlator has two independent units with a time resolution of 4 ns while utilizing less than 15% of a low-end FPGA. The device directly accepts transistor-transistor logic (TTL) signals from two photon counting detectors and calculates two auto- or cross-correlation curves in real time. Test measurements demonstrate that the performance of our correlator is comparable with the current generation of commercial devices. The sensitivity of the optical setup is identical or even superior to current commercial devices. The FPGA design and the optical setup both allow for a straightforward extension to multi-color applications. This inexpensive and compact solution with a very good performance can serve as a versatile platform for uses in education, applied sciences, and basic research.
A novel digital neutron flux monitor for international thermonuclear experimental reactor
NASA Astrophysics Data System (ADS)
Xiang, ZHOU; Zihao, LIU; Chao, CHEN; Renjie, ZHU; Li, ZHAO; Lingfeng, WEI; Zejie, YIN
2018-04-01
A novel full-digital real-time neutron flux monitor (NFM) has been developed for the International Thermonuclear Experimental Reactor. A measurement range of 109 counts per second is achieved with 3 different sensitive fission chambers. The Counting mode and Campbelling mode have been combined as a means to achieve higher measurement range. The system is based on high speed as well as parallel and pipeline processing of the field programmable gate array and has the ability to upload raw-data of analog-to-digital converter in real-time through the PXIe platform. With the advantages of the measurement range, real time performance and the ability of raw-data uploading, the digital NFM has been tested in HL-2A experiments and reflected good experimental performance.
Zachariah, R; Reid, T; Srinath, S; Chakaya, J; Legins, K; Karunakara, U; Harries, A D
2011-11-01
Very limited operational research (OR) emerges from programme settings in low-income countries where the greatest burden of disease lies. The price paid for this void includes a lack of understanding of how health systems are actually functioning, not knowing what works and what does not, and an inability to propose adapted and innovative solutions to programme problems. We use the National Tuberculosis Control Programme as an example to advocate for strong programme-level leadership to steer OR and build viable relationships between programme managers, researchers and policy makers. We highlight the need to create a stimulating environment for conducting OR and identify some of the main practical challenges and enabling factors at programme level. We focus on the important role of an OR focal point within programmes and practical approaches to training that can deliver timely and quantifiable outputs. Finally, we emphasise the need to measure successful OR leadership development at programme level and we propose parameters by which this can be assessed. This paper 1) provides reasons why programmes should take the lead in coordinating and directing OR, 2) identifies the practical challenges and enabling factors for implementing, managing and sustaining OR and 3) proposes parameters for measuring successful leadership capacity development in OR.
Jin, Si Hyung; Jeong, Heon-Ho; Lee, Byungjin; Lee, Sung Sik; Lee, Chang-Soo
2015-01-01
We present a programmable microfluidic static droplet array (SDA) device that can perform user-defined multistep combinatorial protocols. It combines the passive storage of aqueous droplets without any external control with integrated microvalves for discrete sample dispensing and dispersion-free unit operation. The addressable picoliter-volume reaction is systematically achieved by consecutively merging programmable sequences of reagent droplets. The SDA device is remarkably reusable and able to perform identical enzyme kinetic experiments at least 30 times via automated cross-contamination-free removal of droplets from individual hydrodynamic traps. Taking all these features together, this programmable and reusable universal SDA device will be a general microfluidic platform that can be reprogrammed for multiple applications.
The effectiveness of a multidisciplinary pain management programme managing chronic pain.
Dysvik, Elin; Vinsnes, Anne Guttormsen; Eikeland, Ole-Johan
2004-10-01
The aim of this study was to develop and evaluate the effects of a multidisciplinary pain management programme on coping, health-related quality of life and pain intensity. Seventy-six outpatients suffering from chronic pain completed this eight-week programme with the primary aims to increase coping, as measured by the Ways of Coping Checklist, and health-related quality of life, as measured by the Short Form-36 Health Survey. Therapeutic dialogues and education, combined with physical activity, were given in order to increase understanding of and attention to non-medical factors that might affect pain perception. The programme was active, time-limited and structured on the basis of multidisciplinary pain management programmes based on a cognitive-behavioural approach. The findings suggest that this programme has the potential to improve coping skills and health-related quality of life. Additionally, pain intensity, as measured by the Visual Analogue Scale, was reduced. Age and disability were revealed as the prominent predictors of change after treatment. The differences in this sample indicated that the drop-outs tended to be older and reported more health problems, although these findings were non-significant. Clinical and research implications are discussed.
The need for theory evaluation in global citizenship programmes: The case of the GCSA programme.
Goodier, Sarah; Field, Carren; Goodman, Suki
2018-02-01
Many education programmes lack a documented programme theory. This is a problem for programme planners and evaluators as the ability to measure programme success is grounded in the plausibility of the programme's underlying causal logic. Where the programme theory has not been documented, conducting a theory evaluation offers a foundational evaluation step as it gives an indication of whether the theory behind a programme is sound. This paper presents a case of a theory evaluation of a Global Citizenship programme at a top-ranking university in South Africa, subsequently called the GCSA Programme. This evaluation highlights the need for documented programme theory in global citizenship-type programmes for future programme development. An articulated programme theory produced for the GCSA Programme, analysed against the available social science literature, indicated it is comparable to other such programmes in terms of its overarching framework. What the research found is that most other global citizenship programmes do not have an articulated programme theory. These programmes also do not explicitly link their specific activities to their intended outcomes, making demonstrating impact impossible. In conclusion, we argue that taking a theory-based approach can strengthen and enable outcome evaluations in global citizenship programmes. Copyright © 2017. Published by Elsevier Ltd.
Peabody, John W; Shimkhada, Riti; Quimbo, Stella; Solon, Orville; Javier, Xylee; McCulloch, Charles
2014-08-01
Improving clinical performance using measurement and payment incentives, including pay for performance (or P4P), has, so far, shown modest to no benefit on patient outcomes. Our objective was to assess the impact of a P4P programme on paediatric health outcomes in the Philippines. We used data from the Quality Improvement Demonstration Study. In this study, the P4P intervention, introduced in 2004, was randomly assigned to 10 community district hospitals, which were matched to 10 control sites. At all sites, physician quality was measured using Clinical Performance Vignettes (CPVs) among randomly selected physicians every 6 months over a 36-month period. In the hospitals randomized to the P4P intervention, physicians received bonus payments if they met qualifying scores on the CPV. We measured health outcomes 4-10 weeks after hospital discharge among children 5 years of age and under who had been hospitalized for diarrhoea and pneumonia (the two most common illnesses affecting this age cohort) and had been under the care of physicians participating in the study. Health outcomes data collection was done at baseline/pre-intervention and 2 years post-intervention on the following post-discharge outcomes: (1) age-adjusted wasting, (2) C-reactive protein in blood, (3) haemoglobin level and (4) parental assessment of child's health using general self-reported health (GSRH) measure. To evaluate changes in health outcomes in the control vs intervention sites over time (baseline vs post-intervention), we used a difference-in-difference logistic regression analysis, controlling for potential confounders. We found an improvement of 7 and 9 percentage points in GSRH and wasting over time (post-intervention vs baseline) in the intervention sites relative to the control sites (P ≤ 0.001). The results from this randomized social experiment indicate that the introduction of a performance-based incentive programme, which included measurement and feedback, led to improvements in two important child health outcomes. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.
Institutionalizing and sustaining social change in health systems: the case of Uganda.
Hage, Jerald; Valadez, Joseph J
2017-11-01
The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C's: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized 'stability', whereas in global health, the issue is determining how to improve the impact of services by 'changing' programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0-11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used to change health services, and the four separate indicators being used to measure women's health and child survival services. We conclude that the two C's (competent evaluators and control mechanisms) have been critical for sustaining programme evaluation in Uganda. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
Institutionalizing and sustaining social change in health systems: the case of Uganda
Hage, Jerald; Valadez, Joseph J
2017-01-01
Abstract The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C’s: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized ‘stability’, whereas in global health, the issue is determining how to improve the impact of services by ‘changing’ programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0–11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used to change health services, and the four separate indicators being used to measure women's health and child survival services. We conclude that the two C’s (competent evaluators and control mechanisms) have been critical for sustaining programme evaluation in Uganda. PMID:28981663
Is the Colombian health system reform improving the performance of public hospitals in Bogotá?
McPake, Barbara; Yepes, Francisco Jose; Lake, Sally; Sanchez, Luz Helena
2003-06-01
Many countries are experimenting with public hospital reform - both increasing the managerial autonomy with which hospitals conduct their affairs, and separating 'purchaser' and 'provider' sides of the health system, thus increasing the degree of market pressure brought to bear on hospitals. Evidence suggesting that such reform will improve hospital performance is weak. From a theoretical perspective, it is not clear why public hospitals should be expected to behave like firms and seek to maximize profits as this model requires. Empirically, there is very slight evidence that such reforms may improve efficiency, and reason to be concerned about their equity implications. In Colombia, an ambitious reform programme includes among its measures the attempt to universalize a segmented health system, the creation of a purchaser-provider split and the transformation of public hospitals into 'autonomous state entities'. By design, the Colombian reform programme avoids the forces that produce equity losses in other developing countries. This paper reports the results of a study that has tried to track hospital performance in other dimensions in the post-reform period in Bogotá. Trends in hospital inputs, production and productivity, quality and patient satisfaction are presented, and qualitative data based on interviews with hospital workers are analyzed. The evidence we have been able to collect is capable of providing only a partial response to the study question. There is some evidence of increased activity and productivity and sustained quality despite declining staffing levels. Qualitative data suggest that hospital workers have noticed considerable changes, which include greater responsiveness to patients but also a heavier administrative burden. It is difficult to attribute specific causality to all of the changes measured and this reflects the inherent difficulty of judging the effects of large-scale reform programmes as well as weaknesses and gaps in the data available.
New Zealand traffic and local air quality.
Irving, Paul; Moncrieff, Ian
2004-12-01
Since 1996 the New Zealand Ministry of Transport (MOT) has been investigating the effects of road transport on local air quality. The outcome has been the government's Vehicle Fleet Emissions Control Strategy (VFECS). This is a programme of measures designed to assist with the improvement in local air quality, and especially in the appropriate management of transport sector emissions. Key to the VFECS has been the development of tools to assess and predict the contribution of vehicle emissions to local air pollution, in a given urban situation. Determining how vehicles behave as an emissions source, and more importantly, how the combined traffic flows contribute to the total emissions within a given airshed location was an important element of the programme. The actual emissions output of a vehicle is more than that determined by a certified emission standard, at the point of manufacture. It is the engine technology's general performance capability, in conjunction with the local driving conditions, that determines its actual emissions output. As vehicles are a mobile emissions source, to understand the effect of vehicle technology, it is necessary to work with the average fleet performance, or "fleet-weighted average emissions rate". This is the unit measure of performance of the general traffic flow that could be passing through a given road corridor or network, as an average, over time. The flow composition can be representative of the national fleet population, but also may feature particular vehicle types in a given locality, thereby have a different emissions 'signature'. A summary of the range of work that has been completed as part of the VFECS programme is provided. The NZ Vehicle Fleet Emissions Model and the derived data set available in the NZ Traffic Emission Rates provide a significant step forward in the consistent analysis of practical, sustainable vehicle emissions policy and air-quality management in New Zealand.
Francis, Linda; Dunt, David; Cadilhac, Dominique A
2016-05-31
Programmes to address chronic disease are a focus of governments worldwide. Despite growth in 'implementation science', there is a paucity of knowledge regarding the best means to measure sustainability. The aim of this review was to summarise current practice for measuring sustainability outcomes of chronic disease health programmes, providing guidance for programme planners and future directions for the academic field. A scoping review of the literature spanning 1985-2015 was conducted using MEDLINE, CINAHL, PsychINFO and The Cochrane Library limited to English language and adults. Main search terms included chronic disease, acute care, sustainability, institutionalisation and health planning. A descriptive synthesis was required. Settings included primary care, hospitals, mental health centres and community health. Programmes included preventing or managing chronic conditions including diabetes, heart disease, depression, respiratory disease, cancer, obesity, dental hygiene and multiple chronic diseases. Outcome measures included clarifying a sustainability definition, types of methodologies used, timelines for assessment, criteria levels to determine outcomes and how methodology varies between intervention types. Among 153 abstracts retrieved, 87 were retained for full article review and 42 included in the qualitative synthesis. Five definitions for sustainability outcome were identified with 'maintenance of programme activities' most frequent. Achieving sustainability was dependent on inter-relationships between various organisational and social contexts supporting a broad scale approach to evaluation. An increasing trend in use of mixed methods designs over multiple time points to determine sustainability outcomes was found. Despite the importance and investment in chronic disease programmes, few studies are undertaken to measure sustainability. Methods to evaluate sustainability are diverse with some emerging patterns in measurement found. Use of mixed methods approaches over multiple time points may serve to better guide measurement of sustainability. Consensus on aspects of standardised measurement would promote the future possibility of meta-analytic syntheses. 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/
SRB-3D Solid Rocket Booster performance prediction program. Volume 3: Programmer's manual
NASA Technical Reports Server (NTRS)
Winkler, J. C.
1976-01-01
The programmer's manual for the Modified Solid Rocket Booster Performance Prediction Program (SRB-3D) describes the major control routines of SRB-3D, followed by a super index listing of the program and a cross-reference of the program variables.
Latorre Román, Pedro Ángel; Villar Macias, Francisco Javier; García Pinillos, Felipe
2018-04-01
The purpose of this study was to examine the effects of a 10 week contrast training (CT) programme (isometric + plyometric) on jumping, sprinting abilities and agility performance in prepubertal basketball players. Fifty-eight children from a basketball academy (age: 8.72 ± 0.97 years; body mass index: 17.22 ± 2.48 kg/m 2 ) successfully completed the study. Participants were randomly assigned to experimental groups (EG, n = 30) and control groups (CG, n = 28). The CT programme was included in the experimental group's training sessions - twice a week - as part of their usual weekly training regime. This programme included 3 exercises: 1 isometric and 2 plyometric. Jumping, sprinting and agility performance were assessed before and after the training programme. Significant differences were found in posttest between EG and CG in sprint and T-test: EG showed better results than CG. Furthermore, there were significant differences in posttest-pretest between EG and CG in squat jump, countermovement jump, drop jump, sprint and T-test with the EG showing better results than CG. The CT programme led to increases in vertical jump, sprint and agility levels, so that the authors suggest that prepubertal children exhibit high muscular strength trainability.
Soban, Lynn M; Kim, Linda; Yuan, Anita H; Miltner, Rebecca S
2017-09-01
To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes. Data were collected by an e-mail survey to all chief nursing officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarise survey responses and evaluate relationships between some variables. Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalised within individual hospitals. Organisational strategies to support implementation of pressure ulcer preventive programmes are often not optimally operationalised to achieve consistent, sustainable performance. The results of the present study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
Radiation Effects on Current Field Programmable Technologies
NASA Technical Reports Server (NTRS)
Katz, R.; LaBel, K.; Wang, J. J.; Cronquist, B.; Koga, R.; Penzin, S.; Swift, G.
1997-01-01
Manufacturers of field programmable gate arrays (FPGAS) take different technological and architectural approaches that directly affect radiation performance. Similar y technological and architectural features are used in related technologies such as programmable substrates and quick-turn application specific integrated circuits (ASICs). After analyzing current technologies and architectures and their radiation-effects implications, this paper includes extensive test data quantifying various devices total dose and single event susceptibilities, including performance degradation effects and temporary or permanent re-configuration faults. Test results will concentrate on recent technologies being used in space flight electronic systems and those being developed for use in the near term. This paper will provide the first extensive study of various configuration memories used in programmable devices. Radiation performance limits and their impacts will be discussed for each design. In addition, the interplay between device scaling, process, bias voltage, design, and architecture will be explored. Lastly, areas of ongoing research will be discussed.
Devenney, Kate E; Sanders, Marit L; Lawlor, Brian; Olde Rikkert, Marcel G M; Schneider, Stefan
2017-03-22
Exercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Human and animal studies have demonstrated that regular physical activity targets brain function by increasing cognitive reserve. There is also evidence of structural changes caused by exercise in preventing or delaying the genesis of neurodegeneration. Although initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI. This study aims to determine the effects of an extensive exercise programme on the progression of MCI. This randomised controlled clinical intervention study will take place across three European sites. Seventy-five previously sedentary patients with a clinical diagnosis of MCI will be recruited at each site. Participants will be randomised to one of three groups. One group will receive a standardised 1-year extensive aerobic exercise intervention (3 units of 45 min/week). The second group will complete stretching and toning (non-aerobic) exercise (3 units of 45 min/week) and the third group will act as the control group. Change in all outcomes will be measured at baseline (T0), after six months (T1) and after 12 months (T2). The primary outcome, cognitive performance, will be determined by a neuropsychological test battery (CogState battery, Trail Making Test and Verbal fluency). Secondary outcomes include Montreal Cognitive Assessment (MoCA), cardiovascular fitness, physical activity, structural changes of the brain, quality of life measures and measures of frailty. Furthermore, outcome variables will be related to genetic variations on genes related to neurogenesis and epigenetic changes in these genes caused by the exercise intervention programme. The results will add new insights into the prevailing notion that exercise may slow the rate of cognitive decline in MCI. ClinicalTrials.gov NCT02913053.
De Andres, Jose; Villanueva, Vicente; Palmisani, Stefano; Cerda-Olmedo, German; Lopez-Alarcon, Maria Dolores; Monsalve, Vicente; Minguez, Ana; Martinez-Sanjuan, Vicente
2011-05-01
It is common clinical practice to perform magnetic resonance imaging (MRI) in patients with indwelling programmable intrathecal drug delivery (IDD) systems, although the safety of the procedure has never been documented. We performed a single-center, 3-year, prospective evaluation in patients with a programmable implanted IDD to assess patient discomfort, IDD technical failures, and adverse effects during and after exposure to MRI. Forty-three consecutive patients with an implanted programmable IDD system (SynchroMed® EL Implantable Infusion Pump, Model 8626L-18, and SynchroMed® II Model 8637-20, 8637-40; Medtronic, Inc., Minneapolis, MN) requiring a scheduled MRI evaluation were studied during a 3-year period. All MRI scans were performed with a 1.5-tesla clinical use magnet and a specific absorption rate of no more than 0.9 W/kg. Radiograph control was used to confirm postexposure pump rotor movement and detect system dislocations. IDD system failures, patient satisfaction, and discomfort were recorded. None of the patients experienced signs of drug overinfusion that could lead to hemodynamic, respiratory, or neurologic alterations. Radiologic evaluation after MRI revealed no spatial displacements of the intrathecal catheter tip or body pump, and programmer telemetry confirmed the infusion recovery. Patients' satisfaction after the procedure was high. Performing an MRI scan with the proposed protocol in patients with an implanted Medtronic programmable IDD system resulted in virtually no technical or medical complications. © 2011 International Anesthesia Research Society
Building a global business continuity programme.
Lazcano, Michael
2014-01-01
Business continuity programmes provide an important function within organisations, especially when aligned with and supportive of the organisation's goals, objectives and organisational culture. Continuity programmes for large, complex international organisations, unlike those for compact national companies, are more difficult to design, build, implement and maintain. Programmes for international organisations require attention to structural design, support across organisational leadership and hierarchy, seamless integration with the organisation's culture, measured success and demonstrated value. This paper details practical, but sometimes overlooked considerations for building successful global business continuity programmes.
Grillich, Ludwig; Kien, Christina; Takuya, Yanagida; Weber, Michael; Gartlehner, Gerald
2016-07-30
Programmes based on the World Health Organization's Health Promoting Schools framework (HPS) have been implemented in several countries but for evidence-based policy-making more research is required to determine the effectiveness of the HPS approach. We conducted a cluster randomised controlled trial. The units of randomisation were primary school classes recruited in May 2010. Eligible participants were Year 3 primary school classes in Lower Austria that had not participated in a similar programme during the last two years. After baseline assessment in September 2010, 53 classes from 45 primary schools in Lower Austria were randomly assigned to an intervention (n = 26 classes, 432 children) or waiting control arm (n = 27 classes, 493 children aged 8.7 years +/- 4 months). Over the course of 1.5 academic years, participating teachers received on-the-job training (20 h) and two workshops (8 h) to promote health related behaviour in students such as physical activity during the school day and to improve the quality of regular physical education classes. We assessed 15 outcomes grouped into five categories: Emotional and Social Experience in School, Physical Activity, Well-being, and Attention Performance measured by validated and standardised questionnaire and Motor Skills measured by validated and standardised motoric and coordination tests in the school gym. The primary outcome was Classroom Climate and part of the outcomecategory Emotional and Social Experience in School. The final assessment took place in April 2012. All assessors were blinded to the allocation of classes. Multilevel growth modelling was used to investigate programme effectiveness. We could not detect any statistically significant differences between groups for the outcomecategories Emotional and Social Experience in school (p = 0.22 to 0.78), Physical Activity, Well-being, and Attention Performance. Significant differences between groups were limited to the outcomecategory Motor Skills (Complex Reaction Ability, Spatial Orientation Skills, Coordination with Precision) which were higher in the intervention group (P < .05). Despite small statistically significant differences in Motor Skills, our study could not detect any clinically relevant improvements in the Emotional and Social Experience at School (including the primary outcome ClassroomClimate), Physical Activity, Well-being, Motor Skills and Attention Performance of students. German register of clinical studies: DRKS00000622 . Retrospectively registered: 03.12.2010. Approved by the Ethics Committee of Lower Austria (GS4-EK-4/107-2010).
Effect of the programme Plan de egreso on chronically ill patients and their family caregivers.
Melo Melo, Blanca Gregoria; Vargas Hernández, Yamile; Carrillo, Gloria Mabel; Alarcón Trujillo, Diana Katherine
To determine the effect of the programme Hospitalisation discharge plan for patients with chronic diseases and family caregivers to strengthen their home care competence -CUIDAR- and reduce the caregiver burden. Quasi-experimental study approach with intervention group. Participants were 62 patients and their caregivers who consulted with a health care institution in the city of Girardot (Colombia). The intervention was carried out for one month, during which, measurements were performed before and after the programme. Most patients were elderly, diagnosed with diabetes, hypertension or COPD, 35% of them with some degree of dependency. The caregivers were mostly women, between the ages of 35 and 59 years old, domestic caregivers, and responsible for caring for their patients for between 13-24hours a day. At the start of the programme the competency for care was low in both patients and caregivers, after the intervention there was a general increase in care and a statistically significant change. Also, at the beginning, 48% of caregivers had some level of burden, and after the study only 27% reported burden with care. The Hospitalisation discharge plan is a strategy that increases the home care competency of the patient and the caregiver, and decreases the caregiver burden. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
García-Pinillos, Felipe; Laredo-Aguilera, José A; Muñoz-Jiménez, Marcos; Latorre-Román, Pedro A
2017-03-13
This study aimed to analyse the effect of 12-week low-volume HIIT-based concurrent training programme on body composition, upper- and lower-body muscle strength, mobility and balance in older adults, as well as to compare it with a low- moderate-intensity continuous training. 90 active older adults were randomly assigned to experimental (EG, n=47), and control (CG, n=43) groups. Body composition and physical functioning were assessed before (pre-test) and after (post-test) a 12-week intervention. A 2-way repeated measures ANOVA was used to test for an interaction between training programme and groups. The time x group interaction revealed no significant between-group differences at pre-test (p≥0.05). The group x time interaction showed significant improvements for the EG in body composition parameters (p<0.05) and physical functioning (muscle strength: p<0.001; mobility: p<0.001; and balance: p<0.05); while the CG remained unchanged (p≥0.05). This HIIT-based concurrent training programme led to greater improvements in body composition, muscle strength, mobility and balance in healthy older people than a regular low- moderate-intensity continuous training, despite the reduction in overall training volume.
Altobelli, Emma; Rapacchietta, Leonardo; Angeletti, Paolo Matteo; Barbante, Luca; Profeta, Filippo Valerio; Fagnano, Roberto
2017-04-23
Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further, BC seems set to become a public health emergency. The aim of the present study is to provide a systematic review of current BC screening programmes in WHO European Region to identify possible patterns. Multiple correspondence analysis was performed to evaluate the association among: measures of occurrence; GNI level; type of BC screening programme; organization of public information and awareness campaigns regarding primary prevention of modifiable risk factors; type of BC screening services; year of screening institution; screening coverage and data quality. A key difference between High Income (HI) and Low and Middle Income (LMI) States, emerging from the present data, is that in the former screening programmes are well organized, with approved screening centres, the presence of mobile units to increase coverage, the offer of screening tests free of charge; the fairly high quality of occurrence data based on high-quality sources, and the adoption of accurate methods to estimate incidence and mortality. In conclusion, the governments of LMI countries should allocate sufficient resources to increase screening participation and they should improve the accuracy of incidence and mortality rates.
Reforming a Bachelor of Music Programme: A Case Study
ERIC Educational Resources Information Center
Carey, Gemma; Lebler, Don
2012-01-01
In 2010, the authors conducted a formal review of the Queensland Conservatorium's Bachelor of Music programme to determine to what extent the programme prepared graduates for professional life in the 21st century. The process was informed by comprehensive performance indicator data and substantial feedback from staff, students, and other…
Effects of College Programme Characteristics on Graduates' Performance
ERIC Educational Resources Information Center
García-Aracil, Adela
2015-01-01
Education programmes are designed to equip young populations with the qualifications required to assume responsible roles in specific professions and in society generally. In this paper, the focus of the analysis is on the significance of a number of higher education programme characteristics in allocating young higher education graduates across…
Raftery, James; Hanney, Steve; Greenhalgh, Trish; Glover, Matthew; Blatch-Jones, Amanda
2016-10-01
This report reviews approaches and tools for measuring the impact of research programmes, building on, and extending, a 2007 review. (1) To identify the range of theoretical models and empirical approaches for measuring the impact of health research programmes; (2) to develop a taxonomy of models and approaches; (3) to summarise the evidence on the application and use of these models; and (4) to evaluate the different options for the Health Technology Assessment (HTA) programme. We searched databases including Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and The Cochrane Library from January 2005 to August 2014. This narrative systematic literature review comprised an update, extension and analysis/discussion. We systematically searched eight databases, supplemented by personal knowledge, in August 2014 through to March 2015. The literature on impact assessment has much expanded. The Payback Framework, with adaptations, remains the most widely used approach. It draws on different philosophical traditions, enhancing an underlying logic model with an interpretative case study element and attention to context. Besides the logic model, other ideal type approaches included constructionist, realist, critical and performative. Most models in practice drew pragmatically on elements of several ideal types. Monetisation of impact, an increasingly popular approach, shows a high return from research but relies heavily on assumptions about the extent to which health gains depend on research. Despite usually requiring systematic reviews before funding trials, the HTA programme does not routinely examine the impact of those trials on subsequent systematic reviews. The York/Patient-Centered Outcomes Research Institute and the Grading of Recommendations Assessment, Development and Evaluation toolkits provide ways of assessing such impact, but need to be evaluated. The literature, as reviewed here, provides very few instances of a randomised trial playing a major role in stopping the use of a new technology. The few trials funded by the HTA programme that may have played such a role were outliers. The findings of this review support the continued use of the Payback Framework by the HTA programme. Changes in the structure of the NHS, the development of NHS England and changes in the National Institute for Health and Care Excellence's remit pose new challenges for identifying and meeting current and future research needs. Future assessments of the impact of the HTA programme will have to take account of wider changes, especially as the Research Excellence Framework (REF), which assesses the quality of universities' research, seems likely to continue to rely on case studies to measure impact. The HTA programme should consider how the format and selection of case studies might be improved to aid more systematic assessment. The selection of case studies, such as in the REF, but also more generally, tends to be biased towards high-impact rather than low-impact stories. Experience for other industries indicate that much can be learnt from the latter. The adoption of researchfish ® (researchfish Ltd, Cambridge, UK) by most major UK research funders has implications for future assessments of impact. Although the routine capture of indexed research publications has merit, the degree to which researchfish will succeed in collecting other, non-indexed outputs and activities remains to be established. There were limitations in how far we could address challenges that faced us as we extended the focus beyond that of the 2007 review, and well beyond a narrow focus just on the HTA programme. Research funders can benefit from continuing to monitor and evaluate the impacts of the studies they fund. They should also review the contribution of case studies and expand work on linking trials to meta-analyses and to guidelines. The National Institute for Health Research HTA programme.
Anderson, Annie S; Macleod, Maureen; Mutrie, Nanette; Sugden, Jacqueline; Dobson, Hilary; Treweek, Shaun; O'Carroll, Ronan E; Thompson, Alistair; Kirk, Alison; Brennan, Graham; Wyke, Sally
2014-12-17
Breast cancer is the most commonly diagnosed cancer and the second cause of cancer deaths amongst women in the UK. The incidence of the disease is increasing and is highest in women from least deprived areas. It is estimated that around 42% of the disease in post-menopausal women could be prevented by increased physical activity and reductions in alcohol intake and body fatness. Breast cancer control endeavours focus on national screening programmes but these do not include communications or interventions for risk reduction. This study aimed to assess the feasibility of delivery, indicative effects and acceptability of a lifestyle intervention programme initiated within the NHS Scottish Breast Screening Programme (NHSSBSP). A 1:1 randomised controlled trial (RCT) of the 3 month ActWell programme (focussing on body weight, physical activity and alcohol) versus usual care conducted in two NHSSBSP sites between June 2013 and January 2014. Feasibility assessments included recruitment, retention, and fidelity to protocol. Indicative outcomes were measured at baseline and 3 month follow-up (body weight, waist circumference, eating and alcohol habits and physical activity). At study end, a questionnaire assessed participant satisfaction and qualitative interviews elicited women's, coaches, and radiographers' experiences. Statistical analysis used Chi squared tests for comparisons in proportions and paired t tests for comparisons of means. Linear regression analyses were performed, adjusted for baseline values, with group allocation as a fixed effect. A pre-set recruitment target of 80 women was achieved within 12 weeks and 65 (81%) participants (29 intervention, 36 control) completed 3 month assessments. Mean age was 58 ± 5.6 years, mean BMI was 29.2 ± 7.0 kg/m(2) and many (44%) reported a family history of breast cancer. The primary analysis (baseline body weight adjusted) showed a significant between group difference favouring the intervention group of 2.04 kg (95% CI -3.24 kg to -0.85 kg). Significant, favourable between group differences were also detected for BMI, waist circumference, physical activity and sitting time. Women rated the programme highly and 70% said they would recommend it to others. Recruitment, retention, indicative results and participant acceptability support the development of a definitive RCT to measure long term effects. The trial was registered with Current Controlled Trials (ISRCTN56223933).
Does case-mix based reimbursement stimulate the development of process-oriented care delivery?
Vos, Leti; Dückers, Michel L A; Wagner, Cordula; van Merode, Godefridus G
2010-11-01
Reimbursement based on the total care of a patient during an acute episode of illness is believed to stimulate management and clinicians to reduce quality problems like waiting times and poor coordination of care delivery. Although many studies already show that this kind of case-mix based reimbursement leads to more efficiency, it remains unclear whether care coordination improved as well. This study aims to explore whether case-mix based reimbursement stimulates development of care coordination by the use of care programmes, and a process-oriented way of working. Data for this study were gathered during the winter of 2007/2008 in a survey involving all Dutch hospitals. Descriptive and structural equation modelling (SEM) analyses were conducted. SEM reveals that adoption of the case-mix reimbursement within hospitals' budgeting processes stimulates hospitals to establish care programmes by the use of process-oriented performance measures. However, the implementation of care programmes is not (yet) accompanied by a change in focus from function (the delivery of independent care activities) to process (the delivery of care activities as being connected to a chain of interdependent care activities). This study demonstrates that hospital management can stimulate the development of care programmes by the adoption of case-mix reimbursement within hospitals' budgeting processes. Future research is recommended to confirm this finding and to determine whether the establishment of care programmes will in time indeed lead to a more process-oriented view of professionals. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
The TOTEM Experiment at the CERN Large Hadron Collider
NASA Astrophysics Data System (ADS)
TOTEM Collaboration; Anelli, G.; Antchev, G.; Aspell, P.; Avati, V.; Bagliesi, M. G.; Berardi, V.; Berretti, M.; Boccone, V.; Bottigli, U.; Bozzo, M.; Brücken, E.; Buzzo, A.; Cafagna, F.; Calicchio, M.; Capurro, F.; Catanesi, M. G.; Catastini, P. L.; Cecchi, R.; Cerchi, S.; Cereseto, R.; Ciocci, M. A.; Cuneo, S.; Da Vià, C.; David, E.; Deile, M.; Dimovasili, E.; Doubrava, M.; Eggert, K.; Eremin, V.; Ferro, F.; Foussat, A.; Galuška, M.; Garcia, F.; Gherarducci, F.; Giani, S.; Greco, V.; Hasi, J.; Haug, F.; Heino, J.; Hilden, T.; Jarron, P.; Joram, C.; Kalliopuska, J.; Kaplon, J.; Kašpar, J.; Kundrát, V.; Kurvinen, K.; Lacroix, J. M.; Lami, S.; Latino, G.; Lauhakangas, R.; Lippmaa, E.; Lokajíček, M.; Lo Vetere, M.; Rodriguez, F. Lucas; Macina, D.; Macrí, M.; Magazzù, C.; Magazzù, G.; Magri, A.; Maire, G.; Manco, A.; Meucci, M.; Minutoli, S.; Morelli, A.; Musico, P.; Negri, M.; Niewiadomski, H.; Noschis, E.; Notarnicola, G.; Oliveri, E.; Oljemark, F.; Orava, R.; Oriunno, M.; Perrot, A.-L.; Österberg, K.; Paoletti, R.; Pedreschi, E.; Petäjäjärvi, J.; Pollovio, P.; Quinto, M.; Radermacher, E.; Radicioni, E.; Rangod, S.; Ravotti, F.; Rella, G.; Robutti, E.; Ropelewski, L.; Ruggiero, G.; Rummel, A.; Saarikko, H.; Sanguinetti, G.; Santroni, A.; Scribano, A.; Sette, G.; Snoeys, W.; Spinella, F.; Squillacioti, P.; Ster, A.; Taylor, C.; Tazzioli, A.; Torazza, D.; Trovato, A.; Trummal, A.; Turini, N.; Vacek, V.; Van Remortel, N.; Vinš, V.; Watts, S.; Whitmore, J.; Wu, J.
2008-08-01
The TOTEM Experiment will measure the total pp cross-section with the luminosity-independent method and study elastic and diffractive scattering at the LHC. To achieve optimum forward coverage for charged particles emitted by the pp collisions in the interaction point IP5, two tracking telescopes, T1 and T2, will be installed on each side in the pseudorapidity region 3.1 <= |η| <= 6.5, and Roman Pot stations will be placed at distances of ±147 m and ±220 m from IP5. Being an independent experiment but technically integrated into CMS, TOTEM will first operate in standalone mode to pursue its own physics programme and at a later stage together with CMS for a common physics programme. This article gives a description of the TOTEM apparatus and its performance.
Nguyen, Kim V; Nguyen, Phuong Tran My; Jones, Stephanie L
2008-10-01
To determine the effectiveness of hand hygiene in a developing healthcare setting in reducing nosocomial infections (NIs). Prospective study measuring NI rates in a urology ward in Ho Chi Minh City, Vietnam, before and after implementation of a hand hygiene programme with an alcohol-based decontaminant, and compliance rates of medical staff and carers with hand hygiene using standardised observation sheets. Incidence of NIs fell by 84%, from 13.1% to 2.1%, after implementation of the hand hygiene programme. Extended-spectrum beta-lactamase production was detected in 38.2%-50% of Enterobacteriaceae isolated from clinical samples. Length of patient stay and cost to the patient for antibiotics were reduced after implementation of the hand hygiene programme. The hand hygiene programme was effective in reducing incidence of NIs, leading to shorter inpatient stays and reduced treatment costs. Such programmes with measurable outcomes can be implemented at minimal cost in developing health contexts and should be promoted in all healthcare settings.
Cost effectiveness analysis of screening for sight threatening diabetic eye disease
James, Marilyn; Turner, David A; Broadbent, Deborah M; Vora, Jiten; Harding, Simon P
2000-01-01
Objective To measure the cost effectiveness of systematic photographic screening for sight threatening diabetic eye disease compared with existing practice. Design Cost effectiveness analysis Setting Liverpool. Subjects A target population of 5000 diabetic patients invited for screening. Main outcome measures Cost effectiveness (cost per true positive) of systematic and opportunistic programmes; incremental cost effectiveness of replacing opportunistic with systematic screening. Results Baseline prevalence of sight threatening eye disease was 14.1%. The cost effectiveness of the systematic programme was £209 (sensitivity 89%, specificity 86%, compliance 80%, annual cost £104 996) and of the opportunistic programme was £289 (combined sensitivity 63%, specificity 92%, compliance 78%, annual cost £99 981). The incremental cost effectiveness of completely replacing the opportunistic programme was £32. Absolute values of cost effectiveness were highly sensitive to varying prevalence, sensitivity and specificity, compliance, and programme size. Conclusion Replacing existing programmes with systematic screening for diabetic eye disease is justified. PMID:10856062
The efficacy of education programme for preventing constipation in women.
Ayaz, Sultan; Hisar, Filiz
2014-06-01
This study was performed to evaluate the efficiency of the education programme for prevention of constipation in women. This study was performed as a pre-test-posttest design. Thirty-five women were included who have constipation problem. Data were collected by questionnaire: Constipation Severity Instrument (CSI), Constipation Visual Analogue Scale (CVAS) and Bristol Stool Chart (BSC). Eight home visits were made for each of the women and they were followed up for 3 months. Participants received an individual education programme that included advice on dietary consumption such as pulpy-fibrous nutrient consumption, fluid intake, an exercise regime and counselling about optimal position to defecate. The subscales of 'Colonic Inertia' and 'Pain', and CSI total mean scores and CVAS mean scores were decreased significantly after education programme (P < 0.05). According to the BSC, 71.5% of the women stated their stool form to be 'sausage-shaped, but lumpy' before the education programme, but after the said programme the percentage had dropped to 17.1%. Education programme given to women who had constipation were determined to have been effective in alleviating constipation. Nurses should develop appropriate and effective strategies to help women prevent constipation. © 2013 Wiley Publishing Asia Pty Ltd.
Wästberg, Birgitta A; Erlandsson, Lena-Karin; Eklund, Mona
2013-03-01
The Redesigning Daily Occupations programme (ReDO) is a Swedish work rehabilitation programme for women on sick leave due to stress-related disorders. The aim of the study was to investigate the participants' perceptions of taking part in the work rehabilitation programme. Seven of the 38 women who completed ReDO were interviewed during and after the programme. The interviews were analysed by manifest and latent content analysis. The informants were satisfied with the content of the programme and the support they received in the programme and when returning to work. The women thought they had become more aware of what they did during a day and how they performed their daily activities, which helped them to change their ways of performing them. The result highlighted different parts of their rehabilitation process which constituted four sub-themes: "Perceptions of the ReDO", "The intrinsic process", "Person-related changes", and "Perceptions of returning to work", and formed the core theme "Critical parts of the rehabilitation process". The findings may not be generalized to other settings and future research should further investigate work rehabilitation for the target group.
ERIC Educational Resources Information Center
Bolly, Madina; Jonas, Nicolas
2015-01-01
Action Research on Measuring Literacy Programme Participants' Learning Outcomes (RAMAA) aims to develop, implement and collaborate on the creation of a methodological approach to measure acquired learning and study the various factors that influence its development. This report examines how RAMAA I has been implemented over the past four years in…
Canonici, Ana Paula; Andrade, Larissa Pires de; Gobbi, Sebastião; Santos-Galduroz, Ruth Ferreira; Gobbi, Lílian Teresa Bucken; Stella, Florindo
2012-09-01
Cognitive decline has a negative impact on functional activities in Alzheimer's disease. Investigating the effects of motor intervention with the intent to reduce the decline in functionality is an expected target for patients and caregivers. The aim of this study was to verify if a 6-month motor intervention programme promoted functionality in Alzheimer's patients and attenuated caregivers' burden. The sample comprised 32 community patients with Alzheimer's disease and their 32 respective caregivers. Patients were divided into two groups: 16 participated in the motor intervention programme and 16 controls. Subjects performed 60 minutes of exercises, three times per week during the 6-month period, to improve flexibility, strength, agility and balance. Caregivers followed the procedures with their patients during this period. Functionality was evaluated by the Berg Functional Balance Scale and the Functional Independence Measure. Caregivers completed the Neuropsychiatric Inventory Caregiver Distress Scale and the Zarit Carer Burden Scale. Two-way ANOVA was used to verify the interaction between time (pre- and post-intervention) and the motor intervention program. While patients in the motor programme preserved their functionality, as assessed by the Functional Independence Measure, the controls suffered a relative decline (motor intervention group: from 109.6 to 108.4 vs controls: from 99.5 to 71.6; P= 0.01). Patients from motor intervention also had better scores than the controls on functional balance assessed by Berg scale (F: 22.2; P= 0.001). As assessed by the Neuropsychiatric Inventory and Zarit scale, burden was reduced among caregivers whose patients participated in the motor intervention programme compared with caregivers whose patients did not participate in this programme (Neuropsychiatric Inventory, caregiver's part: F: 9.37; P= 0.01; Zarit: F: 11.28; P= 0.01). Patients from the motor intervention group showed reduced functional decline compared to the controls, and there was an associated decrease in caregivers' burden. © 2012 The Authors. Psychogeriatrics © 2012 Japanese Psychogeriatric Society.
Josephson, Erik; Gergen, Jessica; Coe, Martha; Ski, Samantha; Madhavan, Supriya; Bauhoff, Sebastian
2017-01-01
Abstract This paper seeks to systematically describe the length and content of quality checklists used in performance-based financing programmes, their similarities and differences, and how checklists have evolved over time. We compiled a list of supply-side, health facility-based performance-based financing (PBF) programmes in low- and lower middle-income countries based on a document review. We then solicited PBF manuals and quality checklists from implementers and donors of these PBF mechanisms. We entered each indicator from each quality checklist into a database verbatim in English, and translated into English from French where appropriate, and categorized each indicator according to the Donabedian framework and an author-derived categorization. We extracted 8,490 quality indicators from 68 quality checklists across 32 PBF implementations in 28 countries. On average, checklists contained 125 indicators; within the same program, checklists tend to grow as they are updated. Using the Donabedian framework, 80% of indicators were structure-type, 19% process-type, and less than 1% outcome-type. The author-derived categorization showed that 57% of indicators relate to availability of resources, 24% to managing the facility and 17% assess knowledge and effort. There is a high degree of similarity in a narrow set of indicators used in checklists for common service types such as maternal, neonatal and child health. We conclude that performance-based financing offers an appealing approach to targeting specific quality shortfalls and advancing toward the Sustainable Development Goals of high quality coverage. Currently most indicators focus on structural issues and resource availability. There is scope to rationalize and evolve the quality checklists of these programs to help achieve national and global goals to improve quality of care. PMID:28549142
Bleijlevens, Michel HC; Hendriks, Marike RC; van Haastregt, Jolanda CM; van Rossum, Erik; Kempen, Gertrudis IJM; Diederiks, Joseph PM; Crebolder, Harry FJM; van Eijk, Jacques ThM
2008-01-01
Background Falls are a major health threat to older community-living people, and initiatives to prevent falls should be a public health priority. We evaluated a Dutch version of a successful British fall prevention programme. Results of this Dutch study showed no effects on falls or daily functioning. In parallel to the effect evaluation, we carried out a detailed process evaluation to assess the feasibility of our multidisciplinary fall prevention programme. The present study reports on the results of this process evaluation. Methods Our fall prevention programme comprised a medical and occupational-therapy assessment, resulting in recommendations and/or referrals to other services if indicated. We used self-administered questionnaires, structured telephone interviews, structured recording forms, structured face-to-face interviews and a plenary group discussion to collect data from participants allocated to the intervention group (n = 166) and from all practitioners who performed the assessments (n = 8). The following outcomes were assessed: the extent to which the multidisciplinary fall prevention programme was performed according to protocol, the nature of the recommendations and referrals provided to the participants, participants' self-reported compliance and participants' and practitioners' opinions about the programme. Results Both participants and practitioners judged the programme to be feasible. The programme was largely performed according to protocol. The number of referrals and recommendations ensuing from the medical assessment was relatively small. Participants' self-reported compliance as regards contacting their GP to be informed of the recommendations and/or referrals was low to moderate. However, self-reported compliance with such referrals and recommendations was reasonable to good. A large majority of participants reported they had benefited from the programme. Conclusion The results of the present study show that the programme was feasible for both practitioners and participants. Main factors that seem to be responsible for the lack of effectiveness are the relatively low number of referrals and recommendations ensuing from the medical assessments and participants' low compliance as regards contacting their GP about the results of the medical assessment. We do not recommend implementing the programme in its present form in regular care. Trial registration ISRCTN64716113 PMID:18816381
Programmable neural processing on a smartdust for brain-computer interfaces.
Yuwen Sun; Shimeng Huang; Oresko, Joseph J; Cheng, Allen C
2010-10-01
Brain-computer interfaces (BCIs) offer tremendous promise for improving the quality of life for disabled individuals. BCIs use spike sorting to identify the source of each neural firing. To date, spike sorting has been performed by either using off-chip analysis, which requires a wired connection penetrating the skull to a bulky external power/processing unit, or via custom application-specific integrated circuits that lack the programmability to perform different algorithms and upgrades. In this research, we propose and test the feasibility of performing on-chip, real-time spike sorting on a programmable smartdust, including feature extraction, classification, compression, and wireless transmission. A detailed power/performance tradeoff analysis using DVFS is presented. Our experimental results show that the execution time and power density meet the requirements to perform real-time spike sorting and wireless transmission on a single neural channel.
The report should be useful to persons concerned with Air Pollution Measurement Studies of Stationary Industrial Sources. It gives detailed descriptions of 22 separate programs, written specifically for the Hewlett Packard Model HP-25 manually programmable pocket calculator. Each...
The handbook is intended for persons concerned with air pollution measurement studies of stationary industrial sources. It gives detailed descriptions of 22 different programs written specifically for the Hewlett Packard Model HP-65 card-programmable pocket calculator. For each p...
Quality evaluation in the management of child sponsorship programmes.
McDonnell, W A; McDonnell, T P
1994-08-01
Programme evaluation tactics for child sponsorship programmes have historically concentrated on quantitative analysis of service units, amount of money invested, number of countries served, the number of projects, and number of children in each project. While these are valuable measures of programme variables, they do not assess the impact of programmes on the lives of the children sponsored. Outcome measures designed to assess programme impact add greatly to the information available to child welfare professionals. This study collected data about the impact of the programme on the lives of the children. The Child Welfare League's Child Well-Being Scales (CWBS) were used to assess programme impact. Twelve scales were chosen as directly related in type to the programmes administered by Children International, a traditional and well established child sponsorship organization located in Kansas City, Missouri. A thirteenth scale was suggested by field workers in India as particularly relevant to Third World populations. The scales were translated into languages appropriate to each population in the programme countries. Social workers in each country were trained to administer and score them. This analysis used the emerging data technology becoming available to programmes in Third World countries. The system enables administrators in the Third World to evaluate, enhance and summarize their programmes in a way understandable across borders. Epi Info (Dean et al., 1990) was customized to provide the framework for the analysis. The population for this study was selected by a 5% random sampling of children currently enrolled as sponsored children (180,000+ worldwide). These were compared with a waiting-list control group selected randomly from lists of children who have applied for sponsorship but have not yet been receiving services (n = 50 from each project).(ABSTRACT TRUNCATED AT 250 WORDS)
Wang, Yao; Xiao, Lily Dongxia; Ullah, Shahid; He, Guo-Ping; De Bellis, Anita
2017-02-01
The lack of dementia education programmes for health professionals in primary care is one of the major factors contributing to the unmet demand for dementia care services. To determine the effectiveness of a nurse-led dementia education and knowledge translation programme for health professionals in primary care; participants' satisfaction with the programme; and to understand participants' perceptions of and experiences in the programme. A cluster randomized controlled trial was used as the main methodology to evaluate health professionals' knowledge, attitudes and care approach. Focus groups were used at the end of the project to understand health professionals' perceptions of and experiences in the programme. Fourteen community health service centres in a province in China participated in the study. Seven centres were randomly assigned to the intervention or control group respectively and 85 health professionals in each group completed the programme. A train-the-trainer model was used to implement a dementia education and knowledge translation programme. Outcome variables were measured at baseline, on the completion of the programme and at 3-month follow-up. A mixed effect linear regression model was applied to compare the significant differences of outcome measures over time between the two groups. Focus groups were guided by four semi-structured questions and analysed using content analysis. Findings revealed significant effects of the education and knowledge translation programme on participants' knowledge, attitudes and a person-centred care approach. Focus groups confirmed that the programme had a positive impact on dementia care practice. A dementia education and knowledge translation programme for health professionals in primary care has positive effects on their knowledge, attitudes, care approach and care practice. Copyright © 2016 Elsevier Ltd. All rights reserved.
Signal conditioning units for vibration measurement in HUMS
NASA Astrophysics Data System (ADS)
Wu, Kaizhi; Liu, Tingting; Yu, Zirong; Chen, Lijuan; Huang, Xinjie
2018-03-01
A signal conditioning units for vibration measurement in HUMS is proposed in the paper. Due to the frequency of vibrations caused by components in helicopter are different, two steps amplifier and programmable anti-aliasing filter are designed to meet the measurement of different types of helicopter. Vibration signals are converted into measurable electrical signals combing with ICP driver firstly. Then pre-amplifier and programmable gain amplifier is applied to magnify the weak electrical signals. In addition, programmable anti-aliasing filter is utilized to filter the interference of noise. The units were tested using function signal generator and oscilloscope. The experimental results have demonstrated the effectiveness of our proposed method in quantitatively and qualitatively. The method presented in this paper can meet the measurement requirement for different types of helicopter.
Application of a theoretical model to evaluate COPD disease management.
Lemmens, Karin M M; Nieboer, Anna P; Rutten-Van Mölken, Maureen P M H; van Schayck, Constant P; Asin, Javier D; Dirven, Jos A M; Huijsman, Robbert
2010-03-26
Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care.
Dolphens, Mieke; Cagnie, Barbara; Danneels, Lieven; De Clercq, Dirk; De Bourdeaudhuij, Ilse; Cardon, Greet
2011-12-01
The purpose of this study was to investigate the long-term effectiveness of a spine care education programme conducted in 9- to 11-year-old schoolchildren. The study sample included 96 intervention subjects and 98 controls (9- to 11-year-olds at baseline). Intervention consisted of a 6-week school-based back education programme (predominantly biomechanically oriented) and was implemented by a physical therapist. Self-reported outcomes on back care knowledge, spinal care behaviour, self-efficacy towards favourable back care behaviour, prevalence of back and neck pain during the week and fear-avoidance beliefs were evaluated by the use of questionnaires. Post-tests were performed within 1 week after programme completion, after 1 year and after 8 years. Whereas the educational back care programme resulted in increased back care knowledge up to adulthood (P < 0.001), intervention did not change spinal care behaviour or self-efficacy. Pain prevalence figures increased less in the experimental group compared to the controls over the 8-year time span, yet statistical significance was not reached. Dropout analysis revealed spinal pain prevalence rates to be different in both groups throughout the study, including at baseline. Back education at young age did not reinforce fear-avoidance beliefs up to adulthood. Predominantly biomechanical oriented back education in elementary schoolchildren is effective in improving the cognitive aspect of back care up to adulthood, yet not in changing actual behaviour or self-efficacy. The current study does not provide evidence that educational back care programmes have any impact on spinal pain in adulthood. The true long-term impact of school-based spinal health interventions on clinically relevant outcome measures merits further attention.
Application of a theoretical model to evaluate COPD disease management
2010-01-01
Background Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. Methods A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Results Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. Conclusions The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care. PMID:20346135
Tiemessen, Ivo JH; Hulshof, Carel TJ; Frings-Dresen, Monique HW
2007-01-01
Background Whole body vibration (WBV) exposure at work is common and studies found evidence that this exposure might cause low back pain (LBP). A recent review concluded there is a lack of evidence of effective strategies to reduce WBV exposure. Most research in this field is focussed on the technical implications, although changing behaviour towards WBV exposure might be promising as well. Therefore, we developed an intervention programme to reduce WBV exposure in a population of drivers with the emphasis on a change in behaviour of driver and employer. The hypothesis is that an effective reduction in WBV exposure, in time, will lead to a reduction in LBP as WBV exposure is a proxy for an increased risk of LBP. Methods/Design The intervention programme was developed specifically for the drivers of vibrating vehicles and their employers. The intervention programme will be based on the most important determinants of WBV exposure as track conditions, driving speed, quality of the seat, etc. By increasing knowledge and skills towards changing these determinants, the attitude, social influence and self-efficacy (ASE) of both drivers and employers will be affected having an effect on the level of exposure. We used the well-known ASE model to develop an intervention programme aiming at a change or the intention to change behaviour towards WBV exposure. The developed programme consists of: individual health surveillance, an information brochure, an informative presentation and a report of the performed field measurements. Discussion The study protocol described is advantageous as the intervention program actively tries to change behaviour towards WBV exposure. The near future will show if this intervention program is effective by showing a decrease in WBV exposure. PMID:18005400
Monninkhof, Evelyn; van der Aa, Maaike; van der Valk, Paul; van der Palen, Job; Zielhuis, Gerhard; Koning, Karen; Pieterse, Marcel
2004-11-01
The COPE self-management programme, including a self-management education course, self-treatment of exacerbations and a fitness programme, appeared to have no significant effect on health related quality of life (HRQoL) as measured by the St. George's Respiratory Questionnaire (SGRQ). This is in contrast to our hypothesis and despite expressions of satisfaction of patients to healthcare workers. To understand this discrepancy, a qualitative study was performed. A purposive sample of 20 participants of the COPE self-management programme were interviewed at home using in-depth, semi-structured interviews. Interviews were audio taped and transcribed verbatim and analysed according grounded theory. The fitness programme was most positively evaluated by patients due to the perceived increase of exercise capacity and the social aspect of the group training. Major effects gained by the self-management education course reported by patients were the skills to evenly distribute their energy and to listen to their body signals. Most patients thought favourable about self-treatment of exacerbations. The possibility to start early, not having to call a doctor and autonomy were raised as important advantages. Furthermore, several patients reported increased self-confidence and coping behaviour as important effects of the COPE programme. Finally, many patients reported feeling safe due to the frequent follow-up visits and 24h access to the hospital, and this aspect elicited to be very important. In this study, the qualitative interviews suggest that the SGRQ and possibly other existing HRQoL instruments might fail to capture the full experience of patients in self-management studies. The need for more elaborate qualitative research on this subject is indicated.
Lamothe, Martin; McDuff, Pierre; Pastore, Yves D; Duval, Michel; Sultan, Serge
2018-01-01
Objectives To assess the feasibility and acceptability of a mindfulness-based stress reduction (MBSR)-based intervention and determine if the intervention is associated with a significant signal on empathy and emotional competencies. Design Two pre–post proof-of-concept studies. Setting Participants were recruited at the University of Montreal’s Psychology Department (Study 1) and the CHU Sainte-Justine Department of Hematology-Oncology (Study 2). Participants Study 1: 12 students completed the 8-week programme (mean age 24, range 18–34). Study 2: 25 professionals completed the 8-week programme (mean age 48, range 27–63). Intervention Standard MBSR programme including 8-week mindfulness programme consisting of 8 consecutive weekly 2-hour sessions and a full-day silent retreat. Outcomes measures Mindfulness as measured by the Mindful Attention Awareness Scale; empathy as measured by the Interpersonal Reactivity Index (IRI)’s Perspective Taking and Empathic Concern subscales; identification of one’s own emotions and those of others as measured by the Profile of Emotional Competence (PEC)’s Identify my Emotions and Identify Others’ Emotions subscales; emotional acceptance as measured by the Acceptance and Action Questionnaire-II (AAQ-II) and the Emotion Regulation Scale (ERQ)’s Expressive Suppression subscale; and recognition of emotions in others as measured by the Geneva Emotion Recognition Test (GERT). Results In both studies, retention rates (80%–81%) were acceptable. Participants who completed the programme improved on all measures except the PEC’s Identify Others’ Emotions and the IRI’s Empathic Concern (Cohen’s d median=0.92, range 45–1.72). In Study 2, favourable effects associated with the programme were maintained over 3 months on the PEC’s Identify my Emotions, the AAQ-II, the ERQ’s Expressive Suppression and the GERT. Conclusions The programme was feasible and acceptable. It was associated with a significant signal on the following outcomes: perspective taking, the identification of one’s own emotions and emotional acceptance, thus, justifying moving towards efficacy trials using these outcomes. PMID:29306887
Pressure ramp programmer; IMBLMS Phase B4 Additional Tasks: Task 3.0 pressure ramp programmer
NASA Technical Reports Server (NTRS)
Fogal, G. L.; Reinhardt, C. G.
1972-01-01
A pressure ramp programmer model was designed, fabricated and tested. This model, in conjunction with an automatic blood pressure monitor, automatically controls the pressure in the blood pressure monitor arterial cuff. The cuff pressurization cycle is designed to maximize accuracy and repeatability of blood pressure measurements. The key feature of this automatic cycle is rapid blood pressure cuff bleed down from an initial setting until systolic (diastolic) pressure is encountered followed by a short repressurization and slow bleed, long enough to permit accurate systolic (diastolic) pressure determination. The system includes a pressure reservoir which bleeds the cuff through a precision needle valve; a solenoid valve which permits rapid pressurization from the reservoir; and a pressure sensor which provides information for bleed rate and set point controls. Korotkoff sound signals from a microphone in the blood pressure cuff (not part of the system) provide decision information to the digital control system. The system completed a series of engineering tests using simulated Korotkoff sound inputs. The system performed successfully in all cases and was stable over an extended period of time.
Self-Calibrating and Remote Programmable Signal Conditioning Amplifier System and Method
NASA Technical Reports Server (NTRS)
Medelius, Pedro J. (Inventor); Hallberg, Carl G. (Inventor); Simpson, Howard J., III (Inventor); Thayer, Stephen W. (Inventor)
1998-01-01
A self-calibrating, remote programmable signal conditioning amplifier system employs information read from a memory attached to a measurement transducer for automatic calibration. The signal conditioning amplifier is self-calibrated on a continuous basis through use of a dual input path arrangement, with each path containing a multiplexer and a programmable amplifier. A digital signal processor controls operation of the system such that a transducer signal is applied to one of the input paths, while one or more calibration signals are applied to the second input path. Once the second path is calibrated, the digital signal processor switches the transducer signal to the second path. and then calibrates the first path. This process is continually repeated so that each path is calibrated on an essentially continuous basis. Dual output paths are also employed which are calibrated in the same manner. The digital signal processor also allows the implementation of a variety of digital filters which are either programmed into the system or downloaded by an operator, and performs up to eighth order linearization.
McLaughlin, Katrina; Moutray, Marianne; Muldoon, Orla T
2008-01-01
This paper is a report of a study to examine the role of personality and self-efficacy in predicting academic performance and attrition in nursing students. Despite a considerable amount of research investigating attrition in nursing students and new nurses, concerns remain. This particular issue highlights the need for a more effective selection process whereby those selected are more likely to complete their preregistration programme successfully, and remain employed as Registered Nurses. A longitudinal design was adopted. A questionnaire, which included measures of personality and occupational and academic self-efficacy, was administered to 384 students early in the first year of the study. At the end of the programme, final marks and attrition rates were obtained from university records for a total of 350 students. The data were collected from 1999 to 2002. Individuals who scored higher on a psychoticism scale were more likely to withdraw from the programme. Occupational self-efficacy was revealed to be a statistically significant predictor of final mark obtained, in that those with higher self-efficacy beliefs were more likely to achieve better final marks. Extraversion was also shown to negatively predict academic performance in that those with higher extraversion scores were more likely to achieve lower marks. More research is needed to explore the attributes of successful nursing students and the potential contribution of psychological profiling to a more effective selection process.
Warren, McWilson; Ruebush, Trenton K.; Hobbs, Jesse H.; Hippolyte, Robert; Miller, Steve
1985-01-01
A programme emphasizing intensive training, use of protective equipment and uniforms, daily supervision of safety measures at work, and weekly monitoring of blood cholinesterase levels by the tintometric method was instituted to prevent toxicity in Haitian malaria workers during spraying with the organophosphate insecticides fenitrothion and malathion. The programme functioned well, depressed cholinesterase activity (≤ 50% of normal) being detected rapidly prior to the development of serious symptoms. Evidence of fenitrothion overexposure appeared in spraymen early in the first spray cycle, and was associated with faulty protective clothing and a failure to observe strictly the recommended safety measures at work. After these deficiencies were corrected, insecticide application continued without serious incidents or interruption of the programme. No serious reduction of cholinesterase activity was seen in a more limited study of spraymen using malathion. It is strongly recommended that similar training and monitoring programmes should be instituted whenever organophosphate pesticides are used as residual sprays for malaria control. This is particularly important in areas where the more toxic compound, fenitrothion, is to be used. PMID:3874715
George, A C
2015-11-01
The US radon measurement programme began in the late 1950s by the US Public Health Service in Colorado, New Mexico and Utah during the uranium frenzy. After the 1967 Congressional Hearings on the working conditions in uranium mines, the US Atomic Energy Commission (AEC) was asked to conduct studies in active uranium mines to assess the exposure of the miners on the Colorado Plateau and in New Mexico. From 1967 to 1972, the Health and Safety Laboratory of the US AEC in New York investigated more than 20 uranium mines for radon and radon decay product concentrations and particle size in 4 large uranium mines in New Mexico. In 1970, the US Environmental Protection Agency (EPA) was established and took over some of the AEC radon measurement activities. Between 1975 and 1978, the Environmental Measurements Laboratory of the US Department of Energy conducted the first detailed indoor radon survey in the USA. Later in 1984, the very high concentrations of radon found in Pennsylvania homes set the wheels in motion and gave birth to the US Radon Industry. The US EPA expanded its involvement in radon issues and assumed an active role by establishing the National Radon Proficiency Program to evaluate the effectiveness of radon measurement and mitigation methods. In 1998, due to limited resources EPA privatised the radon programme. This paper presents a personal perspective of past events and current status of the US radon programme. It will present an update on radon health effects, the incidence rate of lung cancer in the USA and the number of radon measurements made from 1988 to 2013 using short-term test methods. More than 23 million measurements were made in the last 25 y and as a result more than 1.24 million homes were mitigated successfully. It is estimated that <2 % of the radon measurements performed in the USA are made using long-term testing devices. The number of homes above the US action level of 148 Bq m(-3) (4 pCi l(-1)) may be ∼8.5 million because ∼50 million homes were added since 1990 to the home inventory. This paper will discuss the current instruments and methods used to measure radon in the USA, and what is the effectiveness of radon resistant new construction, the current status of mitigation standards and the proposed testing protocols in schools and large buildings. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Singbartl, G; Schleinzer, W
1994-01-01
This third part of a review on "Autologous Transfusion" deals with preoperative autologous blood donation, with supplemental pharmaco-therapy, with election criteria of the patient as well as with the organizational measures to be taken into account if an intensive autologous predeposit programme is routinely applied. Donation of an autologous predeposit aims at supplying the patient with autologous blood and autologous plasma, respectively, according to the expected blood loss and in order to reduce the need for homologous transfusion. Important aspects, which have to be considered if applying a routine autologous donation programme refer both to the election criteria of the patient and to the organizational programme and measures to be considered. Data in the literature reveal, that the risk of side effects for the patient (who is both the donor and the receiver of the (autologous) blood) during and after donation of an autologous predeposit is definitely not greater than the risk reported for otherwise healthy homologous volunteers. In our opinion, this means, that a patient who has been declared eligible for an elective operative intervention which makes homologous transfusion very probable, can be considered eligible for donating an autologous predeposit; additionally, he should also be eligible for acute normovolemic hemodilution, as donating an autologous predeposit with accompanying volume substitution of the predeposit 'is under hemodynamic aspects' nothing else than an acute and preoperatively performed normovolemic hemodilution. Analysing the data so far reported, volume substitution of the autologous predeposit appears to be a very important component for the patient's safety.(ABSTRACT TRUNCATED AT 250 WORDS)
Reusch, A; Schug, M; Küffner, R; Vogel, H; Faller, H
2013-08-01
High quality demands are being placed on concepts of educational group programmes in medical rehabilitation as well as the related trainer qualifications. A nationwide survey of German medical rehabilitation clinics in 2005 had revealed a need for improving educational practice according to these quality criteria. An updated investigation was performed in 2010 aiming at describing group programmes used in medical rehabilitation. 1 473 inpatient and outpatient medical rehabilitation clinics were invited to participate. 908 clinics reported on their training programmes. Data from clinics caring for patients with somatic disorders could be compared to the 2005 survey. Data from clinics for both psychosomatic and substance abuse disorders was collected for the first time in 2010. Overall, psychologists and physicians were reported to be the most frequent conductors of educative programmes. In somatic clinics, psychologists, dieticians and occupational therapists or physiotherapists were the most common conductors. Two-thirds of the institutions reported no training prerequisites for staff members to perform patient education. 80% of the education programmes were categorized post hoc into 3 classes: "generic health education", "disorder-specific patient education", and "psychoeducational group programmes". Almost two-thirds of all programmes were carried out with 8-15 participants, and many used several interactive didactic methods. Programmes conducted in small groups (<8 participants) used significantly more interactive methods than those conducted in larger groups did (>15 participants). Only half of the programmes were manualized. Significantly more interactive methods were used in completely manualized programmes. Only about half of the programmes were evaluated, and only very few evaluation studies were published. The institutions wished additional support by workshops especially concerning qualification of their staff and concerning educational concepts. A need for further improvement and support exists relative to the training of educators and the development of manuals as well as evaluation and publication of the programmes. © Georg Thieme Verlag KG Stuttgart · New York.
Van de Hoef, S; Huisstede, B M A; Brink, M S; de Vries, N; Goedhart, E A; Backx, F J G
2017-08-22
Hamstring injuries are the most common muscle injury in amateur and professional soccer. Most hamstring injuries occur in the late swing phase, when the hamstring undergoes a stretch-shortening cycle and the hamstring does a significant amount of eccentric work. The incidence of these injuries has not decreased despite there being effective injury prevention programmes focusing on improving eccentric hamstring strength. As this might be because of poor compliance, a more functional injury prevention exercise programme that focuses on the stretch-shortening cycle might facilitate compliance. In this study, a bounding exercise programme consisting of functional plyometric exercises is being evaluated. A cluster-randomized controlled trial (RCT). Male amateur soccer teams (players aged 18-45 years) have been randomly allocated to intervention and control groups. Both groups are continuing regular soccer training and the intervention group is additionally performing a 12-week bounding exercise programme (BEP), consisting of a gradual build up and maintenance programme for the entire soccer season. The primary outcome is hamstring injury incidence. Secondary outcome is compliance with the BEP during the soccer season and 3 months thereafter. Despite effective hamstring injury prevention programmes, the incidence of these injuries remains high in soccer. As poor compliance with these programmes may be an issue, a new plyometric exercise programme may encourage long-term compliance and is expected to enhance sprinting and jumping performance besides preventing hamstring injuries. NTR6129 . Retrospectively registered on 1 November 2016.
2013-01-01
Background Older people with intellectual disabilities have very low physical activity levels. Well designed, theory-driven and evidence-based health promotion programmes for the target population are lacking. This paper describes the design of a cluster-randomised trial for a systematically developed health promotion programme aimed at improving physical activity and increasing fitness among seniors with intellectual disabilities. Methods and design The Intervention Mapping protocol was used for programme development. After defining the programme’s objectives, the following behavioural techniques were selected to achieve them: Tailoring, Education, Modelling, Mirroring, Feedback, Reinforcement and Grading. With professionals and managers of provider services for people with intellectual disabilities, we translated these strategies into a structured day-activity programme, that consisted of a physical activity and an education programme. The programme will be executed in five day-activity centres in groups of eight to ten seniors during eight months, whereas seniors in five other centres receive care as usual. The physical activity level, as measured in number of steps a day, will be used as primary outcome measurement. Secondary outcome measurements include motor fitness, cardio respiratory fitness, morphological and metabolic fitness, ADL, functional deterioration and depressive symptoms. Differences in the primary and secondary outcome measures between participants and controls will be analysed using generalized estimation equations, correcting for day-activity center as cluster. Discussion This paper provides insight into the development and content of a theory-driven intervention aimed at behavioural change in a population with a low intellectual level. Its evaluation design is described. The programme’s applicability to other populations is discussed. Trial registration Trial number: ISRCTN82341588 PMID:23938154
Saab, Mohamad M; McCarthy, Bridie; Andrews, Tom; Savage, Eileen; Drummond, Frances J; Walshe, Nuala; Forde, Mary; Breen, Dorothy; Henn, Patrick; Drennan, Jonathan; Hegarty, Josephine
2017-11-01
This review aims to determine the effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance. Early Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognize and manage deteriorating patients. Little is known as to the effectiveness of these programmes. Systematic review. Academic Search Complete, CINAHL, MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collection, SocINDEX and the UK & Ireland Reference Centre, EMBASE, the Turning Research Into Practice database, the Cochrane Central Register of Controlled Trials (CENTRAL) and Grey Literature sources were searched between October and November 2015. This is a quantitative systematic review using Cochrane methods. Studies published between January 2011 - November 2015 in English were sought. The risk of bias, level of evidence and the quality of evidence per outcome were assessed. Eleven articles with 10 studies were included. Nine studies addressed clinical performance, four addressed knowledge and two addressed confidence. Knowledge, vital signs recording and Early Warning Score calculation were improved in the short term. Two interventions had no effect on nurses' response to clinical deterioration and use of communication tools. This review highlights the importance of measuring outcomes using standardized tools and valid and reliable instruments. Using longitudinal designs, researchers are encouraged to investigate the effect of Early Warning Systems educational programmes. These can include interactive e-learning, on-site interdisciplinary Early Warning Scoring systems training sessions and simulated scenarios. © 2017 John Wiley & Sons Ltd.
An Outcome-Based Assessment Process for Accrediting Computing Programmes
ERIC Educational Resources Information Center
Harmanani, Haidar M.
2017-01-01
The calls for accountability in higher education have made outcome-based assessment a key accreditation component. Accreditation remains a well-regarded seal of approval on college quality, and requires the programme to set clear, appropriate, and measurable goals and courses to attain them. Furthermore, programmes must demonstrate that…
Photoproduction of Λ and Σ 0 hyperons using linearly polarized photons
Paterson, C. A.; Ireland, D. G.; Livingston, K.; ...
2016-06-08
Measurements of polarization observables for the reactionsmore » $$\\vec{\\gamma} p \\rightarrow K^+ \\Lambda$$ and $$\\vec{\\gamma} p \\rightarrow K^+ \\Sigma^0$$ have been performed. This is part of a programme of measurements designed to study the spectrum of baryon resonances. The accurate measurement of several polarization observables provides tight constraints for phenomenological fits. Beam-recoil observables for the $$\\vec{\\gamma} p \\rightarrow K^+ \\Sigma^0$$ reaction have not been reported before now. Furthermore, the measurements were carried out using linearly polarized photon beams and the CLAS detector at the Thomas Jefferson National Accelerator Facility. The energy range of the results is 1.71GeV.« less
High-Performance Cricket Coaches' Perceptions of an Educationally Informed Coach Education Programme
ERIC Educational Resources Information Center
Galvan, Hugh; Fyall, Glenn; Culpan, Ian
2012-01-01
This paper reports and discusses the findings of a research project that investigated the recently conceptualized and implemented New Zealand Cricket, Level 3, high-performance coach education programme (CEP). A qualitative methodology was employed to gather data from six coaches involved in the CEP. In particular the researchers sought the…
HIV-Stigma in Nigeria: Review of Research Studies, Policies, and Programmes
Odimegwu, Clifford O.; Alabi, Olatunji O.
2017-01-01
Nigeria has about 3.8 million people living with HIV, the second largest globally. Stigma and discrimination are major barriers to testing, treatment uptake, and adherence. In this review, we synthesized information on research studies, policies, and programmes related to HIV-stigma in Nigeria. This was with a view to identify critical areas that research and programmes must address in order to accelerate the progress towards zero (new infections, discrimination, and death) target by year 2030. Existing studies were mostly devoted to stigma assessment using varieties of measures. Research, policies, and programmes in the past two decades have made very useful contributions to stigma reduction. We identified the need for a consistent, valid, and objective measure of stigma at different levels of the HIV response. Nigeria does not lack relevant policies; what needs to be strengthened are design, planning, implementation, monitoring, and evaluation of context-specific stigma reduction programmes. PMID:29445545
Using self-assessments to enhance business continuity programmes.
Trousdale, Lisa
2015-01-01
Self-assessments have limitations and are no substitute for independent audits of a business continuity programme. Nevertheless, they can be an economical way to identify gaps, enhance the programme and create awareness. Self- assessments can also help prepare the programme and team members for an independent audit. In a resource-constrained environment, self-assessments can provide an opportunity to obtain measurable outputs about current state that can be tracked over time to capture improvement and maturity or identify deficiencies. Self-assessments can have a valuable place in any business continuity programme.
Thermal imager for dismounted infantry
NASA Astrophysics Data System (ADS)
Bigwood, Christopher R.; Eccles, Lee; Jones, Arwyn O.; Jones, Berwyn; Meakin, David L.; Rickard, Steve; Robinson, Rob
2004-12-01
Thermal Imager for Dismounted Infantry (TIDI), is a UK MOD / Thales Optics Ltd. joint funded technology demonstrator programme and is part of the overall programme managed by QinetiQ. The aim of this programme is to evaluate and demonstrate a cost effective route to equipping the infantry soldier with a small, lightweight, rugged, short range, weapon mounted thermal imaging sight; intended for mass deployment. TIDI is an unusual programme in that the requirement was not rigidly defined in terms of a detailed specification. Instead, the requirement was expressed in terms of the question 'What weapon sight performance can be achieved for a volume production cost of 5000 Euro?' This requirement was subject to the constraints that the sight mass should be less than 500 g and the volume should be less than 500 ml. To address the requirements of this programme, Thales Optics Ltd. have performed a detailed trade-off analysis considering alternative uncooled LWIR sensor formats and technologies. The effect of using alternative sensors on the sight cost, mass, volume, power and performance has been compared. A design study has been performed concentrating on simplification of the optics, mechanics and electronics to minimise the overall sight complexity. Based on this analysis, a demonstrator sight has been designed that is cost effective and suitable for volume manufacture, whilst still offering useful performance to the user. Six technical demonstrator units based on this design have been manufactured and evaluated. This paper will give an overview of the work completed to date on the TIDI program, including a description of the demonstrator hardware and its performance.
Peirone, Eliana; Goria, Paolo Filiberto; Anselmino, Arianna
2014-04-01
To evaluate the safety, feasibility and effectiveness of a dual-task home-based rehabilitation programme on balance impairments among adult patients with acquired brain injury. Single-blind, randomized controlled pilot study. Single rehabilitation centre. Sixteen participants between 12 and 18 months post-acquired brain injury with balance impairments and a score <10 seconds on the One-Leg Stance Test (eyes open). All participants received 50-minutes individualised traditional physiotherapy sessions three times a week for seven weeks. In addition, the intervention group (N = 8) performed an individualised dual-task home-based programme six days a week for seven weeks. The primary outcome measure was the Balance Evaluation System Test; secondary measures were the Activities-specific Balance Confidence Scale and Goal Attainment Scaling. At the end of the pilot study, the intervention group showed significantly greater improvement in Balance Evaluation System Test scores (17.87, SD 6.05) vs. the control group (5.5, SD 3.53; P = 0.008, r = 0.63). There was no significant difference in improvement in Activities-specific Balance Confidence Scale scores between the intervention group (25.25, SD 25.51) and the control group (7.00, SD 14.73; P = 0.11, r = 0.63). There was no significant improvement in Goal Attainment Scaling scores in the intervention (19.37, SD 9.03) vs. the control group (16.28, SD 6.58; P = 0.093, r = 0.63). This pilot study shows the safety, feasibility and short-term benefit of a dual-task home-based rehabilitation programme to improve balance control in patients with acquired brain injury. A sample size of 26 participants is required for a definitive study.
Weaver, M R; Myaya, M; Disasi, K; Regoeng, M; Matumo, H N; Madisa, M; Puttkammer, N; Speilberg, F; Kilmarx, P H; Marrazzo, J M
2008-01-01
Objective: In 2004, the Ministry of Health adopted revised protocols for the syndromic management of sexually transmitted infections (STI) that included routine HIV testing. A training programme for providers was developed on the revised protocols that featured interactive case studies and training videos. An objective of the first phase of the training programme was to test its effect on four measures of clinical practice: (1) routine HIV testing; (2) performance of physical examination; (3) risk-reduction counselling and (4) patient education. Methods: Clinical practice in a district where providers were trained was compared with a district without training. The measures of clinical practice were reported by 185 patients of providers who had been trained and compared with reports by 124 patients at comparison clinics. Results: Relative to patients at comparison clinics, a higher percentage of patients of trainees reported that the provider: (1) offered an HIV test (87% versus 29%; p<0.001); (2) conducted a physical examination (98% versus 64%; p<0.001); (3) helped them to make a plan to avoid future STI acquisition (95% versus 76%; p<0.001) and (4) provided patient-specific information about HIV risk (65% versus 32%; p<0.001). Among patients offered HIV testing, the percentage who accepted did not differ between groups (38% of 161 patients of trainees versus 50% of 36 comparison patients; p = 0.260). Overall, 33% of patients of trainees and 14% of comparison patients were tested (p<0.001). Conclusion: A multifaceted training programme was associated with higher rates of HIV testing, physical examination, risk-reduction counselling and better HIV risk education. PMID:18256107
Vázquez-Lara, Juana María; Ruiz-Frutos, Carlos; Rodríguez-Díaz, Luciano; Ramírez-Rodrigo, Jesús; Villaverde-Gutiérrez, Carmen; Torres-Luque, Gema
2017-09-20
To evaluate the effect of a physical activity programme in the aquatic environment with immersion up to the neck, of six weeks duration, on haemodynamic constants in pregnant women. A six-week physical activity programme in the aquatic environment was carried out with a total of 46 pregnant women, who were distributed into an experimental group (n = 18), which participated in the programme, and a control group (n = 28), which followed routine care. In both groups different haemodynamic measurements were evaluated before and after the program. At the beginning of the programme the mean systolic blood pressure was similar between groups, but diastolic blood pressure was slightly higher in the experimental group. When the measurements at the last session were compared, arterial pressures (systolic, diastolic and mean) were significantly higher in the control group (p <.050). Similarly, the initial plasma volume values did not differ between groups, but after the intervention, the control group women showed a higher mean (p <.010). The fraction of sodium excretion (FENa) increased significantly in the experimental group, after the programme, with a mean three times higher (p <.050). Aldosterone plasma levels did not show significant differences between the groups in the different measurements. A programme of swimming and immersion exercises in pregnant women contributes to hydrosaline balance, preventing an excessive increase in usual plasma volume during pregnancy and in the activity of the renin-aldosterone axis. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Jeong, Eun Ju; Chung, Hyun Soo; Choi, Jeong Yun; Kim, In Sook; Hong, Seong Hee; Yoo, Kyung Sook; Kim, Mi Kyoung; Won, Mi Yeol; Eum, So Yeon; Cho, Young Soon
2017-06-01
The aim of this study was to develop a simulation-based time-out learning programme targeted to nurses participating in high-risk invasive procedures and to figure out the effects of application of the new programme on acceptance of nurses. This study was performed using a simulation-based learning predesign and postdesign to figure out the effects of implementation of this programme. It was targeted to 48 registered nurses working in the general ward and the emergency department in a tertiary teaching hospital. Difference between acceptance and performance rates has been figured out by using mean, standard deviation, and Wilcoxon-signed rank test. The perception survey and score sheet have been validated through content validation index, and the reliability of evaluator has been verified by using intraclass correlation coefficient. Results showed high level of acceptance of high-risk invasive procedure (P<.01). Further, improvement was consistent regardless of clinical experience, workplace, or experience in simulation-based learning. The face validity of the programme showed over 4.0 out of 5.0. This simulation-based learning programme was effective in improving the recognition of time-out protocol and has given the participants the opportunity to become proactive in cases of high-risk invasive procedures performed outside of operating room. © 2017 John Wiley & Sons Australia, Ltd.
An evaluation of the HM prison service "thinking skills programme" using psychometric assessments.
Gobbett, Matthew J; Sellen, Joselyn L
2014-04-01
The most widely implemented offending behaviour programme in the United Kingdom was Enhanced Thinking Skills (ETS), a cognitive-behavioural group intervention that aimed to develop participant's general cognitive skills. A new offending behaviour programme has been developed to replace ETS: the Thinking Skills Programme (TSP). This study reports an evaluation of the effectiveness of TSP using psychometric assessments. Phasing of the two programmes created an opportunity to compare the two programmes consecutively. Forty participants, 20 from each programme, completed a range of psychometric measures to examine cognition, attitudes, and thinking styles. Analysis of pre- and post-programme psychometric results indicated that participants of TSP demonstrated improvements on 14 of the 15 scales, 9 of which were statistically significant. Effect sizes between pre-post results were generally greater for TSP than ETS, demonstrating that TSP had a more positive impact on the thinking styles and attitudes of participants than the ETS programme.
Performance of the National Tuberculosis Control Program in the post conflict Liberia.
Desta, Kassaye Tekie; Masango, T E; Nkosi, Zerish Zethu
2018-01-01
Tuberculosis is a major public health problem in Liberia. According to the World Health Organization (WHO), the incidence of tuberculosis in Liberia is significantly increasing from year to year. However, little is known about the performance of the programme and the challenges after the 14 years of civil war which ended in 2003.The purpose of the study was to evaluate the performance of the TB programme of Liberia. The study utilised mixed research design; both quantitative and qualitative methods were used in this study conducted from 2013 to 2014. For the quantitative part of the study, a questionnaire, laboratory performance and eleven years TB programme data (2003-2013) were used. For the performance of tuberculosis laboratory testing, all the 107 functional tuberculosis microscopy centers in Liberia were included. For the qualitative part of the study, an interview of 10 informants and two focus group discussions (FGDs) were also conducted, each comprising of eight people. Themes and subthemes emerged from the two FGDs. Data was analysed in line with the Donabedian model. Quantitative findings were analysed and presented using both descriptive and inferential statistics. The study findings pointed out that there was overall improvement in the performance of the tuberculosis control programme in Liberia from 2003 to 2013. The percentage of cured patients was 60% in 2005 and 62% in 2013. Percentage of treatment completed was 16% in 2005 and 21% in 2013. The case detection rate was 57% and treatment success rate 80% in 2013. The default rate was 11% in 2013. Of the 139 participants, 120 (86%) completed TB treatment while 19 (14%) did not. Between 2003 and 2013, the National Leprosy and Tuberculosis Control Programme (NLTCP) succeeded in restoring the TB services and improving some of the TB treatment outcomes including the Directly observed treatment short courses(DOTS) coverage. Despite these improvements, the TB treatment, laboratory services and human resource capacity lagged behind. The TB programme of Liberia needs to develop new strategies to address its challenges.
Gilmore, Brynne; Adams, Ben Jack; Bartoloni, Alex; Alhaydar, Bana; McAuliffe, Eilish; Raven, Joanna; Taegtmeyer, Miriam; Vallières, Frédérique
2016-01-01
Introduction Understanding what enhances the motivation and performance of community health workers (CHWs) in humanitarian emergencies represents a key research gap within the field of human resources for health. This paper presents the research protocol for the Performance ImprovEment of CHWs in Emergency Settings (PIECES) research programme. Enhancing Learning and Research in Humanitarian Action (ELRHA) funded the development of this protocol as part of their Health in Humanitarian Crises (R2HC) call (No.19839). PIECES aims to understand what factors improve the performance of CHWs in level III humanitarian emergencies. Methods and analysis The suggested protocol uses a realist evaluation with multiple cases across the 3 country sites: Turkey, Iraq and Lebanon. Working with International Medical Corps (IMC), an initial programme theory was elicited through literature and document reviews, semistructured interviews and focus groups with IMC programme managers and CHWs. Based on this initial theory, this protocol proposes a combination of semistructured interviews, life histories and critical incident narratives, surveys and latent variable modelling of key constructs to explain how contextual factors work to trigger mechanisms for specific outcomes relating to IMC's 300+ CHWs' performance. Participants will also include programme staff, CHWs and programme beneficiaries. Realist approaches will be used to better understand ‘what works, for whom and under what conditions’ for improving CHW performance within humanitarian contexts. Ethics and dissemination Trinity College Dublin's Health Policy and Management/Centre for Global Health Research Ethics Committee gave ethical approval for the protocol development phase. For the full research project, additional ethical approval will be sought from: Université St. Joseph (Lebanon), the Ethics Committee of the Ministry of Health in Baghdad (Iraq) and the Middle East Technical University (Turkey). Dissemination activities will involve a mixture of research feedback, policy briefs, guidelines and recommendations, as well as open source academic articles. PMID:27531730
Gilmore, Brynne; Adams, Ben Jack; Bartoloni, Alex; Alhaydar, Bana; McAuliffe, Eilish; Raven, Joanna; Taegtmeyer, Miriam; Vallières, Frédérique
2016-08-16
Understanding what enhances the motivation and performance of community health workers (CHWs) in humanitarian emergencies represents a key research gap within the field of human resources for health. This paper presents the research protocol for the Performance ImprovEment of CHWs in Emergency Settings (PIECES) research programme. Enhancing Learning and Research in Humanitarian Action (ELRHA) funded the development of this protocol as part of their Health in Humanitarian Crises (R2HC) call (No.19839). PIECES aims to understand what factors improve the performance of CHWs in level III humanitarian emergencies. The suggested protocol uses a realist evaluation with multiple cases across the 3 country sites: Turkey, Iraq and Lebanon. Working with International Medical Corps (IMC), an initial programme theory was elicited through literature and document reviews, semistructured interviews and focus groups with IMC programme managers and CHWs. Based on this initial theory, this protocol proposes a combination of semistructured interviews, life histories and critical incident narratives, surveys and latent variable modelling of key constructs to explain how contextual factors work to trigger mechanisms for specific outcomes relating to IMC's 300+ CHWs' performance. Participants will also include programme staff, CHWs and programme beneficiaries. Realist approaches will be used to better understand 'what works, for whom and under what conditions' for improving CHW performance within humanitarian contexts. Trinity College Dublin's Health Policy and Management/Centre for Global Health Research Ethics Committee gave ethical approval for the protocol development phase. For the full research project, additional ethical approval will be sought from: Université St. Joseph (Lebanon), the Ethics Committee of the Ministry of Health in Baghdad (Iraq) and the Middle East Technical University (Turkey). Dissemination activities will involve a mixture of research feedback, policy briefs, guidelines and recommendations, as well as open source academic articles. 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/
Introducing new diagnostics into STI control programmes: the importance of programme science.
Peeling, Rosanna W; Mabey, David; Ballard, Ronald C
2013-03-01
Many innovative diagnostic technologies will become commercially available over the next 5-10 years. These tests can potentially transform the diagnosis of sexually transmitted infections but their introduction into control programmes can be hampered by health system constraints, and political, cultural, socioeconomic and behavioural factors. We used the introduction of syphilis rapid tests to illustrate the importance of programme science to address the gap between accruing evidence of acceptable test performance and the complexity of programme design, implementation and evaluation of test deployment to address public health needs and improve patient-important outcomes.
Duarte, A; Walker, S; Littlewood, E; Brabyn, S; Hewitt, C; Gilbody, S; Palmer, S
2017-07-01
Computerized cognitive-behavioural therapy (cCBT) forms a core component of stepped psychological care for depression. Existing evidence for cCBT has been informed by developer-led trials. This is the first study based on a large independent pragmatic trial to assess the cost-effectiveness of cCBT as an adjunct to usual general practitioner (GP) care compared with usual GP care alone and to establish the differential cost-effectiveness of a free-to-use cCBT programme (MoodGYM) in comparison with a commercial programme (Beating the Blues) in primary care. Costs were estimated from a healthcare perspective and outcomes measured using quality-adjusted life years (QALYs) over 2 years. The incremental cost-effectiveness of each cCBT programme was compared with usual GP care. Uncertainty was estimated using probabilistic sensitivity analysis and scenario analyses were performed to assess the robustness of results. Neither cCBT programme was found to be cost-effective compared with usual GP care alone. At a £20 000 per QALY threshold, usual GP care alone had the highest probability of being cost-effective (0.55) followed by MoodGYM (0.42) and Beating the Blues (0.04). Usual GP care alone was also the cost-effective intervention in the majority of scenario analyses. However, the magnitude of the differences in costs and QALYs between all groups appeared minor (and non-significant). Technically supported cCBT programmes do not appear any more cost-effective than usual GP care alone. No cost-effective advantage of the commercially developed cCBT programme was evident compared with the free-to-use cCBT programme. Current UK practice recommendations for cCBT may need to be reconsidered in the light of the results.
Im, Sook Bin; Cho, Mi-Kyoung; Kim, Se Young; Heo, Myoung Lyun
2016-05-01
To identify effects of the huddling programme as a strategy for retention of clinical nurses. In Korea, new nurses leave hospitals more than experienced nurses for many reasons. Hospitals with a high nurse turnover require larger budgets and longer periods of time to train large numbers of newly recruited nurses until they can perform as well as those who have left. Furthermore, the remaining nurses have an additional workload associated with both the shortage of manpower and the need to train the incoming nurses. This means that reducing nurse turnover intention requires preventive measures that promote empowerment and organisational commitment among nurses in Korea. Randomised controlled trial. This research used a pretest-post-test experimental-group-control-group design to investigate the effect of the huddling programme. The participants were 49 clinical nurses working at two general hospitals with more than 500 beds that are located in D city and S city of Korea. The experimental group participated in the huddling programme that comprised a full-day retreat and after-work social networking services during January and February 2013. Self-reported questionnaires were used to assess empowerment, organisational commitment and ego-resilience. The data were analysed by descriptive analysis using the t-test. The mean scores for normative commitment and impact of empowerment were higher in the experimental group, but ego-resilience did not differ significantly between the two groups. The huddling program positively increased nurses' perception of organisational commitment and empowerment who participated in huddling programme. The huddling programme could be a useful strategy for improving the retention of clinical nurses. This study is both significant and relevant to nursing science and practice given that it demonstrated the effectiveness of an empowerment programme in increasing organisational commitment and decreasing actual turnover rates of clinical nurses. © 2016 John Wiley & Sons Ltd.
Preparing the prescription: a review of the aim and measurement of social referral programmes.
Rempel, Emily S; Wilson, Emma N; Durrant, Hannah; Barnett, Julie
2017-10-12
Our aim is to review, and qualitatively evaluate, the aims and measures of social referral programmes. Our first objective is to identify the aims of social referral initiatives. Our second objective is to identify the measures used to evaluate whether the aims of social referral were met. Literature review. Social referral programmes, also called social prescribing and emergency case referral, link primary and secondary healthcare with community services, often under the guise of decreasing health system costs. Following the PRISMA guidelines, we undertook a literature review to address that aim. We searched in five academic online databases and in one online non-academic search engine, including both academic and grey literature, for articles referring to 'social prescribing' or 'community referral'. We identified 41 relevant articles and reports. After extracting the aims, measures and type of study, we found that most social referral programmes aimed to address a wide variety of system and individual health problems. This included cost savings, resource reallocation and improved mental, physical and social well-being. Across the 41 studies and reports, there were 154 different kinds of measures or methods of evaluation identified. Of these, the most commonly used individual measure was the Warwick-Edinburgh Mental Well-being Scale, used in nine studies and reports. These inconsistencies in aims and measures used pose serious problems when social prescribing and other referral programmes are often advertised as a solution to health services-budgeting constraints, as well as a range of chronic mental and physical health conditions. We recommend researchers and local community organisers alike to critically evaluate for whom, where and why their social referral programmes 'work'. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Zhang, Q F; Wang, R B; Zheng, B; Xia, Z G; Zhou, S S
2017-05-06
Objective: To analyze the performance of the 5 Global Fund Malaria Programmes in China from 2003 to 2013. Methods: All of the proposals, summaries, progress reports, survey reports, Monitoring& Evaluation reports, and performance rating reports of the 5 Global Fund Malaria Programmes in China and the epidemic data of program areas were collected for statistical analysis from 2012 to 2014. Symposiums were held with relevant experts from national and provincial Centers for Disease Control and Prevention, program managers and staffs from national and provincial Global Fund Malaria Programme offices. The completion of the relevant programme indicators (including the general grant information such as program areas, beneficiaries and funding; the implementation of malaria control measures; the performance of malaria control measures; the malaria incidence in the program areas; the prevalence of malaria parasites; and program management and performance evaluation) were analyzed, and the results: of the symposiums were summarized. Results The implementation period of the 5 Global Fund Malaria Programs were as follows: Round 1 from 2003 to 2008, Round 5 from 2006 to 2010, Round 6 from 2007 to 2012, Round 10 from 2012 to 2013, and National Strategy Application (NSA) from 2010 to 2012. Under the support of all the Global Fund Malaria Programs, a total of 11 936 726 fever cases received microscopic tests, 1 485 915 confirmed and suspected malaria cases were treated, 1 579 773 Long Lasting Insecticide-treated Nets were distributed, 3 414 633 regular nets were treated by insecticide, 40 298 284 primary and middle school students received health education on malaria control. Compared with the baseline value, the completion rates of each indicator increased after the implementation of the programs. The growth value ranged from 12.83% to 83.11%, among which the biggest growth was the value of the indicator'Percentage of households with at least one LLIN/ITN in target areas', and it increased from 9.2% (baseline value of 2006) to 92.31% (value of 2012). The malaria incidence in program areas has dropped significantly year by year, the annual reported malaria incidence in Yunnan and Hainan provinces decreased from 1 950/100 000, 3 850/100 000 in 2002 to 3.31/100 000, 0.15/100 000 in 2012, the P. falciparum malaria incidence in target counties in Hainan province decreased from 90.6/100 000 in 2002 to 0/100 000 in 2012. As from the implementation of NSA grant in 2010 to 2012, the annual reported malaria incidence in 92% of the 75 Type 1 counties was less than 1 per 10 000, 60.00% of Type 1 counties and 98.69% of the 687 Type 2 counties reported zero locally transmitted malaria cases. The Global Fund Secretariat had conducted a total of 37 performance evaluations, of which 9 have been rated as A1, 4 rated as A2, 19 rated as B1 and 5 rated as B1. Conclusions: The Global Fund Malaria Program in China has been closely integrated with the goal and task of National Malaria Control Program, reducing malaria burden in target areas, and pushing Chinese malaria control efforts to move from control to elimination.
System-Level Biochip for Impedance Sensing and Programmable Manipulation of Bladder Cancer Cells
Chuang, Cheng-Hsin; Huang, Yao-Wei; Wu, Yao-Tung
2011-01-01
This paper develops a dielectrophoretic (DEP) chip with multi-layer electrodes and a micro-cavity array for programmable manipulations of cells and impedance measurement. The DEP chip consists of an ITO top electrode, flow chamber, middle electrode on an SU-8 surface, micro-cavity arrays of SU-8 and distributed electrodes at the bottom of the micro-cavity. Impedance sensing of single cells could be performed as follows: firstly, cells were trapped in a micro-cavity array by negative DEP force provided by top and middle electrodes; then, the impedance measurement for discrimination of different stage of bladder cancer cells was accomplished by the middle and bottom electrodes. After impedance sensing, the individual releasing of trapped cells was achieved by negative DEP force using the top and bottom electrodes in order to collect the identified cells once more. Both cell manipulations and impedance measurement had been integrated within a system controlled by a PC-based LabVIEW program. In the experiments, two different stages of bladder cancer cell lines (grade III: T24 and grade II: TSGH8301) were utilized for the demonstration of programmable manipulation and impedance sensing; as the results show, the lower-grade bladder cancer cells (TSGH8301) possess higher impedance than the higher-grade ones (T24). In general, the multi-step manipulations of cells can be easily programmed by controlling the electrical signal in our design, which provides an excellent platform technology for lab-on-a-chip (LOC) or a micro-total-analysis-system (Micro TAS). PMID:22346685
Atmospheric monitoring and model applications at the Pierre Auger Observatory
NASA Astrophysics Data System (ADS)
Keilhauer, Bianca
2015-03-01
The Pierre Auger Observatory detects high-energy cosmic rays with energies above ˜1017 eV. It is built as a multi-hybrid detector measuring extensive air showers with different techniques. For the reconstruction of extensive air showers, the atmospheric conditions at the site of the Observatory have to be known quite well. This is particularly true for reconstructions based on data obtained by the fluorescence technique. For these data, not only the weather conditions near ground are relevant, most important are altitude-dependent atmospheric profiles. The Pierre Auger Observatory has set up a dedicated atmospheric monitoring programme at the site in the Mendoza province, Argentina. Beyond this, exploratory studies were performed in Colorado, USA, for possible installations in the northern hemisphere. In recent years, the atmospheric monitoring programme at the Pierre Auger Observatory was supplemented by applying data from atmospheric models. Both GDAS and HYSPLIT are developments by the US weather department NOAA and the data are freely available. GDAS is a global model of the atmospheric state parameters on a 1 degree geographical grid, based on real-time measurements and numeric weather predictions, providing a full altitude-dependent data set every 3 hours. HYSPLIT is a powerful tool to track the movement of air masses at various heights, and with it the aerosols. Combining local measurements of the atmospheric state variables and aerosol scattering with the given model data, advanced studies about atmospheric conditions can be performed and high precision air shower reconstructions are achieved.
Májek, O; Bartoňková, H; Daneš, J; Skovajsová, M; Dušek, L
2014-01-01
The Czech organised breast cancer screening programme was initiated in 2002. Collection of data on screening mammography examinations, subsequent diagnostic procedures, and final dia-gnosis is an indispensable part of the programme. Data collection is obligatory for all accredited centres, in accordance with regulations issued by the Czech Ministry of Health. This contribution aims to demonstrate the recent results of quality monitoring of the accredited centres. Quality indicators, whose definition complies with international standards, involve the women's participation, the volume of performed examinations, the accuracy of screening mammography, the use of preoperative diagnostics, and the proportion of early detected tumours. Our evaluation documents a continuous improvement in quality of the Czech mammography screening programme, which is thereby in full agreement with international recommendations on quality assurance.
Hulshof, C T J; Verbeek, J H A M; Braam, I T J; Bovenzi, M; van Dijk, F J H
2006-01-01
Objectives To evaluate process and outcome of a multifaceted occupational health intervention programme on whole‐body vibration (WBV) in forklift truck drivers. Methods An experimental pretest/post‐test control group study design. The authors trained occupational health services (OHS) in the experimental group in the use of the programme. OHS in the control group were asked to deliver care as usual. In total, 15 OHS, 32 OHS professionals, 26 companies, and 260 forklift drivers were involved. Post‐test measurements were carried out one year after the start of the programme. Results Baseline data before the start of the programme showed no difference between experimental and control group. Results of the outcome evaluation indicate a slight, although not statistically significant, reduction of WBV exposure in the experimental group (p = 0.06). Process evaluation revealed a positive influence on company policy toward WBV, attitude and intended behaviour of forklift drivers, and a trend towards an increase in knowledge of OHS professionals and company managers. The number of observed control measures with a major impact (levelling of surface and reduction of speed) was rather low. In those cases where control measures had been taken, there was a significant reduction in WBV exposure. This limited effect of the programme might be caused by the short period of follow up and the dropout of participants. The feasibility and the usefulness of the programme within the OHS setting were rated good by the participants. Conclusions This programme to decrease WBV exposure was partially effective. Significant effects on intermediate objectives were observed. More research on the effectiveness of intervention in the field of WBV is needed. PMID:16551762
Lorgelly, Paula; Yamabhai, Inthira
2016-01-01
Abstract Public health programmes tend to be complex and may combine social strategies with aspects of empowerment, capacity building and knowledge across sectors. The nature of the programmes means that some effects are likely to occur outside the healthcare sector; this breadth impacts on the choice of health and non‐health outcomes to measure and value in an economic evaluation. Employing conventional outcome measures in evaluations of public health has been questioned. There are concerns that such measures are too narrow, overlook important dimensions of programme effect and, thus, lead to such interventions being undervalued. This issue is of particular importance for low‐income and middle‐income countries, which face considerable budget constraints, yet deliver a large proportion of health activities within public health programmes. The need to develop outcome measures, which include broader measures of quality of life, has given impetus to the development of a variety of new, holistic approaches, including Sen's capability framework and measures of subjective wellbeing. Despite their promise, these approaches have not yet been widely applied, perhaps because they present significant methodological challenges. This paper outlines the methodological challenges for the identification and measurement of broader outcomes of public health interventions in economic evaluation in low‐income and middle‐income countries. PMID:26804360
An Assessment of the Impact of the Mentoring Programme on Student Performance
ERIC Educational Resources Information Center
Mashela, Langutani Mary; Mabika, Memory
2017-01-01
The University of Venda introduced an academic mentoring programme in 2012. The introduction of the programme was in response to the results of a national study that was conducted by Scott, Yeld and Hendry (2007). The study was replicated at institutional level and it yielded similar results that indicated that at least 30% of undergraduate…
A Masters Programme in telecommunications management - demand-based curriculum design
NASA Astrophysics Data System (ADS)
Gharaibeh, Khaled M.; Kaylani, Hazem; Murphy, Noel; Brennan, Conor; Itradat, Awni; Al-Bataineh, Mohammed; Aloqlah, Mohammed; Salhieh, Loay; Altarazi, Safwan; Rawashdeh, Nathir; Bas Cerdá, María del Carmen; Conchado Peiró, Andrea; Al-Zoubi, Asem; Harb, Bassam; Bany Salameh, Haythem
2015-05-01
This paper presents a curriculum design approach for a Masters Programme in Telecommunications Management based on demand data obtained from surveying the needs of potential students of the proposed programme. Through online surveys disseminated at telecom companies in Jordan, it was possible to measure the demand for such a programme and to determine the required programme contents and specifications. The curriculum design is based on definition of programme outcomes and on using a house of quality approach (HOQ) to determine the list of courses required in the programme. Surveyed competencies are mapped to a long list of proposed courses in a HOQ in order to determine the importance of each of these courses. A final list of core and elective courses is then developed considering the contribution to programme outcomes and the academic standards.
Alfred, Tamuno; Ben-Shlomo, Yoav; Cooper, Rachel; Hardy, Rebecca; Cooper, Cyrus; Deary, Ian J; Elliott, Jane; Gunnell, David; Harris, Sarah E; Kivimaki, Mika; Kumari, Meena; Martin, Richard M; Power, Chris; Sayer, Avan Aihie; Starr, John M; Kuh, Diana; Day, Ian N M
2011-06-01
Several age-related traits are associated with shorter telomeres, the structures that cap the end of linear chromosomes. A common polymorphism near the telomere maintenance gene TERT has been associated with several cancers, but relationships with other aging traits such as physical capability have not been reported. As part of the Healthy Ageing across the Life Course (HALCyon) collaborative research programme, men and women aged between 44 and 90 years from nine UK cohorts were genotyped for the single-nucleotide polymorphism (SNP) rs401681. We then investigated relationships between the SNP and 30 age-related phenotypes, including cognitive and physical capability, blood lipid levels and lung function, pooling within-study genotypic effects in meta-analyses. No significant associations were found between the SNP and any of the cognitive performance tests (e.g. pooled beta per T allele for word recall z-score = 0.02, 95% CI: -0.01 to 0.04, P-value = 0.12, n = 18,737), physical performance tests (e.g. pooled beta for grip strength = -0.02, 95% CI: -0.045 to 0.006, P-value = 0.14, n = 11,711), blood pressure, lung function or blood test measures. Similarly, no differences in observations were found when considering follow-up measures of cognitive or physical performance after adjusting for its measure at an earlier assessment. The lack of associations between SNP rs401681 and a wide range of age-related phenotypes investigated in this large multicohort study suggests that while this SNP may be associated with cancer, it is not an important contributor to other markers of aging. © 2011 The Authors. Aging Cell © 2011 Blackwell Publishing Ltd/Anatomical Society of Great Britain and Ireland.
Kärki, Tommi; Napoli, Christian; Riccardo, Flavia; Fabiani, Massimo; Dente, Maria Grazia; Carballo, Manuel; Noori, Teymur; Declich, Silvia
2014-01-01
Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries. PMID:25337945
Burke, F J T; Ravaghi, V; Mackenzie, L; Priest, N; Falcon, H C
2017-04-21
Aim To assess the performance and thereby the progress of the FDs when they carried out a number of simulated clinical exercises at the start and at the end of their FD year.Methods A standardised simulated clinical restorative dentistry training exercise was carried out by a group of 61 recently qualified dental graduates undertaking a 12 months' duration foundation training programme in England, at both the start and end of the programme. Participants completed a Class II cavity preparation and amalgam restoration, a Class IV composite resin restoration and two preparations for a porcelain-metal full crown. The completed preparations and restorations were independently assessed by an experienced consultant in restorative dentistry, using a scoring system based on previously validated criteria. The data were subjected to statistical analysis.Results There was wide variation in individual performance. Overall, there was a small but not statistically significant improvement in performance by the end of the programme. A statistically significant improvement was observed for the amalgam preparation and restoration, and, overall, for one of the five geographical sub-groups in the study. Possible reasons for the variable performance and improvement are discussed.Conclusions There was variability in the performance of the FDs. The operative performance of FDs at the commencement and end of their FD year indicated an overall moderately improved performance over the year and a statistically significant improvement in their performance with regard to amalgam restoration.
Alban, L; Barfod, K; Petersen, J V; Dahl, J; Ajufo, J C; Sandø, G; Krog, H H; Aabo, S
2010-11-01
Salmonella in pork can be combated during pre- or post-harvest. For large slaughterhouses, post-harvest measures like decontamination might be cost-effective while this is less likely with small-to-medium sized slaughterhouses. In this study, pre-harvest measures might be more relevant. We describe an extended surveillance-and-control programme for Salmonella in finisher pigs, which, to establish equivalence to the Swedish control programme, is intended for implementation on the Danish island, Bornholm. The effect of the programme on food safety was estimated by analysing Salmonella data from pig carcasses originating from herds that would have qualified for the programme during 2006-2008. Food safety was interpreted as prevalence of Salmonella on carcasses as well as the estimated number of human cases of salmonellosis related to pork produced within the programme. Data from the Danish Salmonella programme were obtained from Bornholm. We used a simulation model developed to estimate the number of human cases based on the prevalence of Salmonella on carcass swabs. Herds are only accepted in the programme if they have one or less seropositive sample within the previous 6 months. In this way, the Salmonella load is kept to a minimum. The programme is not yet in operation and pigs that qualify for the programme are currently mixed at slaughter with those that do not qualify. Therefore, we had to assess the impact on the carcass prevalence indirectly. The prevalence of Salmonella in carcass swabs among qualifying herds was 0.46% for the 3 years as a whole, with 2006 as the year with highest prevalence. According to the simulation the expected number of human cases relating to pork produced within the programme was below 10. When the programme is in operation, an extra effect of separating pigs within the programme from those outside is expected to lower the prevalence of Salmonella even further. © 2010 Blackwell Verlag GmbH.
Blunden, Sarah L; Chervin, Ron D
2008-05-01
Problematic behaviour and deficient academic performance have been reported in children with sleep problems, but whether sleep problems are common among children presenting with primary behavioural and performance concerns in remedial programmes is not well studied. We studied this possibility in 80 Australian school children aged 6-15 years and then compared 15 of these children from mainstream schools to 15 demographically matched children in specialist behavioural programmes for problematic behaviour and academic difficulties. Parents completed the Child Behaviour Checklist and the Sleep Disorders Scale for Children. Questionnaires assessed behaviour, academic performance and symptoms of diverse sleep disorders, expressed as T-scores (mean (SD) = 50 (10)). Teachers rated students' academic performance (A, B, C, D, E). When compared with the 15 controls, the 15 index children had significantly more sleep problems, in addition to parental concerns about school performance. In the total sample (n = 80), poor sleep including symptoms of daytime sleepiness, parasomnias, behavioural sleep problems and combined sleep problems was associated with poor academic performance and daytime behavioural issues. This preliminary study suggests that children in remedial school programmes may have poor sleep compared with those in mainstream schools. Sleep problems were associated with problematic behaviour and poor academic performance. If sleep disturbances worsen daytime behaviour, then diagnosis and treatment of underlying sleep disorders could offer a novel therapeutic opportunity.
Programmable differential capacitance-to-voltage converter for MEMS accelerometers
NASA Astrophysics Data System (ADS)
Royo, G.; Sánchez-Azqueta, C.; Gimeno, C.; Aldea, C.; Celma, S.
2017-05-01
Capacitive MEMS sensors exhibit an excellent noise performance, high sensitivity and low power consumption. They offer a huge range of applications, being the accelerometer one of its main uses. In this work, we present the design of a capacitance-to-voltage converter in CMOS technology to measure the acceleration from the capacitance variations. It is based on a low-power, fully-differential transimpedance amplifier with low input impedance and a very low input noise.
ERIC Educational Resources Information Center
Maistry, Suriamurthee
2010-01-01
Continuing professional development (CPD) initiatives for teachers in South Africa take on various forms, ranging from formalised, structured, credit-bearing certification programmes to informal, relatively unstructured, situated learning programmes. While many formal programmes can claim success by measuring throughput rates, there is still much…
Lamothe, Martin; McDuff, Pierre; Pastore, Yves D; Duval, Michel; Sultan, Serge
2018-01-05
To assess the feasibility and acceptability of a mindfulness-based stress reduction (MBSR)-based intervention and determine if the intervention is associated with a significant signal on empathy and emotional competencies. Two pre-post proof-of-concept studies. Participants were recruited at the University of Montreal's Psychology Department (Study 1) and the CHU Sainte-Justine Department of Hematology-Oncology (Study 2). Study 1: 12 students completed the 8-week programme (mean age 24, range 18-34). Study 2: 25 professionals completed the 8-week programme (mean age 48, range 27-63). Standard MBSR programme including 8-week mindfulness programme consisting of 8 consecutive weekly 2-hour sessions and a full-day silent retreat. Mindfulness as measured by the Mindful Attention Awareness Scale; empathy as measured by the Interpersonal Reactivity Index (IRI)'s Perspective Taking and Empathic Concern subscales; identification of one's own emotions and those of others as measured by the Profile of Emotional Competence (PEC)'s Identify my Emotions and Identify Others' Emotions subscales; emotional acceptance as measured by the Acceptance and Action Questionnaire-II (AAQ-II) and the Emotion Regulation Scale (ERQ)'s Expressive Suppression subscale; and recognition of emotions in others as measured by the Geneva Emotion Recognition Test (GERT). In both studies, retention rates (80%-81%) were acceptable. Participants who completed the programme improved on all measures except the PEC's Identify Others' Emotions and the IRI's Empathic Concern (Cohen's d median=0.92, range 45-1.72). In Study 2, favourable effects associated with the programme were maintained over 3 months on the PEC's Identify my Emotions, the AAQ-II, the ERQ's Expressive Suppression and the GERT. The programme was feasible and acceptable. It was associated with a significant signal on the following outcomes: perspective taking, the identification of one's own emotions and emotional acceptance, thus, justifying moving towards efficacy trials using these outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
ERIC Educational Resources Information Center
Brown, Seth
2015-01-01
High-performance sport is a big business, with nations such as Australia and New Zealand dedicating hundreds of millions of dollars in the development of facilities and in creating sporting centres of excellence. Historically, high-performance sport and elite athlete programmes (EAPs) were regulated to an extra-curricular space in schools or local…
Mindstorms robots and the application of cognitive load theory in introductory programming
NASA Astrophysics Data System (ADS)
Mason, Raina; Cooper, Graham
2013-12-01
This paper reports on a series of introductory programming workshops, initially targeting female high school students, which utilised Lego Mindstorms robots. Cognitive load theory (CLT) was applied to the instructional design of the workshops, and a controlled experiment was also conducted investigating aspects of the interface. Results indicated that a truncated interface led to better learning by novice programmers as measured by test performance by participants, as well as enhanced shifts in self-efficacy and lowered perception of difficulty. There was also a transfer effect to another programming environment (Alice). It is argued that the results indicate that for novice programmers, the mere presence on-screen of additional (redundant) entities acts as a form of tacit distraction, thus impeding learning. The utility of CLT to analyse, design and deliver aspects of computer programming environments and instructional materials is discussed.
Leung, M W Y; Wong, B P Y; Leung, A K P; Cho, J S Y; Leung, E T Y; Chao, N S Y; Chung, K W; Kwok, W K; Liu, K K W
2006-12-01
We report our experience of electrical stimulation and biofeedback exercise of pelvic floor muscle for children with faecal incontinence after surgery for anorectal malformation (ARM). Electrical stimulation and biofeedback exercise of pelvic floor muscle were performed on children with post-operative faecal soiling following repair of intermediate or high type ARM. Children under the age of 5 years or with learning difficulties were excluded. They had 6 months supervised programme in the Department of Physiotherapy followed by 6 months home based programme. Bowel management including toilet training, dietary advice, medications and enemas were started before the pelvic floor muscle exercise and continued throughout the programme. Soiling frequency rank, Rintala continence score, sphincter muscle electromyography (EMG) and anorectal manometry were assessed before and after the programme. Wilcoxon signed rank test was performed for statistical analysis. From March 2001 to May 2006, 17 children were referred to the programme. Twelve patients (M:F = 10:2; age = 5-17 years) completed the programme. There was a trend of improvement in Rintala score at sixth month (p = 0.206) and at the end of programme (p = 0.061). Faecal soiling was significantly improved at sixth month (p = 0.01) and at the end of the programme (p = 0.004). Mean sphincter muscle EMG before treatment was 1.699 microV. Mean EMG at sixth month and after the programme was 3.308 microV (p = 0.034) and 3.309 microV (p = 0.002) respectively. After the programme, there was a mean increase in anal sphincter squeeze pressure of 29.9 mmHg (p = 0.007). Electrical stimulation and biofeedback exercise of pelvic floor muscle is an effective adjunct for the treatment of faecal incontinence in children following surgery for anorectal malformation.
The Development of a Graphical Notation for the Formal Specification of Software
1990-12-01
the language. A detailed user survey should be performed after the language implementation is complete to determine the effectiveness of the graphical...productivity. ’Ihere is no better way to improve programmer productivity than to help the programmer to avoid performing the work in the first place. This is...optional prototyping phase is performed ) to develop a computer program (2:40). In 1985, Robert Balzer proposed the program transformation lifecycle
NASA Astrophysics Data System (ADS)
Ofek, N.; Petrenko, A.; Liu, Y.; Vlastakis, B.; Sun, L.; Leghtas, Z.; Heeres, R.; Sliwa, K. M.; Mirrahimi, M.; Jiang, L.; Devoret, M. H.; Schoelkopf, R. J.
2015-03-01
Real-time feedback offers not just the convenience of streamlined data acquisition, but is an essential element in any quantum computational architecture that requires branching based on measurement outcomes. State-preparation, mitigating the effects of qubit decoherence, and recording the trajectories of quantum systems are just a few of the many potential applications of real-time feedback. Photon number parity measurements of cat states in superconducting resonators are a particularly useful platform for demonstrating the clear advantages of having sophisticated feedback schemes to enhance the performance a proposed error-correction protocol [Leghtas et.al. PRL 2013]. In a cQED architecture, where a transmon qubit is coupled to two superconducting cavities, we present a field-programmable gate array (FPGA) device capable of making decisions and calculations with latency times far shorter than the lifetimes of any of the system's constituents. This level of performance opens the door to realizing many complex, previously unfeasible, experiments in superconducting qubit systems.
Assessment of a low-intensity cardiac rehabilitation programme using the six-minute walk test.
Wright, D J; Khan, K M; Gossage, E M; Saltissi, S
2001-04-01
To examine the utility of the six-minute walk test (6'WT), in assessing the effectiveness of a six-week cardiac rehabilitation programme, of which exercise training was an integral part. Royal Liverpool and Broad Green Hospitals Rehabilitation Unit. Two hundred and thirty-nine consecutive patients referred for cardiac rehabilitation were allocated to one of two groups. In group A 209 entered and 159 completed the usual rehabilitation programme whilst group B patients (n = 30) acted as a control by deferring entry to the programme for six weeks, continuing only activities of daily living. Both groups were assessed using the 6'WT, peak expiratory flow rate (PEFR) and isometric grip strength at enrolment and six weeks. At baseline, groups A and B were demographically identical without significant differences in terms of 6'WT, PEFR or grip strength. Following the study period, group A showed a significant increase in 6'WT from 314.7 +/- 76.2 to 377.3 +/- 78.6 m, in PEFR from 406.9 +/- 115.9 to 437.8 +/- 118.6 litres per minute and in grip strength from 28.8 +/- 9.31 to 30.3 +/- 8.93 kg, all p < 0.001. There were no significant changes in group B. The 6'WT proved to be a simple and effective measurement of functional capacity in patients performing cardiac rehabilitation. The clinical programme investigated successfully increased patients' functional capacity as assessed by the 6'WT. Significant improvement in PEFR and grip strength was also demonstrated, compared with a control population.
Quality measurement and improvement in liver transplantation.
Mathur, Amit K; Talwalkar, Jayant
2018-06-01
There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centres. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models. We outline the status quo including the current regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities. Additionally, we further discuss unintended consequences and opportunities for growth in quality measurement. Quality measurement and the integration of quality improvement strategies into liver transplant programmes hold significant promise, but multiple challenges to successful implementation must be addressed to optimise value. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
High-Precision Pulse Generator
NASA Technical Reports Server (NTRS)
Katz, Richard; Kleyner, Igor
2011-01-01
A document discusses a pulse generator with subnanosecond resolution implemented with a low-cost field-programmable gate array (FPGA) at low power levels. The method used exploits the fast carry chains of certain FPGAs. Prototypes have been built and tested in both Actel AX and Xilinx Virtex 4 technologies. In-flight calibration or control can be performed by using a similar and related technique as a time interval measurement circuit by measuring a period of the stable oscillator, as the delays through the fast carry chains will vary as a result of manufacturing variances as well as the result of environmental conditions (voltage, aging, temperature, and radiation).
Cost of microbial larviciding for malaria control in rural Tanzania.
Rahman, Rifat; Lesser, Adriane; Mboera, Leonard; Kramer, Randall
2016-11-01
Microbial larviciding may be a potential supplement to conventional malaria vector control measures, but scant information on its relative implementation costs and effectiveness, especially in rural areas, is an impediment to expanding its uptake. We perform a costing analysis of a seasonal microbial larviciding programme in rural Tanzania. We evaluated the financial and economic costs from the perspective of the public provider of a 3-month, community-based larviciding intervention implemented in twelve villages in the Mvomero District of Tanzania in 2012-2013. Cost data were collected from financial reports and invoices and through discussion with programme administrators. Sensitivity analysis explored the robustness of our results to varying key parameters. Over the 2-year study period, approximately 6873 breeding sites were treated with larvicide. The average annual economic costs of the larviciding intervention in rural Tanzania are estimated at 2014 US$ 1.44 per person protected per year (pppy), US$ 6.18 per household and US$ 4481.88 per village, with the larvicide and staffing accounting for 14% and 58% of total costs, respectively. We found the costs pppy of implementing a seasonal larviciding programme in rural Tanzania to be comparable to the costs of other larviciding programmes in urban Tanzania and rural Kenya. Further research should evaluate the cost-effectiveness of larviciding relative to, and in combination with, other vector control strategies in rural settings. © 2016 John Wiley & Sons Ltd.
Bodicoat, Danielle H; Mundet, Xavier; Gray, Laura J; Cos, Xavier; Davies, Melanie J; Khunti, Kamlesh; Cano, Juan-Franciso
2014-12-01
Continuous quality improvement programmes often target several aspects of care, some of which may be more effective meaning that resources could be focussed on these. The objective was to identify the effective and ineffective aspects of a successful continuous quality improvement programme for individuals with type 2 diabetes in primary care. Data were from a series of cross-sectional studies (GEDAPS) in primary care, Catalonia, Spain, in 55 centres (2239 participants) in 1993, and 92 centres (5819 participants) in 2002. A structural equation modelling approach was used. The intervention was associated with improved microvascular outcomes through microalbuminuria and funduscopy screening, which had a direct effect on microvascular outcomes, and through attending 2-4 nurse visits and having ≥1 blood pressure measurement, which acted through reducing systolic blood pressure. The intervention was associated with improved macrovascular outcomes through blood pressure measurement and attending 2-4 nurse visits (through systolic blood pressure) and having ≥3 education topics, ≥1 HbA1c measurement and adequate medication (through HbA1c). Cholesterol measurement, weight measurement and foot examination did not contribute towards the effectiveness of the intervention. The pathways through which a continuous quality improvement programme appeared to act to reduce microvascular and macrovascular complications were driven by reductions in systolic blood pressure and HbA1c, which were attained through changes in nurse and education visits, measurement and medication. This suggests that these factors are potential areas on which future quality improvement programmes should focus. © 2014 John Wiley & Sons, Ltd.
ERIC Educational Resources Information Center
Borji, Rihab; Sahli, Sonia; Baccouch, Rym; Laatar, Rabeb; Kachouri, Hiba; Rebai, Haithem
2018-01-01
Background: This study aimed to compare the effectiveness of a hopping and jumping training programme (HJP) versus a sensorimotor rehabilitation programme (SRP) on postural performances in children with intellectual disability. Methods: Three groups of children with intellectual disability participated in the study: the HJP group, the SRP group…
Levesque, Jean-Frederic; Sutherland, Kim
2017-01-01
Objective Across healthcare systems, there is consensus on the need for independent and impartial assessment of performance. There is less agreement about how measurement and reporting performance improves healthcare. This paper draws on academic theories to develop a conceptual framework—one that classifies in an integrated manner the ways in which change can be leveraged by healthcare performance information. Methods A synthesis of published frameworks. Results The framework identifies eight levers for change enabled by performance information, spanning internal and external drivers, and emergent and planned processes: (1) cognitive levers provide awareness and understanding; (2) mimetic levers inform about the performance of others to encourage emulation; (3) supportive levers provide facilitation, implementation tools or models of care to actively support change; (4) formative levers develop capabilities and skills through teaching, mentoring and feedback; (5) normative levers set performance against guidelines, standards, certification and accreditation processes; (6) coercive levers use policies, regulations incentives and disincentives to force change; (7) structural levers modify the physical environment or professional cultures and routines; (8) competitive levers attract patients or funders. Conclusion This framework highlights how performance measurement and reporting can contribute to eight different levers for change. It provides guidance into how to align performance measurement and reporting into quality improvement programme. PMID:28851769
Otero-Esquina, Carlos; de Hoyo Lora, Moisés; Gonzalo-Skok, Óliver; Domínguez-Cobo, Sergio; Sánchez, Hugo
2017-11-01
The aim of this study was to analyse the effects of a combined strength-training programme (full-back squat, YoYo TM leg curl, plyometrics and sled towing exercises) on performance in elite young soccer players and to examine the effects when this training programme was performed one or two days per week. Thirty-six male soccer players (U-17 to U-19) were recruited and assigned to experimental groups (EXP1: 1 s w -1 ; EXP2: 2 s w -1 ) or a control group (CON). Performance was assessed through a countermovement jump (CMJ) test (relative peak power [CMJ PP ] and CMJ height [CMJ H ]), a 20-m linear sprint test with split-times at 10-m, and a change of direction test (V-cut test) 1 week before starting the training programme and also 1 week after performing such training programme. Within-group analysis showed substantial improvements in CMJ variables (ES: 0.39-0.81) and COD (ES: 0.70 and 0.76) in EXP1 and EXP2, while EXP2 also showed substantial enhancements in all linear sprinting tests (ES: 0.43-0.52). Between-group analysis showed substantially greater improvements in CMJ variables (ES: 0.39-0.68) in experimental groups in comparison to CON. Furthermore, EXP2 achieved a substantial better performance in 20-m (ES: 0.48-0.64) than EXP1 and CON. Finally, EXP2 also showed greater enhancements in 10-m (ES: 0.50) and V-cut test (ES: 0.52) than EXP1. In conclusion, the combined strength-training programme improved jumping ability, independently of training frequency, though the achievement of two sessions per week also enhanced sprinting abilities (linear and COD) in young soccer players.
Perceived access to fruits and vegetables associated with increased consumption.
Caldwell, Erin M; Miller Kobayashi, M; DuBow, W M; Wytinck, S M
2009-10-01
To examine the association between fruit and vegetable access in the community and change in fruit and vegetable consumption among participants in community-based health promotion programmes. Fruit and vegetable consumption and perceived access to fresh fruit and vegetables were measured by self-administered questionnaires at programme start, end and 1-year follow-up. Community produce availability was determined by grocery store assessments measuring the display space devoted to fruit and vegetable offerings, as well as price, variety and freshness. A total of nine communities were studied; 130 participants completed the fruit and vegetable portions of the questionnaires and could be linked to grocery store assessments. Participants made modest but significant increases in fruit and vegetable consumption from programme start to end: the average increase was 2.88 (95% CI 1.52, 4.25) servings weekly; the average increase from start to follow-up was 2.52 (95% CI 1.09, 3.95) servings weekly. Greater perceived access to fruits and vegetables was significantly associated with higher increases in fruit and vegetable consumption from programme start to programme end. Greater availability of produce was associated with greater increases in fruit and vegetable servings from programme start to programme end as measured by store assessments. Environmental factors, such as access to fruits and vegetables, can modify the effects of community interventions. Interventions with the goal of increasing fruit and vegetable consumption should consider focusing on increasing access to fresh fruits and vegetables in target communities. Similarly, researchers may want to study access as an intervention, not just a contextual variable.
Financial aspects of veterinary herd health management programmes.
Ifende, V I; Derks, M; Hooijer, G A; Hogeveen, H
2014-09-06
Veterinary herd health management (VHHM) programmes have been shown to be economically effective in the past. However, no current information is available on costs and benefits of these programmes. This study compared economics and farm performance between participants and non-participants in VHHM programmes in 1013 dairy farms with over 40 cows. Milk Production Registration (MPR) data and a questionnaire concerning VHHM were used. Based on the level of participation in VHHM (as indicated in the questionnaire), costs of the programmes were calculated using a normative model. The economic value of the production effects was similarly calculated using normative modelling based on MPR data. Participants in VHHM had a better performance with regard to production, but not with regard to reproduction. Over 90 per cent of the VHHM participants were visited at least once every six weeks and most participants discussed at least three topics. In most farms, the veterinarian did the pregnancy checks as part of the VHHM programmes. There was a benefit to cost ratio of about five per cow per year for VHHM participants, and a mean difference in net returns of €30 per cow per year after adjusting for the cost of the programme. This portrays that participation in a VHHM programme is cost-efficient. There is, however, much unexplained variation in the net returns, possibly due to diverse approaches by veterinarians towards VHHM or by other factors not included in this analysis, like nutritional quality or management abilities of the farmer. British Veterinary Association.
Global Fund grant programmes: an analysis of evaluation scores.
Radelet, Steven; Siddiqi, Bilal
2007-05-26
The Global Fund to Fight AIDS, Tuberculosis and Malaria evaluates programme performance after 2 years to help decide whether to continue funding. We aimed to identify the correlation between programme evaluation scores and characteristics of the programme, the health sector, and the recipient country. We obtained data on the first 140 Global Fund grants evaluated in 2006, and analysed 134 of these. We used an ordered probit multivariate analysis to link evaluation scores to different characteristics, allowing us to record the association between changes in those characteristics and the probability of a programme receiving a particular evaluation score. Programmes that had government agencies as principal recipients, had a large amount of funding, were focused on malaria, had weak initial proposals, or were evaluated by the accounting firm KPMG, scored lowest. Countries with a high number of doctors per head, high measles immunisation rates, few health-sector donors, and high disease-prevalence rates had higher evaluation scores. Poor countries, those with small government budget deficits, and those that have or have had socialist governments also received higher scores. Our results show associations, not causality, and they focus on evaluation scores rather than actual performance of the programmes. Yet they provide some early indications of characteristics that can help the Global Fund identify and monitor programmes that might be at risk. The results should not be used to influence the distribution of funding, but rather to allocate resources for oversight and risk management.
Kawonga, Mary; Blaauw, Duane; Fonn, Sharon
2015-06-01
With increasing interest in maximising synergies between disease control programmes (DCP) and general health services (GHS), methods are needed to measure interactions between DCP and GHS actors. In South Africa, administrative integration reforms make GHS managers at decentralised level (district managers) responsible for the oversight of DCP operations within districts, with DCP managers (programme managers) providing specialist support. The reforms necessitate interdependence, but these actors work together ineffectively. Communication is crucial for joint working, but no research to assess communication between these actors has been done. This study explores the use of social network analysis (SNA) to measure the extent to which programme and district managers in South Africa communicate, using HIV monitoring and evaluation (M&E) as an exemplar. Data were collected from fifty one managers in two provinces during 2010-2011, to measure: a) one-on-one task-related communication - talking about the collation (verification, reporting) and use of HIV data for monitoring HIV interventions; and b) group communication through co-participating in management committees where HIV data are used for monitoring HIV interventions in districts. SNA measures were computed to describe actor centrality, network density (cohesion), and communication within and between respective manager groups. Block modelling was applied to identify management committees that connect respective manager groups. Results show HIV programme managers located at higher level communicated largely amongst themselves as a group (homophily), seldom talked to the district managers to whom they are supposed to provide specialist HIV M&E support, and rarely participated with them in management committees. This research demonstrates the utility of SNA as a tool for measuring the extent of communication between DCP and GHS actors at sub-national level. Actions are needed to bridge observed communication gaps in order to promote collaborative monitoring of HIV programme interventions within districts. Copyright © 2015 Elsevier Ltd. All rights reserved.
Versatile all-digital time interval measuring system
NASA Astrophysics Data System (ADS)
Vyhlidal, David; Cech, Miroslav
2011-06-01
This paper describes a design and performance of a versatile all-digital time interval measuring system. The measurement method is based on an interpolation principle. In this principle the time interval is first roughly digitized by a coarse counter driven by a high stability reference clock and the fractions between the clock periods are measured by two Time-to-Digital Converter chips TDC-GPX manufactured by Acam messelectronic. Control circuits allow programmable customization of the system to satisfy many applications such as laser range finding, event counting, or time-of-flight measurements in various physics experiments. The system has two reference clocks inputs and two independent channels for measuring start and stop events. Only one 40 MHz reference is required for the measurement. The second reference can be, for example, 1 PPS (Pulse per Second) signal from a GPS (Global Positioning System) to time tag events. Time intervals are measured using the highest resolution mode of the TDC-GPX chips. The resolution of each chip is software programmable and is PLL (Phase Locked Loop) stabilized against temperature and voltage variations. The system can achieve a timing resolution better than 15 ps rms with up to 90 kHz repetition rate. The time interval measurement range is from 0 ps up to 1 second. The power consumption of the whole system is 18 W including an embedded computer board and an LCD (Liquid Crystal Display) screen. The embedded computer controls the whole system, collects and evaluates measurement data and with the display provides a user interface. The system is implemented using commercially available components.
Knowledge level of nurses in Jordan on ventilator-associated pneumonia and preventive measures.
Hassan, Zeinab M; Wahsheh, Moayad A
2017-05-01
Ventilator-associated pneumonia is the most prevalent infection in Intensive Care Units, with the highest mortality rate; crude mortality rates may be as high as 20-75%. Many practices such as prevention measures (e.g. hand washing, wearing gloves, suctioning, elevated head of bed between 30° and 45°) have demonstrated an effect of reducing the incidence of this infection. To identify the level of nurses' knowledge of ventilator-associated pneumonia and prevention measures before an educational programme, identify the level of nurses' knowledge on ventilator-associated pneumonia and prevention post an educational programme and identify the reasons for not applying ventilator-associated pneumonia prevention measures among nurses in Jordan. Pre- and post-intervention observational study. Data based on a self-reported questionnaire from 428 nurses who worked in intensive care units were analysed. PowerPoint lectures, videos, printed materials and electronic materials were used in the intervention. Paired t-tests were used to test research questions. More than three-quarters of nurses had a low knowledge level regarding pathophysiology, risk factors and ventilator-associated pneumonia preventative measures. Nurses showed significant improvements in mean scores on the knowledge level of ventilator-associated pneumonia and prevention measures after an educational programme (p < 0.05). The main reasons for not applying prevention measures were the lack of time and no followed protocols in the units. Health education programmes about ventilator-associated pneumonia must be conducted among nurses in Jordan through continuous education. Hospital and nursing administrators should be actively involved in educational programmes and in assuring support for continuing education. Protocol for ventilator-associated pneumonia prevention should be developed based on current evidence-based guidelines. © 2016 British Association of Critical Care Nurses.
ERIC Educational Resources Information Center
Schwind, Jessica S.; Gilardi, Kirsten V. K.; Beasley, Val R.; Mazet, Jonna A. K.; Smith, Woutrina A.
2016-01-01
Objectives: The objectives of this study were to assess whether the Envirovet programme served to increase the number of practising ecosystem health professionals, as well as to measure the lasting professional and personal impact of the programme on participants. Design: Impact programme evaluation. Setting: An emerging strategy among global…
Cost Analysis of Chronic Disease Self-Management Programmes Being Delivered in South Florida
ERIC Educational Resources Information Center
Page, Timothy F.; Palmer, Richard C.
2014-01-01
Background: Chronic disease accounts for the majority of healthcare costs. The Chronic Disease Self-Management Programme (CDSMP) has been shown to be effective in reducing the burden of chronic disease. Objectives: The objective of this study was to measure the cost of delivering the Chronic Disease Self-Management Programme (CDSMP) in order to…
Brownlie, Tom S; Morton, John M; Heuer, Cord; McDougall, Scott
2015-02-01
A group-based reproductive management extension programme has been designed to help managers of dairy herds improve herd reproductive performance. The aims of this study were, firstly, to assess effects of participation by key decision makers (KDMs) in a farmer action group programme in 2009 and 2010 on six key management outcomes (KMOs) that affect reproductive performance over 2 years (2009-2010 and 2010-2011), and secondly, to describe KDM intentions to change management behaviour(s) affecting each management outcome after participation in the programme. Seasonal calving dairy herds from four regions of New Zealand were enrolled in the study. Intentions to modify management behaviour were recorded using the formal written action plans developed during the extension programme. KMOs assessed were calving pattern of the herd, pre-calving heifer liveweight, pre-calving and premating body condition score (BCS), oestrus detection, anoestrus cow management and bull management. Participation was associated with improvements in heifer liveweight, more heifers calving in the first 6 weeks of the seasonal calving period, premating BCS and oestrus detection. No significant effects were observed on anoestrus cow management or bull management. KDMs with greater numbers of proposed actions had lower 6 week in-calf rates in the second study year than KDMs who proposed fewer actions. A more effective strategy to ensure more appropriate objectives is proposed. Strategies to help KDMs to implement proposed actions more successfully should be investigated to improve the programme further. Copyright © 2014 Elsevier Ltd. All rights reserved.
Härter, Martin; Bermejo, Isaac; Ollenschläger, Günter; Schneider, Frank; Gaebel, Wolfgang; Hegerl, Ulrich; Niebling, Wilhelm; Berger, Mathias
2006-04-01
Depressive disorders are of great medical and political significance. The potential inherent in achieving better guideline orientation and a better collaboration between different types of care is clear. Throughout the 1990s, educational initiatives were started for implementing guidelines. Evidence-based guidelines on depression have been formulated in many countries. This article presents an action programme for structural, educational, and research-related measures to implement evidence-based care of depressive disorders in the German health system. The starting points of the programme are the 'Guidelines Critical Appraisal Reports' of the 'Guideline Clearing House' and measures from the 'Competence Network on Depression and Suicidality' (CNDS) funded by the Federal Ministry of Education and Research. The article gives an overview of the steps achieved as recommended by the Guidelines Critical Appraisal Reports and the ongoing transfer process into the German health care system. The action programme shows that comprehensive interventions to develop and introduce evidence-based guidelines for depression can achieve benefits in the care of depression, e.g. in recognition, management, and clinical outcome. It was possible to implement the German Action Programme in selected care settings, and initial evaluation results suggest some improvements. The action programme provides preliminary work, materials, and results for developing a future 'Disease Management Programme' (DMP) for depression.
ERIC Educational Resources Information Center
Malm, Joakim; Bryngfors, Leif; Mörner, Lise-Lotte
2015-01-01
Supplemental Instruction (SI) is a programme that is attached to difficult courses with the objective of increasing student performance and retention. However, an SI programme also has the potential to increase overall student performance and retention during the first critical year if applied to introductory courses. In this study the latter…
Improved Remapping Processor For Digital Imagery
NASA Technical Reports Server (NTRS)
Fisher, Timothy E.
1991-01-01
Proposed digital image processor improved version of Programmable Remapper, which performs geometric and radiometric transformations on digital images. Features include overlapping and variably sized preimages. Overcomes some of limitations of image-warping circuit boards implementing only those geometric tranformations expressible in terms of polynomials of limited order. Also overcomes limitations of existing Programmable Remapper and made to perform transformations at video rate.
Motivating Visually Impaired and Deaf-Blind People to Perform Regular Physical Exercises
ERIC Educational Resources Information Center
Surakka, Airi; Kivela, Tero
2008-01-01
The aim of this study was to examine the different ways in which visually impaired and deaf-blind people can be motivated to perform regular physical exercises through the use of a physical training programme. The programme was designed for visually impaired and deaf-blind people with the aim of reducing their most common physical problems: those…
ERIC Educational Resources Information Center
Amasuomo, Japo Oweikeye
2015-01-01
The study examined the academic performance of students in the compulsory courses in technical education during the transition period of first and second years of three years Nigeria Certificate in Education (NCE) Technical programme before choosing their disciplines in the third year. The study comprised of 237 students that consisted of…
ERIC Educational Resources Information Center
Pholphirul, Piriya
2017-01-01
Several research papers have assessed the long-term benefits of pre-primary education in terms of academic performance and labor market outcomes. This study analyzes data obtained from the Programme for International Student Assessment (PISA) to estimate the effects of preschool enrollment of Thai students on producing long-term benefits in their…
Employee Post-Training Behaviour and Performance: Evaluating the Results of the Training Process
ERIC Educational Resources Information Center
Diamantidis, Anastasios D.; Chatzoglou, Prodromos D.
2014-01-01
Despite the fact that firms invest in training, there is considerable evidence to show that training programmes often fail to achieve the intended result of improving worker and organization performance. The purpose of this paper is to examine the medium- to long-term effects of training programmes on firms by means of an integrated research model…
Wheels, hubs and spokes: incorporating a scorecard into a business continuity programme.
Stourac, Tracy
2014-01-01
A scorecard can provide much more than periodic measurements; it can actually serve as the 'hub' of a programme. By taking a strategic look at what one is trying to accomplish, using consistent messaging, following a flexible but defined process and creating an actionable report for the senior leadership, a programme can be built that not only gets attention but is also efficient and effective. The scorecard establishes accountability and consistency while creating a brand for a business continuity programme.
A low-cost spectrometer for NMR measurements in the Earth's magnetic field
NASA Astrophysics Data System (ADS)
Michal, Carl A.
2010-10-01
We describe and demonstrate an inexpensive, easy-to-build, portable spectrometer for nuclear magnetic resonance measurements in the Earth's magnetic field. The spectrometer is based upon a widely available inexpensive microcontroller, which acts as a pulse programmer, audio-frequency synthesizer and digitizer, replacing what are typically the most expensive specialized components of the system. The microcontroller provides the capability to execute arbitrarily long and complicated sequences of phase-coherent, phase-modulated excitation pulses and acquire data sets of unlimited duration. Suitably packaged, the spectrometer is amenable to measurements in the research lab, in the field or in the teaching lab. The choice of components was heavily weighted by cost and availability, but required no significant sacrifice in performance. Using an existing personal computer, the resulting design can be assembled for as little as US200. The spectrometer performance is demonstrated with spin-echo and Carr-Purcell-Meiboom-Gill pulse sequences on a water sample.
Baqui, Abdullah H; Rosecrans, Amanda M; Williams, Emma K; Agrawal, Praween K; Ahmed, Saifuddin; Darmstadt, Gary L; Kumar, Vishwajeet; Kiran, Usha; Panwar, Dharmendra; Ahuja, Ramesh C; Srivastava, Vinod K; Black, Robert E; Santosham, Mathuram
2008-07-01
Socio-economic disparities in health have been well documented around the world. This study examines whether NGO facilitation of the government's community-based health programme improved the equity of maternal and newborn health in rural Uttar Pradesh, India. A quasi-experimental study design included one intervention district and one comparison district of rural Uttar Pradesh. A household survey conducted between January and June 2003 established baseline rates of programme coverage, maternal and newborn care practices, and health care utilization during 2001-02. An endline household survey was conducted after 30 months of programme implementation between January and March 2006 to measure the same indicators during 2004-05. The changes in the indicators from baseline to endline in the intervention and comparison districts were calculated by socio-economic quintiles, and concentration indices were constructed to measure the equity of programme indicators. The equity of programme coverage and antenatal and newborn care practices improved from baseline to endline in the intervention district while showing little change in the comparison district. Equity in health care utilization for mothers and newborns also showed some improvements in the intervention district, but notable socio-economic differentials remained, with the poor demonstrating less ability to access health services. NGO facilitation of government programmes is a feasible strategy to improve equity of maternal and neonatal health programmes. Improvements in equity were most pronounced for household practices, and inequities were still apparent in health care utilization. Furthermore, overall programme coverage remained low, limiting the ability to address equity. Programmes need to identify and address barriers to universal coverage and care utilization, particularly in the poorest segments of the population.
Collard, Dorine C M; Chinapaw, Mai J M; van Mechelen, Willem; Verhagen, Evert A L M
2009-01-01
Health benefits of physical activity in children are well known. However, a drawback is the risk of physical activity-related injuries. Children are at particular risk for these injuries, because of a high level of exposure. Because of the high prevalence of physical activity injuries and the negative short- and long-term consequences, prevention of these injuries in children is important. This article describes how we systematically developed a school-based physical activity injury prevention programme using the intervention mapping (IM) protocol. IM describes a process for developing theory- and evidence-based health promotion programmes. The development can be described in six steps: (i) perform a needs assessment; (ii) identify programme and performance objectives; (iii) select methods and strategies; (iv) develop programme; (v) adopt and implement; and (vi) evaluate. First, the results of the needs assessment showed the injury problem in children and the different risk factors for physical activity injuries. Based on the results of the needs assessment the main focus of the injury prevention programme was described. Second, the overall programme objective of the injury prevention programme was defined as reducing the incidence of lower extremity physical activity injuries. Third, theoretical methods and practical strategies were selected to accomplish a decrease in injury incidence. The theoretical methods used were active learning, providing cues and scenario-based risk information, and active processing of information. The practical strategy of the injury prevention programme was an 8-month course about injury prevention to be used in physical education classes in primary schools. Fourth, programme materials that were used in the injury prevention programme were developed, including newsletters for children and parents, posters, exercises to improve motor fitness, and an information website. Fifth, an implementation plan was designed in order to ensure that the prevention programme would be implemented, adopted and sustained over time. Finally, an evaluation plan was designed. The injury prevention programme is being evaluated in a cluster randomized controlled trial with more than 2200 children from 40 primary schools throughout the Netherlands. The IM process is a useful process for developing an injury prevention programme. Based on the steps of the IM we developed an 8-month injury prevention programme to be used in physical education classes of primary schools.
Group aquatic training improves gait efficiency in adolescents with cerebral palsy.
Ballaz, Laurent; Plamondon, Suzanne; Lemay, Martin
2011-01-01
To evaluate the effect and feasibility of a 10-week group aquatic training programme on gait efficiency in adolescents with cerebral palsy (CP). The secondary purpose was to determine the exercise intensity during aquatic training in a heterogeneous group of adolescents with CP and to investigate the impact of the training programme on the musculoskeletal system. Twelve ambulatory adolescents with spastic CP were recruited. They participated in 20 aquatic training sessions (45 min twice a week). Three physical therapists and a sports teacher supervised the training sessions. Participants wore a heart rate monitor to assess sessions' intensity and a floatation device as appropriate. The primary outcome measure was gait efficiency as measured by the gait energy expenditure index (EEI). The secondary measures were (1) gait spatiotemporal parameters, (2) maximal isometric knee strength and (3) gross motor function. Ten adolescents completed the training programme. No adverse effect was reported. Average exercise intensity was mild to moderate for more than half of the training session. A significant reduction of the EEI and the heart rate during walking was observed following the training programme. No significant change was observed on secondary outcome measures. Group aquatic training increases gait efficiency in adolescents with CP. This improvement is related to systemic cardiorespiratory adaptations. Group aquatic training programme is feasible in adolescents presenting CP at different levels of severity.
Characterizing Task-Based OpenMP Programs
Muddukrishna, Ananya; Jonsson, Peter A.; Brorsson, Mats
2015-01-01
Programmers struggle to understand performance of task-based OpenMP programs since profiling tools only report thread-based performance. Performance tuning also requires task-based performance in order to balance per-task memory hierarchy utilization against exposed task parallelism. We provide a cost-effective method to extract detailed task-based performance information from OpenMP programs. We demonstrate the utility of our method by quickly diagnosing performance problems and characterizing exposed task parallelism and per-task instruction profiles of benchmarks in the widely-used Barcelona OpenMP Tasks Suite. Programmers can tune performance faster and understand performance tradeoffs more effectively than existing tools by using our method to characterize task-based performance. PMID:25860023
Empathy among students in engineering programmes
NASA Astrophysics Data System (ADS)
Rasoal, Chato; Danielsson, Henrik; Jungert, Tomas
2012-10-01
Engineers face challenges when they are to manage project groups and be leaders for organisations because such positions demand skills in social competence and empathy. Previous studies have shown that engineers have low degrees of social competence skills. In this study, the level of empathy as measured by the four subscales of the Interpersonal Reactivity Index, perspective taking, fantasy, empathic distress and empathic concern, among engineering students was compared to students in health care profession programmes. Participants were undergraduate students at Linköping University, 365 students from four different health care profession programmes and 115 students from two different engineering programmes. When the empathy measures were corrected for effects of sex, engineering students from one of the programmes had lower empathy than psychology and social worker students on the fantasy and perspective-taking subscales. These results raise questions regarding opportunities for engineering students to develop their empathic abilities. It is important that engineering students acquire both theoretical and practical knowledge and skills regarding empathy.
[How patient safety programmes can be successfully implemented - an example from Switzerland].
Kobler, Irene; Mascherek, Anna; Bezzola, Paula
2015-01-01
Internationally, the implementation of patient safety programmes poses a major challenge. In the first part, we will demonstrate that various measures have been found to be effective in the literature but that they often do not reach the patient because their implementation proves difficult. Difficulties arise from both the complexity of the interventions themselves and from different organisational settings in individual hospitals. The second part specifically describes the implementation of patient safety improvement programmes in Switzerland and discusses measures intended to bridge the gap between the theory and practice of implementation in Switzerland. Then, the national pilot programme to improve patient safety in surgery is presented, which was launched by the federal Swiss government and has been implemented by the patient safety foundation. Procedures, challenges and highlights in implementing the programme in Switzerland on a national level are outlined. Finally, first (preliminary) results are presented and critically discussed. Copyright © 2015. Published by Elsevier GmbH.
Multimedia systems in ultrasound image boundary detection and measurements
NASA Astrophysics Data System (ADS)
Pathak, Sayan D.; Chalana, Vikram; Kim, Yongmin
1997-05-01
Ultrasound as a medical imaging modality offers the clinician a real-time of the anatomy of the internal organs/tissues, their movement, and flow noninvasively. One of the applications of ultrasound is to monitor fetal growth by measuring biparietal diameter (BPD) and head circumference (HC). We have been working on automatic detection of fetal head boundaries in ultrasound images. These detected boundaries are used to measure BPD and HC. The boundary detection algorithm is based on active contour models and takes 32 seconds on an external high-end workstation, SUN SparcStation 20/71. Our goal has been to make this tool available within an ultrasound machine and at the same time significantly improve its performance utilizing multimedia technology. With the advent of high- performance programmable digital signal processors (DSP), the software solution within an ultrasound machine instead of the traditional hardwired approach or requiring an external computer is now possible. We have integrated our boundary detection algorithm into a programmable ultrasound image processor (PUIP) that fits into a commercial ultrasound machine. The PUIP provides both the high computing power and flexibility needed to support computationally-intensive image processing algorithms within an ultrasound machine. According to our data analysis, BPD/HC measurements made on PUIP lie within the interobserver variability. Hence, the errors in the automated BPD/HC measurements using the algorithm are on the same order as the average interobserver differences. On PUIP, it takes 360 ms to measure the values of BPD/HC on one head image. When processing multiple head images in sequence, it takes 185 ms per image, thus enabling 5.4 BPD/HC measurements per second. Reduction in the overall execution time from 32 seconds to a fraction of a second and making this multimedia system available within an ultrasound machine will help this image processing algorithm and other computer-intensive imaging applications become a practical tool for the sonographers in the feature.
Investigating the sustainability of outcomes in a chronic disease treatment programme.
Bailie, Ross S; Robinson, Gary; Kondalsamy-Chennakesavan, Srinivas N; Halpin, Stephen; Wang, Zhiqiang
2006-09-01
This study examines trends in chronic disease outcomes from initiation of a specialised chronic disease treatment programme through to incorporation of programme activities into routine service delivery. We reviewed clinical records of 98 participants with confirmed renal disease or hypertension in a remote indigenous community health centre in Northern Australia. For each participant the review period spanned an initial three years while participating in a specialised cardiovascular and renal disease treatment programme and a subsequent three years following withdrawal of the treatment programme. Responsibility for care was incorporated into the comprehensive primary care service which had been recently redeveloped to implement best practice care plans. The time series analysis included at least six measures prior to handover of the specialised programme and six following handover. Main outcome measures were trends in blood pressure (BP) control, and systolic and diastolic BP. We found an improvement in BP control in the first 6-12 months of the programme, followed by a steady declining trend. There was no significant difference in this trend between the pre- compared to the post-programme withdrawal period. This finding was consistent for control at levels below 130/80 and 140/90, and for trends in mean systolic and diastolic BP. Investigation of the sustainability of programme outcomes presents major challenges for research design. Sustained success in the management of chronic disease through primary care services requires better understanding of the causal mechanisms related to clinical intervention, the basis upon which they can be 'institutionalised' in a given context, and the extent to which they require regular revitalisation to maintain their effect.
ERIC Educational Resources Information Center
Recio, R. Vazquez; Diaz, J. Ojeda
2010-01-01
The article explores the Social Guarantee Programmes, one measure at attending to diversity within the Spanish educational system. It is an alternative measure that aims to break away from the organisational structure of Obligatory Secondary Education, seeking an organisational model and educational strategies that pursue satisfactory results…
Woods, R; Longmire, W; Galloway, M; Smellie, W
2000-01-01
The aim of this study was to develop a competency based training programme to support multidisciplinary working in a combined biochemistry and haematology laboratory. The training programme was developed to document that staff were trained in the full range of laboratory tests that they were expected to perform. This programme subsequently formed the basis for the annual performance review of all staff. All staff successfully completed the first phase of the programme. This allowed laboratory staff to work unsupervised at night as part of a partial shift system. All staff are now working towards achieving a level of competence equivalent to the training level required for state registration by the Council for Professions Supplementary to Medicine. External evaluation of the training programme has included accreditation by the Council for Professions Supplementary to Medicine and reinspection by Clinical Pathology Accreditation (UK) Ltd. The development of a competency based training system has facilitated the introduction of multidisciplinary working in the laboratory. In addition, it enables the documentation of all staff to ensure that they are fully trained and are keeping up to date, because the continuing professional development programme in use in our laboratory has been linked to this training scheme. This approach to documentation of training facilitated a recent reinspection by Clinical Pathology Accreditation (UK) Ltd. Key Words: Keyword: multidisciplinary working • competency based training PMID:10889827
Battisti, Francesca; Cristaudo, Alfonso; Sartorelli, Pietro; Calà, Piergiuseppe
2018-01-01
Asbestos-related diseases usually have a long latency since first exposure and this legitimates a health surveillance programme addressed to asbestos workers after the cessation of their occupational exposure. After a brief history of health surveillance initiatives performed in Italy as well as in other countries, we describe a regional programme for former asbestos-exposed workers, focusing on organizational features. A regional group of experts defined its operational and economical aspects. The Regional Council supported the whole programme, making it free of charge for all subjects who fulfil the predefined enrolment criteria (being resident in the region, being younger than 80 years old with cessation of occupational asbestos exposure within the last 30 years). The programme activities are classified in two levels: a first level for a basic health evaluation and a second level for in-depth analyses. In order to guarantee an homogeneous delivery in the whole region, the programme has to be performed by public health services with a quality control of activities. The involvement of specific public health services and the cooperation of social stakeholders are expected to play a major role in overcoming still open critical issues, such as the lack of programme existence awareness and adhesion, the correct stratification of subjects for the follow-up, and the real homogeneous delivery of the health surveillance in whole region. PMID:29507808
Freimann, Tiina; Merisalu, Eda; Pääsuke, Mati
2015-01-01
Cervical and lumbar range of motion limitations are usually associated with musculoskeletal pain in the neck and lower back, and are a major health problem among nurses. Physical exercise has been evaluated as an effective intervention method for improving cervical and lumbar range of motion, and for preventing and reducing musculoskeletal pain. The purpose of this study was to investigate the effects of a home-exercise therapy programme on cervical and lumbar range of motion among intensive care unit nurses who had experienced mild to moderate musculoskeletal pain in the neck and or lower back during the previous six months. A quasi-experimental study was conducted among intensive care unit nurses at Tartu University Hospital (Estonia) between May and July 2011. Thirteen nurses who had suffered musculoskeletal pain episodes in the neck and or lower back during the previous six months underwent an 8-week home-exercise therapy programme. Eleven nurses without musculoskeletal pain formed a control group. Questions from the Nordic Musculoskeletal Questionnaire and the 11-point Visual Analogue Scale were used to select potential participants for the experimental group via an assessment of the prevalence and intensity of musculoskeletal pain. Cervical range of motion and lumbar range of motion in flexion, extension, lateral flexion and (cervical range of motion only) rotation were measured with a digital goniometer. A paired t-test was used to compare the measured parameters before and after the home-exercise therapy programme. A Student's t-test was used to analyse any differences between the experimental and control groups. After the home-exercise therapy, there was a significant increase (p < 0.05) in cervical range of motion in flexion, extension, lateral flexion and rotation, and in lumbar range of motion in lateral flexion. Cervical range of motion in flexion was significantly higher (p < 0.01) in the experimental group compared to the control group after therapy. Our results suggest an 8-week intensive home-exercise therapy programme may improve cervical and lumbar range of motion among intensive care nurses. Further studies are needed to develop this simple but effective home-exercise therapy programme to help motivate nurses to perform such exercises regularly. Current Controlled Trials ISRCTN19278735. Registered 27 November 2015.
The status of water demand management in selected cities of southern Africa
NASA Astrophysics Data System (ADS)
Gumbo, Bekithemba
As a result of the rapid rate of urbanisation throughout Africa, many African cities face mounting challenges of providing their increasing populations with adequate and sustainable water services. Water demand management (WDM) offers a sustainable solution to water woes experienced in most cities in the southern Africa region. The region is characterised by frequent droughts, floods and erratic, unevenly distributed rainfall. Meanwhile nearly half of the southern Africa’s 200 million inhabitants do not have access to safe water and sanitation. This paper makes an assessment of the status of WDM in eight cities in the region based on published data and reports. It provides a basis of benchmarking the progress and success in WDM programmes by using selected key performance indicators. Gross unaccounted-for-water (UAW) is used as a crude measure of WDM good practice. From the eight selected case studies, Windhoek, Bulawayo and Hermanus have achieved considerable success in water use efficiency, implementing WDM programmes and recording UAW values of less than 20%, whilst Johannesburg; Maputo; Maseru; Lusaka and Mutare cannot account for about 40-60% of the water introduced into the distribution system. WDM projects require some key performance indicators which need to be recorded systematically by water supply agencies to enable a consistent monitoring and evaluation of programme. Finally for WDM to succeed, a new breed of professionals with multi-disciplinary skills is required as well as training of operatives, i.e. technicians, plumbers and meter readers.
Terré, Marta; Bach, Alex; Devant, Maria
2006-11-01
Nineteen calves were reared in individual pens (IP), and twenty calves were grouped in four pens of five calves each (GP) to study the effects of grouping on behaviour and performance. All calves were on an enhanced-growth feeding programme and had unlimited access to starter. Total dry matter intake (DMI) body weight (BW), serum urea, non-esterified fatty acid (NEFA), cortisol, insulin, and glucose concentrations, and immune response to vaccination were measured. Behaviour patterns categorized as: non-nutritive oral behaviour, cross-sucking, inter-sucking, and self-grooming, were monitored 20 min following the morning and afternoon milk replacer consumption, and at the same times after weaning. There were no differences in final BW and starter DMI between treatments. The decrease of average daily gain (ADG) during the week following weaning was more pronounced in GP than in IP calves. Serum NEFA concentration increased at the beginning of the study in IP calves but serum urea concentrations were greater in GP than in IP calves the week after weaning. Self-grooming increased in both treatments throughout the study but GP calves increased non-nutritive oral behaviour and decreased cross-sucking and inter-sucking behaviours throughout the study. Rearing calves in groups following an enhanced-growth feeding programme did not increase starter intake. Furthermore, cross-sucking and inter-sucking behaviours in calves reared in groups did not seem to cause increased metabolic or immunological distress.
A systematic review of integrated use of disease-management interventions in asthma and COPD.
Lemmens, Karin M M; Nieboer, Anna P; Huijsman, Robbert
2009-05-01
The effectiveness of multiple interventions in asthma and chronic obstructive pulmonary disease (COPD) is unclear. To examine the effectiveness of multiple interventions as compared to single interventions or usual care on health outcomes and health care utilisation within the context of integrated disease management in asthma and COPD. MEDLINE and the Cochrane Library (1995-May 2008) were searched for controlled trials. Two reviewers independently extracted data and assessed study quality. Meta-analyses were performed on quality of life and health care utilisation data. Furthermore, the effects of multiple interventions versus single interventions and usual care were assessed qualitatively. Of the 36 studies included, 17 targeted double interventions (patient-related and organisational interventions); 19 studies performed triple interventions (patient-related, professional-directed and organisational interventions). They were heterogeneous in terms of (combinations of) interventions, outcomes measured, study design and setting. Pooled data showed that studied disease management programmes significantly improved quality of life on several domains. Patients within triple intervention programmes had less chance of at least one hospital admission compared with usual care. No significant effects were found in number of emergency department visits. Qualitative analyses revealed positive trends on process improvements and satisfaction. Inconclusive results were reported on symptoms; no effects were found in lung function. In spite of the heterogeneity of disease management studies in asthma and COPD care, this review showed promising improvements in quality of life and reductions in hospitalisations, especially for triple intervention programmes.
NASA Astrophysics Data System (ADS)
Wang, Xicheng; Gao, Jiaobo; Wu, Jianghui; Li, Jianjun; Cheng, Hongliang
2017-02-01
Recently, hyperspectral image projectors (HIP) have been developed in the field of remote sensing. For the advanced performance of system-level validation, target detection and hyperspectral image calibration, HIP has great possibility of development in military, medicine, commercial and so on. HIP is based on the digital micro-mirror device (DMD) and projection technology, which is capable to project arbitrary programmable spectra (controlled by PC) into the each pixel of the IUT1 (instrument under test), such that the projected image could simulate realistic scenes that hyperspectral image could be measured during its use and enable system-level performance testing and validation. In this paper, we built a visible hyperspectral image projector also called the visible target simulator with double DMDs, which the first DMD is used to product the selected monochromatic light from the wavelength of 410 to 720 um, and the light come to the other one. Then we use computer to load image of realistic scenes to the second DMD, so that the target condition and background could be project by the second DMD with the selected monochromatic light. The target condition can be simulated and the experiment could be controlled and repeated in the lab, making the detector instrument could be tested in the lab. For the moment, we make the focus on the spectral engine design include the optical system, research of DMD programmable spectrum and the spectral resolution of the selected spectrum. The detail is shown.
An extensive literature review of the evaluation of HIV prevention programmes.
Coleman, L M; Ford, N J
1996-09-01
This paper draws out and distils three key themes that have emerged from a substantial bibliographical review of a range of HIV intervention programmes, implemented throughout the world between years 1987 and 1995. Specifically, the paper assesses (1) to what extent intervention programmes have been tailored to meet the requirements and needs of specific target groups; (2) to what extent intervention programmes are supported by social and psychological theory of attitudinal and behavioural change, and also to what extent the results and findings from the interventions have amended existing theory; and, finally, (3) the range of methodologies employed in evaluating intervention programmes and also to what extent behavioural measures have been used in examining a programme's effectiveness. In light of these themes, the paper presents and discusses the principal factors thought to contribute towards the effectiveness of HIV intervention programmes.
A prospective study on gait-related intrinsic risk factors for lower leg overuse injuries.
Ghani Zadeh Hesar, N; Van Ginckel, A; Cools, A; Peersman, W; Roosen, P; De Clercq, D; Witvrouw, E
2009-12-01
To determine prospectively gait-related risk factors for lower leg overuse injury (LLOI). A prospective cohort study. Male and female recruits from a start-to-run (STR) programme during a 10-week training period. 131 healthy subjects (20 men and 111 women), without a history of any lower leg complaint, participated in the study. Before the start of the 10-week STR programme, plantar force measurements during running were performed. During STR, lower leg injuries were diagnosed and registered by a sports physician. Plantar force measurements during running were performed using a footscan pressure plate. During the STR, 27 subjects (five men and 22 women) developed a LLOI. Logistic regression analysis revealed that subjects who developed a LLOI had a significantly more laterally directed force distribution at first metatarsal contact and forefoot flat, a more laterally directed force displacement in the forefoot contact phase, foot flat phase and at heel-off. These subjects also had a delayed change of the centre of force (COF) at forefoot flat, a higher force and loading underneath the lateral border of the foot, and a significantly higher directed force displacement of the COF at forefoot flat. These findings suggest that a less pronated heel strike and a more laterally directed roll-off can be considered as risk factors for LLOI. Clinically, the results of this study can be considered important in identifying individuals at risk of LLOI.
Jam, R; Hernández, O; Mesquida, J; Turégano, C; Carrillo, E; Pedragosa, R; Gómez, V; Martí, L; Vallés, J; Delgado-Hito, P
To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses' knowledge and the application of preventive measures or between workload and the application of preventive measures. Nurses' knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.
Tredrea, Matthew; Dascombe, Ben; Sanctuary, Colin E; Scanlan, Aaron Terrence
2017-10-01
This study aimed to identify attributes that discriminate selected from non-selected players and predict selection into a rugby league development programme in older adolescent players. Anthropometric, performance and psychological attributes were measured in under-16 (N = 100) and under-18 (N = 60) rugby league players trialling for selection into a development programme with a professional Australian club. Sprint times (P < 0.001), predicted VO 2max (P = 0.002) and push-ups 1 min (P = 0.004) were superior in selected under-16 players, and sprint times (P ≤ 0.045), push-ups 1 min (P < 0.001) and chin-ups 1 min (P = 0.013) were superior in selected under-18 players. Further, 10-m sprint (β = -7.706, standard error [SE] = 2.412), VO 2max (β = 0.168, SE = 0.052) and body mass (β = 0.071, SE = 0.023) significantly predicted selection (R 2 = 0.339) in under-16 players, while push-ups 1 min (β = 0.564, SE = 0.250), 10-m sprint (β = -68.477, SE = 28.107), body mass (β = 0.360, SE = 0.155) and chronological age (β = -3.577, SE = 1.720) significantly predicted selection (R 2 = 0.894) in under-18 players. These findings emphasise the importance of performance attributes in junior rugby league and indicate talent identification test batteries should be age-specific in older adolescent players.
Bizzini, Mario; Dvorak, Jiri
2015-01-01
In 2009, FIFA promoted and disseminated the FIFA 11+ injury prevention programme worldwide. Developed and studied by the FIFA Medical Assessment and Research Centre (F-MARC), the programme was based on a randomised controlled study and one countrywide campaign in amateur football that significantly reduced injuries and healthcare costs. Since the FIFA 11+ launch, key publications have confirmed the preventive effects of the programme and have evaluated its performance effects in female as well as male amateur football players. Furthermore, implementation strategies of this prevention programme have also been studied. The goal of this narrative review was to summarise the available scientific evidence about the FIFA 11+ programme. While FIFA continues to disseminate and implement FIFA 11+ among its Member Associations, adaptations of the injury prevention programme for children and referees have been developed and are currently being evaluated. PMID:25878073
NASA Astrophysics Data System (ADS)
Matthiesen, Stephan; Palmer, Paul; Watson, Andrew; Williams, Mathew
2016-04-01
We give an overview over the structure, objectives, and methods of the UK-based Greenhouse Gases Emissions and Feedback Programme. The overarching objective of this research programme is to deliver improved GHG inventories and predictions for the UK, and for the globe at a regional scale. To address this objective, the Programme has developed a comprehensive, multi-year and interlinked measurement and data analysis programme, focussing on the major GHGs carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O). The Programme integrates three UK research consortia with complementary objectives, focussing on observation and modelling in the atmosphere, the oceans, and the terrestrial biosphere: GAUGE (Greenhouse gAs Uk and Global Emissions) will produce robust estimates of the UK GHG budget, using new and existing atmospheric measurement networks and modelling activities at a range of scales. It integrates inter-calibrated information from ground-based, airborne, ferry-borne, balloon-borne, and space-borne sensors, including new sensor technology. The GREENHOUSE (Generating Regional Emissions Estimates with a Novel Hierarchy of Observations and Upscaled Simulation Experiments) project aims to understand the spatio-temporal patterns of biogenic GHG emissions in the UK's landscape of managed and semi-managed ecosystems. It uses existing UK field data and several targeted new measurement campaigns to build regional GHG inventories and improve the capabilities of land surface models. RAGNARoCC (Radiatively active gases from the North Atlantic Region and Climate Change) is an oceanographic project to investigate the air-sea fluxes of GHGs in the North Atlantic region. Through dedicated research cruises as well as data collection from ships of opportunity, it develops a comprehensive budget of natural and anthropogenic components of the carbon cycle in the North Atlantic and a better understanding of why the air-sea fluxes of CO2 vary regionally, seasonally and multi-annually. Integration activities link these three projects to foster knowledge exchange across different scales, methods and sub-disciplines, both within the Programme and with the wider research community. The three projects are integrated to improve our understanding of greenhouse gases across domains and scales. The observational components lay the foundation of new measurement infrastructure that will deliver beyond the lifetime of this Programme. Through the development of robust methods to reduce uncertainties in GHG emissions estimates, the Programme supports regulatory efforts to monitor emissions trends and the efficacy of reduction strategies.
Longitudinal study of the effect of high intensity weight training on aerobic capacity.
Nakao, M; Inoue, Y; Murakami, H
1995-01-01
To investigate the effect of a long-term weight lifting programme characterized by high intensity, low repetition and long rest period between sets on maximal oxygen consumption (VO2max) and to determine the advantage of this programme combined with jogging, 26 male untrained students were involved in weight training for a period of 3 years. The VO2max and body composition of the subjects were examined at beginning, 1 year, 2 years (T2), and 3 years after (T3) training. Of the group, 19 subjects performed the weight lifting programme 5 days each week for 3 years (W-group), 4 subjects performed the same weight lifting programme for 3 years with an additional running programme consisting of 2 miles of jogging once a week during the 3rd year (R1-group), and 3 subjects performed the weight lifting programme during the 1st year and the same combined jogging and weight lifting programme as the R1-group during the 2nd and 3rd years (R2-group). The average VO2max relative to their body mass of the W-group decreased significantly during the 1st year, followed by an insignificant decrease in the 2nd year and a levelling off in the 3rd year. The average VO2max of the W-group at T2 and T3 was 44.2 and 44.1 ml.kg-1.min-1, respectively. The tendency of VO2max changes in the R1- and R2-groups was similar to the W-group until they started the jogging programme, after which they recovered significantly to the initial level within a year of including that programme, and they then levelled off during the next year. Lean body mass estimated from skinfold thicknesses had increased by about 8% after 3 years of weight lifting. The maximal muscle strength, defined by total olympic lifts (snatch, and clean and jerk), of these three groups increased significantly and there was no significant difference among the amounts of the increase in the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Clarkson, Sean; Wheat, Jon; Heller, Ben; Choppin, Simon
2016-01-01
Use of anthropometric data to infer sporting performance is increasing in popularity, particularly within elite sport programmes. Measurement typically follows standards set by the International Society for the Advancement of Kinanthropometry (ISAK). However, such techniques are time consuming, which reduces their practicality. Schranz et al. recently suggested 3D body scanners could replace current measurement techniques; however, current systems are costly. Recent interest in natural user interaction has led to a range of low-cost depth cameras capable of producing 3D body scans, from which anthropometrics can be calculated. A scanning system comprising 4 depth cameras was used to scan 4 cylinders, representative of the body segments. Girth measurements were calculated from the 3D scans and compared to gold standard measurements. Requirements of a Level 1 ISAK practitioner were met in all 4 cylinders, and ISO standards for scan-derived girth measurements were met in the 2 larger cylinders only. A fixed measurement bias was identified that could be corrected with a simple offset factor. Further work is required to determine comparable performance across a wider range of measurements performed upon living participants. Nevertheless, findings of the study suggest such a system offers many advantages over current techniques, having a range of potential applications.
Subcutaneous ICD screening with the Boston Scientific ZOOM programmer versus a 12-lead ECG machine.
Chang, Shu C; Patton, Kristen K; Robinson, Melissa R; Poole, Jeanne E; Prutkin, Jordan M
2018-02-24
The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires preimplant screening to ensure appropriate sensing and reduce risk of inappropriate shocks. Screening can be performed using either an ICD programmer or a 12-lead electrocardiogram (ECG) machine. It is unclear whether differences in signal filtering and digital sampling change the screening success rate. Subjects were recruited if they had a transvenous single-lead ICD without pacing requirements or were candidates for a new ICD. Screening was performed using both a Boston Scientific ZOOM programmer (Marlborough, MA, USA) and General Electric MAC 5000 ECG machine (Fairfield, CT, USA). A pass was defined as having at least one lead that fit within the screening template in both supine and sitting positions. A total of 69 subjects were included and 27 sets of ECG leads had differing screening results between the two machines (7%). Of these sets, 22 (81%) passed using the ECG machine but failed using the programmer and five (19%) passed using the ECG machine but failed using the programmer (P < 0.001). Four subjects (6%) passed screening using the ECG machine but failed using the programmer. No subject passed screening with the programmer but failed with the ECG machine. There can be occasional disagreement in S-ICD patient screening between an ICD programmer and ECG machine, all of whom passed with the ECG machine but failed using the programmer. On a per lead basis, the ECG machine passes more subjects. It is unknown what the inappropriate shock rate would be if an S-ICD was implanted. Clinical judgment should be used in borderline cases. © 2018 Wiley Periodicals, Inc.
Multi-parameter fibre Bragg grating sensor-array for thermal vacuum cycling test
NASA Astrophysics Data System (ADS)
Cheng, L.; Ahlers, B.; Toet, P.; Casarosa, G.; Appolloni, M.
2017-11-01
Fibre Bragg Grating (FBG) sensor systems based on optical fibres are gaining interest in space applications. Studies on Structural Health Monitoring (SHM) of the reusable launchers using FBG sensors have been carried out in the Future European Space Transportation Investigations Programme (FESTIP). Increasing investment in the development on FBG sensor applications is foreseen for the Future Launchers Preparatory Programme (FLPP). TNO has performed different SHM measurements with FBGs including on the VEGA interstage [1, 2] in 2006. Within the current project, a multi-parameter FBG sensor array demonstrator system for temperature and strain measurements is designed, fabricated and tested under ambient as well as Thermal Vacuum (TV) conditions in a TV chamber of the European Space Agency (ESA), ESTEC site. The aim is the development of a multi-parameters measuring system based on FBG technology for space applications. During the TV tests of a Space Craft (S/C) or its subsystems, thermal measurements, as well as strain measurements are needed by the engineers in order to verify their prediction and to validate their models. Because of the dimensions of the test specimen and the accuracy requested to the measurement, a large number of observation/measuring points are needed. Conventional sensor systems require a complex routing of the cables connecting the sensors to their acquisition unit. This will add extra weight to the construction under test. FBG sensors are potentially light-weight and can easily be multiplexed in an array configuration. The different tasks comply of a demonstrator system design; its component selection, procurement, manufacturing and finally its assembly. The temperature FBG sensor is calibrated in a dedicated laboratory setup down to liquid nitrogen (LN2) temperature at TNO. A temperature-wavelength calibration curve is generated. After a test programme definition a setup in thermal vacuum is realised at ESA premises including a mechanical strain transducer to generate strain via a dedicated feed through in the chamber. Thermocouples are used to log the temperature for comparison to the temperature FBG sensor. Extreme temperature ranges from -150°C and +70°C at a pressure down to 10-4 Pa (10-6 mbar) are covered as well as testing under ambient conditions. In total five thermal cycles during a week test are performed. The FBG temperature sensor test results performed in the ESA/ESTEC TV chamber reveal high reproducibility (within 1 °C) within the test temperature range without any evidence of hysteresis. Differences are detected to the previous calibration curve. Investigation is performed to find the cause of the discrepancy. Differences between the test set-ups are identified. Equipment of the TNO test is checked and excluded to be the cause. Additional experiments are performed. The discrepancy is most likely caused by a 'thermal shock' due to rapid cooling down to LN2 temperature, which results in a wavelength shift. Test data of the FBG strain sensor is analysed. The read-out of the FBG strain sensor varies with the temperature during the test. This can be caused by temperature induced changes in the mechanical setup (fastening of the mechanical parts) or impact of temperature to the mechanical strain transfer to the FBG. Improvements are identified and recommendations given for future activities.
ERIC Educational Resources Information Center
Serenko, Alexander
2011-01-01
The purpose of this project is to empirically investigate several antecedents and consequences of student satisfaction (SS) with Canadian university music programmes as well as to measure students' level of programme satisfaction. For this, the American Customer Satisfaction Model was tested through a survey of 276 current Canadian music students.…
Tay, Laura; Lim, Wee Shiong; Chan, Mark; Ali, Noorhazlina; Chong, Mei Sian
2016-01-01
Gait disorders are common in early dementia, with particularly pronounced dual-task deficits, contributing to the increased fall risk and mobility decline associated with cognitive impairment. This study examines the effects of a combined cognitive stimulation and physical exercise programme (MINDVital) on gait performance under single- and dual-task conditions in older adults with mild dementia. Thirty-nine patients with early dementia participated in a multi-disciplinary rehabilitation programme comprising both physical exercise and cognitive stimulation. The programme was conducted in 8-week cycles with participants attending once weekly, and all participants completed 2 successive cycles. Cognitive, functional performance and behavioural symptoms were assessed at baseline and at the end of each 8-week cycle. Gait speed was examined under both single- (Timed Up and Go and 6-metre walk tests) and dual-task (animal category and serial counting) conditions. A random effects model was performed for the independent effect of MINDVital on the primary outcome variable of gait speed under dual-task conditions. The mean age of patients enroled in the rehabilitation programme was 79 ± 6.2 years; 25 (64.1%) had a diagnosis of Alzheimer's dementia, and 26 (66.7%) were receiving a cognitive enhancer therapy. There was a significant improvement in cognitive performance [random effects coefficient (standard error) = 0.90 (0.31), p = 0.003] and gait speed under both dual-task situations [animal category: random effects coefficient = 0.04 (0.02), p = 0.039; serial counting: random effects coefficient = 0.05 (0.02), p = 0.013], with reduced dual-task cost for gait speed [serial counting: random effects coefficient = -4.05 (2.35), p = 0.086] following successive MINDVital cycles. No significant improvement in single-task gait speed was observed. Improved cognitive performance over time was a significant determinant of changes in dual-task gait speed [random effects coefficients = 0.01 (0.005), p = 0.048, and 0.02 (0.005), p = 0.003 for category fluency and counting backwards, respectively]. A combined physical and cognitive rehabilitation programme leads to significant improvements in dual-task walking in early dementia, which may be contributed by improvement in cognitive performance, as single-task gait performance remained stable. © 2016 S. Karger AG, Basel.
Zwijsen, S A; Gerritsen, D L; Eefsting, J A; Smalbrugge, M; Hertogh, C M P M; Pot, A M
2015-01-01
Caring for people with dementia in dementia special care units is a demanding job. Challenging behaviour is one of the factors influencing the job satisfaction and burnout of care staff. A care programme for the challenging behaviour of nursing home residents with dementia might, next to diminishing the challenging behaviour of residents, improve job satisfaction and reduce the care staff's feelings of burnout. To determine the effects of a care programme for the challenging behaviour of nursing home residents with dementia on the burnout, job satisfaction and job demands of care staff. The care programme was implemented according to a stepped wedge design in which care units were randomly divided over five groups with different time points of starting with implementation. 17 Dutch dementia special care units. Care staff members of the 17 units. The care programme consists of an education package and of various structured assessment tools that guide professionals through the multidisciplinary detection, analysis, treatment and evaluation of treatment of challenging behaviour. Burnout, job satisfaction and job demands were measured before implementation, halfway through the implementation process and after all the care units had implemented the care programme. Burnout was measured with the Dutch version of the Maslach burnout inventory (UBOS-C, three subscales); job satisfaction and job demands were measured with subscales of the Leiden Quality of Work Questionnaire. Mixed model analyses were used to determine effects. Care staff could not be blinded for the intervention. Of the 1441 questionnaires, 645 were returned (response 45%, 318 control measurements, 327 intervention measurements) by 380 unique care staff members. Significant effects were found on job satisfaction (0.93, 95% CI 0.48-1.38). On the other outcomes, no significant changes in the scores were found. Positive effects of using the Grip on Challenging behaviour care programme were found on job satisfaction, without an increase in job demands. Copyright © 2014 Elsevier Ltd. All rights reserved.
A critical review of adolescent mindfulness-based programmes.
Tan, Lucy B G
2016-04-01
Previous research has demonstrated that mindfulness-based programmes improve psychological functioning in a myriad of adult domains. These include health care, marketing and sports industries. The efficacy of mindfulness-based programmes in the adult population is well established. Indeed, compared to adult empirical literature, mindfulness programmes for adolescents are relatively developmental and less articulated until now. It may be argued that mindfulness-based programmes could and should begin early and be applicable to young people at a time that is critical in their development. Hence, this article analyses the characteristics, objectives and outcomes of mindfulness interventions for adolescents, focusing on the mindfulness programme adjustments and adaptations made to the content for this target group. A critique of the literature that included published articles of mindfulness-based interventions (both clinical and universal programmes) for adolescents were sourced and reviewed. Conference papers and unpublished dissertations were excluded. The review indicated that a majority of these were longitudinal and feasibility studies, with only one clinical randomised controlled trial study. Preliminary evidence for the use of mindfulness-based with adolescents continues to be nascent, with many of the studies using inappropriate or no mindfulness process measures at all. In addition, a majority of the studies did not provide specific details of the mindfulness programmes for adolescents, nor discuss what modifications were undertaken--all of which makes comparison difficult. However, with the availability of recent and age-appropriate mindfulness measures for adolescents, more rigorous and robust research looks promising. © The Author(s) 2015.
Extracurricular leadership development programme to prepare future Saudi physicians as leaders.
Ayuob, Nasra Naeim; Al Sayes, Faten Mohamed; El Deek, Basem Salama
2016-06-01
To describe and evaluate an innovative approach for developing leadership skills in a cohort of medical students through an extracurricular programme. The study was conducted at King Abdulaziz University, Jeddah, Saudi Arabia, from April to June of the academic year 2014-15, and comprised medical students from all batches. Mixed-method design was used to evaluate the leadership development programme. Pre- and post-tests were conducted to assess students' learning and their satisfaction was evaluated at the end of the programme. Focus groups were conducted to assess the programme's impact on participants' behaviour. Data analysis was done using SPSS 16. Of the 55 participants, 45(82%) responded to the evaluation survey. Of them, 29(65%) reported intended changes in their leadership practices immediately after the programme, with 8(28%) of them reporting more than one change. The mean students' satisfaction with the overall performance of the speakers and programme organisation was high at 4.12±0.91 and 4.54±0.89, respectively. Early experience of the leadership development programme produced positive results. An intense programme analysis is required to fully understand this significant organisational need.
Sterdt, Elena; Pape, Natalie; Kramer, Silke; Urban, Michael; Werning, Rolf; Walter, Ulla
2013-09-03
Preschools offer high potential for preventive interventions. However, little is known about the structure of preschool programmes to promote physical activity (PA) in preschoolers although almost all children aged three to six years spend one third of the day at preschool. The aim of this study was to determine whether and to what extent preschools implement systematic PA promotion measures using an instrument specifically developed to assess and systematize preschool PA programmes. In the cross-sectional study a baseline survey of preschool education policies was conducted to identify and assess the type and extent of PA programmes and opportunities in preschools in the State of Lower Saxony, Germany. An assessment instrument was developed to identify preschools with systematic PA programmes (type 1) and those without PA programmes (type 2) based on the following quality criteria: A) written PA policy, B) structured weekly PA offerings for all children; C) at least one qualified physical education teacher; D) PA-friendly indoor and outdoor facilities (exercise room, situational PA opportunities, outdoor areas, play equipment etc.), and E) structured PA promotion in place for at least two years. A third type of preschool that promotes PA in children to some extent (i.e., that meets the criteria partially but not completely) was classified as "preschools with limited PA programmes". 2415 preschools participated in the survey (response rate: 59%). The results show that 26% (n = 554) have a systematic PA programme while 3% (n = 64) have no PA programme. Most (71%, n = 1514) were classified as limited PA programme preschools. All three types of preschools differed significantly (p = .000) from each other in terms of size (small vs. large). Most of the preschools without PA programmes are small half-day preschools. The study investigated an assessment-instrument providing extensive insight into the nature, extent and routine practical implementation of PA promotion in preschools. The criteria used to evaluate preschool PA programmes are well-suited to identify the different preschool PA programme types and target areas in the field of PA promotion in which specific measures (teacher education, structured PA offerings, etc.) can be implemented in future interventions.
Methods and circuitry for reconfigurable SEU/SET tolerance
NASA Technical Reports Server (NTRS)
Shuler, Jr., Robert L. (Inventor)
2010-01-01
A device is disclosed in one embodiment that has multiple identical sets of programmable functional elements, programmable routing resources, and majority voters that correct errors. The voters accept a mode input for a redundancy mode and a split mode. In the redundancy mode, the programmable functional elements are identical and are programmed identically so the voters produce an output corresponding to the majority of inputs that agree. In a split mode, each voter selects a particular programmable functional element output as the output of the voter. Therefore, in the split mode, the programmable functional elements can perform different functions, operate independently, and/or be connected together to process different parts of the same problem.
Graham-Brown, M P M; March, D S; Churchward, D R; Young, H M L; Dungey, M; Lloyd, S; Brunskill, N J; Smith, A C; McCann, G P; Burton, J O
2016-07-08
There is emerging evidence that exercise training could positively impact several of the cardiovascular risk factors associated with sudden cardiac death amongst patients on haemodialysis. The primary aim of this study is to evaluate the effect of an intradialytic exercise programme on left ventricular mass. Prospective, randomised cluster open-label blinded endpoint clinical trial in 130 patients with end stage renal disease on haemodialysis. Patients will be randomised 1:1 to either 1) minimum of 30 min continuous cycling thrice weekly during dialysis or 2) standard care. The primary outcome is change in left ventricular mass at 6 months, assessed by cardiac MRI (CMR). In order to detect a difference in LV mass of 15 g between groups at 80 % power, a sample size of 65 patients per group is required. Secondary outcome measures include abnormalities of cardiac rhythm, left ventricular volumes and ejection fraction, physical function measures, anthropometric measures, quality of life and markers of inflammation, with interim assessment for some measures at 3 months. This study will test the hypothesis that an intradialytic programme of exercise leads to a regression in left ventricular mass, an important non-traditional cardiovascular risk factor in end stage renal disease. For the first time this will be assessed using CMR. We will also evaluate the efficacy, feasibility and safety of an intradialytic exercise programme using a number of secondary end-points. We anticipate that a positive outcome will lead to both an increased patient uptake into established intradialytic programmes and the development of new programmes nationally and internationally. ISRCTN11299707 (registration date 5(th) March 2015).
pH-programmable DNA logic arrays powered by modular DNAzyme libraries.
Elbaz, Johann; Wang, Fuan; Remacle, Francoise; Willner, Itamar
2012-12-12
Nature performs complex information processing circuits, such the programmed transformations of versatile stem cells into targeted functional cells. Man-made molecular circuits are, however, unable to mimic such sophisticated biomachineries. To reach these goals, it is essential to construct programmable modular components that can be triggered by environmental stimuli to perform different logic circuits. We report on the unprecedented design of artificial pH-programmable DNA logic arrays, constructed by modular libraries of Mg(2+)- and UO(2)(2+)-dependent DNAzyme subunits and their substrates. By the appropriate modular design of the DNA computation units, pH-programmable logic arrays of various complexities are realized, and the arrays can be erased, reused, and/or reprogrammed. Such systems may be implemented in the near future for nanomedical applications by pH-controlled regulation of cellular functions or may be used to control biotransformations stimulated by bacteria.
Capio, C M; Poolton, J M; Sit, C H P; Eguia, K F; Masters, R S W
2013-04-01
Children with intellectual disabilities (ID) have been found to have inferior motor proficiencies in fundamental movement skills (FMS). This study examined the effects of training the FMS of overhand throwing by manipulating the amount of practice errors. Participants included 39 children with ID aged 4-11 years who were allocated into either an error-reduced (ER) training programme or a more typical programme in which errors were frequent (error-strewn, ES). Throwing movement form, throwing accuracy, and throwing frequency during free play were evaluated. The ER programme improved movement form, and increased throwing activity during free play to a greater extent than the ES programme. Furthermore, ER learners were found to be capable of engaging in a secondary cognitive task while manifesting robust throwing accuracy performance. The findings support the use of movement skills training programmes that constrain practice errors in children with ID, suggesting that such approach results in improved performance and heightened movement engagement in free play. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.
Rees, Clare S; Anderson, Rebecca A; Finlay-Jones, Amy
2015-04-29
OCD? Not Me! is a novel, web-based, self-guided intervention designed to treat obsessive-compulsive disorder (OCD) in young people aged 12-18, using the principles of exposure and response prevention. The current paper presents the protocol for the development of the programme and for an open trial that will evaluate the effectiveness of this programme for OCD in young people, and associated distress and symptom accommodation in their parents and caregivers. We will measure the impact of the OCD? Not Me! programme on OCD symptoms using the Children's Florida Obsessive Compulsive Inventory (C-FOCI), and both the self-report and parent report of the Children's Obsessional Compulsive Inventory-Revised (ChOCI-R). The impact of the programme on OCD-related functional impairment will be measured using the parent report of the Child Obsessive-Compulsive Impact Scale-Revised (COIS-R). Secondary outcome measures include the Rosenberg Self-Esteem Scale and the Youth Quality of Life-Short Form (YQoL-SF). The 21-item Depression Anxiety Stress Scales (DASS-21) will be used to measure the impact of the programme on parent/caregiver distress, while the Family Accommodation Scale (FAS) will be used to measure change in family accommodation of OCD symptoms. Multilevel mixed effects linear regression will be used to analyse the impact of the intervention on the outcome measures. This study has been approved by the Curtin University Human Research Ethics Committee. The results of the study will be reported in international peer-reviewed journals. Australian New Zealand Clinical Trials Registry: ACTRN12613000152729. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Rees, Clare S; Anderson, Rebecca A
2015-01-01
Background OCD? Not Me! is a novel, web-based, self-guided intervention designed to treat obsessive-compulsive disorder (OCD) in young people aged 12–18, using the principles of exposure and response prevention. The current paper presents the protocol for the development of the programme and for an open trial that will evaluate the effectiveness of this programme for OCD in young people, and associated distress and symptom accommodation in their parents and caregivers. Methods We will measure the impact of the OCD? Not Me! programme on OCD symptoms using the Children's Florida Obsessive Compulsive Inventory (C-FOCI), and both the self-report and parent report of the Children's Obsessional Compulsive Inventory—Revised (ChOCI-R). The impact of the programme on OCD-related functional impairment will be measured using the parent report of the Child Obsessive-Compulsive Impact Scale—Revised (COIS-R). Secondary outcome measures include the Rosenberg Self-Esteem Scale and the Youth Quality of Life—Short Form (YQoL-SF). The 21-item Depression Anxiety Stress Scales (DASS-21) will be used to measure the impact of the programme on parent/caregiver distress, while the Family Accommodation Scale (FAS) will be used to measure change in family accommodation of OCD symptoms. Multilevel mixed effects linear regression will be used to analyse the impact of the intervention on the outcome measures. Ethics and dissemination This study has been approved by the Curtin University Human Research Ethics Committee. The results of the study will be reported in international peer-reviewed journals. Trial registration number Australian New Zealand Clinical Trials Registry: ACTRN12613000152729. PMID:25926148
Smartphones and Programmable Shunts: Are These Indispensable Phones Safe and Smart?
Ozturk, Sait; Cakin, Hakan; Kurtuldu, Huseyin; Kocak, Onur; Erol, Fatih S; Kaplan, Metin
2017-06-01
This study aimed to determine whether smartphones affect programmable shunts. iPhone 5S (Apple Inc., Cupertino, CA, USA) and Samsung Galaxy S5 (Samsung Electronics, Gumi, South Korea) smartphones were chosen for this study. For both phones, magnetic field mapping was performed with 3-dimensional magnetic scanning systems constructed with high-precision motorized stages, and a Hall effect sensor was used to measure the flux density on the smartphone surface. The distance (h) between the distal outlet of the reservoir and the rugby ball of the Strata valve (Medtronic Inc., Minneapolis, MN, USA) was measured using highly sensitive microanalysis optical method. During optical microanalysis, while keeping a 3-cm distance between the valve and the magnetic generator, the h value (μm) was recorded for different magnetic flux densities (MFDs). Then, direct x-ray radiography was performed for radiologic assessment after each process under different magnetic fields. For analysis of the Codman Certas valve (Codman Neuro, Raynham, MA, USA), the magnet orientation and the angle between the magnet with the tantalum ball were measured with the same optical analysis. Maximum MFDs found 62 G for iPhone 5S and 61 G for Samsung Galaxy S5. When the magnetic generator formed a current at 0, 30, 60, and 90 G, the h values of the Strata valve adjusted to 100 mm H 2 O opening pressure were 320, 280, 190, and 175 μm, respectively. When the magnetic generator was removed from the environment, the h value returned to 320 μm. In direct graphs taken after each optical analysis at different Gauss values, substitution was not observed at the indicator. The angle in the Codman Certas valve was 123.9°, 112.5°, and 103.6° at the magnetic flux densities of 0, 60, and 90 G, respectively. When the magnetic field was removed (0 G), the angle was still 103.6°, suggesting an irreversible effect in the shunt construct. Smartphones exert reversible effects on Strata programmable valves without producing remarkable radiologic findings and irreversible effects on Codman Certas valves. Copyright © 2017 Elsevier Inc. All rights reserved.
Chai, Louis Y A; Ong, Kian Chung; Kee, Adrian; Earnest, Arul; Lim, Fabian C L; Wong, John C M
2009-10-01
This study objectively evaluates the effectiveness of a 6-week Preparatory Training Phase (PTP) programme prior to Basic Military Training (BMT) for less physically conditioned conscripts in the Singapore Armed Forces. We compared exercise test results of a group of less fi t recruits who underwent a 16-week modified-BMT (mBMT) programme (consisting of a 6-week PTP and 10-week BMT phase) with their 'fitter' counterparts enlisted in the traditional 10-week direct-intake BMT (dBMT) programme in this prospective cohort study consisting of 36 subjects. The main outcome measures included cardiopulmonary responses parameters (VO(2)max and V(O2AT)) with clinical exercise testing and distance run timings. Although starting off at a lower baseline in terms of physical fitness [VO(2)max 1.73 +/- 0.27 L/min (mBMT group) vs 1.97 +/- 0.43 L/min (dBMT), P = 0.032; V(O2AT) 1.02 +/- 0.19 vs 1.14 +/- 0.32 L/min respectively, P = 0.147], the mBMT group had greater improvement in cardiopulmonary indices and physical performance profiles than the dBMT cohort as determined by cardiopulmonary exercise testing [VO(2)max 2.34 +/- 0.24 (mBMT) vs 2.36 +/- 0.36 L/min (dBMT), P = 0.085; V(O2AT) 1.22 +/- 0.17 vs 1.21 +/- 0.24 L/min respectively, P = 0.303] and 2.4 kilometres timed-run [mBMT group 816.1 sec (pre-BMT) vs 611.1 sec (post-BMT), dBMT group 703.8 sec vs 577.7 sec, respectively; overall P value 0.613] at the end of the training period. Initial mean difference in fitness between mBMT and dBMT groups on enlistment was negated upon graduation from BMT. Pre-enlistment fitness stratification with training modification in a progressive albeit longer BMT programme for less-conditioned conscripts appears efficacious when measured by resultant physical fitness.
An Architecture for Measuring Joint Angles Using a Long Period Fiber Grating-Based Sensor
Perez-Ramirez, Carlos A.; Almanza-Ojeda, Dora L.; Guerrero-Tavares, Jesus N.; Mendoza-Galindo, Francisco J.; Estudillo-Ayala, Julian M.; Ibarra-Manzano, Mario A.
2014-01-01
The implementation of signal filters in a real-time form requires a tradeoff between computation resources and the system performance. Therefore, taking advantage of low lag response and the reduced consumption of resources, in this article, the Recursive Least Square (RLS) algorithm is used to filter a signal acquired from a fiber-optics-based sensor. In particular, a Long-Period Fiber Grating (LPFG) sensor is used to measure the bending movement of a finger. After that, the Gaussian Mixture Model (GMM) technique allows us to classify the corresponding finger position along the motion range. For these measures to help in the development of an autonomous robotic hand, the proposed technique can be straightforwardly implemented on real time platforms such as Field Programmable Gate Array (FPGA) or Digital Signal Processors (DSP). Different angle measurements of the finger's motion are carried out by the prototype and a detailed analysis of the system performance is presented. PMID:25536002
Raphael-Greenfield, Emily
2012-09-01
This study investigates the utility of an occupational therapy assessment of executive and performance functioning and indicators of community adjustment among adults with histories of homelessness and substance abuse. A sample of 60 individuals living in a supported housing programme was interviewed about community living experiences and was assessed using the Executive Function Performance Test (EFPT). A descriptive and correlational study design was used. Measurable levels of cognitive and task impairment were documented, in older adults, non-US citizens and those diagnosed with cognitive impairments. Those who had completed a supported education/employment programme (Total EFPT t = -2.83, 0.008) performed better as did those who were employed (Total EFPT t = -2.33, 0.03), met regularly with their case managers (cooking t = -2.07, 0.04), had hobbies (paying bills r = -0.31, 0.02) and had longer periods of abstinence (organization/planning t = -3.59, 0.001). Limitations of the study include the unanticipated need by the clients for additional translation services. Future directions include a randomized controlled intervention study using the EFPT. An implication of this study for occupational therapists working with homeless clients who abuse substances is the importance of assessing and treating their cognitive impairments as well as providing these services within housing first agencies. Copyright © 2012 John Wiley & Sons, Ltd.
Poltavski, Dmitri; Biberdorf, David
2015-01-01
Abstract In the growing field of sports vision little is still known about unique attributes of visual processing in ice hockey and what role visual processing plays in the overall athlete's performance. In the present study we evaluated whether visual, perceptual and cognitive/motor variables collected using the Nike SPARQ Sensory Training Station have significant relevance to the real game statistics of 38 Division I collegiate male and female hockey players. The results demonstrated that 69% of variance in the goals made by forwards in 2011-2013 could be predicted by their faster reaction time to a visual stimulus, better visual memory, better visual discrimination and a faster ability to shift focus between near and far objects. Approximately 33% of variance in game points was significantly related to better discrimination among competing visual stimuli. In addition, reaction time to a visual stimulus as well as stereoptic quickness significantly accounted for 24% of variance in the mean duration of the player's penalty time. This is one of the first studies to show that some of the visual skills that state-of-the-art generalised sports vision programmes are purported to target may indeed be important for hockey players' actual performance on the ice.
2014-01-01
Background The goal of this pilot study was to examine the feasibility and clinical outcomes of a brief (6-session) group therapy programme in adolescent outpatients with depression. The programme had previously been assessed in in-patients, with positive results. Methods A total of 15 outpatients aged 13 to 18 years took part in the programme between October 2010 and May 2011, in 3 separate groups of 4–6 participants each. The outcomes measured were feasibility of the programme, as assessed by attendance rate, user feedback, fidelity of implementation, and response to treatment, as assessed by pre- and post-intervention measurement of depressive symptoms, quality of life, and suicidal ideation. Results The programme demonstrated good feasibility, with a mean attendance rate of 5.33 out of 6 sessions, a mean rating by participants on overall satisfaction with the programme of 7.21 out of 10 (SD = 1.89), and a 93% concurrence between the contents of the sessions and the contents of the treatment manual. Compared to baseline scores, depressive symptoms at follow-up test were significantly reduced, as assessed by the Children’s Depression Rating Scale Revised (F(1, 12) = 11.76, p < .01) and the Beck Depression Inventory Revision (F(1, 32) = 11.19, p < .01); quality of life improved, as assessed by the Inventory of Quality of Life (F(1, 31) = 5.27, p < .05); and suicidal ideation was reduced. No significant changes were seen on the measures of the Parent Rating Scale for Depression and the Clinical Global Impression scale. Conclusions Based on the results of this pilot study, it is feasible to further assess this brief outpatient treatment programme in a randomized controlled trial without further modifications. PMID:24655595
Analysing the operative experience of basic surgical trainees in Ireland using a web-based logbook
2011-01-01
Background There is concern about the adequacy of operative exposure in surgical training programmes, in the context of changing work practices. We aimed to quantify the operative exposure of all trainees on the National Basic Surgical Training (BST) programme in Ireland and compare the results with arbitrary training targets. Methods Retrospective analysis of data obtained from a web-based logbook (http://www.elogbook.org) for all general surgery and orthopaedic training posts between July 2007 and June 2009. Results 104 trainees recorded 23,918 operations between two 6-month general surgery posts. The most common general surgery operation performed was simple skin excision with trainees performing an average of 19.7 (± 9.9) over the 2-year training programme. Trainees most frequently assisted with cholecystectomy with an average of 16.0 (± 11.0) per trainee. Comparison of trainee operative experience to arbitrary training targets found that 2-38% of trainees achieved the targets for 9 emergency index operations and 24-90% of trainees achieved the targets for 8 index elective operations. 72 trainees also completed a 6-month post in orthopaedics and recorded 7,551 operations. The most common orthopaedic operation that trainees performed was removal of metal, with an average of 2.90 (± 3.27) per trainee. The most common orthopaedic operation that trainees assisted with was total hip replacement, with an average of 10.46 (± 6.21) per trainee. Conclusions A centralised web-based logbook provides valuable data to analyse training programme performance. Analysis of logbooks raises concerns about operative experience at junior trainee level. The provision of adequate operative exposure for trainees should be a key performance indicator for training programmes. PMID:21943313
Assessment of laparoscopic suturing skills of urology residents: a pan-European study.
Kroeze, Stephanie G C; Mayer, Erik K; Chopra, Samarth; Aggarwal, Rajesh; Darzi, Ara; Patel, Anup
2009-11-01
It has been acknowledged that standardised training programmes are needed to improve laparoscopic training of urologic trainees. Previous studies have suggested that simulator-based laparoscopic training can improve performance during real laparoscopic procedures. To determine if there are performance differences for the completion of a simulated laparoscopic suturing task among urology residents based on their postgraduate year of training (PGY). Using a validated scoring checklist, two independent observers objectively scored the completion of a standardised laparoscopic suturing task in a bench-top laparoscopic box trainer. PGY and previous exposure to laparoscopic surgery and laparoscopic simulated training was obtained from self-administered questionnaires. Data acquisition was undertaken at the European Urological Residents Education Programme (EUREP) 2007, run by the European School of Urology, and included a pan-European cohort of 201 urology residents. Reliability among those rating the suturing tasks was excellent (Cronbach's α=0.83). Each resident was scored for the suturing task. Residents were categorised into three groups based on their PGY status (junior [n=8]; intermediate [n=37]; senior [n=156]). The Kruskal-Wallis test was used to measure trend across the PGY; the Mann-Whitney U test was used to determine variation among categorised PGY groups. Laparoscopic suturing skill was significantly different across PGY levels (p=0.032), and between junior residents and both intermediate and senior residents (p=0.008 and p=0.012, respectively). There was no significant difference between intermediate and senior residents (p=0.697). Only 12% of participants rated their existing volume of laparoscopic operative cases as sufficient, while 55% of participants had no regular opportunities, and 32% of participants had not performed laparoscopic procedures as primary surgeon. Most residents (96%) reported the use of laparoscopic simulators to be beneficial in training, although current European training programmes appear to provide <50% of residents with the opportunity to train with them. A discernable relationship existed between the score obtained for a laparoscopic suturing task and year of resident training. Modular simulator training as part of a formal training programme may help to overcome some of the shortfall in residents' exposure to laparoscopic procedures as primary surgeon.
Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali.
Druetz, Thomas
2018-05-25
Randomized controlled trials have established that seasonal malaria chemoprevention (SMC) in children is a promising strategy to reduce malaria transmission in Sahelian West Africa. This strategy was recently introduced in a dozen countries, and about 12 million children received SMC in 2016. However, evidence on SMC effectiveness under routine programme conditions is sparse. We aim to measure the effects of the nationwide SMC programme in Mali on the prevalence of malaria and anemia in children 6-59 months. We used data from the 2015 nationally representative malaria indicator survey. A post-test only with non-randomized control group study was designed. We fitted a generalized structural equation model that controlled for potential bias on observed and non-observed variables (endogenous treatment effect model). Having received SMC reduced by 44% (95% CI [0.39-0.49]) the risk of having a positive rapid diagnostic test for malaria. In addition, the programme indirectly reduced by 18% the risk of moderate-to-severe anemia (95% CI [0.15-0.21]). SMC in Mali has substantial protective effects under routine nationwide programme conditions. Endogenous treatment effects analyses can contribute to rigorously measuring the effectiveness of health programmes and to bridging a widening gap in evaluation methods to measure progress towards achieving malaria elimination.
Online Measurement of Academic Programme Preferences for Distance Learners in Hong Kong
ERIC Educational Resources Information Center
Zhang, Wei-yuan; Yeung, Lai-hung Au
2003-01-01
The purpose of this paper is to report on the development of the first online self-directed inventory on the measurement of academic programme preferences (MAPP) for potential students at the Open University of Hong Kong (OUHK). In this study, trait-factor theory and personality type theory were employed. 1,963 respondents in Hong Kong were…
The Impact of Resistance Training on Swimming Performance: A Systematic Review.
Crowley, Emmet; Harrison, Andrew J; Lyons, Mark
2017-11-01
The majority of propulsive forces in swimming are produced from the upper body, with strong correlations between upper body strength and sprint performance. There are significant gaps in the literature relating to the impact of resistance training on swimming performance, specifically the transfer to swimming performance. The aims of this systematic literature review are to (1) explore the transfer of resistance-training modalities to swimming performance, and (2) examine the effects of resistance training on technical aspects of swimming. Four online databases were searched with the following inclusion criteria: (1) journal articles with outcome measures related to swimming performance, and (2) competitive swimmers participating in a structured resistance-training programme. Exclusion criteria were (1) participants with a mean age <16 years; (2) untrained, novice, masters and paraplegic swimmers; (3) triathletes and waterpolo players; (4) swimmers with injuries or illness; and (5) studies of starts and turns specifically. Data were extracted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the Physiotherapy Evidence Database (PEDro) scale was applied. For optimal transfer, specific, low-volume, high-velocity/force resistance-training programmes are optimal. Stroke length is best achieved through resistance training with low repetitions at a high velocity/force. Resisted swims are the most appropriate training modality for improving stroke rate. Future research is needed with respect to the effects of long-term resistance-training interventions on both technical parameters of swimming and overall swimming performance. The results of such work will be highly informative for the scientific community, coaches and athletes.
Roberts, Martin J; Gale, Thomas C E; McGrath, John S; Wilson, Mark R
2016-05-01
The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an important opportunity to examine applicants' reactions to acute stress. In the context of multi-station selection centres for recruitment to anaesthesia training programmes, we investigated the factors influencing candidates' pre-station challenge/threat evaluations and the extent to which their evaluations predicted subsequent station performance. Candidates evaluated the perceived stress of upcoming stations using a measure of challenge/threat evaluation-the cognitive appraisal ratio (CAR)-and consented to release their demographic details and station scores. Using regression analyses we determined which candidate and station factors predicted variation in the CAR and whether, after accounting for these factors, the CAR predicted candidate performance in the station. The CAR was affected by the nature of the station and candidate gender, but not age, ethnicity, country of training or clinical experience. Candidates perceived stations involving work related tasks as more threatening. After controlling for candidates' demographic and professional profiles, the CAR significantly predicted station performance: 'challenge' evaluations were associated with better performance, though the effect was weak. Our selection centre model can help recruit prospective anaesthetists who are able to rise to the challenge of performing in stressful situations but results do not support the direct use of challenge/threat data for recruitment decisions.
Piloting an outcome-based programme evaluation tool in undergraduate medical education.
Raupach, Tobias; Schiekirka, Sarah; Münscher, Christian; Beißbarth, Tim; Himmel, Wolfgang; Burckhardt, Gerhard; Pukrop, Tobias
2012-01-01
Different approaches to performance-oriented allocation of resources according to teaching quality are currently being discussed within German medical schools. The implementation of these programmes is impeded by a lack of valid criteria to measure teaching quality. An assessment of teaching quality should include structural and procedural aspects but focus on learning outcome itself. The aim of this study was to implement a novel, outcome-based evaluation tool within the clinical phase of a medical curriculum and address differences between the novel tool and traditional evaluation methods. Student self-assessments before and after completion of a teaching module were used to compute performance gains for specific learning objectives. Mean performance gains in each module were compared to student expectations before the module and data derived from a traditional evaluation tool using overall course ratings at the end of the module. A ranking of the 21 modules according to computed performance gains yielded entirely different results than module rankings based on overall course ratings. There was no significant correlation between performance gain and overall ratings. However, the latter were significantly correlated to student expectations before entering the module as well as structural and procedural parameters (Pearson's r 0.7-0.9). Performance gain computed from comparative self-assessments adds an important new dimension to course evaluation in medical education. In contrast to overall course ratings, the novel tool is less heavily confounded by construct-irrelevant factors. Thus, it appears to be more appropriate than overall course ratings in determining teaching quality and developing algorithms to guide performance-oriented resource allocation in medical education.
Structural Tailoring of Advanced Turboprops (STAT) programmer's manual
NASA Technical Reports Server (NTRS)
Brown, K. W.; Harvey, P. R.
1989-01-01
The Structural Tailoring of Advanced Turboprops (STAT) computer program was developed to perform numerical optimizations on highly swept propfan blades. This manual describes the functionality of the STAT system from a programmer's viewpoint. It provides a top-down description of module intent and interaction. The purpose of this manual is to familiarize the programmer with the STAT system should he/she wish to enhance or verify the program's function.
Developing a music programme for preschool children with cochlear implants.
Koşaner, Julie; Kilinc, Aynur; Deniz, Murat
2012-11-01
Although music perception is especially challenging for cochlear implant (CI) users, young CI users' musical perception abilities are improved by participation in structured musical activities. To design, implement, evaluate, and publish a music training programme with a monitoring tool for preschool CI users, for use in family-centred habilitation programmes. We devised a programme of musical activities, Musical EARS®, and a curriculum-related hierarchical Evaluation Form to represent performance. The programme included sections on singing; recognizing songs, tunes, and timbre; and responding appropriately to music and rhythm. It was implemented over 18 months at Ilkses Rehabilitation Centre, with 25 paediatric MED-EL CI users split into three groups of varying age, duration of CI use, and ability. Mean total scores increased significantly for all groups. Scores increased unevenly across subscales. Participation in and enjoyment of musical activities increased for both children and parents. Significant correlations were found between scores and length of CI use. The training programme effectively enriches child CI users' musical experience. To varying degrees, children learned to perform the Musical EARS® activities. The study allowed us to validate the lesson content and the hierarchical nature of the Evaluation Form. We conclude that prelingually deafened CI users should be systematically involved in musical activities to help them acquire skills acquired more easily by hearing peers.
Rahman, Rachel Jane; Hudson, Joanne; Thøgersen-Ntoumani, Cecilie; Doust, Jonathan H
2015-01-01
This research examined the processes underpinning changes in psychological well-being and behavioural regulation in cardiac rehabilitation (CR) patients using self-determination theory (SDT). A repeated measures design was used to identify the longitudinal relationships between SDT variables, psychological well-being and exercise behaviour during and following a structured CR programme. Participants were 389 cardiac patients (aged 36-84 years; M(age) = 64 ± 9 years; 34.3% female) referred to a 12-week-supervised CR programme. Psychological need satisfaction, behavioural regulation, health-related quality of life, physical self-worth, anxiety and depression were measured at programme entry, exit and six month post-programme. During the programme, increases in autonomy satisfaction predicted positive changes in behavioural regulation, and improvements in competence and relatedness satisfaction predicted improvements in behavioural regulation and well-being. Competence satisfaction also positively predicted habitual physical activity. Decreases in external regulation and increases in intrinsic motivation predicted improvements in physical self-worth and physical well-being, respectively. Significant longitudinal relationships were identified whereby changes during the programme predicted changes in habitual physical activity and the mental quality of life from exit to six month follow-up. Findings provide insight into the factors explaining psychological changes seen during CR. They highlight the importance of increasing patients' perceptions of psychological need satisfaction and self-determined motivation to improve well-being during the structured component of a CR programme and longer term physical activity.
The work and social adjustment scale: reliability, sensitivity and value.
Zahra, Daniel; Qureshi, Adam; Henley, William; Taylor, Rod; Quinn, Cath; Pooler, Jill; Hardy, Gillian; Newbold, Alexandra; Byng, Richard
2014-06-01
To investigate the psychometric properties of the Work and Social Adjustment Scale (WSAS) as an outcome measure for the Improving Access to Psychological Therapy programme, assessing its value as an addition to the Patient Health (PHQ-9) and Generalised Anxiety Disorder questionnaires (GAD-7). Little research has investigated these properties to date. Reliability and responsiveness to change were assessed using data from 4,835 patients. Principal components analysis was used to determine whether the WSAS measures a factor distinct from the PHQ-9 and GAD-7. The WSAS measures a distinct social functioning factor, has high internal reliability, and is sensitive to treatment effects. The WSAS, PHQ-9 and GAD-7 perform comparably on measures of reliability and sensitivity. The WSAS also measures a distinct social functioning component suggesting it has potential as an additional outcome measure.
Distributed solid state programmable thermostat/power controller
NASA Technical Reports Server (NTRS)
Smith, Dennis A. (Inventor); Alexander, Jane C. (Inventor); Howard, David E. (Inventor)
2008-01-01
A self-contained power controller having a power driver switch, programmable controller, communication port, and environmental parameter measuring device coupled to a controllable device. The self-contained power controller needs only a single voltage source to power discrete devices, analog devices, and the controlled device. The programmable controller has a run mode which, when selected, upon the occurrence of a trigger event changes the state of a power driver switch and wherein the power driver switch is maintained by the programmable controller at the same state until the occurrence of a second event.
de Figueiredo, Alexandre; Johnston, Iain G; Smith, David M D; Agarwal, Sumeet; Larson, Heidi J; Jones, Nick S
2016-10-01
Incomplete immunisation coverage causes preventable illness and death in both developing and developed countries. Identification of factors that might modulate coverage could inform effective immunisation programmes and policies. We constructed a performance indicator that could quantitatively approximate measures of the susceptibility of immunisation programmes to coverage losses, with an aim to identify correlations between trends in vaccine coverage and socioeconomic factors. We undertook a data-driven time-series analysis to examine trends in coverage of diphtheria, tetanus, and pertussis (DTP) vaccination across 190 countries over the past 30 years. We grouped countries into six world regions according to WHO classifications. We used Gaussian process regression to forecast future coverage rates and provide a vaccine performance index: a summary measure of the strength of immunisation coverage in a country. Overall vaccine coverage increased in all six world regions between 1980 and 2010, with variation in volatility and trends. Our vaccine performance index identified that 53 countries had more than a 50% chance of missing the Global Vaccine Action Plan (GVAP) target of 90% worldwide coverage with three doses of DTP (DTP3) by 2015. These countries were mostly in sub-Saharan Africa and south Asia, but Austria and Ukraine also featured. Factors associated with DTP3 immunisation coverage varied by world region: personal income (Spearman's ρ=0·66, p=0·0011) and government health spending (0·66, p<0·0001) were informative of immunisation coverage in the Eastern Mediterranean between 1980 and 2010, whereas primary school completion was informative of coverage in Africa (0·56, p<0·0001) over the same period. The proportion of births attended by skilled health staff correlated significantly with immunisation coverage across many world regions. Our vaccine performance index highlighted countries at risk of failing to achieve the GVAP target of 90% coverage by 2015, and could aid policy makers' assessments of the strength and resilience of immunisation programmes. Weakening correlations with socioeconomic factors show a need to tackle vaccine confidence, whereas strengthening correlations point to clear factors to address. UK Engineering and Physical Sciences Research Council. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.
Pizzi, Laura T; Waisbourd, Michael; Hark, Lisa; Sembhi, Harjeet; Lee, Paul; Crews, John E; Saaddine, Jinan B; Steele, Deon; Katz, L Jay
2018-02-01
Glaucoma is the foremost cause of irreversible blindness, and more than 50% of cases remain undiagnosed. Our objective was to report the costs of a glaucoma detection programme operationalised through Philadelphia community centres. The analysis was performed using a healthcare system perspective in 2013 US dollars. Costs of examination and educational workshops were captured. Measures were total programme costs, cost/case of glaucoma detected and cost/case of any ocular disease detected (including glaucoma). Diagnoses are reported at the individual level (therefore representing a diagnosis made in one or both eyes). Staff time was captured during site visits to 15 of 43 sites and included time to deliver examinations and workshops, supervision, training and travel. Staff time was converted to costs by applying wage and fringe benefit costs from the US Bureau of Labor Statistics. Non-staff costs (equipment and mileage) were collected using study logs. Participants with previously diagnosed glaucoma were excluded. 1649 participants were examined. Mean total per-participant examination time was 56 min (SD 4). Mean total examination cost/participant was $139. The cost/case of glaucoma newly identified (open-angle glaucoma, angle-closure glaucoma, glaucoma suspect, or primary angle closure) was $420 and cost/case for any ocular disease identified was $273. Glaucoma examinations delivered through this programme provided significant health benefit to hard-to-reach communities. On a per-person basis, examinations were fairly low cost, though opportunities exist to improve efficiency. Findings serve as an important benchmark for planning future community-based glaucoma examination programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Margitai, Barnabás; Dózsa, Csaba; Bárdos-Csenteri, Orsolya Karola; Sándor, János; Gáll, Tibor; Gődény, Sándor
2018-01-01
Objective Quantitative studies have shown the various benefits for having accreditation in hospitals. However, neither of these explored the general conditions before applying for an accreditation. To close this gap, this study aimed to investigate the possible association between joining an accreditation programme with various hospital characteristics. Design A cross-sectional study was implemented using the databases of the 2013 Hungarian hospital survey and of the Hungarian State Treasury. Setting Public general hospitals in Hungary. Participants The analysis involved 44 public general hospitals, 14 of which joined the preparatory project for a newly developed accreditation programme. Main outcome measures The outcomes included the percentage of compliance in quality management, patient information and identification, internal professional regulation, safe surgery, pressure sore prevention, infection control, the opinions of the heads of quality management regarding the usefulness of quality management and clinical audits, and finally, the total debt of the hospital per bed and per discharged patient. Results According to our findings, the general hospitals joining the preparatory project of the accreditation programme performed better in four of the six investigated activities, the head of quality management had a better opinion on the usefulness of quality management, and both the debt per bed number and the debt per discharged patient were lower than those who did not join. However, no statistically significant differences between the two groups were found in any of the examined outcomes. Conclusions The findings suggest that hospitals applying for an accreditation programme do not differ significantly in characteristics from those which did not apply. This means that if in the future the accredited hospitals become better than other hospitals, then the improvement could be solely contributed to the accreditation. PMID:29391381
Detering, Karen; Silvester, William; Corke, Charlie; Milnes, Sharyn; Fullam, Rachael; Lewis, Virginia; Renton, Jodie
2014-09-01
To develop and evaluate an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training. Development of training materials was overseen by a committee; informed by literature and previous teaching experience. The evaluation assessed participant confidence, knowledge and attitude toward ACP before and after training. Training provided to metropolitan and rural settings in Victoria, Australia. 148 doctors participated in training. The majority were aged at least 40 years with more than 10 years work experience; 63% had not trained in Australia. The programme included prereading, a DVD, interactive patient e-simulation workshop and a training manual. All educational materials followed an evidence-based stepwise approach to ACP: Introducing the topic, exploring concepts, introducing solutions and summarising the conversation. The primary outcome was the change in doctors' self-reported confidence to undertake ACP conversations. Secondary measures included pretest/post-test scores in patient ACP e-simulation, change in ACP knowledge and attitude, and satisfaction with programme materials. 69 participants completed the preworkshop and postworkshop evaluation. Following education, there was a significant change in self-reported confidence in six of eight items (p=0.008 -0.08). There was a significant improvement (p<0.001) in median scores on the e-simulation (pre 7/80, post 60/80). There were no significant differences observed in ACP knowledge following training, and most participants were supportive of patient autonomy and ACP pretraining. Educational materials were rated highly. A short multimodal interactive education programme improves doctors' confidence with ACP and performance on an ACP patient e-simulation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Heron, Neil; Kee, Frank; Cardwell, Christopher; Tully, Mark A; Donnelly, Michael; Cupples, Margaret E
2017-01-01
Strokes are often preceded by a transient ischaemic attack (TIA) or 'minor' stroke. The immediate period after a TIA/minor stroke is a crucial time to initiate secondary prevention. However, the optimal approach to prevention, including non-pharmacological measures, after TIA is not clear. To systematically review evidence about the effectiveness of delivering secondary prevention, with lifestyle interventions, in comprehensive rehabilitation programmes, initiated within 90 days of a TIA/minor stroke. Also, to categorise the specific behaviour change techniques used. The review identified randomised controlled trials by searching the Cochrane Library, Ovid MEDLINE, Ovid EMBASE, Web of Science, EBSCO CINAHL and Ovid PsycINFO. Two review authors independently screened titles and abstracts for eligibility (programmes initiated within 90 days of event; outcomes reported for TIA/minor stroke) and extracted relevant data from appraised studies; a meta-analysis was used to synthesise the results. A total of 31 potentially eligible papers were identified and four studies, comprising 774 patients post-TIA or minor stroke, met the inclusion criteria; two had poor methodological quality. Individual studies reported increased aerobic capacity but meta-analysis found no significant change in resting and peak systolic blood pressure, resting heart rate, aerobic capacity, falls, or mortality. The main behaviour change techniques were goal setting and instructions about how to perform given behaviours. There is limited evidence of the effectiveness of early post-TIA rehabilitation programmes with preventive lifestyle interventions. Further robust randomised controlled trials of comprehensive rehabilitation programmes that promote secondary prevention and lifestyle modification immediately after a TIA are needed. © British Journal of General Practice 2017.
Conradsson, Mia; Littbrand, Håkan; Lindelof, Nina; Gustafson, Yngve; Rosendahl, Erik
2010-07-01
To evaluate the effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people dependent in activities of daily living (ADL) and living in residential care facilities. Cluster-randomized controlled study. Participants were 191 older people, aged 65-100, dependent in ADL and with Mini Mental State Examination scores between 10 and 30. One-hundred (52%) of the participants had a diagnosed dementia disorder. A high-intensity functional weight-bearing exercise programme and a control activity were performed in groups. Sessions were held five times over each two week period for three months, a total of 29 times. The outcome measures, Geriatric Depression Scale (GDS-15) and Philadelphia Geriatric Center Morale Scale (PGCMS) were blindly assessed at baseline, three and six months. At baseline, mean +/- SD (range) for GDS was 4.4 +/- 3.2 (0-14), and for PGCMS 11.0 +/- 3.5 (2-17). There were no significant differences in GDS or PGCMS between the exercise and the control group at the three and six month follow-ups in the total sample. Among people with dementia, there was a between-group difference at three months in PGCMS scores in favour of the exercise group. A high-intensity functional exercise programme seems generally not to influence depressive symptoms or psychological well-being among older people dependent in ADL and living in residential care facilities. An individualized and multifactorial intervention may be needed in this group. However, an exercise programme as a single intervention may have a short-term effect on well-being among people with dementia.
2010-01-01
Background The PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members. Methods The impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course. Results Across all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance. Conclusions Participation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further. PMID:20587062
Taylor, Cath; Sippitt, Joanna M; Collins, Gary; McManus, Chris; Richardson, Alison; Dawson, Jeremy; Richards, Michael; Ramirez, Amanda J
2010-06-29
The PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members. The impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course. Across all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance. Participation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further.
NASA Technical Reports Server (NTRS)
Keymeulen, D.; Klimeck, G.; Zebulum, R.; Stoica, A.; Jin, Y.; Lazaro, C.
2000-01-01
This paper describes the EHW development system, a tool that performs the evolutionary synthesis of electronic circuits, using the SPICE simulator and the Field Programmable Transistor Array hardware (FPTA) developed at JPL.
Quantitative phase imaging using a programmable wavefront sensor
NASA Astrophysics Data System (ADS)
Soldevila, F.; Durán, V.; Clemente, P.; Lancis, J.; Tajahuerce, E.
2018-02-01
We perform phase imaging using a non-interferometric approach to measure the complex amplitude of a wavefront. We overcome the limitations in spatial resolution, optical efficiency, and dynamic range that are found in Shack-Hartmann wavefront sensing. To do so, we sample the wavefront with a high-speed spatial light modulator. A single lens forms a time-dependent light distribution on its focal plane, where a position detector is placed. Our approach is lenslet-free and does not rely on any kind of iterative or unwrap algorithm. The validity of our technique is demonstrated by performing both aberration sensing and phase imaging of transparent samples.
NASA Technical Reports Server (NTRS)
Greenberg, J. S.
1986-01-01
An economic evaluation and planning procedure which assesses the effects of various policies on fixed satellite business ventures is described. The procedure is based on a stochastic financial simulation model, the Domsat II, which evaluates spacecraft reliability, market performance, and cost uncertainties. The application of the Domsat II model to the assessment of NASA's ion thrusters for on-orbit propulsion and GaAs solar cell technology is discussed. The effects of insurance rates and the self-insurance option on the financial performance of communication satellite business ventures are investigated. The selection of a transportation system for placing the satellites into GEO is analyzed.
Comparison of the performance of the next generation of optical interferometers
NASA Astrophysics Data System (ADS)
Pisani, Marco; Yacoot, Andrew; Balling, Petr; Bancone, Nicola; Birlikseven, Cengiz; Çelik, Mehmet; Flügge, Jens; Hamid, Ramiz; Köchert, Paul; Kren, Petr; Kuetgens, Ulrich; Lassila, Antti; Bartolo Picotto, Gian; Şahin, Ersoy; Seppä, Jeremias; Tedaldi, Matthew; Weichert, Christoph
2012-08-01
Six European National Measurement Institutes (NMIs) have joined forces within the European Metrology Research Programme funded project NANOTRACE to develop the next generation of optical interferometers having a target uncertainty of 10 pm. These are needed for NMIs to provide improved traceable dimensional metrology that can be disseminated to the wider nanotechnology community, thereby supporting the growth in nanotechnology. Several approaches were followed in order to develop the interferometers. This paper briefly describes the different interferometers developed by the various partners and presents the results of a comparison of performance of the optical interferometers using an x-ray interferometer to generate traceable reference displacements.
ERIC Educational Resources Information Center
Mughal, Muhammad Kashif; Ginn, Carla S.; Perry, Robert L.; Benzies, Karen M.
2016-01-01
We explored longitudinal effects of a two-generation preschool programme on receptive language scores in children (n = 78) at age 10 years, living with low income. Scores at four time-points, programme intake, exit, age 7, and age 10 years were measured using the "Peabody picture vocabulary test" (3rd ed.). Effects of culture…
Miklitsch, Claudia; Krewer, Carmen; Freivogel, Susanna; Steube, Diethard
2013-10-01
To investigate the effects of a predefined mini-trampoline therapy programme for increasing postural control, mobility and the ability to perform activities of daily living after stroke. Randomized non-blinded controlled pilot study. Neurological rehabilitation hospital. First-time stroke; age 18-80 years; independent standing ability for a minimum of 2 minutes. Patients were randomized into two groups: the mini-trampoline group (n = 20) received 10 sessions of balance training using the mini-trampoline over three weeks. The patients of the control group (n =20) participated 10 times in a group balance training also over three weeks. Postural control (Berg Balance Scale, BBS), mobility and gait endurance (timed 'up and go' test, TUG; 6-minute walk test, 6MWT) and the ability to perform activities of daily living (Barthel Index, BI). Measurements were undertaken prior to and after the intervention period. Both groups were comparable before the study. The mini-trampoline group improved significantly more in the BBS (P = 0.003) compared to the control group. Mean or median differences of both groups showed improvements in the TUG 10.12 seconds/7.23 seconds, the 6MWT 135 m/75 m and the BI 20 points/13 points for the mini-trampoline and control group, respectively. These outcome measurements did not differ significantly between the two groups. A predefined mini-trampoline training programme resulted in significantly increased postural control in stroke patients compared to balance training in a group. Although not statistically significant, the mini-trampoline training group showed increased improvement in mobility and activities of daily living. These differences could have been statistically significant if we had investigated more patients (i.e. a total sample of 84 patients for the TUG, 98 patients for the 6MWT, and 186 patients for the BI).
Translating theory into practice: results of a 2-year trial for the LEAD programme.
Shelton, D
2008-05-01
This paper presents data for 2 years of a continuing study aimed to reduce the risk of first-time involvement by minority youth with the juvenile justice system. A quasi-experimental design was used to test a 14-week expressive art curriculum (LEAD: leadership, education, achievement and development) implemented in two rural communities. A total of 70 African American youth participated in the programme over a 2-year period. Pre- and post-test differences were examined for protective factors, behavioural self-control, self-esteem and resilience measures. When compared with the after-school programme (control group), youth in the LEAD programme in both communities had more dramatic increases in post-test scores following the intervention. The combined data from year 1 and year 2 provide positive findings in support of LEAD as a prevention programme for young offenders. The placement of the programme within an African American church in year 2 improved the processes of the LEAD programme and seemed to provide a better fit with the original design of the programme, highlighting the importance of the context, in which the programme was provided.
Finatto, Paula; Silva, Edson Soares Da; Okamura, Alexandre B.; Almada, Bruna P.; Oliveira, Henrique B.
2018-01-01
Purpose Strength training improves distance running economy and performance. This finding is based predominantly on maximal and explosive strength programmes applied to locomotor muscles, particularly on the lower limbs. It is not certain whether a minimization of metabolic cost (Cmet) and an improvement in running performance is feasible with strength training of the postural and trunk muscles. Methods Using kinematic, neuromuscular and metabolic measurements of running at two different speeds before and after a 12-week Pilates training programme, we tested the hypothesis that core training might improve the running Cmet and performance of trained runners. Thirty-two individuals were randomly assigned to the control group (CG, n = 16) or the Pilates group (PG, n = 16). Results Confirming our hypothesis, a significant improvement (p<0.05) was observed for running performance in the PG (pre: 25.65±0.4 min; post: 23.23±0.4 min) compared to the CG (pre: 25.33±0.58 min; post: 24.61±0.52 min). Similarly, the PG (4.33±0.07 J.kg-1.m-1) had better responses than the CG (4.71±0.11 J.kg-1.m-1) during post-training for Cmet. These findings were accompanied by decreased electromyographic activity of the postural muscles at submaximal running intensities in the PG. Conclusions Overall, these results provide a rationale for selecting strength training strategies that target adaptations on specific postural and locomotor muscles for trained distance runners. PMID:29561907
Finatto, Paula; Silva, Edson Soares Da; Okamura, Alexandre B; Almada, Bruna P; Oliveira, Henrique B; Peyré-Tartaruga, Leonardo A
2018-01-01
Strength training improves distance running economy and performance. This finding is based predominantly on maximal and explosive strength programmes applied to locomotor muscles, particularly on the lower limbs. It is not certain whether a minimization of metabolic cost (Cmet) and an improvement in running performance is feasible with strength training of the postural and trunk muscles. Using kinematic, neuromuscular and metabolic measurements of running at two different speeds before and after a 12-week Pilates training programme, we tested the hypothesis that core training might improve the running Cmet and performance of trained runners. Thirty-two individuals were randomly assigned to the control group (CG, n = 16) or the Pilates group (PG, n = 16). Confirming our hypothesis, a significant improvement (p<0.05) was observed for running performance in the PG (pre: 25.65±0.4 min; post: 23.23±0.4 min) compared to the CG (pre: 25.33±0.58 min; post: 24.61±0.52 min). Similarly, the PG (4.33±0.07 J.kg-1.m-1) had better responses than the CG (4.71±0.11 J.kg-1.m-1) during post-training for Cmet. These findings were accompanied by decreased electromyographic activity of the postural muscles at submaximal running intensities in the PG. Overall, these results provide a rationale for selecting strength training strategies that target adaptations on specific postural and locomotor muscles for trained distance runners.
Faber, Irene R; Elferink-Gemser, Marije T; Faber, Niels R; Oosterveld, Frits G J; Nijhuis-Van der Sanden, Maria W G
2016-01-01
Forecasting future performance in youth table tennis players based on current performance is complex due to, among other things, differences between youth players in growth, development, maturity, context and table tennis experience. Talent development programmes might benefit from an assessment of underlying perceptuo-motor skills for table tennis, which is hypothesized to determine the players' potential concerning the perceptuo-motor domain. The Dutch perceptuo-motor skills assessment intends to measure the perceptuo-motor potential for table tennis in youth players by assessing the underlying skills crucial for developing technical and tactical qualities. Untrained perceptuo-motor tasks are used as these are suggested to represent a player's future potential better than specific sport skills themselves as the latter depend on exposure to the sport itself. This study evaluated the value of the perceptuo-motor skills assessment for a talent developmental programme by evaluating its predictive validity for competition participation and performance in 48 young table tennis players (7-11 years). Players were tested on their perceptuo-motor skills once during a regional talent day, and the subsequent competition results were recorded half-yearly over a period of 2.5 years. Logistic regression analysis showed that test scores did not predict future competition participation (p >0.05). Yet, the Generalized Estimating Equations analysis, including the test items 'aiming at target', 'throwing a ball', and 'eye-hand coordination' in the best fitting model, revealed that the outcomes of the perceptuo-motor skills assessment were significant predictors for future competition results (R2 = 51%). Since the test age influences the perceptuo-motor skills assessment's outcome, another multivariable model was proposed including test age as a covariate (R2 = 53%). This evaluation demonstrates promising prospects for the perceptuo-motor skills assessment to be included in a talent development programme. Future studies are needed to clarify the predictive value in a larger sample of youth competition players over a longer period in time.
Exercise for Fall Risk Reduction in Community-Dwelling Older Adults: A Systematic Review
Arnold, Catherine M.; Sran, Meena M.; Harrison, Elizabeth L.
2008-01-01
Purpose: To evaluate the influence of exercise on falls and fall risk reduction in community-dwelling older adults and to present an updated synthesis of outcome measures for the assessment of fall risk in community-dwelling older adults. Method: A systematic review was performed, considering English-language articles published from 2000 to 2006 and accessible through MEDLINE, CINAHL, PEDro, EMBASE, and/or AMED. Included were randomized controlled clinical trials (RCTs) that used an exercise or physical activity intervention and involved participants over age 50. Screening and methodological quality for internal validity were conducted by two independent reviewers. Results: The search retrieved 156 abstracts; 22 articles met the internal validity criteria. Both individualized and group exercise programmes were found to be effective in reducing falls and fall risk. The optimal type, frequency, and dose of exercise to achieve a positive effect have not been determined. A variety of outcome measures have been used to measure fall risk, especially for balance. Conclusions: Falls and fall risk can be reduced with exercise interventions in the community-dwelling elderly, although the most effective exercise variables are unknown. Future studies in populations with comorbidities known to increase fall risk will help determine optimal, condition-specific fall-prevention programmes. Poor balance is a key risk factor for falls; therefore, the best measure of this variable should be selected when evaluating patients at risk of falling. PMID:20145768
Benn, Jonathan; Burnett, Susan; Parand, Anam; Pinto, Anna; Vincent, Charles
2012-07-01
The study had two specific objectives: (1) To analyse change in a survey measure of organisational patient safety climate and capability (SCC) resulting from participation in the UK Safer Patients Initiative and (2) To investigate the role of a range of programme and contextual factors in predicting change in SCC scores. Single group longitudinal design with repeated measurement at 12-month follow-up. Multiple service areas within NHS hospital sites across England, Wales, Scotland and Northern Ireland. Stratified sample of 284 respondents representing programme teams at 19 hospital sites. A complex intervention comprising a multi-component quality improvement collaborative focused upon patient safety and designed to impact upon hospital leadership, communication, organisation and safety climate. A survey including a 31-item SCC scale was administered at two time-points. Modest but significant positive movement in SCC score was observed between the study time-points. Individual programme responsibility, availability of early adopters, multi-professional collaboration and extent of process measurement were significant predictors of change in SCC. Hospital type and size, along with a range of programme preconditions, were not found to be significant. A range of social, cultural and organisational factors may be sensitive to this type of intervention but the measurable effect is small. Supporting critical local programme implementation factors may be an effective strategy in achieving development in organisational patient SCC, regardless of contextual factors and organisational preconditions.
ERIC Educational Resources Information Center
Snowling, Margaret J.; Hulme, Charles; Bailey, Alison M.; Stothard, Susan E.; Lindsay, Geoff
2011-01-01
It is well-established that language skills are amongst the best predictors of educational success. Consistent with this, findings from a population-based longitudinal study of parents and children in the UK indicate that language development at the age of two years predicts children's performance on entering primary school. Moreover, children who…
Deterrence and the United States Coast Guard: Enhancing Current Practice with Performance Measures
2012-03-01
Talley, Jin , Kite Powell, The US Coast Guard Vessel Inspection Programme (2005) Deterrence and the United States Coast Guard: Enhancing Current...practical problem-solving, not from theory or strategy. As a result, the activities are fractured and may not even be recognized as related to...of Sun Tzu’s admonition: “Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat.” The US
Takeda, Shuntaro; Furusawa, Akira
2017-09-22
We propose a scalable scheme for optical quantum computing using measurement-induced continuous-variable quantum gates in a loop-based architecture. Here, time-bin-encoded quantum information in a single spatial mode is deterministically processed in a nested loop by an electrically programmable gate sequence. This architecture can process any input state and an arbitrary number of modes with almost minimum resources, and offers a universal gate set for both qubits and continuous variables. Furthermore, quantum computing can be performed fault tolerantly by a known scheme for encoding a qubit in an infinite-dimensional Hilbert space of a single light mode.
NASA Astrophysics Data System (ADS)
Takeda, Shuntaro; Furusawa, Akira
2017-09-01
We propose a scalable scheme for optical quantum computing using measurement-induced continuous-variable quantum gates in a loop-based architecture. Here, time-bin-encoded quantum information in a single spatial mode is deterministically processed in a nested loop by an electrically programmable gate sequence. This architecture can process any input state and an arbitrary number of modes with almost minimum resources, and offers a universal gate set for both qubits and continuous variables. Furthermore, quantum computing can be performed fault tolerantly by a known scheme for encoding a qubit in an infinite-dimensional Hilbert space of a single light mode.
Davis, Daniel P; Graham, Patricia G; Husa, Ruchika D; Lawrence, Brenna; Minokadeh, Anushirvan; Altieri, Katherine; Sell, Rebecca E
2015-07-01
Traditional resuscitation training models are inadequate to achieving and maintaining resuscitation competency. This analysis evaluates the effectiveness of a novel, performance improvement-based inpatient resuscitation programme. This was a prospective, before-and-after study conducted in an urban, university-affiliated hospital system. All inpatient adult cardiac arrest victims without an active Do Not Attempt Resuscitation order from July 2005 to June 2012 were included. The advanced resuscitation training (ART) programme was implemented in Spring 2007 and included a unique treatment algorithm constructed around the capabilities of our providers and resuscitation equipment, a training programme with flexible format and content including early recognition concepts, and a comprehensive approach to performance improvement feeding directly back into training. Our inpatient resuscitation registry and electronic patient care record were used to quantify arrest rates and survival-to-hospital discharge before and after ART programme implementation. Multiple logistic regression analysis was used to adjust for age, gender, location of arrest, initial rhythm, and time of day. A total of 556 cardiac arrest victims were included (182 pre- and 374 post-ART). Arrest incidence decreased from 2.7 to 1.2 per 1000 patient discharges in non-ICU inpatient units, with no change in ICU arrest rate. An increase in survival-to-hospital discharge from 21 to 45% (p < 0.01) was observed following ART programme implementation. Adjusted odds ratios for survival-to-discharge (OR 2.2, 95% CI 1.4-3.4) and good neurological outcomes (OR 3.0, 95% CI 1.7-5.3) reflected similar improvements. Arrest-related deaths decreased from 2.1 to 0.5 deaths per 1000 patient discharges in non-ICU areas and from 1.5 to 1.3 deaths per 1000 patient discharges in ICU areas, and overall hospital mortality decreased from 2.2% to 1.8%. Implementation of a novel, performance improvement-based inpatient resuscitation programme was associated with a decrease in the incidence of cardiac arrest and improved clinical outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Brown, Adrian; Gouldstone, Amy; Fox, Emily; Field, Annmarie; Todd, Wendy; Shakher, Jayadave; Bellary, Srikanth; Teh, Ming Ming; Azam, Muhammad; John, Reggie; Jagielski, Alison; Arora, Teresa; Thomas, G Neil; Taheri, Shahrad
2015-01-01
Background Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was −4.1 kg (95% CI −3.6 to −4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving −5.5 kg (95% CI −4.2 to −6.2 kg, p=0.0001) and non-completers achieving −2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. Conclusions The SLiM programme is an effective group intervention for the management of severe and complex obesity. PMID:25854970
Petersen, Nora; Lambrecht, Gunda; Scott, Jonathan; Hirsch, Natalie; Stokes, Maria; Mester, Joachim
2017-01-01
Postflight reconditioning of astronauts is understudied. Despite a rigorous, daily inflight exercise countermeasures programme during six months in microgravity (μG) on-board the International Space Station (ISS), physiological impairments occur and postflight reconditioning is still required on return to Earth. Such postflight programmes are implemented by space agency reconditioning specialists. Case Description and Assessments: A 38 year old male European Space Agency (ESA) crewmember's pre- and postflight (at six and 21 days after landing) physical performance from a six-month mission to ISS are described. muscle strength (squat and bench press 1 Repetition Maximum) and power (vertical jump), core muscle endurance and hip flexibility (Sit and Reach, Thomas Test). In-flight, the astronaut undertook a rigorous daily (2-h) exercise programme. The 21 day postflight reconditioning exercise concept focused on motor control and functional training, and was delivered in close co-ordination by the ESA physiotherapist and exercise specialist to provide the crewmember with comprehensive reconditioning support. Despite an intensive inflight exercise programme for this highly motivated crewmember, postflight performance showed impairments at R+6 for most parameters, all of which recovered by R+21 except muscular power (jump tests). Regardless of intense inflight exercise countermeasures and excellent compliance to postflight reconditioning, postflight performance showed impairments at R+6 for most parameters. Complex powerful performance tasks took longer to return to preflight values. Research is needed to develop optimal inflight and postflight exercise programmes to overcome the negative effects of microgravity and return the astronaut to preflight status as rapidly as possible. Copyright © 2016 Elsevier Ltd. All rights reserved.
Dawson-Squibb, John-Joe; Davids, Eugene Lee; de Vries, Petrus J
2018-03-01
EarlyBird and EarlyBird Plus are parent education and training programmes designed by the UK National Autistic Society in 1997 and 2003, having been delivered to more than 27,000 families in 14 countries. These group-based programmes aim to (1) support parents immediately after diagnosis of autism spectrum disorder, (2) empower parents, encouraging a positive perception of their child's autism spectrum disorder and (3) help parents establish good practice. In the absence of any previous comprehensive review, we performed a scoping review of all peer-reviewed publications on EarlyBird/EarlyBird Plus. A search was conducted between February and June 2016 using EbscoHost, Sabinet, SAGE Journals, Directory of Open Access Journals, BioMed Central, Scopus, ScienceDirect and grey literature. Two reviewers independently screened titles and abstracts for inclusion. In total, 18 articles were identified: 16 from the United Kingdom and 2 from New Zealand. We reviewed the context, study populations, design, outcome measures, whether focus was on parental perception, parental change or child changes and programme feasibility. Strong parental support for the acceptability but lower level evidence of efficacy of EarlyBird/EarlyBird Plus was found. Future research should consider randomised controlled trials. There is no research on EarlyBird/EarlyBird Plus in low-resource settings; therefore, we recommend broader feasibility evaluation of EarlyBird/EarlyBird Plus including accessibility, cultural appropriateness and scalability.
The complexity of team training: what we have learned from aviation and its applications to medicine
Hamman, W
2004-01-01
Errors in health care that compromise patient safety are tied to latent failures in the structure and function of systems. Teams of people perform most care delivered today, yet training often remains focused on individual responsibilities. Training programmes for all healthcare workers need to increase the educational experience of working in interdisciplinary teams. The complexities of team training require a multifunctional (systems) approach, which crosses organisational divisions to allow communication, accountability, and creation and maintenance of interdisciplinary teams. This report identifies challenges for medical education in performing the research, identifying performance measurements, and modifying educational curricula for the advancement of interdisciplinary teams, based on the complexity of team training identified in commercial aviation. PMID:15465959
The Use of Programmable Calculators in the Teaching of Economics, Part II
ERIC Educational Resources Information Center
Addis, G. H.
1978-01-01
Describes the use of programmable calculators to perform classroom controlled experiments on economic models. The complete program for exploring the dynamics of the Harrod-Domar equation is given. Some difficulties encountered and statistical uses are mentioned. (BC)
The Effects of Architecture and Process on the Hardness of Programmable Technologies
NASA Technical Reports Server (NTRS)
Katz, Richard; Wang, J. J.; Reed, R.; Kleyner, I.; DOrdine, M.; McCollum, J,; Cronquist, B.; Howard, J.
1999-01-01
Architecture and process, combined, significantly affect the hardness of programmable technologies. The effects of high energy ions, ferroelectric memory architectures, and shallow trench isolation are investigated. A detailed single event latchup (SEL) study has been performed.
PRT: A Suitable Transport System for Urban Areas in Sweden
DOT National Transportation Integrated Search
1998-03-18
This report summarizes a thematic research programme "Advanced transit systems" performed at Chalmers University ofTechnology during the years 1994-97. The programme aims to investigate if Personal R apid Transit (PRT) may be a suitable system for ur...
PATHway: Decision Support in Exercise Programmes for Cardiac Rehabilitation.
Filos, Dimitris; Triantafyllidis, Andreas; Chouvarda, Ioanna; Buys, Roselien; Cornelissen, Véronique; Budts, Werner; Walsh, Deirdre; Woods, Catherine; Moran, Kieran; Maglaveras, Nicos
2016-01-01
Rehabilitation is important for patients with cardiovascular diseases (CVD) to improve health outcomes and quality of life. However, adherence to current exercise programmes in cardiac rehabilitation is limited. We present the design and development of a Decision Support System (DSS) for telerehabilitation, aiming to enhance exercise programmes for CVD patients through ensuring their safety, personalising the programme according to their needs and performance, and motivating them toward meeting their physical activity goals. The DSS processes data originated from a Microsoft Kinect camera, a blood pressure monitor, a heart rate sensor and questionnaires, in order to generate a highly individualised exercise programme and improve patient adherence. Initial results within the EU-funded PATHway project show the potential of our approach.
Steuten, Lotte; Vrijhoef, Bert; Van Merode, Frits; Wesseling, Geert-Jan; Spreeuwenberg, Cor
2006-12-01
To assess the impact of a population-based disease management programme for adult patients with asthma or chronic obstructive pulmonary disease (COPD) on process measures, intermediate outcomes, and endpoints of care. Quasi-experimental design with 12-month follow-up. Region of Maastricht (the Netherlands) including university hospital and 16 general practices. Nine hundred and seventy-five patients of whom 658 have asthma and 317 COPD. Disease management programme. Endpoints of care are respiratory health, health utility, patient satisfaction, and total health care costs related to asthma or COPD. Quality aspects of care, disease control, self-care behaviour, smoking status, disease-specific knowledge, and patients' satisfaction improved after implementation of the programme. Lung function was not affected by implementation of the programme. For COPD patients, a significant improvement in health utility was found. For patients with asthma, significant cost savings were measured. Organizing health care according to principles of disease management for adults with asthma or COPD is associated with significant improvements in several processes and outcomes of care, while costs of care do not exceed the existing budget.
Fricke, Silke; Burgoyne, Kelly; Bowyer-Crane, Claudine; Kyriacou, Maria; Zosimidou, Alexandra; Maxwell, Liam; Lervåg, Arne; Snowling, Margaret J; Hulme, Charles
2017-10-01
Oral language skills are a critical foundation for literacy and more generally for educational success. The current study shows that oral language skills can be improved by providing suitable additional help to children with language difficulties in the early stages of formal education. We conducted a randomized controlled trial with 394 children in England, comparing a 30-week oral language intervention programme starting in nursery (N = 132) with a 20-week version of the same programme starting in Reception (N = 133). The intervention groups were compared to an untreated waiting control group (N = 129). The programmes were delivered by trained teaching assistants (TAs) working in the children's schools/nurseries. All testers were blind to group allocation. Both the 20- and 30-week programmes produced improvements on primary outcome measures of oral language skill compared to the untreated control group. Effect sizes were small to moderate (20-week programme: d = .21; 30-week programme: d = .30) immediately following the intervention and were maintained at follow-up 6 months later. The difference in improvement between the 20-week and 30-week programmes was not statistically significant. Neither programme produced statistically significant improvements in children's early word reading or reading comprehension skills (secondary outcome measures). This study provides further evidence that oral language interventions can be delivered successfully by trained TAs to children with oral language difficulties in nursery and Reception classes. The methods evaluated have potentially important policy implications for early education. © 2017 Association for Child and Adolescent Mental Health.
Masiye, Felix; Rehnberg, Clas
2005-12-15
Zambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control. This paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status. A contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP) was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids. The study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of USD 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed.
Anaemia control: lessons from the flour fortification programme.
Sadighi, J; Mohammad, K; Sheikholeslam, R; Amirkhani, M A; Torabi, P; Salehi, F; Abdolahi, Z
2009-12-01
Anaemia is an important public health problem in Iran; therefore, a programme of flour fortification with iron was launched in two pilot provinces. The present study was conducted in January 2009 to evaluate the effectiveness and process of this programme. A 'before-and-after study' was conducted to evaluate the effectiveness of the flour fortification programme, and the process of the programme was evaluated using a cross-sectional study. To evaluate the effectiveness of the programme, blood haemoglobin and ferritin levels were measured in sample populations from Bushehr and Golestan provinces. The target population was women aged 15-49 years. Iron content was measured in samples of flour and bread to evaluate the flour fortification process in these two national pilot provinces. The total study population was 600 women from Bushehr province and 652 women from Golestan province. Similar trends were found in the indicators of anaemia/iron deficiency among the women studied in both provinces. The flour fortification programme only appears to have had a beneficial effect on ferritin levels (iron deficiency) in the two provinces. The prevalence of iron-deficiency anaemia before and after the intervention did not differ significantly in either province. Interestingly, the prevalence of anaemia (low haemoglobin) was significantly higher after the intervention in women from both provinces. The coverage of fortified flour and bread was 90% and 98.7% in Bushehr province, and 94.1% and 95% in Golestan province, respectively. In areas where anaemia is not mainly due to iron deficiency, an iron fortification programme might decrease the prevalence of iron deficiency without affecting the prevalence of anaemia.
Masiye, Felix; Rehnberg, Clas
2005-01-01
Background Zambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control. Aims and objectives This paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status. Methods A contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP) was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids. Findings The study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of US$ 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed. PMID:16356176
Results and Analysis of the ESA SSA Radar Tracking Campaigns
NASA Astrophysics Data System (ADS)
Fontdecaba Baig, Jordi; Martinerie, Francis; Sutter, Moise; Martinot, Vincent; Ameline, Patrick; Blazejczak, Eric; Fletcher, Emmet
2013-08-01
Following the decision at the Ministerial Council 2008 to initiate a Preparatory Programme on Space Situational Awareness (SSA), the European Space Agency started a series of activities together with industry, implementing both classical design approaches: bottom-up and top-down. For the Space Surveillance and Tracking segment of the programme, the bottom-up approach was initially addressed through various activities to evaluate the potential performance of contemporary European resources. One element of this investigation was the assessment of the existing European assets that can be used to generate tracking data on Earth orbiting objects at all altitudes between LEO and the GEO graveyard orbits. The study addressed both the technical performances of the assets and the identification of the operational constraints characteristic for each sensor. In this context, a paper was presented at the 2011 European Space Surveillance Conference in Madrid, Spain that discussed the results obtained using two existing European radars: EISCAT and Chilbolton. The emphasis of this new paper is to analyse the results obtained from a third asset: the BEM Monge, a measurement and test vessel of the French Navy operated for the French Direction Générale de l'Armement (DGA). The Monge's three primary radars were designed with the specific mission to detect and characterise the trajectory of missiles as part of France's national missile defence programme, however the radar on-board the Monge are also able to detect and track Earth-orbiting objects. Even though this role is not the primary one for the system, the achieved accuracy of the orbital tracks and resulting orbit determination is several orders of magnitude better than radars that have been developed for other uses. The evaluation carried out in the frame of the SSA programme helped demonstrate that the systems provided by the Monge are able to perform orbital tracking within the performance requirements of a federated SSA system. During the campaigns, the radars on the Monge were used to track several known satellites, pre-selected so as to cover a wide range of altitudes and inclinations in the LEO region. Several separate campaigns were done to track the satellites. Upon receipts of the resulting tracking data, orbit restitution was performed in order to characterise the significance and influence of the distinct observation parameters and to indicate the optimum procedure to improve the orbit estimation performance with a single asset or with a combination of the different assets used within the study. This paper describes the preparation of the campaigns as well as the results obtained. The campaigns were mainly driven by the availability of radar assets and the visibilities of the satellites. The precise orbit determination enabled the comparison of the performance of the different assets.
NASA Astrophysics Data System (ADS)
Benveniste, J.; Cotton, D.; Moreau, T.; Varona, E.; Roca, M.; Cipollini, P.; Cancet, M.; Martin, F.; Fenoglio-Marc, L.; Naeije, M.; Fernandes, J.; Restano, M.; Ambrozio, A.
2016-12-01
The ESA Sentinel-3 satellite, launched in February 2016 as a part of the Copernicus programme, is the second satellite to operate a SAR mode altimeter. The Sentinel 3 Synthetic Aperture Radar Altimeter (SRAL) is based on the heritage from Cryosat-2, but this time complemented by a Microwave Radiometer (MWR) to provide a wet troposphere correction, and operating at Ku and C-Bands to provide an accurate along-track ionospheric correction. Together this instrument package, including both GPS and DORIS instruments for accurate positioning, allows accurate measurements of sea surface height over the ocean, as well as measurements of significant wave height and surface wind speed. SCOOP (SAR Altimetry Coastal & Open Ocean Performance) is a project funded under the ESA SEOM (Scientific Exploitation of Operational Missions) Programme Element, started in September 2015, to characterise the expected performance of Sentinel-3 SRAL SAR mode altimeter products, in the coastal zone and open-ocean, and then to develop and evaluate enhancements to the baseline processing scheme in terms of improvements to ocean measurements. There is also a work package to develop and evaluate an improved Wet Troposphere correction for Sentinel-3, based on the measurements from the on-board MWR, further enhanced mostly in the coastal and polar regions using third party data, and provide recommendations for use. At the end of the project recommendations for further developments and implementations will be provided through a scientific roadmap. In this presentation we provide an overview of the SCOOP project, highlighting the key deliverables and discussing the potential impact of the results in terms of the application of delay-Doppler (SAR) altimeter measurements over the open-ocean and coastal zone. We also present the initial results from the project, including: Key findings from a review of the current "state-of-the-art" for SAR altimetry, Specification of the initial "reference" delay-Doppler and echo modelling /retracking processing schemes, Evaluation of the initial Test Data Set in the Open Ocean and Coastal Zone Overview of modifications planned to the reference delay-Doppler and echo modelling/ re-tracking processing schemes.
Nutrition advocacy and national development: the PROFILES programme and its application.
Burkhalter, B R; Abel, E; Aguayo, V; Diene, S M; Parlato, M B; Ross, J S
1999-01-01
Investment in nutritional programmes can contribute to economic growth and is cost-effective in improving child survival and development. In order to communicate this to decision-makers, the PROFILES nutrition advocacy and policy development programme was applied in certain developing countries. Effective advocacy is necessary to generate financial and political support for scaling up from small pilot projects and maintaining successful national programmes. The programme uses scientific knowledge to estimate development indicators such as mortality, morbidity, fertility, school performance and labour productivity from the size and nutritional condition of populations. Changes in nutritional condition are estimated from the costs, coverage and effectiveness of proposed programmes. In Bangladesh this approach helped to gain approval and funding for a major nutrition programme. PROFILES helped to promote the nutrition component of an early childhood development programme in the Philippines, and to make nutrition a top priority in Ghana's new national child survival strategy. The application of PROFILES in these and other countries has been supported by the United States Agency for International Development, the United Nations Children's Fund, the World Bank, the Asian Development Bank, the Micronutrient Initiative and other bodies.
Prospects for comparison of matter and antimatter gravitation with ALPHA-g.
Bertsche, W A
2018-03-28
The ALPHA experiment has recently entered an expansion phase of its experimental programme, driven in part by the expected benefits of conducting experiments in the framework of the new AD + ELENA antiproton facility at CERN. With antihydrogen trapping now a routine operation in the ALPHA experiment, the collaboration is leading progress towards precision atomic measurements on trapped antihydrogen atoms, with the first excitation of the 1S-2S transition and the first measurement of the antihydrogen hyperfine spectrum (Ahmadi et al. 2017 Nature 541 , 506-510 (doi:10.1038/nature21040); Nature 548 , 66-69 (doi:10.1038/nature23446)). We are building on these successes to extend our physics programme to include a measurement of antimatter gravitation. We plan to expand a proof-of-principle method (Amole et al. 2013 Nat. Commun. 4 , 1785 (doi:10.1038/ncomms2787)), first demonstrated in the original ALPHA apparatus, and perform a precise measurement of antimatter gravitational acceleration with the aim of achieving a test of the weak equivalence principle at the 1% level. The design of this apparatus has drawn from a growing body of experience on the simulation and verification of antihydrogen orbits confined within magnetic-minimum atom traps. The new experiment, ALPHA-g, will be an additional atom-trapping apparatus located at the ALPHA experiment with the intention of measuring antihydrogen gravitation.This article is part of the Theo Murphy meeting issue 'Antiproton physics in the ELENA era'. © 2018 The Authors.
Prospects for comparison of matter and antimatter gravitation with ALPHA-g
NASA Astrophysics Data System (ADS)
Bertsche, W. A.
2018-03-01
The ALPHA experiment has recently entered an expansion phase of its experimental programme, driven in part by the expected benefits of conducting experiments in the framework of the new AD + ELENA antiproton facility at CERN. With antihydrogen trapping now a routine operation in the ALPHA experiment, the collaboration is leading progress towards precision atomic measurements on trapped antihydrogen atoms, with the first excitation of the 1S-2S transition and the first measurement of the antihydrogen hyperfine spectrum (Ahmadi et al. 2017 Nature 541, 506-510 (doi:10.1038/nature21040); Nature 548, 66-69 (doi:10.1038/nature23446)). We are building on these successes to extend our physics programme to include a measurement of antimatter gravitation. We plan to expand a proof-of-principle method (Amole et al. 2013 Nat. Commun. 4, 1785 (doi:10.1038/ncomms2787)), first demonstrated in the original ALPHA apparatus, and perform a precise measurement of antimatter gravitational acceleration with the aim of achieving a test of the weak equivalence principle at the 1% level. The design of this apparatus has drawn from a growing body of experience on the simulation and verification of antihydrogen orbits confined within magnetic-minimum atom traps. The new experiment, ALPHA-g, will be an additional atom-trapping apparatus located at the ALPHA experiment with the intention of measuring antihydrogen gravitation. This article is part of the Theo Murphy meeting issue 'Antiproton physics in the ELENA era'.
Prospects for comparison of matter and antimatter gravitation with ALPHA-g
2018-01-01
The ALPHA experiment has recently entered an expansion phase of its experimental programme, driven in part by the expected benefits of conducting experiments in the framework of the new AD + ELENA antiproton facility at CERN. With antihydrogen trapping now a routine operation in the ALPHA experiment, the collaboration is leading progress towards precision atomic measurements on trapped antihydrogen atoms, with the first excitation of the 1S–2S transition and the first measurement of the antihydrogen hyperfine spectrum (Ahmadi et al. 2017 Nature 541, 506–510 (doi:10.1038/nature21040); Nature 548, 66–69 (doi:10.1038/nature23446)). We are building on these successes to extend our physics programme to include a measurement of antimatter gravitation. We plan to expand a proof-of-principle method (Amole et al. 2013 Nat. Commun. 4, 1785 (doi:10.1038/ncomms2787)), first demonstrated in the original ALPHA apparatus, and perform a precise measurement of antimatter gravitational acceleration with the aim of achieving a test of the weak equivalence principle at the 1% level. The design of this apparatus has drawn from a growing body of experience on the simulation and verification of antihydrogen orbits confined within magnetic-minimum atom traps. The new experiment, ALPHA-g, will be an additional atom-trapping apparatus located at the ALPHA experiment with the intention of measuring antihydrogen gravitation. This article is part of the Theo Murphy meeting issue ‘Antiproton physics in the ELENA era’. PMID:29459415
Social Housing Policies and Best Practice Review for Retrofit Action - Case Studies from Parma (IT)
NASA Astrophysics Data System (ADS)
Gherri, Barbara; Cavagliano, Chiara; Orsi, Samuele
2017-10-01
The paper aims at investigating the most suitable Energy Saving Measures -ESMs- for the retrofitting of Social Housing Stock -SHS- in Europe. A global awareness has been increasing, as well as education and training among architects and building sectors employees, in order to identify tailored financing schemes and advanced integrated retrofitting solutions. Several European financed programmes have been tested so far and the results are here summarized and deeply investigated in order to increase the energy performance of social housing buildings, to improve knowledge of problems associated with the retrofitting of these households, in order to provide the most appropriate solutions to be applied. Afterward, the best practices selected have been applied to some study cases in Italy, to demonstrate that the large variety of SH programmes in Europe can seriously be used, promoting the best practises’ application. A lot of theoretical and analytical work has been carried out by many European projects in the last decade, defining different approaches according to typologies of social housing buildings, focusing on national or regional regulation, on existing typologies and building techniques, on retrofitting solutions, on energy saving strategies and other managing approaches and energy saving devices. Due to the high participation of social housing organisations -SHO- and related European financed programmes, this academic research is focused on the most effective ESMs in order to encompass a large variety of needs and related solutions, even though some of them are still on course and other ones have already been completed. This research clearly demonstrates the valuable contribution these kinds of programme have in exchanging and sharing of knowledge and experience in the field of retrofit of Social Housing building across Europe, in order to primary improve the energy performance of the existing building stock and the quality of life of their inhabitants.
Portable and programmable clinical EOG diagnostic system.
Chen, S C; Tsai, T T; Luo, C H
2000-01-01
Monitoring eye movements is clinically important in diagnosis of diseases of the central nervous system. Electrooculography (EOG) is one method of obtaining such records which uses skin electrodes, and utilizes the anterior posterior polarization of the eye. A new EOG diagnostic system has been developed that utilizes two off-the-shelf portable notebook computers, one projector and simple electronic hardware. It can be operated under Windows 95, 98, NT, and has significant advantages over any other similar equipment, including programmability, portability, improved safety and low cost. Especially, portability of the instrument is extremely important for acutely ill or handicapped patients. The purpose of this paper is to introduce the techniques of computer animation, data acquisition, real time analysis of measured data, and database management to implement a portable, programmable and inexpensive contacting EOG instrument. It is very convenient to replace the present expensive, inflexible and large-sized commercially available EOG instruments. A lot of interesting stimulation patterns for clinical application can be created easily in different shape, time sequence, and colour by programming in Delphi language. With the help of Winstar (a software package that is used to control I/O and interrupt functions of the computer under Windows 95, 98, NT), the I/O communication between two notebook computers and A/D interface module can be effectively programmed. In addition, the new EOG diagnostic system is battery operated and it has the advantages of low noise as well as isolation from electricity. Two kinds of EOG tests, pursuit and saccade, were performed on 20 normal subjects with this new portable and programmable instrument. Based on the test result, the performance of the new instrument is superior to the other commercially available instruments. In conclusion, we hope that it will be more convenient for doctors and researchers to do the clinical EOG diagnosis and basic medical science research by using this new creation.
Mahendradhata, Yodi; Probandari, Ari; Widjanarko, Bagoes; Riono, Pandu; Mustikawati, Dyah; Tiemersma, Edine W.; Alisjahbana, Bachti
2014-01-01
There is growing recognition that operational research (OR) should be embedded into national disease control programmes. However, much of the current OR capacity building schemes are still predominantly driven by international agencies with limited integration into national disease control programmes. We demonstrated that it is possible to achieve a more sustainable capacity building effort across the country by establishing an OR group within the national tuberculosis (TB) control programme in Indonesia. Key challenges identified include long-term financial support, limited number of scientific publications, and difficulties in documenting impact on programmatic performance. External evaluation has expressed concerns in regard to utilisation of OR in policy making. Efforts to address this concern have been introduced recently and led to indications of increased utilisation of research evidence in policy making by the national TB control programme. Embedding OR in national disease control programmes is key in establishing an evidence-based disease control programme. PMID:25361728
Assessment of a Targeted Trap-Neuter-Return Pilot Study in Auckland, New Zealand
Zito, Sarah; Vigeant, Shalsee; Dale, Arnja
2018-01-01
Simple Summary It is generally accepted that stray cats need to be managed to minimise the associated negative impacts and there is a need for effective and humane management tools. One such potential tool is trap-neuter-return (TNR), which anecdotally has been used in New Zealand to manage stray cats, but no concerted and targeted implementation of this technique has been reported, nor any formal assessments conducted. A targeted TNR (TTNR) programme for urban stray cats was implemented and assessed in one Auckland suburb. Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray feline, underage euthanasia, and unsocialised stray cat euthanasia numbers all reduced for the targeted suburb when these outcome measures were compared for the years before and after the programme. These outcome measures had a greater reduction in the targeted suburb compared to the other Auckland suburbs not targeted by the TTNR programme, although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable humane cat management tool in urban New Zealand, and further assessment is warranted. Abstract There is a need for effective and humane management tools to manage urban stray cats and minimise negative impacts associated with stray cats. One such tool is targeted trap-neuter-return (TTNR), but no concerted implementation of this technique or formal assessments have been reported. To address this deficit, a TTNR programme was implemented and assessed in one Auckland suburb from May 2015 to June 2016; the programme sterilised and returned 348 cats (4.2 cats/1000 residents). Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray felines, underage euthanasias, and unsocialised stray cat euthanasias were all reduced for the targeted suburb when compared for the years before and after the programme (the percentage reduction in these parameters was −39, −17, −34, −7, and −47, respectively). These outcome measures had a greater reduction in the targeted suburb compared to the Auckland suburbs not targeted by the TTNR programme (p < 0.01), although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable, humane cat management tool in urban New Zealand, and further assessment is warranted. PMID:29757255
An evaluation of the association between an antimicrobial stewardship score and antimicrobial usage
Pakyz, Amy L.; Moczygemba, Leticia R.; Wang, Hui; Stevens, Michael P.; Edmond, Michael B.
2015-01-01
Objectives To determine whether an antimicrobial stewardship ‘intensity’ score predicts hospital antimicrobial usage. Methods An antimicrobial stewardship score for 44 academic medical centres was developed that comprised two main categories: resources (antimicrobial stewardship programme personnel and automated surveillance software) and strategies (preauthorization, audit with intervention and feedback, education, guidelines and clinical pathways, parenteral to oral therapy programmes, de-escalation of therapy, antimicrobial order forms and dose optimization). Multiple regression analyses were used to assess whether the composite score and also the categories were associated with either total or antimicrobial stewardship programme-target antimicrobial use as measured in days of therapy. Results The mean antimicrobial stewardship programme score was 55 (SD 21); the total composite score was not significantly associated with total or target antimicrobial use [estimate –0.49 (95% CI –2.30 to 0.89)], while the category strategies was significantly and negatively associated with target antimicrobial use [–5.91 (95% CI –9.51 to –2.31)]. Conclusions The strategy component of a score developed to measure the intensity of antimicrobial stewardship was associated with the amount of antimicrobials used. Thus, the number and types of strategies employed by antimicrobial stewardship programmes may be of particular importance in programme effectiveness. PMID:25614043
Heard, Renee; O'Halloran, Robyn; McKinley, Kathryn
2017-06-01
The purpose of this study is to determine if the E-Learning Plus communication partner training (CPT) programme is as effective as the Supported Conversation for Adults with Aphasia (SCA TM ) CPT programme in improving healthcare professionals' confidence and knowledge communicating with patients with aphasia. Forty-eight healthcare professionals working in inpatient rehabilitation participated. Participants were randomised to one of the CPT programmes. The three outcome measures were self-rating of confidence, self-rating of knowledge and a test of knowledge of aphasia. Measures were taken pre-, immediately post- and 3-4 months post-training. Data were analysed using mixed between within ANOVAs. Homogeneity of variance was adequate for self-rating of confidence and test of knowledge of aphasia data to continue analysis. There was a statistically significant difference in self-rating of confidence and knowledge of aphasia for both interventions across time. No statistically significant difference was found between the two interventions. Both CPT interventions were associated with an increase in health care professionals' confidence and knowledge of aphasia, but neither programme was superior. As the E-Learning Plus CPT programme is more accessible and sustainable in the Australian healthcare context, further work will continue on this CPT programme.
Community-based pilot intervention to tackle childhood obesity: a whole-system approach.
Vamos, E P; Lewis, E; Junghans, C; Hrobonova, E; Dunsford, E; Millett, C
2016-11-01
Go-Golborne is a pilot intervention to prevent childhood obesity in the Royal Borough of Kensington and Chelsea between 2014 and 2018. It is a multistrategy approach targeting children aged 0-16 years and their families in all settings where children live, learn and play. This paper describes the methodology and the practical steps in the development of Go-Golborne. The programme uses a quasi-experimental design for the evaluation of changes in weight status using data from the extended National Child Measurement Programme across local schools. For specific behavioural change objectives, baseline self-reported lifestyle measures will be compared against annual follow-up data over the 3-year study period. Qualitative methods will be used to explore the perceptions of stakeholders and participants and organizational change. Go-Golborne aims to mobilize everyone in the community who has a role or interest in shaping the local environment, norms and behaviours across a range of sectors. A community network of local organizations has been established to codesign all programme activities. The Steering Group of Council officers support programme implementation and environmental changes. The programme has identified six specific behaviour change objectives representing the key areas of need in Golborne and all activities in the council and the community target these objectives during specific programme phases. Key components include community capacity building, community-wide social marketing, environment and policy change and evaluation. The programme is currently at the beginning of its implementation phase with activities in the community and council targeting the first behaviour change objective. The pilot aims to test the effectiveness of this approach to support behaviour change and prevent unhealthy weight gain in children using multiple strategies. This programme will inform the development of an intervention model that defines essential programme components, accountability of partner organizations delivering obesity prevention programmes and the effective use of existing assets. Copyright © 2016 The Royal Society for Public Health. All rights reserved.
Timko, Christine; Valenstein, Helen; Stuart, Gregory L; Moos, Rudolf H
2015-11-01
The association between substance abuse and intimate partner violence is quite robust. A promising area to improve treatment for the dual problems of substance abuse and violence perpetration is the identification of client characteristics and organisational and programme factors as predictors of health outcomes. Therefore, we examined associations of client, organisational and programme factors with outcomes in community health settings. Directors of 241 substance use disorder programmes (SUDPs) and 235 batterer intervention programmes (BIPs) reported outcomes of programme completion and substance use and violence perpetration rates at discharge; data collection and processing were completed in 2012. SUDPs having more female, non-white, younger, uneducated, unemployed and lower income clients reported lower completion rates. In SUDPs, private, for-profit programmes reported higher completion rates than public or private, non-profit programmes. SUDPs with lower proportions of their budgets from government sources, and higher proportions from client fees, reported better outcomes. Larger SUDPs had poorer programme completion and higher substance use rates. Completion rates in SUDPs were higher when clients could obtain substance- and violence-related help at one location, and programmes integrated violence-prevention contracting into care. In BIPs, few client, organisational and programme factors were associated with outcomes, but the significant factors associated with programme completion were consistent with those for SUDPs. Publicly owned and larger programmes, and SUDPs lacking staff to integrate violence-related treatment, may be at risk of poorer client outcomes, but could learn from programmes that perform well to yield better outcomes. © 2014 John Wiley & Sons Ltd.
Giordano, Alessandro; Bonometti, Gian Pietro; Vanoglio, Fabio; Paneroni, Mara; Bernocchi, Palmira; Comini, Laura; Giordano, Amerigo
2016-12-07
Fall incidents are the third cause of chronic disablement in elderly according to the World Health Organization (WHO). Recent meta-analyses shows that a multifactorial falls risk assessment and management programmes are effective in all older population studied. However, the application of these programmes may not be the same in all National health care setting and, consequently, needs to be evaluated by cost-effectiveness studies before to plan this intervention in regular care. In Italy structured collaboration between hospital staff and primary care is generally lacking and the role of Information and Communication Technologies (ICT) in a fall prevention programme at home has never been explored. This will be a two-group randomised controlled trial aiming to evaluate the effects of a home-based intervention programme delivered by a multidisciplinary health team. The home tele-management programme, previously adopted in our Institute for chronic patients, will be proposed to elderly people affected by chronic diseases at high risk of falling at hospital discharge. The programme will involve the hospital staff and will be managed thanks to the collaboration between hospital and primary care setting. Patients will be followed for 6 months after hospital discharge. A nurse-tutor telephone support and tele-exercise will characterize the intervention programme. People in the control group will receive usual care. The main outcome measure of the study will be the percentage of patients sustaining a fall during the 6-months follow-up period. An economic evaluation will be performed from a societal perspective and will involve calculating cost-effectiveness and cost utility ratios. To date, no adequately powered studies have investigated the effect of the Information and Communication Technologies (ICT) in a home fall prevention program. We aim the program will be feasible in terms of intensity and characteristics, but particularly in terms of patient and provider compliance. The results of the economic evaluation could provide information about the cost-effectiveness of the intervention and the effects on quality of life. In case of shown effectiveness and cost effectiveness, the program could be implemented into health services settings. ClinicalTrials.gov ( NCT02487589 ).