78 FR 6155 - Self-Regulatory Organizations; Miami International Securities Exchange LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-29

... directed order flow to the Exchange. RMMs are not eligible to receive Directed Orders and therefore will... Priority Customer Accounts There will be no transaction fees assessed to EEMs entering orders for the account(s) of Priority Customers.\\10\\ Similarly, NYSEAmex and PHLX do not charge transaction fees for non...

Ensuring Customer Delight: A Quality Approach to Excellence in Management Education

ERIC Educational Resources Information Center

Popli, Sapna

2005-01-01

A customer can recognise a professional institute almost immediately from the manner in which the customer is dealt with. The institute makes the customer (read student) feel special and deals with the customer as a matter of priority rather than as a secondary issue, less important than the undertaking of other activities. The customers of…

Required competencies of occupational physicians: a Delphi survey of UK customers.

PubMed

Reetoo, K N; Harrington, J M; Macdonald, E B

2005-06-01

Occupational physicians can contribute to good management in healthy enterprises. The requirement to take into account the needs of the customers when planning occupational health services is well established. To establish the priorities of UK employers, employees, and their representatives regarding the competencies they require from occupational physicians; to explore the reasons for variations of the priorities in different groups; and to make recommendations for occupational medicine training curricula in consideration of these findings. This study involved a Delphi survey of employers and employees from public and private organisations of varying business sizes, and health and safety specialists as well as trade union representatives throughout the UK. It was conducted in two rounds by a combination of computer assisted telephone interview (CATI) and postal survey techniques, using a questionnaire based on the list of competencies described by UK and European medical training bodies. There was broad consensus about the required competencies of occupational physicians among the respondent subgroups. All the competencies in which occupational physicians are trained were considered important by the customers. In the order of decreasing importance, the competencies were: Law and Ethics, Occupational Hazards, Disability and Fitness for Work, Communication, Environmental Exposures, Research Methods, Health Promotion, and Management. The priorities of customers differed from previously published occupational physicians' priorities. Existing training programmes for occupational physicians should be regularly reviewed and where necessary, modified to ensure that the emphasis of training meets customer requirements.

An Overview of Customer Satisfaction Models.

ERIC Educational Resources Information Center

Hom, Willard

This document is a report on how California community colleges can incorporate customer satisfaction models and theories from business to better serve students. Emphasis is given to two levels of customer satisfaction: macro- and micro-models. Macro-models look at how customer satisfaction relates to other elements or priorities of community…

Benchmarking for the competitive marketplace.

PubMed

Clarke, R W; Sucher, T O

1999-07-01

One would get little argument these days regarding the importance of performance measurement in the health care industry. The traditional approach has been the straightforward use of measurable units such as financial comparisons and clinical indicators (e.g., length of stay). Also we in the health care industry have traditionally benchmarked our performance and strategies against those most like ourselves. Today's competitive market demands a more customer-focused set of performance measures that go beyond traditional approaches such as customer service. The most important task in today's environment is to study the customers' emerging priorities and adjust our business to meet those priorities.

Systematically Prioritizing Media Services and Customers.

ERIC Educational Resources Information Center

Butler, David; Butler, Janice

1979-01-01

Suggests standard operating procedures for non-routine and low priority customer requests for media services and gives an example of prioritizing the distribution of audiovisual presentation services. (RAO)

Is your company ready for one-to-one marketing?

PubMed

Peppers, D; Rogers, M; Dorf, B

1999-01-01

One-to-one marketing, also known as relationship marketing, promises to increase the value of your customer base by establishing a learning relationship with each customer. The customer tells you of some need, and you customize your product or service to meet it. Every interaction and modification improves your ability to fit your product to the particular customer. Eventually, even if a competitor offers the same type of service, your customer won't be able to enjoy the same level of convenience without taking the time to teach your competitor the lessons your company has already learned. Although the theory behind one-to-one marketing is simple, implementation is complex. Too many companies have jumped on the one-to-one band-wagon without proper preparation--mistakenly understanding it as an excuse to badger customers with excessive telemarketing and direct mail campaigns. The authors offer practical advice for implementing a one-to-one marketing program correctly. They describe four key steps: identifying your customers, differentiating among them, interacting with them, and customizing your product or service to meet each customer's needs. And they provide activities and exercises, to be administered to employees and customers, that will help you identify your company's readiness to launch a one-to-one initiative. Although some managers dismiss the possibility of one-to-one marketing as an unattainable goal, even a modest program can produce substantial benefits. This tool kit will help you determine what type of program your company can implement now, what you need to do to position your company for a large-scale initiative, and how to set priorities.

Alternative Fuels Data Center: Going Beyond Gas: Nissan Brings Car Charging

Science.gov Websites

Charging to Indianapolis Convenience Store Chain " We've seen a steady increase in our customer base that alleviating customer concerns needed to be a top priority. "PEV sales hinge on customers steady increase in our customer base since installing the equipment a couple of years ago." Although

75 FR 76282 - Domestic Shipping Services Pricing and Mailing Standards Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... when using a qualifying shipping label managed by the PC Postage system used. b. Permit imprint... system used. b. Permit imprint customers. * * * * * 1.8 Determining Single-Piece Weight [Revise the last... imprint customers. c. Priority Mail Open and Distribute (PMOD) customers whose account volume exceeds 600...

78 FR 66094 - Self-Regulatory Organizations: Miami International Securities Exchange LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... Priority Customer Rebate Program (the ``Program'') until November 30, 2013.\\3\\ The Program currently... Customer \\6\\ order transmitted by that Member which is executed on the Exchange in all multiply-listed... thresholds are calculated based on the customer average daily volume over the course of the month. Volume...

76 FR 2170 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... to market participants that add or remove liquidity from the Exchange (``maker/taker fees'') in 100... contract for Market Maker, Market Maker Plus,\\4\\ Firm Proprietary and Customer (Professional) \\5\\ orders... Customer \\7\\ orders for 100 or more contracts. Priority Customer orders for less than 100 contracts are not...

75 FR 5824 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

.... Those public customers who continue to receive priority in the execution algorithm are called Priority... standard execution algorithm: \\3\\ Securities Exchange Act Release No. 59287 (January 23, 2009), 74 FR 5694...

Impact of the Internet on Customer Service and Product Development Among the CENDI Agencies

DTIC Science & Technology

1997-08-01

CENDI / 97-2 IMPACT OF THE INTERNET ON CUSTOMER SERVICE AND PRODUCT DEVELOPMENT AMONG THE CENDI AGENCIES Workshops Held February 4, 1997 and...Public Release Distribution Unlimited 20000411 146 CENDI / 97-2 CENDI WORKSHOP ~ FEBRUARY 4,1997 AT DOE THE IMPACT OF THE INTERNET ON CUSTOMER ...priorities. TABLE OF CONTENTS EXECUTIVE SUMMARY 1 Introduction 1 CENDI / 97-2 Background 2 1.0 THE IMPACT OF THE INTERNET ON CUSTOMER

Creating Customer Delight.

ERIC Educational Resources Information Center

Black, Jim

1995-01-01

This article proposes that college admissions officers interested in improving service should focus on creating customer delight rather than simply satisfaction, studying the system when things go wrong rather than placing blame, establishing employee well-being as the highest priority of the organization, providing necessary tools and training…

76 FR 49517 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... rules), BOX's proposed rule change does not address or impact any priority relationship for Professional... any priority relationship for Professional orders as opposed to other BOX orders, nor does it impact... Options Participants representing as agent Customer Orders on BOX and those non-Market Maker Participants...

76 FR 63686 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-13

... Exchange's proposal does not address or impact any priority relationship for Professional as opposed to... traded by Options Members (which may include trades on behalf of Public Customers) \\8\\ on BATS Options, a... Members representing as agent Customer Orders on BATS Options and those non- Market Maker Members...

75 FR 26830 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... to the following categories of market participants: (i) Market Maker; (ii) Market Maker Plus; \\6\\ (iii) Non-ISE Market Maker; \\7\\ (iv) Firm Proprietary; (v) Customer (Professional); \\8\\ (vi) Priority... currently charges a fee for removing liquidity to the following class of market participants: (i) Customer...

Customers' Precedence for Service Quality Dimensions in Indian Private Healthcare Setting: A Ridit Approach.

PubMed

Panda, Rajeev Kumar; Kondasani, Rama Koteswara Rao

2017-01-01

Changes in demographic and sociocultural environment, improved health awareness, and information technology have considerably changed the outlook of healthcare sector in India. While both the public and the private healthcare sectors have priority of increasing access while minimizing costs, they try hard to achieve goals without letting the quality suffer. Customers with rising disposable income no longer have faith in the public healthcare system and are willing to migrate to the private healthcare sector, which is more professional, technology savvy, and trustworthy. However, there are enough loopholes in the private healthcare sector that are yet to be plugged. The purpose of this research study was to identify and assess the relative importance of the diverse service quality dimensions and prioritize them to draw meaningful conclusions. Survey responses from 370 customers were analyzed using factor analysis to find underlying relationships between the survey items. This allowed the individual items to be placed into related groups. Independently, a ridit analysis was conducted to determine the relative importance of each item to the survey respondents. Based on the ridit analysis a priority ranking was assigned to each item. An analysis was then undertaken of the degree to which the items grouped into each particular factor tended to have high or low priority rankings. The results of the study may be helpful to the managers of the private healthcare sector to focus their strategies and plan their efforts in line with the findings to gain superior customer satisfaction and retention.

Applying CBR to machine tool product configuration design oriented to customer requirements

NASA Astrophysics Data System (ADS)

Wang, Pengjia; Gong, Yadong; Xie, Hualong; Liu, Yongxian; Nee, Andrew Yehching

2017-01-01

Product customization is a trend in the current market-oriented manufacturing environment. However, deduction from customer requirements to design results and evaluation of design alternatives are still heavily reliant on the designer's experience and knowledge. To solve the problem of fuzziness and uncertainty of customer requirements in product configuration, an analysis method based on the grey rough model is presented. The customer requirements can be converted into technical characteristics effectively. In addition, an optimization decision model for product planning is established to help the enterprises select the key technical characteristics under the constraints of cost and time to serve the customer to maximal satisfaction. A new case retrieval approach that combines the self-organizing map and fuzzy similarity priority ratio method is proposed in case-based design. The self-organizing map can reduce the retrieval range and increase the retrieval efficiency, and the fuzzy similarity priority ratio method can evaluate the similarity of cases comprehensively. To ensure that the final case has the best overall performance, an evaluation method of similar cases based on grey correlation analysis is proposed to evaluate similar cases to select the most suitable case. Furthermore, a computer-aided system is developed using MATLAB GUI to assist the product configuration design. The actual example and result on an ETC series machine tool product show that the proposed method is effective, rapid and accurate in the process of product configuration. The proposed methodology provides a detailed instruction for the product configuration design oriented to customer requirements.

The Strategic Value and Transaction Effectiveness of HRD: A Qualitative Study of Internal Customer Perspectives

ERIC Educational Resources Information Center

Alagaraja, Meera

2013-01-01

Purpose: The purpose of this article is to outline the role of human resource development (HRD) in Lean strategy as the context for assessing interactions with internal customers. Identifying the perceived gap in role expectations and fulfillment emphasizes important priorities and offers tangible measures for assessing HRD contributions. A focus…

78 FR 75629 - Self-Regulatory Organizations; Miami International Securities Exchange LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... Effectiveness of a Proposed Rule Change To Amend the MIAX Fee Schedule December 6, 2013. Pursuant to the... Priority Customer Rebate Program (the ``Program'') to (i) lower the volume thresholds of the four highest... thresholds in a month as described below. The volume thresholds are calculated based on the customer average...

78 FR 16338 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-14

... trades where none of the parties to the trade are Priority Customers (i.e., market makers, broker-dealers... that this proposed rule change is a fair way to address the issue of a trade executing through a customer's limit order price while balancing the competing interests of certainty that trades stand versus...

Quantitative Tools for the Logistics Manager.

DTIC Science & Technology

1980-04-01

aft essentialy the a, mini= Custom support while oumidn the cost tradeoffs of Inventory anGmmt, and ain"m21ia the total bwb*we days when obtaiin item...manainth as mplq sistem requiresmgmn attention. In two areas. Coitrol, issue and rePLema " mm1 09 Laeo siv ntorye - eusto Control amd issu of Customer ...few analysis. ase laImutorsm e follows I 1. Customer Support 3f~~.5 2. Stookitge Uftivemes i6- 3. Not Mis.sion Capale - . -ly . - - , 4. Priority

An empirical research on customer satisfaction study: a consideration of different levels of performance.

PubMed

Lee, Yu-Cheng; Wang, Yu-Che; Lu, Shu-Chiung; Hsieh, Yi-Fang; Chien, Chih-Hung; Tsai, Sang-Bing; Dong, Weiwei

2016-01-01

Customer satisfaction is the key factor for successful and depends highly on the behaviors of frontline service providers. Customers should be managed as assets, and that customers vary in their needs, preferences, and buying behavior. This study applied the Taiwan Customer Satisfaction Index model to a tourism factory to analyze customer satisfaction and loyalty. We surveyed 242 customers served by one tourism factory organizations in Taiwan. A partial least squares was performed to analyze and test the theoretical model. The results show that perceived quality had the greatest influence on the customer satisfaction for satisfied and dissatisfied customers. In addition, in terms of customer loyalty, the customer satisfaction is more important than image for satisfied and dissatisfied customers. The contribution of this paper is to propose two satisfaction levels of CSI models for analyzing customer satisfaction and loyalty, thereby helping tourism factory managers improve customer satisfaction effectively. Compared with traditional techniques, we believe that our method is more appropriate for making decisions about allocating resources and for assisting managers in establishing appropriate priorities in customer satisfaction management.

Perceived usability and use of custom-made footwear in diabetic patients at high risk for foot ulceration.

PubMed

Arts, Mark L J; de Haart, Mirjam; Bus, Sicco A; Bakker, Jan P J; Hacking, Hub G A; Nollet, Frans

2014-04-01

To assess the perceived usability and use of custom- made footwear in diabetic patients who are at high-risk for foot ulceration, and to elucidate the determinants of usability and use. Survey. A total of 153 patients with diabetes, peripheral neuropathy, prior plantar foot ulceration and newly prescribed custom-made footwear, recruited from 10 Dutch multidisciplinary foot clinics. The Questionnaire of Usability Evaluation was used to assess the patients' perception of weight, appearance, comfort, durability, donning/doffing, stability, benefit and overall appreciation of their prescription footwear (all expressed as visual analogue scores). Data on priorities for usability and footwear use (in h/day) were obtained from patient reports. Multivariate logistic regression analysis was used to assess determinants of usability and use. Median (interquartile range) score for overall appreciation was 8.3 (7.1-9.1). Scores ranged from 6.5 (4.5-8.6) for weight to 9.6 (6.3-9.9) for donning/doffing. Footwear comfort was listed most often (33.3%) as the highest priority. Footwear use was <60% of daytime (where daytime was defined as 16 h out of bed) in 58% of patients. The only significant determinant of footwear use was the perceived benefit of the footwear (p = 0.045). Perceived usability of footwear was mostly positive, although individual scores and priorities varied considerably. Footwear use was low to moderate and dependent only on the perceived benefit of the footwear. Therefore, practitioners should focus on enhancing the patient's ap-preciation of the therapeutic benefit of custom-made footwear.

77 FR 47681 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... against the customer order designated for the PIP (``PIP Order'') in price/time priority. The result of... PIP Broadcast: \\3\\ Capitalized terms not otherwise defined herein shall have the meaning as defined in the Exchange Rules. Public Customer to buy 30 contracts at $2.00; Market Maker A to buy 40 contracts...

Mapping online transportation service quality and multiclass classification problem solving priorities

NASA Astrophysics Data System (ADS)

Alamsyah, Andry; Rachmadiansyah, Imam

2018-03-01

Online transportation service is known for its accessibility, transparency, and tariff affordability. These points make online transportation have advantages over the existing conventional transportation service. Online transportation service is an example of disruptive technology that change the relationship between customers and companies. In Indonesia, there are high competition among online transportation provider, hence the companies must maintain and monitor their service level. To understand their position, we apply both sentiment analysis and multiclass classification to understand customer opinions. From negative sentiments, we can identify problems and establish problem-solving priorities. As a case study, we use the most popular online transportation provider in Indonesia: Gojek and Grab. Since many customers are actively give compliment and complain about company’s service level on Twitter, therefore we collect 61,721 tweets in Bahasa during one month observations. We apply Naive Bayes and Support Vector Machine methods to see which model perform best for our data. The result reveal Gojek has better service quality with 19.76% positive and 80.23% negative sentiments than Grab with 9.2% positive and 90.8% negative. The Gojek highest problem-solving priority is regarding application problems, while Grab is about unusable promos. The overall result shows general problems of both case study are related to accessibility dimension which indicate lack of capability to provide good digital access to the end users.

Creating a successful relationship with customers.

PubMed

Cotton, L; Sparrow, E

1998-01-01

In 1997, several employers commissioned an inpatient survey for a group of businesses that included hospitals in southeast Michigan. Its results indicated that the University of Michigan Health System (UMHS) needed to become more customer-focused. To meet this challenge, UMHS mandated that customer service to its patients and their families should be its first priority. A pilot project in the radiology department's pediatric division was established to recognize and reward employees for outstanding service to customers. The program is now used to reward employees throughout the radiology department, on the assumption that when employees feel special, so will their customers. Management's focus is on employees--they are the health system. The department also invested in employee development, a continuous training program that centers on customer service and teaches tools and skills for better communication. The goal of the development program at UMHS is to exceed the needs of its customers.

[On the implementation by Rospotrebnadzor (Federal service for the oversight of consumer protection and welfare) common principles and rules of technical regulation within the agreement of the Customs Union].

PubMed

Onishchenko, G G

2013-01-01

In accordance with the Agreement of the Customs Union on sanitary measures between the Government of the Russian Federation, the Republic of Belarus and the Republic of Kazakhstan in the customs territory of the Customs Union the Uniform sanitary and epidemiological and hygienic requirements for goods subject to sanitary-epidemiological control are applied. Common sanitary requirements are binding for executive authorities of the Member States of the Customs union, local authorities, legal persons, whatever legalform, individual entrepreneurs, individuals. Currently, out of 47 planned to take priority technical regulations of the Customs Union 31 regulation, including the safety of railway rolling stock, production of perfumery and cosmetics, toys and products for children and teenagers, food products, grain, and other furniture products was adopted.

DoD Program for Stability of Civilian Employment

DTIC Science & Technology

1990-02-01

Custom House - 2nd & Chestnut Streets AC 215, 597-4736 Army ATTN: CENAD-PE-P Philadelphia, PA 19106-2991 NUMBER OF CIVILIAN POSITIONS: 500 TWX ADDRESS...soldier and family, and a valued relationship with the civilian community. U. S. Army Engineer District, New Orleans Priority Placement Officer 405A P.O...property disposal operations worldwide including reutilization of serviceable assets in support of the military services and other authorized customers

Quality and customer satisfaction: A case study in Brazil

NASA Astrophysics Data System (ADS)

Barcellos, Paulo Fernando Pinto

The dissertation deals with the case of CEEE-Companhia Estadual de Energia Eletrica, an electric power utility located in Rio Grande do Sul, the southernmost state of Brazil. Customer satisfaction with the services provided by CEEE is investigated within three groups of consumers: residential, commercial, and industrial. The purpose of the dissertation is to find answers to the following research questions: (1) What is service quality in public utilities, and particularly in an electric power company? (2) What service quality dimensions do customers want to be provided and favor the most? (3) How does the market measure service quality? (4) What should be done by companies, and particularly by an electric utility monopoly, to increase the performance of the rendered service? (5) How does this impact customer satisfaction, retention, and intention to recommend? and (6) How do we start a company-wide quality program provided that the resources are scarce and therefore priorities should be set forth? To investigate the posed questions, the study begins with an exploratory survey of CEEE's Board. The survey is followed by qualitative research of the three customer groups. After qualitative analysis of the data is concluded, questionnaires for the quantitative research, as well as hypothetical models, are developed. Dillman's "Total Design Method" is used to design the questionnaires. The basic ACSI (American Customer Satisfaction Model) is used to approach customer satisfaction. Data are processed by PLS (Partial Least Squares) which follows the procedure developed at the National Quality Research Center of the University of Michigan Business School. In summary, commercial customers are the most dissatisfied with the services provided by CEEE, while residential customers are the most satisfied. To improve quality, priority should be placed on commercial customers and include efforts to improve productivity gains throughout the company. Also, CEEE's image should be improved through a better communication process with the market and an intensive and extensive training of personnel. A special marketing campaign could help build a better image by explaining CEEE's goals to improve quality. Finally, a bottom line of satisfaction scores (as quality indicators) should be set for the entire company.

15 CFR 200.110 - Priorities and time of completion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... calibrations and other tests will generally be made in the order in which confirmed requests are received... considerably longer, particularly if their abnormal behavior requires reruns to check reliability. The customer...

The National Map 2.0 Tactical Plan: "Toward the (Integrated) National Map"

USGS Publications Warehouse

Zulick, Carl A.

2008-01-01

The National Map's 2-year goal, as described in this plan, is to provide a range of geospatial products and services that meet the basic goals of the original vision for The National Map while furthering the National Spatial Data Infrastructure that underpins U.S. Geological Survey (USGS) science. To accomplish this goal, the National Geospatial Program (NGP) will acquire, store, maintain, and distribute base map data. The management team for the NGP sets priorities for The National Map in three areas: Data and Products, Services, and Management. Priorities for fiscal years 2008 and 2009 (October 1, 2007 through September 30, 2009), involving the current data inventory, data acquisition, and the integration of data, are (1) incorporating current data from Federal, State, and local organizations into The National Map to the degree possible, given data availability and program resources; (2) collaborating with other USGS programs to incorporate data that support the USGS Science Strategy; (3) supporting the Department of the Interior (DOI) high-priority geospatial information needs; (4) emergency response; (5) homeland security, natural hazards; and (6) graphics products delivery. The management team identified known constraints, enablers, and drivers for the acquisition and integration of data. The NGP management team also identified customer-focused products and services of The National Map. Ongoing planning and management activities direct the development and delivery of these products and services. Management of work flow processes to support The National Map priorities are identified and established through a business-driven prioritization process. This tactical plan is primarily for use as a document to guide The National Map program for the next two fiscal years. The document is available to the public because of widespread interest in The National Map. The USGS collaborates with a broad range of customers and partners who are essential to the success of The National Map, including the science community, State and Federal agencies involved in homeland security, planners and emergency responders at the local level, and private companies. Partner contributions and data remain a primary input and foundation of The National Map. Partnership strategies for each of The National Map's component data themes are outlined in this plan. Because of the importance of The National Map customers, a reassessment of customer needs will be completed during 2008. Results of the assessment will be incorporated into future decisions and priorities. A performance milestone matrix has been developed that contains the full list of milestones, major deliverables, and major tasks. The matrix forms the basis for reporting on accomplishments and issues. However, a number of risks, dependencies, and issues have been identified that could affect meeting milestones in the matrix, such as: the USGS is not the Circular A-16 lead for boundaries, transportation, and structures; availability of sufficient and sustainable funding; availability of Federal workforce and contractors with necessary skills, and numerous competing customer and stakeholder requirements.

Economical ground data delivery

NASA Technical Reports Server (NTRS)

Markley, Richard W.; Byrne, Russell H.; Bromberg, Daniel E.

1994-01-01

Data delivery in the Deep Space Network (DSN) involves transmission of a small amount of constant, high-priority traffic and a large amount of bursty, low priority data. The bursty traffic may be initially buffered and then metered back slowly as bandwidth becomes available. Today both types of data are transmitted over dedicated leased circuits. The authors investigated the potential of saving money by designing a hybrid communications architecture that uses leased circuits for high-priority network communications and dial-up circuits for low-priority traffic. Such an architecture may significantly reduce costs and provide an emergency backup. The architecture presented here may also be applied to any ground station-to-customer network within the range of a common carrier. The authors compare estimated costs for various scenarios and suggest security safeguards that should be considered.

Transforming Multidisciplinary Customer Requirements to Product Design Specifications

NASA Astrophysics Data System (ADS)

Ma, Xiao-Jie; Ding, Guo-Fu; Qin, Sheng-Feng; Li, Rong; Yan, Kai-Yin; Xiao, Shou-Ne; Yang, Guang-Wu

2017-09-01

With the increasing of complexity of complex mechatronic products, it is necessary to involve multidisciplinary design teams, thus, the traditional customer requirements modeling for a single discipline team becomes difficult to be applied in a multidisciplinary team and project since team members with various disciplinary backgrounds may have different interpretations of the customers' requirements. A new synthesized multidisciplinary customer requirements modeling method is provided for obtaining and describing the common understanding of customer requirements (CRs) and more importantly transferring them into a detailed and accurate product design specifications (PDS) to interact with different team members effectively. A case study of designing a high speed train verifies the rationality and feasibility of the proposed multidisciplinary requirement modeling method for complex mechatronic product development. This proposed research offersthe instruction to realize the customer-driven personalized customization of complex mechatronic product.

41 CFR 101-26.107 - Priorities for use of supply sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

...); (v) Central supply sources, such as the stock, special order, or customer supply center programs of...), the Defense Logistics Agency (see subpart 101-26.6), the Department of Veterans Affairs (see § 101-26...

41 CFR 101-26.107 - Priorities for use of supply sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

...); (v) Central supply sources, such as the stock, special order, or customer supply center programs of...), the Defense Logistics Agency (see subpart 101-26.6), the Department of Veterans Affairs (see § 101-26...

Design Process Improvement for Electric CAR Harness

NASA Astrophysics Data System (ADS)

Sawatdee, Thiwarat; Chutima, Parames

2017-06-01

In an automobile parts design company, the customer satisfaction is one of the most important factors for product design. Therefore, the company employs all means to focus its product design process based on the various requirements of customers resulting in high number of design changes. The objective of this research is to improve the design process of the electric car harness that effects the production scheduling by using Fault Tree Analysis (FTA) and Failure Mode and Effect Analysis (FMEA) as the main tools. FTA is employed for root cause analysis and FMEA is used to ranking a High Risk Priority Number (RPN) which is shows the priority of factors in the electric car harness that have high impact to the design of the electric car harness. After the implementation, the improvements are realized significantly since the number of design change is reduced from 0.26% to 0.08%.

A VIEW OF TURKEY AND EUROPEAN RELATIONS FROM THE PERSPECTIVE OF MEDICAL LEGISLATION: AN ASSESMENT OF STATE OF PLAY

PubMed Central

Ekmekçi, Perihan Elif; Arda, Berna

2015-01-01

The aim of this paper is to reflect the situation of health legislation alignment in Turkey in its accession process to the European Union and Customs Union Agreement, and to discuss the the EU’s health priorities of in parallel with the Turkish ones. The health legislation alignment processes consist of three titles which are: European Union alignment process, the harmonization done in the framework of membership to Council of Europe, and the obligations under the Customs Union Agreement. Significant human resources are required for the adoption of the legislations which make ethically imperative the discussion of whether there is a harmony among the priorities of both parities. Unless this harmony and paralellisim is shown, the human resources appointed for the adoption of health legislation process would not prove their efficiency and effectiveness. In this article, the Customs Union and formal negotiations for full EU membership are included in the phrase “the alignment process to European Union”. Council Decisions 1/95 and 2/97 ground on the obligations provided by the Customs Union Agreement. The reference document used to discuss the formal negotiation process for full membership to European Union is the Turkish National Program for the Adoption of the EU Acquis 2008–2013. The legislative obligations of Turkey arising from its membership of the Council of Europe, which has significant contributions to the medical legislation especially in the field of medical ethics, are also included in this article. PMID:26269696

Assessment as a Strategic Weapon.

ERIC Educational Resources Information Center

Alfred, Richard L.

2000-01-01

Sets forth eight rules for using assessment to allow community colleges to create a distinctive image: create a "brand identity," differentiate the institution from competitors, big picture goals, total institution performance, priority assigned to stakeholders, measuring intangible benefits, continuous customer touch, and urgency for action.…

Report to Congress on innovative safety and security technology solutions for alternative transportation facilities

DOT National Transportation Integrated Search

2017-05-01

This research collected information on the frequency and impact of safety and security incidents (threats) at selected facilities and identified priority incidents at each facility. A customized all hazards approach was used to determine the ha...

77 FR 22034 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-12

... Basis for, the Proposed Rule Change 1. Purpose The Exchange proposes to further incentivize Customers who transact Complex Orders in SPY. The Exchange currently pays a Customer Complex Order Rebate for Adding Liquidity of $0.32 per contract and a Customer Complex Order Rebate for Removing Liquidity of $0...

Integrating Stakeholders and Users into the Geography Discipline's Research Process

USGS Publications Warehouse

Hermans, Caroline M.; Taketa, Richard

2006-01-01

Future research priorities of Geography emphasize the discipline's leadership role in the U.S. Geological Survey (USGS) in multidisciplinary and integrated research on human and environmental systems and how these systems are interrelated and respond to change Geography's research priorities also emphasize providing science that is usable to society and creating decision support products applicable to given customer problems. To achieve these goals, we must understand the relationship between our research and our customer, and how to integrate the customer into the research process. This report details the elements of the research process that help achieve the degree of stakeholder involvement necessary to ensure a successful end-product. It offers suggestions that can help researchers better understand stakeholders and customers and involve them in the research process more effectively, while preserving the integrity of the science. Its aim is to help researchers understand the problems and challenges faced by our customers and communicate the ways in which Geography can help address their problems. Adopting these guidelines can improve the efficiency of the research process and lead to higher quality output. We will be able to conduct better research because we will have an improved understanding of the research problem and the stakeholders involved. This report covers a broad range of topics, from identifying and communicating with stakeholders and users, to the use of language, to how to effectively present scientific information to the user. It does not offer a 'one size fits all' method. Instead, perhaps only specific sections are suitable for a given project and customers, depending on project scope and needs. This report is based on the objectives of Geography's strategic plan, U. S. Geological Survey's strategic plan, and Department of Interior's strategic plan. Section 2 of these guidelines describes the purpose of the research process in Geography and the need for better user involvement in the process. Section 3 explains how to conduct a stakeholder analysis. Section 4 explains how to conduct a user-needs assessment.

Perioperative leadership: managing change with insights, priorities, and tools.

PubMed

Taylor, David L

2014-07-01

The personal leadership of the perioperative director is a critical factor in the success of any change management initiative. This article presents an approach to perioperative nursing leadership that addresses obstacles that prevent surgical departments from achieving high performance in clinical and financial outcomes. This leadership approach consists of specific insights, priorities, and tools: key insights include self-understanding of personal barriers to leadership and accuracy at understanding economic and strategic considerations related to the OR environment; key priorities include creating a customer-centered organization, focusing on process improvement, and concentrating on culture change; and key tools include using techniques (e.g., direct engagement, collaborative leadership) to align surgical organizations with leadership priorities and mitigate specific perioperative management risks. Included in this article is a leadership development plan for perioperative directors. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Determining the need for improvement of infant incubator design with quality function deployment

NASA Astrophysics Data System (ADS)

Tarigan, U.; Ginting, R.; Siregar, I.

2018-02-01

A Newborns need particular attention because it takes time to adapt to the outside world. In accordance with the standard post-neonatal procedures, newborns should be incorporated into the incubator within a specified period of time according to the infant’s health level. Infant incubator as a medical device used to care for newborns, often get complaints from doctors and child nurses. The complaint indicates consumer dissatisfaction with incubator products in the hospital. Broadly speaking, objection against infant incubators lie in inappropriate designs. To overcome these complaints the researchers apply the method of Quality Function Deployment to determine the characteristics of priority techniques in accordance with the wishes of consumers with it. The primary focus of QFD is to engage customers in the product development process as early as possible, which their needs and desires serve as the starting point of the QFD process. Therefore, QFD is called the voice of customer. The underlying philosophy is that customers are not always satisfied with a product even though the product has been perfectly produced. The results show that the category used as a priority improvement is the additional function of the oxygen cylinder and the size of the door hole. QFD phase one produces technical characteristics of Ergonomy, Features and Cost as critical part determinants.

A report card from Missourians : 2009

DOT National Transportation Integrated Search

2009-07-01

This survey populates data for five customer satisfaction measures for the MoDOT Tracker; 5a, 12j, 13c, 17d and 18b. The survey also asks other evaluative and priority questions that measure the publics support for various ways of raising and appr...

A report card from Missourians : 2010.

DOT National Transportation Integrated Search

2010-07-01

This survey populates data for five customer satisfaction measures for the MoDOT Tracker; 5a, 12j, 13c, 17d and 18b. The survey : also asks other evaluative and priority questions that measure the publics support for various ways of raising and ap...

A report card from Missourians : 2010.

DOT National Transportation Integrated Search

2010-07-01

This survey populates data for five customer satisfaction measures for the MoDOT Tracker; 5a, 12j, 13c, 17d and 18b. The survey also asks other evaluative and priority questions that measure the publics support for various ways of raising and appr...

Make customer service a priority.

PubMed

2017-09-02

BVA has partnered with Moneypenny, one of the UK's leading outsourced communications providers, to provide members with an effective way to respond to client calls. Moneypenny talked to Pauline Sloan, receptionist at Village Vets in East Lothian, about her practice's experience of using their service. British Veterinary Association.

77 FR 6172 - Discretionary Bus and Bus Facilities Program and National Research Program Funds.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... Interagency Coordinating Council on Access and Mobility's (Coordinating Council or CCAM) Veterans... of the U.S. Department of Transportation (DOT) through March 31, 2012, and provides contract... coordination and simplified customer access priorities established by the Coordinating Council's partnership...

A report card from Missourians : 2011.

DOT National Transportation Integrated Search

2011-07-01

This survey populates data for seven customer satisfaction measures for the MoDOT Tracker; 4b, 4c, 5a, 12i, 13c, 16a and 17b. : The survey also asks other evaluative and priority questions that measure the publics support for various ways of raisi...

Radio and Optical Telescopes for School Students and Professional Astronomers

NASA Astrophysics Data System (ADS)

Hosmer, Laura; Langston, G.; Heatherly, S.; Towner, A. P.; Ford, J.; Simon, R. S.; White, S.; O'Neil, K. L.; Haipslip, J.; Reichart, D.

2013-01-01

The NRAO 20m telescope is now on-line as a part of UNC's Skynet worldwide telescope network. The NRAO is completing integration of radio astronomy tools with the Skynet web interface. We present the web interface and astronomy projects that allow students and astronomers from all over the country to become Radio Astronomers. The 20 meter radio telescope at NRAO in Green Bank, WV is dedicated to public education and also is part of an experiment in public funding for astronomy. The telescope has a fantastic new web-based interface, with priority queuing, accommodating priority for paying customers and enabling free use of otherwise unused time. This revival included many software and hardware improvements including automatic calibration and improved time integration resulting in improved data processing, and a new ultra high resolution spectrometer. This new spectrometer is optimized for very narrow spectral lines, which will allow astronomers to study complex molecules and very cold regions of space in remarkable detail. In accordance with focusing on broader impacts, many public outreach and high school education activities have been completed with many confirmed future activities. The 20 meter is now a fully automated, powerful tool capable of professional grade results available to anyone in the world. Drop by our poster and try out real-time telescope control!

77 FR 35723 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-14

.../taker fees and rebates, which are designed to attract complex orders to the Exchange, and has a specific... per contract applicable to customers that transact in complex orders, i.e., customer complex orders that interact with complex orders residing on the complex order book thereby taking liquidity from the...

A Look Inside Corporate Employee Volunteer Programs.

ERIC Educational Resources Information Center

Benjamin, Ellen J.

2001-01-01

A survey of 15 corporate volunteer program managers found that administration was complicated by limited staff time and lack of clear policies; employee preferences and incentives/rewards had a higher priority than impact on customers and community; feedback on program results was mostly informal; and 73% reported no measurement process. (Contains…

Analyzing the Interaction of Performance Appraisal Factors Using Interpretive Structural Modeling

ERIC Educational Resources Information Center

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

2010-01-01

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

The role of reengineering in health care delivery.

PubMed

Boland, P

1996-01-01

Health care reengineering is a powerful methodology that helps organizations reorder priorities, provide more cost-effective care, and increase value to customers. It should be driven by what the customer wants and what the market needs. Systemwide reengineering integrates three levels of activity: managing community and health plan partnerships; consolidating overlapping delivery system functions among participating providers and vendors; and redesigning administrative functions, clinical services, and caregiving programs to improve health status. Reengineering is not a panacea; it is a critical core competency and requisite skill for health care organizations if they are to succeed under managed care in the future.

Silo busting: how to execute on the promise of customer focus.

PubMed

Gulati, Ranjay

2007-05-01

For many senior executives, shifting from selling products to selling solutions--packages of products and services--is a priority in today's increasingly commoditized markets. Companies, however, aren't always structured to make that shift. Knowledge and expertise often reside in silos, and many companies have trouble harnessing their resources across those boundaries in a way that customers value and are willing to pay for. Some companies--like GE Healthcare, Best Buy, and commercial real estate provider Jones Lang LaSalle (JLL)--have restructured themselves around customer needs to deliver true solutions. They did so by engaging in four sets of activities: COORDINATION: To deliver customer-focused solutions, three things must occur easily across boundaries: information sharing, division of labor, and decision making. Sometimes this involves replacing traditional silos with customer-focused ones, but more often it entails transcending existing boundaries. JLL has experimented with both approaches. COOPERATION: Customer-centric companies, such as Cisco Systems, develop metrics for customer satisfaction and incentives that reward customer-focused cooperation. Most also shake up the power structure so that people who are closest to customers have the authority to act on their behalf. CAPABILITY: Delivering customer-focused solutions requires some employees to be generalists instead of specialists. They need experience with more than one product or service, a deep knowledge of customer needs, and the ability to traverse internal boundaries. CONNECTION: By combining their offerings with those of a partner, companies can cut costs even as they create higher-value solutions, as Starbucks has found through its diverse partnerships. To stand out in a commoditized market, companies must understand what customers value. Ultimately, some customers may be better off purchasing products and services piecemeal.

76 FR 30412 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

... marketing charges for Customer executions in the complex order book is hindering their ability to route and...\\ The standard marketing charges are $0.25 per contract for any electronic Customer order in a Penny...-imposition of marketing charges on market makers who trade with electronic Customer orders in the complex...

76 FR 16460 - Mail Classification Change for Priority Mail Flat Mail

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... online model and the retail model. The online model will allow customers to purchase packs from a Web...: March 23, 2011. ADDRESSES: Submit comments electronically by accessing the ``Filing Online'' link in the... Commission's Filing Online system at https://www.prc.gov/prc-pages/filing-online/login.aspx . Commenters who...

The Frazzled Principal's Wellness Plan: Reclaiming Time, Managing Stress, and Creating a Healthy Lifestyle

ERIC Educational Resources Information Center

Queen, J. Allen; Queen, Patsy S.

2004-01-01

This wellness guide for today's busy principals, school leaders, supervisors, and administrators has been custom crafted by the authors to address the stresses of managing workplace environments, juggling time and competing priorities, learning to delegate, balancing personal and professional agendas, and creating win-win situations. Special…

Characterizing and Managing Intrusion Detection System (IDS) Alerts with Multi-Server/Multi-Priority Queuing Theory

DTIC Science & Technology

2014-12-26

administrators dashboard , so that they can be effectively triaged, analyzed, and used to implement defensive actions to keep the network safe and...For the bank teller, some customers will require straight forward services (a quick deposit or cashing a check) while others will have questions or

Customer value propositions in business markets.

PubMed

Anderson, James C; Narus, James A; van Rossum, Wouter

2006-03-01

Examples of consumer value propositions that resonate with customers are exceptionally difficult to find. When properly constructed, value propositions force suppliers to focus on what their offerings are really worth. Once companies become disciplined about understanding their customers, they can make smarter choices about where to allocate scarce resources. The authors illuminate the pitfalls of current approaches, then present a systematic method for developing value propositions that are meaningful to target customers and that focus suppliers' efforts on creating superior value. When managers construct a customer value proposition, they often simply list all the benefits their offering might deliver. But the relative simplicity of this all-benefits approach may have a major drawback: benefit assertion. In other words, managers may claim advantages for features their customers don't care about in the least. Other suppliers try to answer the question, Why should our firm purchase your offering instead of your competitor's? But without a detailed understanding of the customer's requirements and preferences, suppliers can end up stressing points of difference that deliver relatively little value to the target customer. The pitfall with this approach is value presumption: assuming that any favorable points of difference must be valuable for the customer. Drawing on the best practices of a handful of suppliers in business markets, the authors advocate a resonating focus approach. Suppliers can provide simple, yet powerfully captivating, consumer value propositions by making their offerings superior on the few elements that matter most to target customers, demonstrating and documenting the value of this superior performance, and communicating it in a way that conveys a sophisticated understanding of the customer's business priorities.

78 FR 76339 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... November 1, 2013 the Exchange further amended its Schedule of Fees to increase its Market Maker Plus rebate... Maker Plus and are affiliated with an Electronic Access Member that executes a total affiliated Priority Customer ADV of 200,000 contracts in a calendar month.\\4\\ When introducing this new Market Maker Plus...

75 FR 44995 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... options on the following FX option currencies traded on the Exchange: New Zealand dollar, Mexican peso.../dealer and is not a Priority Customer. For all other FX option currencies traded on the Exchange, this... Rule Change Relating to Foreign Currency Options Orders Fee Discount for Market Makers and Non-ISE...

Non-Uniform Per-Packet Priority Marker for Use with Adaptive Protocols

DTIC Science & Technology

2014-01-07

through con­ gestion points that would totally stop traffic from a customer using the SLA shown in FIG. 5, though only some fraction of his traffic...assigning priori­ ties to TCP flows. PDQoS has potential to fill the need for a quality of service mechanism that is simple to configure and to

Trade-Offs, Biases, and Uncertainty in Project Planning and Execution: A Problem-Based Simulation Exercise

ERIC Educational Resources Information Center

Smith-Daniels, Dwight E.; Smith-Daniels, Vicki L.

2008-01-01

The ability to plan and execute projects is a fundamental skill required among managers and business school graduates. In the opening phase of a project, the project team makes decisions about the relative priority of project time, cost, and performance objectives, oftentimes without complete information about customer and stakeholder…

77 FR 74719 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-17

... for Electronic Complex Order executions, and (vii) include days when the Exchange closes early in the... combined thresholds in contracts from Customer posted orders in Penny Pilot issues and Electronic Complex Orders.\\5\\ The Exchange proposes not to count Electronic Complex Orders toward the Customer monthly...

A study of worldwide communications markets: The relationship between federally sponsored research and development and competitiveness of US industry in this market

NASA Technical Reports Server (NTRS)

1977-01-01

Many factors have been reviewed in an attempt to seek criteria for the establishment of regions or nations as potential customers for space communication systems. These include economic measures, demographic distributions, topographic variations, physical size, national dispersion, telephones available, investment credit viability, and the general level of technology within the population. A major consideration is the fact that essentially all nations are subject to significant financial constraints. Consequently, some form of national investment priorities becomes necessary, and these priorities are generally perceived differently according to the factors mentioned above and also according to the personalities and interests of each nation's decision makers.

The utility and its customer: A complex relationship

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

Covelli, L.; Williams, M.V.

Developing methods of tracking customer satisfaction for utilities presents major problems since the customer reacts to the utility on many different levels. The more obvious are in relation to the product (energy) and the services the company provides. More recently there has been talk of the {open_quotes}brand{close_quotes} elements of the company-customer relationship. Ontario Hydro (OH) has developed a method utilizing four separate domains for measuring and tracking customer satisfaction: product, service, competitiveness, and institutional relationships. Ontario Hydro conducted a survey of over 1200 residential customers. The respondents received a detailed in-person survey of their estimation of the importance of specificmore » aspects of customer service and their view of Ontario Hydro`s performance on those same issues. The data yielded 28 factors covered a large variety of separate concerns: customer service, and treatment of customers to export policy. OH concluded that the utility`s relationship with its customer is more complex than the susual customer-vendor interaction. A utility not only provides a product and a service, it has a institutional personality and provides an absolutely necessary product under an exclusive franchise and executes government policy as a regulated monopoly. It was found that customers are sensitive to all of these attributes.« less

The four faces of mass customization.

PubMed

Gilmore, J H; Pine, B J

1997-01-01

Virtually all executives today recognize the need to provide outstanding service to customers. Focusing on the customer, however, is both an imperative and a potential curse. In their desire to become customer driven, many companies have resorted to inventing new programs and procedures to meet every customer's request. But as customers and their needs grow increasingly diverse, such an approach has become a surefire way to add unnecessary cost and complexity to operations. Companies around the world have embraced mass customization in an attempt to avoid those pitfalls. Readily available information technology and flexible work processes permit them to customize goods or services for individual customers in high volumes at low cost. But many managers have discovered that mass customization itself can produce unnecessary cost and complexity. They are realizing that they did not examine thoroughly enough what kind of customization their customers would value before they plunged ahead. That is understandable. Until now, no framework has existed to help managers determine the type of customization they should pursue. James Gilmore and Joseph Pine provide managers with just such a framework. They have identified four distinct approaches to customization. When designing or redesigning a product, process, or business unit, managers should examine each approach for possible insights into how to serve their customers best. In some cases, a single approach will dominate the design. More often, however, managers will need a mix of some or all of the four approaches to serve their own particular set of customers.

77 FR 16311 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

... Rule Change To Adopt a Route-Out Fee for Priority Customer Orders March 14, 2012. Pursuant to Section... Statement of the Terms of Substance of the Proposed Rule Change The ISE is proposing to adopt a fee related..., the Proposed Rule Change 1. Purpose The purpose of this proposed rule change is to adopt a fee related...

76 FR 38226 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... principal office of the Exchange, at the Commission's Public Reference Room and also on the Exchange's... time priority: (1) Market Maker offer on the Book to buy 100 contracts at $2.00. (2) Public Customer... execute 40 contracts (40% of 100) against the Agency Order; and the Market Maker on the Book would execute...

76 FR 40976 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... Exchange proposes to correct Rule 1080(m) to reflect the priority of routed orders that are not executed on... routed orders in Rule 1080. Currently, Rule 1080(m) governs the routing of orders on the Exchange and... or not available for routing. Customer FIND and SRCH Orders, as defined in Rule 1080(m)(iv...

[On the improvement of the legal support of the food safety in the conditions of trade and economic integration of states-members of the Customs union and the Russian Federation's accession to the WTO].

PubMed

Bragina, I V; Aksenova, O I; Bokit'ko, B G; Gorsky, A A

2013-01-01

In the article priority activities of The Federal Service for the Oversight of Consumer Protection and Welfare on improvement of standard legal support of safety of foodstuff and control of compliance of foodstuff to legislation requirements are reported. The main documents directed on harmonization of the international requirements with national ones and requirements of the Customs union on safety of foodstuff are submitted. Work within a framework of Russian Federation's accession to the WTO is described. And data on control of quality and safety of foodstuff are provided also.

Penalty-rewards contrast analysis (PRCA) on the KL monorail services

NASA Astrophysics Data System (ADS)

Muda, Nora; Suradi, Nur Riza; Mat Roji, Noor Sulawati

2013-04-01

Changes in living standards, tastes, views and education has changed the lifestyles where people are more emphasizing on quality and satisfaction with public amenities provided. One of the services provided is the KL Monorail; a public transport service which is based on a single beam track in the city that connects the north and center of Kuala Lumpur. Therefore, this study measures the customer satisfaction on the KL Monorail services and to identify the factors that should be given priority in improving their service levels. There were seven attributes being studied, namely the informations, the situation at the station, the situation in the KL Monorail, customer service, safety, efficiency and other aspects. The analysis found that the overall customer satisfactionis mean is 4.86. Based on the measurement of Penalty-Reward Contrast Analysis (PRCA), most of the KL Monorail service attribute are at moderate level of satisfaction except for the attributes at the station that have lower level of satisfaction. Therefore, a remedial actions or planning is needed to improve the customer satisfaction on the KL Monorail services.

Comparison of Customer Preference for Bulk Material Handling Equipment through Fuzzy-AHP Approach

NASA Astrophysics Data System (ADS)

Sen, Kingshuk; Ghosh, Surojit; Sarkar, Bijan

2017-06-01

In the present study, customer's perception has played one of the important roles for selection of the exact equipment out of available alternatives. The present study is dealt with the method of optimization of selection criteria of a material handling equipment, based on the technical specifications considered to be available at the user end. In this work, the needs of customers have been identified and prioritized, that lead to the selection of number of criteria, which have direct effect upon the performance of the equipment. To check the consistency of selection criteria, first of all an AHP based methodology is adopted with the identified criteria and available product categories, based upon which, the judgments of the users are defined to derive the priority scales. Such judgments expressed the relative strength or intensity of the impact of the elements of the hierarchy. Subsequently, all the alternatives have ranked for each identified criteria with subsequent constitution of weighted matrices. The same has been compared with the normalized values of approximate selling prices of the equipments to determine individual cost-benefit ratio. Based on the cost-benefit ratio, the equipment is ranked. With same conditions, the study is obtained again with a Fuzzy AHP concept, where a fuzzy linguistic approach has reduced the amount of uncertainty in decision making, caused by conventional AHP due to lack of deterministic approach. The priority vectors of category and criteria are determined separately and multiplied to obtain composite score. Subsequently, the average of fuzzy weights was determined and the preferences of equipment are ranked.

Leadership Education Priorities for a Democratic Society

ERIC Educational Resources Information Center

Jenlink, Patrick M.

2010-01-01

Determining the priorities for leadership education in a democratic society is a complex, challenging responsibility, not a task to be taken lightly. It is complex on one level in that to be a leader in schools "today is to understand a profoundly human as well as a professional responsibility." It is challenging on another level in that preparing…

A Policy Assessment of Priorities and Functional Needs for the Military Computer-Assisted Instruction Terminal

DTIC Science & Technology

1975-12-01

ceases to act as a testing ground for determining user needs when demand is low relative to high initial development costs. Customers are forced to...ANASTASIO Associate Director Data Analysis Research Division Educational Testing Service Princeton, NJ 08540 (609)921-9000 Director of Educational...technology and educational psychology - Indiana University. Research interestes in adaptive, interactive instructional systems. Management

Enabling complex nanoscale pattern customization using directed self-assembly.

PubMed

Doerk, Gregory S; Cheng, Joy Y; Singh, Gurpreet; Rettner, Charles T; Pitera, Jed W; Balakrishnan, Srinivasan; Arellano, Noel; Sanders, Daniel P

2014-12-16

Block copolymer directed self-assembly is an attractive method to fabricate highly uniform nanoscale features for various technological applications, but the dense periodicity of block copolymer features limits the complexity of the resulting patterns and their potential utility. Therefore, customizability of nanoscale patterns has been a long-standing goal for using directed self-assembly in device fabrication. Here we show that a hybrid organic/inorganic chemical pattern serves as a guiding pattern for self-assembly as well as a self-aligned mask for pattern customization through cotransfer of aligned block copolymer features and an inorganic prepattern. As informed by a phenomenological model, deliberate process engineering is implemented to maintain global alignment of block copolymer features over arbitrarily shaped, 'masking' features incorporated into the chemical patterns. These hybrid chemical patterns with embedded customization information enable deterministic, complex two-dimensional nanoscale pattern customization through directed self-assembly.

QFD-ANP Approach for the Conceptual Design of Research Vessels: A Case Study

NASA Astrophysics Data System (ADS)

Venkata Subbaiah, Kambagowni; Yeshwanth Sai, Koneru; Suresh, Challa

2016-10-01

Conceptual design is a subset of concept art wherein a new idea of product is created instead of a visual representation which would directly be used in a final product. The purpose is to understand the needs of conceptual design which are being used in engineering designs and to clarify the current conceptual design practice. Quality function deployment (QFD) is a customer oriented design approach for developing new or improved products and services to enhance customer satisfaction. House of quality (HOQ) has been traditionally used as planning tool of QFD which translates customer requirements (CRs) into design requirements (DRs). Factor analysis is carried out in order to reduce the CR portions of HOQ. The analytical hierarchical process is employed to obtain the priority ratings of CR's which are used in constructing HOQ. This paper mainly discusses about the conceptual design of an oceanographic research vessel using analytical network process (ANP) technique. Finally the QFD-ANP integrated methodology helps to establish the importance ratings of DRs.

Magnet status as a competitive strategy of hospital organizations: marketing a culture of excellence in nursing services.

PubMed

Tropello, Paula Grace Dunn

2003-01-01

With issues of patient safety, the nursing shortage, and managed care fiscal constraints, hospital organizations can strategically capture market share, while insuring best care practices, if they adopt the "Magnet Status" accreditation model. This quality indicator signifies to the consumer a culture of excellence in nursing services and fulfills the priority of customer satisfaction as a marketing strategy objective.

A Process-Centered Tool for Evaluating Patient Safety Performance and Guiding Strategic Improvement

DTIC Science & Technology

2005-01-01

next patient safety steps in individual health care organizations. The low priority given to Category 3 (Focus on patients , other customers , and...presents a patient safety applicator tool for implementing and assessing patient safety systems in health care institutions. The applicator tool consists...the survey rounds. The study addressed three research questions: 1. What critical processes should be included in health care patient safety systems

The Quality Education Checklist: An Instrument for Self-Auditing. Developing Quality Schools: Learning Module #2. Making It Work--The Quality Schools Approach.

ERIC Educational Resources Information Center

Barlosky, Martin; Lawton, Stephen

The Quality Education Checklist focuses on key inputs, processes, and outputs of schools needed to ensure continuous improvement. Intended as a self-auditing aid for schools, the checklist may also be used as a method to define the priority of areas for improvement, as a way to gather information from customers, as a professional development…

Evaluation of purchase intention of customers in two wheeler automobile segment: AHP and TOPSIS

NASA Astrophysics Data System (ADS)

Sri Yogi, Kottala

2018-03-01

Winning heart of customers is preeminent main design of any business organization in global business environment. This paper explored customer’s priorities while purchasing a two wheeler automobile segment using Analytical Hierarchy Process (AHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) as a multi criteria decision making tools to accomplish the research objectives. Study has been done to analyze different criteria to be considered during purchasing of two wheeler automobiles among respondents using structured questionnaire based on SAATY scale. Based on our previous work on empirical & fuzzy logic approach to product quality and purchase intention of customers in two wheeler- operational, performance, economic, brand value and maintenance aspects are considered as decision criteria of customers while purchasing a two wheeler. The study suggests high pick up during overtaking, petrol saving, reasonable spare parts price, unique in design and identity and easy to change gear as main criterion in purchasing process. We also found some leading two wheeler automobiles models available in Indian market using some objective function criterion in choosing some important characteristics like price, cylinder capacity, brake horse power and weight during purchasing process of two wheeler automobile in Indian market based on respondents perception.

Costing Complex Products, Operations & Support

DTIC Science & Technology

2011-10-19

last version of the Harrier II family introduced in the UK. As such it is similar to the U.S. Marine Corps’ AV-8B in basic structure , systems , and...ABSTRACT Complex products and systems (CoPS) are major capital goods in which customers play a central role from design through to disposal, such as...Complex products and systems (CoPS) are major capital goods in which customers play a central role from design through to disposal, such as large defense

Everyday value conflicts and integrative complexity of thought.

PubMed

Myyry, Liisa

2002-12-01

This study examined the value pluralism model in everyday value conflicts, and the effect of issue context on complexity of thought. According to the cognitive manager model we hypothesized that respondents would obtain a higher level of integrative complexity on personal issues that on professional and general issues. We also explored the relations of integrative complexity to value priorities, measured by the Schwartz Value Survey, and to emotional empathy. The value pluralism model was not supported by the data collected from 126 university students from social science, business and technology. The cognitive manager model was partially confirmed by data from females but not from males. Concerning value priorities, more complex respondents had higher regard for self-transcendence values, and less complex respondents for self-enhancement values Emotional empathy was also significantly related to complexity score.

The impact of manufacturing complexity drivers on performance-a preliminary study

NASA Astrophysics Data System (ADS)

Huah Leang, Suh; Mahmood, Wan Hasrulnizzam Wan; Rahman, Muhamad Arfauz A.

2018-03-01

Manufacturing systems, in pursuit of cost, time and flexibility optimisation are becoming more and more complex, exhibiting a dynamic and nonlinear behaviour. Unpredictability is a distinct characteristic of such behaviour and effects production planning significantly. Therefore, this study was undertaken to investigate the priority level and current achievement of manufacturing performance in Malaysia’s manufacturing industry and the complexity drivers on manufacturing productivity performance. The results showed that Malaysia’s manufacturing industry prioritised product quality and they managed to achieve a good on time delivery performance. However, for other manufacturing performance, there was a difference where the current achievement of manufacturing performances in Malaysia’s manufacturing industry is slightly lower than the priority given to them. The strong correlation of significant value for priority status was observed between efficient production levelling (finished goods) and finish product management while the strong correlation of significant value for current achievement was minimised the number of workstation and factory transportation system. This indicates that complexity drivers have an impact towards manufacturing performance. Consequently, it is necessary to identify complexity drivers to achieve well manufacturing performance.

Ballistic Missile Proliferation: An Emerging Threat 1992

DTIC Science & Technology

1992-10-01

ticipation by major countries and an increased Scud B but using a Chinese guidance system. priority by their policymakers before they can en - sure...Soviets. Hepatitis A >4 weeks Hepatitis B >4 weeks A 1970 World Health Organization report con- Turberculosis >4 weeks cluded that biological warfare was... a turbojet en - Range gine, replacing the liquid-propellant motors of the Missile (km) IOC Customers HY-2. The HY-4 has been developed primarily

Facility Composer Design Wizards: A Method for Extensible Codified Design Logic Based on Explicit Facility Criteria

DTIC Science & Technology

2004-11-01

institutionalized approaches to solving problems, company/client specific mission priorities (for example, State Department vs . Army Reserve and... independent variables that let the user leave a particular step before fin- ishing all the items, and to return at a later time without any data loss. One...Sales, Main Exchange, Miscellane- ous Shops, Post Office, Restaurant , and Theater.) Authorized customers served 04 Other criteria pro- vided by the

On-site customization of silicone stents: towards optimal palliation of complex airway conditions.

PubMed

Breen, David P; Dutau, Hervé

2009-01-01

Stents may be indicated as treatment of benign and malignant conditions of the central airways. Occasionally, aberrant and/or distorted airways secondary to therapy or surgery may preclude the use of commercially manufactured stents. The customization of stents is well described for nonpulmonary diseases, but to date there are only limited data in the literature on prosthesis customization for airway disease. To review all the different techniques and indications of on-site silicone stent customizations and their related complications. A retrospective study was undertaken to identify all patients who underwent treatment with a silicone stent which was customized on site by the physician. The study included subjects treated during an 8-year period. Forty-nine on-site customizations were performed in 43 patients (34 males, mean age 63 +/- 5.2 years). Stent customization was performed in 5.4% of the cases. Stent customization was performed for malignant and benign disease in 35 (81.3%) and 8 (18.7%) cases, respectively. In all cases, the stent deployed successfully and performed well while in situ. Stent manipulation did not increase complications. Customization of airway stents by the physician can lead to successful stenting of difficult airway lesions with a good short-term safety profile. Standard commercially available stents may have resulted in suboptimal management of complex airway pathologies. A prospective study is warranted to further investigate the safety profile and complications associated with stent customization. Copyright 2009 S. Karger AG, Basel.

Sustainability of utility-scale solar energy: Critical environmental concepts

NASA Astrophysics Data System (ADS)

Hernandez, R. R.; Moore-O'Leary, K. A.; Johnston, D. S.; Abella, S.; Tanner, K.; Swanson, A.; Kreitler, J.; Lovich, J.

2017-12-01

Renewable energy development is an arena where ecological, political, and socioeconomic values collide. Advances in renewable energy will incur steep environmental costs to landscapes in which facilities are constructed and operated. Scientists - including those from academia, industry, and government agencies - have only recently begun to quantify trade-off in this arena, often using ground-mounted, utility-scale solar energy facilities (USSE, ≥ 1 megawatt) as a model. Here, we discuss five critical ecological concepts applicable to the development of more sustainable USSE with benefits over fossil-fuel-generated energy: (1) more sustainable USSE development requires careful evaluation of trade-offs between land, energy, and ecology; (2) species responses to habitat modification by USSE vary; (3) cumulative and large-scale ecological impacts are complex and challenging to mitigate; (4) USSE development affects different types of ecosystems and requires customized design and management strategies; and (5) long-term ecological consequences associated with USSE sites must be carefully considered. These critical concepts provide a framework for reducing adverse environmental impacts, informing policy to establish and address conservation priorities, and improving energy production sustainability.

Sustainability of utility-scale solar energy – critical ecological concepts

USGS Publications Warehouse

Moore-O'Leary, Kara A.; Hernandez, Rebecca R.; Johnston, Dave S.; Abella, Scott R.; Tanner, Karen E.; Swanson, Amanda C.; Kreitler, Jason R.; Lovich, Jeffrey E.

2017-01-01

Renewable energy development is an arena where ecological, political, and socioeconomic values collide. Advances in renewable energy will incur steep environmental costs to landscapes in which facilities are constructed and operated. Scientists – including those from academia, industry, and government agencies – have only recently begun to quantify trade-offs in this arena, often using ground-mounted, utility-scale solar energy facilities (USSE, ≥1 megawatt) as a model. Here, we discuss five critical ecological concepts applicable to the development of more sustainable USSE with benefits over fossil-fuel-generated energy: (1) more sustainable USSE development requires careful evaluation of trade-offs between land, energy, and ecology; (2) species responses to habitat modification by USSE vary; (3) cumulative and large-scale ecological impacts are complex and challenging to mitigate; (4) USSE development affects different types of ecosystems and requires customized design and management strategies; and (5) long-term ecological consequences associated with USSE sites must be carefully considered. These critical concepts provide a framework for reducing adverse environmental impacts, informing policy to establish and address conservation priorities, and improving energy production sustainability.

The ultimately accountable job: leading today's sales organization.

PubMed

Colletti, Jerome A; Fiss, Mary S

2006-01-01

In recent years, sales leaders have had to devote considerable time and energy to establishing and maintaining disciplined processes. The thing is, many of them stop there--and they can't afford to, because the business environment has changed. Customers have gained power and gone global, channels have proliferated, more product companies are selling services, and many suppliers have begun providing a single point of contact for customers. Such changes require today's sales leaders to fill various new roles: Company leader. The best sales chiefs actively help formulate and execute company strategy, and they collaborate with all functions of the business to deliver value to customers. Customer champion. Customers want C-level relationships with suppliers in order to understand product strategy, look at offerings in advance, and participate in decisions made about future products--and sales leaders are in the best position to offer that kind of contact. Process guru. Although sales chiefs must look beyond the sales and customer processes they have honed over the past decade, they can't abandon them. The focus on process has become only more important as many organizations have begun bundling products and services to meet important customers' individual needs. Organization architect. Good sales leaders spend a lot of time evaluating and occasionally redesigning the sales organization's structure to ensure that it supports corporate strategy. Often, this involves finding the right balance between specialized and generalized sales roles. Course corrector. Sales leaders must watch the horizon, but they can't take their hands off the levers or forget about the dials. If they do, they might fail to respond when quick adjustments in priorities are needed.

The utility of 3D printing for surgical planning and patient-specific implant design for complex spinal pathologies: case report.

PubMed

Mobbs, Ralph J; Coughlan, Marc; Thompson, Robert; Sutterlin, Chester E; Phan, Kevin

2017-04-01

OBJECTIVE There has been a recent renewed interest in the use and potential applications of 3D printing in the assistance of surgical planning and the development of personalized prostheses. There have been few reports on the use of 3D printing for implants designed to be used in complex spinal surgery. METHODS The authors report 2 cases in which 3D printing was used for surgical planning as a preoperative mold, and for a custom-designed titanium prosthesis: one patient with a C-1/C-2 chordoma who underwent tumor resection and vertebral reconstruction, and another patient with a custom-designed titanium anterior fusion cage for an unusual congenital spinal deformity. RESULTS In both presented cases, the custom-designed and custom-built implants were easily slotted into position, which facilitated the surgery and shortened the procedure time, avoiding further complex reconstruction such as harvesting rib or fibular grafts and fashioning these grafts intraoperatively to fit the defect. Radiological follow-up for both cases demonstrated successful fusion at 9 and 12 months, respectively. CONCLUSIONS These cases demonstrate the feasibility of the use of 3D modeling and printing to develop personalized prostheses and can ease the difficulty of complex spinal surgery. Possible future directions of research include the combination of 3D-printed implants and biologics, as well as the development of bioceramic composites and custom implants for load-bearing purposes.

CEM-designer: design of custom expression microarrays in the post-ENCODE Era.

PubMed

Arnold, Christian; Externbrink, Fabian; Hackermüller, Jörg; Reiche, Kristin

2014-11-10

Microarrays are widely used in gene expression studies, and custom expression microarrays are popular to monitor expression changes of a customer-defined set of genes. However, the complexity of transcriptomes uncovered recently make custom expression microarray design a non-trivial task. Pervasive transcription and alternative processing of transcripts generate a wealth of interweaved transcripts that requires well-considered probe design strategies and is largely neglected in existing approaches. We developed the web server CEM-Designer that facilitates microarray platform independent design of custom expression microarrays for complex transcriptomes. CEM-Designer covers (i) the collection and generation of a set of unique target sequences from different sources and (ii) the selection of a set of sensitive and specific probes that optimally represents the target sequences. Probe design itself is left to third party software to ensure that probes meet provider-specific constraints. CEM-Designer is available at http://designpipeline.bioinf.uni-leipzig.de. Copyright © 2014 Elsevier B.V. All rights reserved.

U.S. Immigration and Naturalization Service: Dysfunctional Not by Design

DTIC Science & Technology

2007-03-01

is for show, politics and press releases. Kiddie porn cases are done like fast food investigations so Assistant Secretary Myers can look like a deer...bringing in 30 tons of cocaine?” Another legacy Customs supervisor added, “we have just about closed down child exploitation. We now do reactive INS...drugs, drugs, kiddie porn , strategic, drugs. HQ’s forcing immigration priorities, but SACS are fighting it. How do you account for 3 groups working

Delivering good service: personal resources, job satisfaction and nurses' 'customer' (patient) orientation.

PubMed

Gountas, Sandra; Gountas, John; Soutar, Geoffrey; Mavondo, Felix

2014-07-01

To explore the complex relationships between nurses' personal resources, job satisfaction and 'customer' (patient) orientation. Previous research has shown that nursing is highly intensive, emotionally charged work, which affects nurses' job performance and their customer orientation as well as patient or 'customer' satisfaction. This study contributes to the literature by examining how nurses' personal resources relate to their personal satisfaction and customer orientation and the relationships between them. Specifically, this study explores the effects of two facets of emotional labour (deep acting and surface acting), empathic concern, self-efficacy and emotional exhaustion on personal job satisfaction and customer orientation. We also test the moderating effects of inauthenticity and emotional contagion. A quantitative survey. Data were collected through a self-completion questionnaire administered to a sample of 159 Australian nurses, in a public teaching hospital, in 2010. The data were analysed using Partial Least Square analysis. Partial Least Square analysis indicates that the final model is a good fit to the data (Goodness of Fit = 0.51). Deep acting and surface acting have different effects (positive and negative) on job satisfaction and 'customer' orientation, self-efficacy has a positive effect on both and emotional exhaustion has a positive effect on customer orientation and a negative effect on job satisfaction. The moderating effects of emotional contagion and empathic concern, in the final model, are discussed. Understanding the complex interactions between personal resources, job satisfaction and customer orientation helps to increase service providers' (nurses in this study) personal satisfaction and 'customer' orientation particularly in difficult contexts. © 2013 John Wiley & Sons Ltd.

Method for optimizing resource allocation in a government organization. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Afarin, James

1994-01-01

The managers in Federal agencies are challenged to control the extensive activities in government and still provide high-quality products and services to the American taxpayers. Considering today's complex social and economic environment and the $3.8 billion daily cost of operating the Federal Government, it is evident that there is a need to develop decision-making tools for accurate resource allocation and total quality management. The goal of this thesis is to provide a methodical process that will aid managers in Federal Government to make budgetary decisions based on the cost of services, the agency's objectives, and the customers' perception of the agency's product. A general resource allocation procedure was developed in this study that can be applied to any government organization. A government organization, hereafter the 'organization,' is assumed to be a multidivision enterprise. This procedure was applied to a small organization for the proof of the concept. This organization is the Technical Services Directorate (TSD) at the NASA Lewis Research Center in Cleveland, Ohio. As part of the procedure, a nonlinear programming model was developed to account for the resources of the organization, the outputs produced by the organization, the decision-maker's views, and the customers' satisfaction with the organization. The information on the resources of the organization was acquired from current budget levels of the organization and the human resources assigned to the divisions. The outputs of the organization were defined and measured by identifying metrics that assess the outputs, the most challenging task in this study. The decision-maker's views are represented in the model as weights assigned to the various outputs and were quantified by using the analytic hierarchy process. The customer's opinions regarding the outputs of the organization were collected through questionnaires that were designed for each division individually. Following the philosophy of total quality management, information on customers' satisfaction is presented in the model as the quality of output. The model is a nonlinear one whose objective is to maximize customers' satisfaction such that the total cost of operation does not exceed the organization's budget. This model represents a structured approach or policy mechanism, at the agency level, to make capital investment decisions based on the priorities of the agency and the quality of outputs. This procedure applied to TSD resulted in a resources allocation scheme that was reasonable and acceptable to the decision-makers and, as expected, dependent on the assumptions and accuracy of the data used in the model.

Climate policy: Uncovering ocean-related priorities

NASA Astrophysics Data System (ADS)

Barkemeyer, Ralf

2017-11-01

Given the complexity and multi-faceted nature of policy processes, national-level policy preferences are notoriously difficult to capture. Now, research applying an automated text mining approach helps to shed light on country-level differences and priorities in the context of marine climate issues.

Youth and Peace.

ERIC Educational Resources Information Center

Barliba, Dan Mihai

1984-01-01

The complex and dynamic relationship of youth and peace is examined, educational priorities regarding peace education of youth are discussed, and characterisitcs of youth movements for peace and disarmament are described. Peace is one of the main priorities expressed by the themes of International Youth Year 1985. (RM)

76 FR 9067 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... pay a rebate solely for Customer complex orders that add liquidity in order to continue to attract... because this Customer rebate would attract Customer order flow to the Exchange for the benefit of all..., priced at a net debit or credit based on the relative prices of the individual components, for the same...

Determination and prioritizing of addiction prevention factors in delfan city, iran.

PubMed

Mirzaei, Davod; Zamani, Bibi Eshrat; Mousavi, Sayyed Hojat

2011-01-01

In recent decades, drug abuse has been one of the most important problems of human societies and has been imposing enormous charges to them. Exposing addicts to infectious diseases, social and economic harmful impacts, expensive and reversibility of treatment methods have caused that drug abuse prevention programs be more inexpensive and more effective than treatment. One of the most important methods of drug abuse prevention is identification and prioritization of them according to scientific methods. The purpose of this study was to investigate addiction prevention methods among adolescents and teenagers from the viewpoints of addicts, their parents, authorities and prioritizing the prevention methods based on analytical hierarchy process (AHP) model in Delfan city, Iran. Statistical samples included 17 authorities, 42 addicts, and 23 parents that have been selected through purposive sampling. Data collection instruments involved structured and semi-structured interviews. Data were analyzed based on quantitative and qualitative methods, encoding and categorization. In this study, AHP model was used for prioritizing the prevention methods. This model is one of the most efficient and comprehensive designed techniques for multi-criteria decision making; it formulates the possibility of natural complex problems as hierarchy. The results indicated that the most important methods of drug abuse prevention were using media, case studies, planning for leisure times, educating social skills, integrating drug prevention methods in religious customs and respect to teenagers. Among these factors, the media and respect to adolescents with weights 0.3321 and 0.2389 had the highest preferences for the prevention of drug addiction, respectively. Planning for leisure time with weight of 0.1349 had the lowest importance than media and teenager respectful factor and higher priority than religion customs, dating and learning lessons factors. On the contrary, integrating in religion customs, using case studies with weights 0.1145, 0.1114 and 0.0680 had the lowest preferences, respectively, and can be considered in later settings. The interviewees mentioned the most important addiction prevention methods in respect to teenagers, religious customs, media, dating skills, learning lessons from examples and attention to the leisure times among which the media has been the most efficient method. Because, publicity of the media as a national media is available to the public and it is not dedicated for a special group or class of people and everyone can use it regardless of his literacy and knowledge level.

The Evolution of ICT Markets: An Agent-Based Model on Complex Networks

NASA Astrophysics Data System (ADS)

Zhao, Liangjie; Wu, Bangtao; Chen, Zhong; Li, Li

Information and communication technology (ICT) products exhibit positive network effects.The dynamic process of ICT markets evolution has two intrinsic characteristics: (1) customers are influenced by each others’ purchasing decision; (2) customers are intelligent agents with bounded rationality.Guided by complex systems theory, we construct an agent-based model and simulate on complex networks to examine how the evolution can arise from the interaction of customers, which occur when they make expectations about the future installed base of a product by the fraction of neighbors who are using the same product in his personal network.We demonstrate that network effects play an important role in the evolution of markets share, which make even an inferior product can dominate the whole market.We also find that the intensity of customers’ communication can influence whether the best initial strategy for firms is to improve product quality or expand their installed base.

The one number you need to grow.

PubMed

Reichheld, Frederick F

2003-12-01

Companies spend lots of time and money on complex tools to assess customer satisfaction. But they're measuring the wrong thing. The best predictor of top-line growth can usually be captured in a single survey question: Would you recommend this company to a friend? This finding is based on two years of research in which a variety of survey questions were tested by linking the responses with actual customer behavior--purchasing patterns and referrals--and ultimately with company growth. Surprisingly, the most effective question wasn't about customer satisfaction or even loyalty per se. In most of the industries studied, the percentage of customers enthusiastic enough about a company to refer it to a friend or colleague directly correlated with growth rates among competitors. Willingness to talk up a company or product to friends, family, and colleagues is one of the best indicators of loyalty because of the customer's sacrifice in making the recommendation. When customers act as references, they do more than indicate they've received good economic value from a company; they put their own reputations on the line. And they will risk their reputations only if they feel intense loyalty. The findings point to a new, simpler approach to customer research, one directly linked to a company's results. By substituting a single question--blunt tool though it may appear to be--for the complex black box of the customer satisfaction survey, companies can actually put consumer survey results to use and focus employees on the task of stimulating growth.

78 FR 4926 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-23

... on the proposed rule change from interested persons. \\1\\ 15 U.S.C. 78s(b)(1). \\2\\ 17 CFR 240.19b-4. I....'' Specifically, the Exchange proposes to amend the Customer Rebate Program, Select Symbols,\\5\\ Simple and Complex... Category D to the Customer Rebate Program relating to Customer Simple Orders in Select Symbols. The...

A model-Driven Approach to Customize the Vocabulary of Communication Boards: Towards More Humanization of Health Care.

PubMed

Franco, Natália M; Medeiros, Gabriel F; Silva, Edson A; Murta, Angela S; Machado, Aydano P; Fidalgo, Robson N

2015-01-01

This work presents a Modeling Language and its technological infrastructure to customize the vocabulary of Communication Boards (CB), which are important tools to provide more humanization of health care. Using a technological infrastructure based on Model-Driven Development (MDD) approach, our Modelin Language (ML) creates an abstraction layer between users (e.g., health professionals such as an audiologist or speech therapist) and application code. Moreover, the use of a metamodel enables a syntactic corrector for preventing creation of wrong models. Our ML and metamodel enable more autonomy for health professionals in creating customized CB because it abstracts complexities and permits them to deal only with the domain concepts (e.g., vocabulary and patient needs). Additionally, our infrastructure provides a configuration file that can be used to share and reuse models. This way, the vocabulary modelling effort will decrease our time since people share vocabulary models. Our study provides an infrastructure that aims to abstract the complexity of CB vocabulary customization, giving more autonomy to health professionals when they need customizing, sharing and reusing vocabularies for CB.

Neonatal survival in complex humanitarian emergencies: setting an evidence-based research agenda

PubMed Central

2014-01-01

Background Over 40% of all deaths among children under 5 are neonatal deaths (0–28 days), and this proportion is increasing. In 2012, 2.9 million newborns died, with 99% occurring in low- and middle-income countries. Many of the countries with the highest neonatal mortality rates globally are currently or have recently been affected by complex humanitarian emergencies. Despite the global burden of neonatal morbidity and mortality and risks inherent in complex emergency situations, research investments are not commensurate to burden and little is known about the epidemiology or best practices for neonatal survival in these settings. Methods We used the Child Health and Nutrition Research Initiative (CHNRI) methodology to prioritize research questions on neonatal health in complex humanitarian emergencies. Experts evaluated 35 questions using four criteria (answerability, feasibility, relevance, equity) with three subcomponents per criterion. Using SAS 9.2, a research prioritization score (RPS) and average expert agreement score (AEA) were calculated for each question. Results Twenty-eight experts evaluated all 35 questions. RPS ranged from 0.846 to 0.679 and the AEA ranged from 0.667 to 0.411. The top ten research priorities covered a range of issues but generally fell into two categories– epidemiologic and programmatic components of neonatal health. The highest ranked question in this survey was “What strategies are effective in increasing demand for, and use of skilled attendance?” Conclusions In this study, a diverse group of experts used the CHRNI methodology to systematically identify and determine research priorities for neonatal health and survival in complex humanitarian emergencies. The priorities included the need to better understand the magnitude of the disease burden and interventions to improve neonatal health in complex humanitarian emergencies. The findings from this study will provide guidance to researchers and program implementers in neonatal and complex humanitarian fields to engage on the research priorities needed to save lives most at risk. PMID:24959198

Reliability evaluation of a multistate network subject to time constraint under routing policy

NASA Astrophysics Data System (ADS)

Lin, Yi-Kuei

2013-08-01

A multistate network is a stochastic network composed of multistate arcs in which each arc has several possible capacities and may fail due to failure, maintenance, etc. The quality of a multistate network depends on how to meet the customer's requirements and how to provide the service in time. The system reliability, the probability that a given amount of data can be transmitted through a pair of minimal paths (MPs) simultaneously under the time constraint, is a proper index to evaluate the quality of a multistate network. An efficient solution procedure is first proposed to calculate it. In order to further enhance the system reliability, the network administrator decides the routing policy in advance to indicate the first and the second priority pairs of MPs. The second priority pair of MPs takes charge of the transmission duty if the first fails. The system reliability under the routing policy can be subsequently evaluated.

Risk assessment of failure modes of gas diffuser liner of V94.2 siemens gas turbine by FMEA method

NASA Astrophysics Data System (ADS)

Mirzaei Rafsanjani, H.; Rezaei Nasab, A.

2012-05-01

Failure of welding connection of gas diffuser liner and exhaust casing is one of the failure modes of V94.2 gas turbines which are happened in some power plants. This defect is one of the uncertainties of customers when they want to accept the final commissioning of this product. According to this, the risk priority of this failure evaluated by failure modes and effect analysis (FMEA) method to find out whether this failure is catastrophic for turbine performance and is harmful for humans. By using history of 110 gas turbines of this model which are used in some power plants, the severity number, occurrence number and detection number of failure determined and consequently the Risk Priority Number (RPN) of failure determined. Finally, critically matrix of potential failures is created and illustrated that failure modes are located in safe zone.

Prioritized LT Codes

NASA Technical Reports Server (NTRS)

Woo, Simon S.; Cheng, Michael K.

2011-01-01

The original Luby Transform (LT) coding scheme is extended to account for data transmissions where some information symbols in a message block are more important than others. Prioritized LT codes provide unequal error protection (UEP) of data on an erasure channel by modifying the original LT encoder. The prioritized algorithm improves high-priority data protection without penalizing low-priority data recovery. Moreover, low-latency decoding is also obtained for high-priority data due to fast encoding. Prioritized LT codes only require a slight change in the original encoding algorithm, and no changes at all at the decoder. Hence, with a small complexity increase in the LT encoder, an improved UEP and low-decoding latency performance for high-priority data can be achieved. LT encoding partitions a data stream into fixed-sized message blocks each with a constant number of information symbols. To generate a code symbol from the information symbols in a message, the Robust-Soliton probability distribution is first applied in order to determine the number of information symbols to be used to compute the code symbol. Then, the specific information symbols are chosen uniform randomly from the message block. Finally, the selected information symbols are XORed to form the code symbol. The Prioritized LT code construction includes an additional restriction that code symbols formed by a relatively small number of XORed information symbols select some of these information symbols from the pool of high-priority data. Once high-priority data are fully covered, encoding continues with the conventional LT approach where code symbols are generated by selecting information symbols from the entire message block including all different priorities. Therefore, if code symbols derived from high-priority data experience an unusual high number of erasures, Prioritized LT codes can still reliably recover both high- and low-priority data. This hybrid approach decides not only "how to encode" but also "what to encode" to achieve UEP. Another advantage of the priority encoding process is that the majority of high-priority data can be decoded sooner since only a small number of code symbols are required to reconstruct high-priority data. This approach increases the likelihood that high-priority data is decoded first over low-priority data. The Prioritized LT code scheme achieves an improvement in high-priority data decoding performance as well as overall information recovery without penalizing the decoding of low-priority data, assuming high-priority data is no more than half of a message block. The cost is in the additional complexity required in the encoder. If extra computation resource is available at the transmitter, image, voice, and video transmission quality in terrestrial and space communications can benefit from accurate use of redundancy in protecting data with varying priorities.

Decision Making for the Environment: Social and Behavioral Science Research Priorities

ERIC Educational Resources Information Center

Brewer, Garry D., Ed.; Stern, Paul C., Ed.

2005-01-01

With the growing number, complexity, and importance of environmental problems come demands to include a full range of intellectual disciplines and scholarly traditions to help define and eventually manage such problems more effectively. "Decision Making for the Environment: Social and Behavioral Science Research Priorities" is the result…

Development of user customized smart keyboard using Smart Product Design-Finite Element Analysis Process in the Internet of Things.

PubMed

Kim, Jung Woo; Sul, Sang Hun; Choi, Jae Boong

2018-06-07

In a hyper-connected society, IoT environment, markets are rapidly changing as smartphones penetrate global market. As smartphones are applied to various digital media, development of a novel smart product is required. In this paper, a Smart Product Design-Finite Element Analysis Process (SPD-FEAP) is developed to adopt fast-changing tends and user requirements that can be visually verified. The user requirements are derived and quantitatively evaluated from Smart Quality Function Deployment (SQFD) using WebData. Then the usage scenarios are created according to the priority of the functions derived from SQFD. 3D shape analysis by Finite Element Analysis (FEA) was conducted and printed out through Rapid Prototyping (RP) technology to identify any possible errors. Thus, a User Customized Smart Keyboard has been developed using SPD-FEAP. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

The ODDI Odyssey: Developing and Integrating Operations for the International Space Station

NASA Astrophysics Data System (ADS)

Deal, Ryan W.

2002-01-01

International Space Station (ISS) comprise the deliverable products (OP-01 Reports) of the Boeing Operations Data Development and Integration (ODDI) Integrated Product Team (IPT) to the NASA customer. The ODDI IPT's mission is to exceed the customer's expectations by providing high-quality data and sound techniques for assembling and operating the ISS. strategies in order to streamline the generation of operations products that the Mission Operations Directorate (MOD) utilizes for its crew and ground operations procedures development. Just as for other business practices, operations is a transformation process, converting inputs (resources) into outputs (products) based on a strategy that works best for the established competitive priorities of the operations organization. product reviews, and supporting other ISS operations duties (such as Mission Evaluation Room support) must be balanced with meeting schedules for delivery of the ODDI IPT's OP-01 Reports in accordance with the ISS assembly sequence timeline.

Prioritizing Seafloor Mapping for Washington’s Pacific Coast

PubMed Central

Battista, Timothy; Buja, Ken; Christensen, John; Hennessey, Jennifer; Lassiter, Katrina

2017-01-01

Remote sensing systems are critical tools used for characterizing the geological and ecological composition of the seafloor. However, creating comprehensive and detailed maps of ocean and coastal environments has been hindered by the high cost of operating ship- and aircraft-based sensors. While a number of groups (e.g., academic research, government resource management, and private sector) are engaged in or would benefit from the collection of additional seafloor mapping data, disparate priorities, dauntingly large data gaps, and insufficient funding have confounded strategic planning efforts. In this study, we addressed these challenges by implementing a quantitative, spatial process to facilitate prioritizing seafloor mapping needs in Washington State. The Washington State Prioritization Tool (WASP), a custom web-based mapping tool, was developed to solicit and analyze mapping priorities from each participating group. The process resulted in the identification of several discrete, high priority mapping hotspots. As a result, several of the areas have been or will be subsequently mapped. Furthermore, information captured during the process about the intended application of the mapping data was paramount for identifying the optimum remote sensing sensors and acquisition parameters to use during subsequent mapping surveys. PMID:28350338

I want products my own way, but which way? The effects of different product categories and cues on customer responses to Web-based customizations.

PubMed

Chang, Chia-Chi; Chen, Hui-Yun

2009-02-01

Mass customization is a strategy that has been adopted by companies to tailor their products in order to match customer needs more precisely. Therefore, to fully capture the value of mass customization, it is crucial to explore how customers react to mass customization. In previous studies, an implied premise has been that consumers are keen to embrace customized products, and this assumption has also been treated by firms as a prerequisite for successful mass customization strategies. However, an undesirable complexity may result from difficult configuration processes that may intimidate and confuse some customers. Hence, this study explores strategies that marketers can employ to facilitate the customization process. Specifically, this study investigates how to enhance customer satisfaction and purchase decision toward customized products by providing cues compatible with the product category. It is hypothesized that for search products, customers rely more on intrinsic cues when making configuration decisions. On the other hand, for experience products, customers perceive extrinsic cues to be more valuable in assisting them to make configuration decisions. The results suggest that consumers tend to respond more favorably toward customized search products when intrinsic cues are provided than when extrinsic or irrelevant ones are provided. In contrast, when customizing experience products, customers tend to depend more on extrinsic cues than on intrinsic or irrelevant ones.

It Takes Two to Tango: Customization and Standardization as Colluding Logics in Healthcare

PubMed Central

Greenfield, David; Eljiz, Kathy; Butler-Henderson, Kerryn

2018-01-01

The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, ‘standardization’ and ‘customization,’ and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being ‘competing’ logics in healthcare, standardization and customization are long standing ‘colluding’ logics. Mannion and Exworthy’s call for further sustained work to understand this complex, contested space is endorsed, noting that it is critical to inform future debates and service decisions. PMID:29524942

Space Weather Impacts on Spacecraft Operations: Identifying and Establishing High-Priority Operational Services

NASA Astrophysics Data System (ADS)

Lawrence, G.; Reid, S.; Tranquille, C.; Evans, H.

2013-12-01

Space Weather is a multi-disciplinary and cross-domain system defined as, 'The physical and phenomenological state of natural space environments. The associated discipline aims, through observation, monitoring, analysis and modelling, at understanding and predicting the state of the Sun, the interplanetary and planetary environments, and the solar and non-solar driven perturbations that affect them, and also at forecasting and nowcasting the potential impacts on biological and technological systems'. National and Agency-level efforts to provide services addressing the myriad problems, such as ESA's SSA programme are therefore typically complex and ambitious undertakings to introduce a comprehensive suite of services aimed at a large number and broad range of end users. We focus on some of the particular threats and risks that Space Weather events pose to the Spacecraft Operations community, and the resulting implications in terms of User Requirements. We describe some of the highest-priority service elements identified as being needed by the Operations community, and outline some service components that are presently available, or under development. The particular threats and risks often vary according to orbit, so the particular User Needs for Operators at LEO, MEO and GEO are elaborated. The inter-relationship between these needed service elements and existing service components within the broader Space Weather domain is explored. Some high-priority service elements and potential correlation with Space Weather drivers include: solar array degradation and energetic proton storms; single event upsets at GEO and solar proton events and galactic cosmic rays; surface charging and deep dielectric charging at MEO and radiation belt dynamics; SEUs at LEO and the South Atlantic Anomaly and its variability. We examine the current capability to provide operational services addressing such threats and identify some advances that the Operations community can expect to benefit from in the short- and medium-term, such as: enhanced forecasting eg. using Bayesian statistics; optimization and standardization of effects tools; operations-ready real-time data tools, with customization options tailored around the operator's views; next-generation SWE-specific sensors and provision of key data to Operators.

Mining consumer reviews to generate ratings of different product attributes while producing feature-based review-summary

NASA Astrophysics Data System (ADS)

Kangale, Akshay; Krishna Kumar, S.; Arshad Naeem, Mohd; Williams, Mark; Tiwari, M. K.

2016-10-01

With the massive growth of the internet, product reviews increasingly serve as an important source of information for customers to make choices online. Customers depend on these reviews to understand users' experience, and manufacturers rely on this user-generated content to capture user sentiments about their product. Therefore, it is in the best interest of both customers and manufacturers to have a portal where they can read a complete comprehensive summary of these reviews in minimum time. With this in mind, we arrived at our first objective which is to generate a feature-based review-summary. Our second objective is to develop a predictive model to know the next week's product sales based on numerical review ratings and textual features embedded in the reviews. When it comes to product features, every user has different priorities for different features. To capture this aspect of decision-making, we have designed a new mechanism to generate a numerical rating for every feature of the product individually. The data have been collected from a well-known commercial website for two different products. The validation of the model is carried out using a crowd-sourcing technique.

Quality of service policy control in virtual private networks

NASA Astrophysics Data System (ADS)

Yu, Yiqing; Wang, Hongbin; Zhou, Zhi; Zhou, Dongru

2004-04-01

This paper studies the QoS of VPN in an environment where the public network prices connection-oriented services based on source, destination and grade of service, and advertises these prices to its VPN customers (users). As different QoS technologies can produce different QoS, there are according different traffic classification rules and priority rules. The internet service provider (ISP) may need to build complex mechanisms separately for each node. In order to reduce the burden of network configuration, we need to design policy control technologies. We considers mainly directory server, policy server, policy manager and policy enforcers. Policy decision point (PDP) decide its control according to policy rules. In network, policy enforce point (PEP) decide its network controlled unit. For InterServ and DiffServ, we will adopt different policy control methods as following: (1) In InterServ, traffic uses resource reservation protocol (RSVP) to guarantee the network resource. (2) In DiffServ, policy server controls the DiffServ code points and per hop behavior (PHB), its PDP distributes information to each network node. Policy server will function as following: information searching; decision mechanism; decision delivering; auto-configuration. In order to prove the effectiveness of QoS policy control, we make the corrective simulation.

76 FR 20708 - Agency Information Collection Activities: Proposed Collection; Comments Requested: Elder Justice...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... perceive the priorities for elder justice. Concept mapping is a well-documented method of applied research..., and research priorities in the field of elder abuse, neglect, and exploitation and to help develop a... understanding of the complex interrelationships between policy, practice, and research elements in the field of...

THE GENOTOXICITY OF PRIORITY POLYCYCLIC AROMATIC HYDROCARBONS IN COMPLEX MIXTURES

EPA Science Inventory

Risk assessment of complex environmental samples suffers from difficulty in identifying toxic components, inadequacy of available toxicity data, and a paucity of knowledge about the behavior of geno(toxic) substances in complex mixtures. Lack of information about the behavior of ...

Managing change in the care of children with complex needs: healthcare providers' perspectives.

PubMed

Law, James; McCann, Dolly; O'May, Fiona

2011-12-01

 This paper is a report of a descriptive qualitative study of the role and activities of nursing and allied health professionals caring for children with complex needs in a community setting. Health care is changing in terms of service provision and delivery, with an increased focus on person-centred care, prevention and community-based services. The role of nursing and allied health professionals is central to these changes but is not well described in terms of capacity, or the knowledge and skills required to meet increasing demand. Within four Health Boards, semi-structured telephone interviews were conducted in 2007 with three nursing and four allied health managers, followed by four focus groups with 15 nursing and 11 allied health practitioners; in addition, three nurses and one speech therapist were interviewed by telephone. Respondents identified challenges related to communication and information systems, equity of service provision, family-centred care and partnership working. Generic and specialized knowledge and skills are needed, although providing the right skills in the right place can often prove problematic with potential implications for service provision. Findings support the adoption of integrated partnership working, going beyond the identification of key professionals, to developing a set of criteria against which future service provision could be judged. Research priorities were identified; comparative evaluation of services, better understanding of the transition process and a clearer sense of the individual's response to the increasing customization of services. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Shared-resource computing for small research labs.

PubMed

Ackerman, M J

1982-04-01

A real time laboratory computer network is described. This network is composed of four real-time laboratory minicomputers located in each of four division laboratories and a larger minicomputer in a centrally located computer room. Off the shelf hardware and software were used with no customization. The network is configured for resource sharing using DECnet communications software and the RSX-11-M multi-user real-time operating system. The cost effectiveness of the shared resource network and multiple real-time processing using priority scheduling is discussed. Examples of utilization within a medical research department are given.

A Strategic Framework for Improving the Patient Experience in Hospitals.

PubMed

Birkelien, Natalie L

Hospitals are taking new approaches to satisfy consumers and deliver on customer expectations by enhancing their patients' comprehensive experience. The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey and value-based purchasing initiatives have tied reimbursement to patient satisfaction scores, bringing patient perspectives on care to the forefront of hospitals' strategic priorities. This essay reviews the patient experience literature and argues that hospitals should adopt an expanded approach beyond HCAHPS measures to enhance the patient experience. Such an approach allows providers to deliver quality outcomes that satisfy patients' wants and needs.

Rollout and Installation of Risk Management at the IMINT Directorate, National Reconnaissance Office

DTIC Science & Technology

1999-12-01

strong entry into the 21st century. Programs were forging multiple mission partners and customers into cohesive program delivery systems that could...requires a higher level of cooperation and a meshing of divergent program operations. Customer requirements are more complex and distributed. As a... customers , such as the U.S. Central Intelligence Agency (CIA) and the U.S. Department of Defense (DoD), can warn of potential trouble spots around the

Research Priorities for School Nursing in the United Arab Emirates (UAE).

PubMed

Al-Yateem, Nabeel; Docherty, Charles; Brenner, Maria; Alhosany, Jameela; Altawil, Hanan; Al-Tamimi, Muna

2017-10-01

School nurses are challenged with more children having complex conditions, who are now surviving into school age. This is paralleled by a shift in focus of health systems toward primary care, and national efforts to develop the health-care services, especially those offered to vulnerable populations. Being at the forefront of this change, school nurses in United Arab Emirates (UAE) are finding themselves under pressure to adapt to and facilitate these changes both by improving their practice and by contributing to its underpinning evidence. A cross-sectional design was used in this study in which 370 school nurses participated, identifying 11 research priorities. The three most important, as ranked by participants, were management of children with complex health-care needs; nutrition, obesity, and lifestyle issues of schoolchildren; and managing illnesses, injuries, and emergencies in schools and provision of medical support. These priorities should direct future research activities in the field.

Challenges to counseling customers at the pharmacy counter--why do they exist?

PubMed

Kaae, Susanne; Traulsen, Janine Morgall; Nørgaard, Lotte Stig

2012-01-01

Challenges to engage pharmacy customers in medicine dialogues at the counter have been identified comprising a new and extended clinical role for pharmacists in the health care system. This article seeks to expand understanding of factors involved in successful interaction at the pharmacy counter between customers and pharmacy staff to develop their relationship further. Practical challenges to customer encounters experienced by community pharmacists are discussed using theory from the field of mainly inter-relational communication and particular studies on pharmacy communication. Preconceived expectation of customers, the type of question asked by pharmacy staff, and differences in perception of illness and medicines between staff and customers are discussed. Both staff and customer influence the outcome of attempts by pharmacy staff to engage customers in dialogue about their medicine use through a complex mechanism of interaction. It is recommended that practitioners and researchers begin to distinguish, both theoretically and practically, between the content of a conversation and the underlying relationship when exploring and further developing the therapeutic relationship between pharmacy personnel and customers. Copyright © 2012 Elsevier Inc. All rights reserved.

Optical characterization of the InFocus TVT-6000 liquid crystal television (LCTV) using custom drive electronics

NASA Astrophysics Data System (ADS)

Duffey, Jason N.; Jones, Brian K.; Loudin, Jeffrey A.; Booth, Joseph J.

1995-03-01

Liquid crystal televisions are popular low-cost spatial light modulators. One LCTV of interest is found in the InFocus TVT-6000 television projector. A wavefront splitting interferometer has been constructed and analyzed for measuring the complex characteristics of these modulators, including phase and amplitude coupling. The results of this evaluation using the TVT-6000 projector drive electronics have been presented in a previous work. This work will present results of the complex characterizations of these modulators using custom drive electronics.

Human-tracking strategies for a six-legged rescue robot based on distance and view

NASA Astrophysics Data System (ADS)

Pan, Yang; Gao, Feng; Qi, Chenkun; Chai, Xun

2016-03-01

Human tracking is an important issue for intelligent robotic control and can be used in many scenarios, such as robotic services and human-robot cooperation. Most of current human-tracking methods are targeted for mobile/tracked robots, but few of them can be used for legged robots. Two novel human-tracking strategies, view priority strategy and distance priority strategy, are proposed specially for legged robots, which enable them to track humans in various complex terrains. View priority strategy focuses on keeping humans in its view angle arrange with priority, while its counterpart, distance priority strategy, focuses on keeping human at a reasonable distance with priority. To evaluate these strategies, two indexes(average and minimum tracking capability) are defined. With the help of these indexes, the view priority strategy shows advantages compared with distance priority strategy. The optimization is done in terms of these indexes, which let the robot has maximum tracking capability. The simulation results show that the robot can track humans with different curves like square, circular, sine and screw paths. Two novel control strategies are proposed which specially concerning legged robot characteristics to solve human tracking problems more efficiently in rescue circumstances.

Custom-Made Total Talonavicular Replacement in a Professional Rock Climber.

PubMed

Giannini, Sandro; Cadossi, Matteo; Mazzotti, Antonio; Ramponi, Laura; Belvedere, Claudio; Leardini, Alberto

Professional athletes are often eager to resume sporting activities at preinjury levels. When facing the challenge of restoring joint function after a complex articular fracture, innovative solutions must be explored. We describe the results of what we believe to be the first custom-made talonavicular prosthesis implanted in a professional rock climber who had developed post-traumatic ankle and talonavicular arthritis as sequelae of a complex talar and navicular fracture. Using computed tomography scan reconstruction of the contralateral healthy ankle and direct metal laser sintering, a custom-made talonavicular prosthesis was obtained and implanted using an anteromedial approach. The patient was clinically and radiographically evaluated every 6 months after surgery for 30 months. A 3-dimensional videofluoroscopic analysis was performed to assess the range of motion about the prosthesis. At the last follow-up visit, the functional scores were excellent (Tegner activity scale score of 9 of 10), and he had completely resumed his sporting activity. The American Orthopaedic Foot and Ankle Society score had increased from 36 to 81 points, and no signs of radiolucency were observed on the radiographs. The 3-dimensional videofluoroscopic analysis showed 15° of dorsiflexion and 4° of plantar flexion at the ankle. A customized solution is an option when the patient's expectations are not likely to be met by standard treatment, such as arthrodesis. A custom-made talonavicular prosthesis can be an effective solution for complex ankle injury sequelae in patients demanding high functionality. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

[A Triage Scale for Mental Health, an Emerging Practice, a Value-Add for Measuring Demand for Mental Health Services].

PubMed

Boucher, Lucie

Objectives The article aims to present two studies supporting the development of l'Échelle brève de triage RIFCAS en santé mentale 0-99 ans, a measuring instrument used to determine - based on the level of customer demand, seriousness, and urgent need for intervention - the priority of a mental health service across all age groups.Methods Both versions have been subject to a measurement interjudge agreement that is compared against the judgment of professionals and other comparison tools.Results The results produced by the interjudge agreement reflect significant correlations with the priorities established by l'Échelle brève de triage RIFCAS en santé mentale 0-99 ans, the judgment of professional experts and the usual instruments used.Conclusion The final version of the triage scale provides an objective measure for the priority that should be given to all mental health service requests - these encompass all recognized and essential clinical information. Clinicians can rely on a reliable and proven instrument to prioritize service requests before placing them on the waiting list. The use of this instrument facilitates the development of a common procedure between professionals and ensures a fair and safe treatment of users.

77 FR 42029 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

... to market participants that add or remove liquidity in the complex order book (``maker/taker fees and... quotations for complex order strategies in the complex order book.\\8\\ Given this enhancement to the complex... Customer orders, the Exchange has adopted maker fees that apply to transactions in the complex order book...

Congestion control strategy on complex network with privilege traffic

NASA Astrophysics Data System (ADS)

Li, Shi-Bao; He, Ya; Liu, Jian-Hang; Zhang, Zhi-Gang; Huang, Jun-Wei

The congestion control of traffic is one of the most important studies in complex networks. In the previous congestion algorithms, all the network traffic is assumed to have the same priority, and the privilege of traffic is ignored. In this paper, a privilege and common traffic congestion control routing strategy (PCR) based on the different priority of traffic is proposed, which can be devised to cope with the different traffic congestion situations. We introduce the concept of privilege traffic in traffic dynamics for the first time and construct a new traffic model which taking into account requirements with different priorities. Besides, a new factor Ui is introduced by the theoretical derivation to characterize the interaction between different traffic routing selection, furthermore, Ui is related to the network throughput. Since the joint optimization among different kinds of traffic is accomplished by PCR, the maximum value of Ui can be significantly reduced and the network performance can be improved observably. The simulation results indicate that the network throughput with PCR has a better performance than the other strategies. Moreover, the network capacity is improved by 25% at least. Additionally, the network throughput is also influenced by privilege traffic number and traffic priority.

Ocean Research Priorities: Similarities and Differences among Scientists, Policymakers, and Fishermen in the United States

PubMed Central

Mason, Julia G.; Rudd, Murray A.; Crowder, Larry B.

2017-01-01

Abstract Understanding and solving complex ocean conservation problems requires cooperation not just among scientific disciplines but also across sectors. A recently published survey that probed research priorities of marine scientists, when provided to ocean stakeholders, revealed some agreement on priorities but also illuminated key differences. Ocean acidification, cumulative impacts, bycatch effects, and restoration effectiveness were in the top 10 priorities for scientists and stakeholder groups. Significant priority differences were that scientists favored research questions about ocean acidification and marine protected areas; policymakers prioritized questions about habitat restoration, bycatch, and precaution; and fisheries sector resource users called for the inclusion of local ecological knowledge in policymaking. These results quantitatively demonstrate how different stakeholder groups approach ocean issues and highlight the need to incorporate other types of knowledge in the codesign of solutions-oriented research, which may facilitate cross-sectoral collaboration. PMID:28533565

Ocean Research Priorities: Similarities and Differences among Scientists, Policymakers, and Fishermen in the United States.

PubMed

Mason, Julia G; Rudd, Murray A; Crowder, Larry B

2017-05-01

Understanding and solving complex ocean conservation problems requires cooperation not just among scientific disciplines but also across sectors. A recently published survey that probed research priorities of marine scientists, when provided to ocean stakeholders, revealed some agreement on priorities but also illuminated key differences. Ocean acidification, cumulative impacts, bycatch effects, and restoration effectiveness were in the top 10 priorities for scientists and stakeholder groups. Significant priority differences were that scientists favored research questions about ocean acidification and marine protected areas; policymakers prioritized questions about habitat restoration, bycatch, and precaution; and fisheries sector resource users called for the inclusion of local ecological knowledge in policymaking. These results quantitatively demonstrate how different stakeholder groups approach ocean issues and highlight the need to incorporate other types of knowledge in the codesign of solutions-oriented research, which may facilitate cross-sectoral collaboration.

Factors affecting occupational therapists' decision to join their regional professional association: Facteurs influençant la décision des ergothérapeutes de joindre les rangs de leur association professionnelle régionale.

PubMed

Reyes, Angelica N; Brown, Cary A

2018-01-01

Voluntary occupational therapy organizations fill an important role. However, recruitment and retention can be problematic. Little is known about factors influencing occupational therapists to join/maintain membership in professional associations. This study investigated factors influencing occupational therapists' decision to join/remain members of their association. An electronic survey was carried out and data were analyzed using SPSS software and manual categorization of open-ended comments. Two hundred and fifty-four therapists responded. Generation of new ideas, opportunities for professional development, self-improvement, maintenance of standards, improvement of the profession, and discounts on equipment/educational opportunities were significant factors in deciding to join the organization. The factors perceived as priorities varied in relation to participants' year of graduation. More-customized strategies, reflecting priorities that vary during a therapist's career path, may need to be employed to best address recruitment and retention across the range of therapists' needs and goals.

77 FR 68856 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing of Amendments No. 1, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

... increased order flow provides better execution quality on the Exchange because customers enjoy greater price... flow, and on the extent of price improvement provided to directed customer Complex Orders. The data... 707 is intended to prohibit coordinated actions between Directed Participants and order flow providers...

78 FR 11243 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-15

.... Specifically, the Exchange is proposing to increase the threshold in which it waives customer transaction fees, implement a $0.25 marketing fee for trading in SPY and QQQ options, and eliminate the complex order... customer transaction fee in ``ETF, ETN and HOLDRs Options.'' Currently, the Exchange waives transaction...

It Takes Two to Tango: Customization and Standardization as Colluding Logics in Healthcare Comment on "(Re) Making the Procrustean Bed Standardization and Customization as Competing Logics in Healthcare".

PubMed

Greenfield, David; Eljiz, Kathy; Butler-Henderson, Kerryn

2017-06-28

The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, 'standardization' and 'customization,' and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being 'competing' logics in healthcare, standardization and customization are long standing 'colluding' logics. Mannion and Exworthy's call for further sustained work to understand this complex, contested space is endorsed, noting that it is critical to inform future debates and service decisions. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Social customer relationship management: taking advantage of Web 2.0 and Big Data technologies.

PubMed

Orenga-Roglá, Sergio; Chalmeta, Ricardo

2016-01-01

The emergence of Web 2.0 and Big Data technologies has allowed a new customer relationship strategy based on interactivity and collaboration called Social Customer Relationship Management (Social CRM) to be created. This enhances customer engagement and satisfaction. The implementation of Social CRM is a complex task that involves different organisational, human and technological aspects. However, there is a lack of methodologies to assist companies in these processes. This paper shows a novel methodology that helps companies to implement Social CRM, taking into account different aspects such as social customer strategy, the Social CRM performance measurement system, the Social CRM business processes, or the Social CRM computer system. The methodology was applied to one company in order to validate and refine it.

Future Research Priorities for Morbidity Control of Lymphedema.

PubMed

Narahari, S R; Aggithaya, Madhur Guruprasad; Moffatt, Christine; Ryan, T J; Keeley, Vaughan; Vijaya, B; Rajendran, P; Karalam, S B; Rajagopala, S; Kumar, N K; Bose, K S; Sushma, K V

2017-01-01

Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research. A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients' priorities. One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema. A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP.

Future Research Priorities for Morbidity Control of Lymphedema

PubMed Central

Narahari, S R; Aggithaya, Madhur Guruprasad; Moffatt, Christine; Ryan, T J; Keeley, Vaughan; Vijaya, B; Rajendran, P; Karalam, S B; Rajagopala, S; Kumar, N K; Bose, K S; Sushma, K V

2017-01-01

Background: Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research. Methods: A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients’ priorities. Results: One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema. Conclusion: A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP. PMID:28216723

A Quality Function Deployment-Based Expert System for Cotton Fibre Selection

NASA Astrophysics Data System (ADS)

Chakraborty, Shankar; Prasad, Kanika

2018-01-01

The textile industries have seen resurgence in customers' demand for quality products during the preceding few years. This product range is extremely varied, with hand-spun and hand-woven products at one end of the spectrum, while products manufactured from the capital intensive sophisticated machineries at the other end. Since, cotton fibres are predominantly employed as the raw material for manufacturing these products, their proper selection is crucial for sustainable development of the textile/spinning industries. However, availability of numerous cotton fibre alternatives with various physical properties makes this selection process unwieldy and time consuming. Thus, there is need for a structured approach that can incorporate customers' demand into the selection process. This paper demonstrates the application of a structured and logical procedure of selecting the best cotton fibre type to fulfill a set of specified end product requirements through design and development of a quality function deployment (QFD)-based expert system. The QFD technique is employed here to provide due importance to the customers' spoken and unspoken needs, and subsequently calculate the priority weights of the considered cotton fibre properties. Two real time illustrative examples are presented to explicate the applicability and potentiality of the developed expert system to resolve cotton fibre selection problems.

A hands-on experience of the voice of customer analysis in maternity care from Iran.

PubMed

Aghlmand, Siamak; Lameei, Aboulfath; Small, Rhonda

2010-01-01

The purpose of this paper is to describe the use of voice of customer (VoC) analysis in a maternity care case study, where the aim was to identify the most important requirements of women giving birth and to determine targets for the improvement of maternity care in Fayazbakhsh Hospital in Tehran, Iran. The tools of VoC analysis were used to identify: the main customer segment of maternity care; the most important of women's needs and requirements; the level of maternal satisfaction with delivered services at the study hospital and at a competitor; the nature of women's of requirements (termed Kano levels: assumed, expected, and unexpected); and the priorities of the study hospital for meeting these requirements. Women identified the well-being of mother and baby as the most important requirements. Women's satisfaction with the services was, with a few exceptions, low to moderate. Services related to most of the maternal requirements were ranked better in the competitor hospital than the study hospital. The results form a solid basis for achieving improvements in the processes of care for mothers and babies. The paper presents a systematic approach to VoC analysis in health care settings as a basis for clinical process improvement initiatives.

A Quality Function Deployment-Based Expert System for Cotton Fibre Selection

NASA Astrophysics Data System (ADS)

Chakraborty, Shankar; Prasad, Kanika

2018-06-01

The textile industries have seen resurgence in customers' demand for quality products during the preceding few years. This product range is extremely varied, with hand-spun and hand-woven products at one end of the spectrum, while products manufactured from the capital intensive sophisticated machineries at the other end. Since, cotton fibres are predominantly employed as the raw material for manufacturing these products, their proper selection is crucial for sustainable development of the textile/spinning industries. However, availability of numerous cotton fibre alternatives with various physical properties makes this selection process unwieldy and time consuming. Thus, there is need for a structured approach that can incorporate customers' demand into the selection process. This paper demonstrates the application of a structured and logical procedure of selecting the best cotton fibre type to fulfill a set of specified end product requirements through design and development of a quality function deployment (QFD)-based expert system. The QFD technique is employed here to provide due importance to the customers' spoken and unspoken needs, and subsequently calculate the priority weights of the considered cotton fibre properties. Two real time illustrative examples are presented to explicate the applicability and potentiality of the developed expert system to resolve cotton fibre selection problems.

A multi-stakeholder evaluation of the Baltimore City virtual supermarket program.

PubMed

Lagisetty, Pooja; Flamm, Laura; Rak, Summer; Landgraf, Jessica; Heisler, Michele; Forman, Jane

2017-10-23

Increasing access to healthy foods and beverages in disadvantaged communities is a public health priority due to alarmingly high rates of obesity. The Virtual Supermarket Program (VSP) is a Baltimore City Health Department program that uses online grocery ordering to deliver food to low-income neighborhoods. This study evaluates stakeholder preferences and barriers of program implementation. This study assessed the feasibility, sustainability and efficacy of the VSP by surveying 93 customers and interviewing 14 programmatic stakeholders who had recently used the VSP or been involved with program design and implementation. We identified the following themes: The VSP addressed transportation barriers and food availability. The VSP impacted customers and the city by including improving food purchasing behavior, creating a food justice "brand for the city", and fostering a sense of community. Customers appreciated using Supplemental Nutrition Assistance Program (SNAP) benefits to pay for groceries, but policy changes are needed allow online processing of SNAP benefits. This evaluation summarizes lessons learned and serves as a guide to other public health leaders interested in developing similar programs. Provisions in the U.S. Department of Agriculture (USDA) Farm Bill 2014 allow for select grocers to pilot online transactions with SNAP benefits. If these pilots are efficacious, the VSP model could be easily disseminated.

Study protocol: developing a decision system for inclusive housing: applying a systematic, mixed-method quasi-experimental design.

PubMed

Zeeman, Heidi; Kendall, Elizabeth; Whitty, Jennifer A; Wright, Courtney J; Townsend, Clare; Smith, Dianne; Lakhani, Ali; Kennerley, Samantha

2016-03-15

Identifying the housing preferences of people with complex disabilities is a much needed, but under-developed area of practice and scholarship. Despite the recognition that housing is a social determinant of health and quality of life, there is an absence of empirical methodologies that can practically and systematically involve consumers in this complex service delivery and housing design market. A rigorous process for making effective and consistent development decisions is needed to ensure resources are used effectively and the needs of consumers with complex disability are properly met. This 3-year project aims to identify how the public and private housing market in Australia can better respond to the needs of people with complex disabilities whilst simultaneously achieving key corporate objectives. First, using the Customer Relationship Management framework, qualitative (Nominal Group Technique) and quantitative (Discrete Choice Experiment) methods will be used to quantify the housing preferences of consumers and their carers. A systematic mixed-method, quasi-experimental design will then be used to quantify the development priorities of other key stakeholders (e.g., architects, developers, Government housing services etc.) in relation to inclusive housing for people with complex disabilities. Stakeholders randomly assigned to Group 1 (experimental group) will participate in a series of focus groups employing Analytical Hierarchical Process (AHP) methodology. Stakeholders randomly assigned to Group 2 (control group) will participate in focus groups employing existing decision making processes to inclusive housing development (e.g., Risk, Opportunity, Cost, Benefit considerations). Using comparative stakeholder analysis, this research design will enable the AHP methodology (a proposed tool to guide inclusive housing development decisions) to be tested. It is anticipated that the findings of this study will enable stakeholders to incorporate consumer housing preferences into commercial decisions. Housing designers and developers will benefit from the creation of a parsimonious set of consumer-led housing preferences by which to make informed investments in future housing and contribute to future housing policy. The research design has not been applied in the Australian research context or elsewhere, and will provide a much needed blueprint for market investment to develop viable, consumer directed inclusive housing options for people with complex disability.

Life Cost Based FMEA Manual: A Step by Step Guide to Carrying Out a Cost-based Failure Modes and Effects Analysis

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

Rhee, Seung; Spencer, Cherrill; /Stanford U. /SLAC

2009-01-23

Failure occurs when one or more of the intended functions of a product are no longer fulfilled to the customer's satisfaction. The most critical product failures are those that escape design reviews and in-house quality inspection and are found by the customer. The product may work for a while until its performance degrades to an unacceptable level or it may have not worked even before customer took possession of the product. The end results of failures which may lead to unsafe conditions or major losses of the main function are rated high in severity. Failure Modes and Effects Analysis (FMEA)more » is a tool widely used in the automotive, aerospace, and electronics industries to identify, prioritize, and eliminate known potential failures, problems, and errors from systems under design, before the product is released (Stamatis, 1997). Several industrial FMEA standards such as those published by the Society of Automotive Engineers, US Department of Defense, and the Automotive Industry Action Group employ the Risk Priority Number (RPN) to measure risk and severity of failures. The Risk Priority Number (RPN) is a product of 3 indices: Occurrence (O), Severity (S), and Detection (D). In a traditional FMEA process design engineers typically analyze the 'root cause' and 'end-effects' of potential failures in a sub-system or component and assign penalty points through the O, S, D values to each failure. The analysis is organized around categories called failure modes, which link the causes and effects of failures. A few actions are taken upon completing the FMEA worksheet. The RPN column generally will identify the high-risk areas. The idea of performing FMEA is to eliminate or reduce known and potential failures before they reach the customers. Thus, a plan of action must be in place for the next task. Not all failures can be resolved during the product development cycle, thus prioritization of actions must be made within the design group. One definition of detection difficulty (D) is how well the organization controls the development process. Another definition relates to the detectability of a particular failure in the product when it is in the hands of the customer. The former asks 'What is the chance of catching the problem before we give it to the customer'? The latter asks 'What is the chance of the customer catching the problem before the problem results in a catastrophic failure?' (Palady, 1995) These differing definitions confuse the FMEA users when one tries to determine detection difficulty. Are we trying to measure how easy it is to detect where a failure has occurred or when it has occurred? Or are we trying to measure how easy or difficult it is to prevent failures? Ordinal scale variables are used to rank-order industries such as, hotels, restaurants, and movies (Note that a 4 star hotel is not necessarily twice as good as a 2 star hotel). Ordinal values preserve rank in a group of items, but the distance between the values cannot be measured since a distance function does not exist. Thus, the product or sum of ordinal variables loses its rank since each parameter has different scales. The RPN is a product of 3 independent ordinal variables, it can indicate that some failure types are 'worse' than others, but give no quantitative indication of their relative effects. To resolve the ambiguity of measuring detection difficulty and the irrational logic of multiplying 3 ordinal indices, a new methodology was created to overcome these shortcomings, Life Cost-Based FMEA. Life Cost-Based FMEA measures failure/risk in terms of monetary cost. Cost is a universal parameter that can be easily related to severity by engineers and others. Thus, failure cost can be estimated using the following simplest form: Expected Failure Cost = {sup n}{Sigma}{sub i=1}p{sub i}c{sub i}, p: Probability of a particular failure occurring; c: Monetary cost associated with that particular failure; and n: Total number of failure scenarios. FMEA is most effective when there are inputs into it from all concerned disciplines of the product development team. However, FMEA is a long process and can become tedious and won't be effective if too many people participate. An ideal team should have 3 to 4 people from: design, manufacturing, and service departments if possible. Depending on how complex the system is, the entire process can take anywhere from one to four weeks working full time. Thus, it is important to agree to the time commitment before starting the analysis else, anxious managers might stop the procedure before it is completed.« less

Development of a monitoring instrument to assess the performance of the Swiss primary care system.

PubMed

Ebert, Sonja T; Pittet, Valérie; Cornuz, Jacques; Senn, Nicolas

2017-11-29

The Swiss health system is customer-driven with fee-for-service paiement scheme and universal coverage. It is highly performing but expensive and health information systems are scarcely implemented. The Swiss Primary Care Active Monitoring (SPAM) program aims to develop an instrument able to describe the performance and effectiveness of the Swiss PC system. Based on a Literature review we developed a conceptual framework and selected indicators according to their ability to reflect the Swiss PC system. A two round modified RAND method with 24 inter-/national experts took place to select primary/secondary indicators (validity, clarity, agreement). A limited set of priority indicators was selected (importance, priority) in a third round. A conceptual framework covering three domains (structure, process, outcome) subdivided into twelve sections (funding, access, organisation/ workflow of resources, (Para-)Medical training, management of knowledge, clinical-/interpersonal care, health status, satisfaction of PC providers/ consumers, equity) was generated. 365 indicators were pre-selected and 335 were finally retained. 56 were kept as priority indicators.- Among the remaining, 199 were identified as primary and 80 as secondary indicators. All domains and sections are represented. The development of the SPAM program allowed the construction of a consensual instrument in a traditionally unregulated health system through a modified RAND method. The selected 56 priority indicators render the SPAM instrument a comprehensive tool supporting a better understanding of the Swiss PC system's performance and effectiveness as well as in identifying potential ways to improve quality of care. Further challenges will be to update indicators regularly and to assess validity and sensitivity-to-change over time.

76 FR 71089 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

... Receipts/SPDRs (``SPY''); (ii) the PowerShares QQQ Trust (``QQQ'') [reg]; (iii) Apple, Inc. (``AAPL''); (iv... initially filed a proposed rule change \\6\\ to pay a different Customer Complex Order Rebate to Add Liquidity... the Exchange from continuing to increase its order flow. Currently, the Exchange pays a Customer...

Critical Reflections on Realist Review: Insights from Customizing the Methodology to the Needs of Participatory Research Assessment

ERIC Educational Resources Information Center

Jagosh, Justin; Pluye, Pierre; Wong, Geoff; Cargo, Margaret; Salsberg, Jon; Bush, Paula L.; Herbert, Carol P.; Green, Lawrence W.; Greenhalgh, Trish; Macaulay, Ann C.

2014-01-01

Realist review has increased in popularity as a methodology for complex intervention assessment. Our experience suggests that the process of designing a realist review requires its customization to areas under investigation. To elaborate on this idea, we first describe the logic underpinning realist review and then present critical reflections on…

Assuring quality in high-consequence engineering

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

Hoover, Marcey L.; Kolb, Rachel R.

2014-03-01

In high-consequence engineering organizations, such as Sandia, quality assurance may be heavily dependent on staff competency. Competency-dependent quality assurance models are at risk when the environment changes, as it has with increasing attrition rates, budget and schedule cuts, and competing program priorities. Risks in Sandia's competency-dependent culture can be mitigated through changes to hiring, training, and customer engagement approaches to manage people, partners, and products. Sandia's technical quality engineering organization has been able to mitigate corporate-level risks by driving changes that benefit all departments, and in doing so has assured Sandia's commitment to excellence in high-consequence engineering and national service.

Bottom-up priority setting revised. A second evaluation of an institutional intervention in a Swedish health care organisation.

PubMed

Waldau, Susanne

2015-09-01

Transparent priority setting in health care based on specific ethical principles is requested by the Swedish Parliament since 1997. Implementation has been limited. In this case, transparent priority setting was performed for a second time round and engaged an entire health care organisation. Objectives were to refine a bottom-up priority setting process, reach a political decision on service limits to make reallocation towards higher prioritised services possible, and raise systems knowledge. An action research approach was chosen. The national model for priority setting was used with addition of dimensions costs, volumes, gender distribution and feasibility. The intervention included a three step process and specific procedures for each step which were created, revised and evaluated regarding factual and functional aspects. Evaluations methods included analyses of documents, recordings and surveys. Vertical and horizontal priority setting occurred and resources were reallocated. Participants' attitudes remained positive, however less so than in the first priority setting round. Identifying low-priority services was perceived difficult, causing resentment and strategic behaviour. The horizontal stage served to raise quality of the knowledge base, level out differences in ranking of services and raise systems knowledge. Existing health care management systems do not meet institutional requirements for transparent priority setting. Introducing transparent priority setting constitutes a complex institutional reform, which needs to be driven by management/administration. Strong managerial commitment is required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2018-02-01

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

Linking service quality, customer satisfaction, and behavioral intention.

PubMed

Woodside, A G; Frey, L L; Daly, R T

1989-12-01

Based on the service quality and script theory literature, a framework of relationships among service quality, customer satisfaction, and behavioral intention for service purchases is proposed. Specific models are developed from the general framework and the models are applied and tested for the highly complex and divergent consumer service of overnight hospital care. Service quality, customer satisfaction, and behavioral intention data were collected from recent patients of two hospitals. The findings support the specific models and general framework. Implications for theory, service marketing, and future research are discussed.

[Custom-made implant for complex facial reconstruction: A case of total replacement of temporo-mandibular joint, zygomatic arch and malar bone].

PubMed

Guillier, D; Moris, V; See, L-A; Girodon, M; Wajszczak, B-L; Zwetyenga, N

2017-02-01

Total prosthetic replacement of the temporo-mandibular joint (TMJ) has become a common procedure, but it is usually limited to the TMJ itself. We report about one case of complex prosthetic joint reconstruction extending to the neighbouring bony structures. A 57-year-old patient, operated several times for a cranio-facial fibrous dysplasia, presented with a recurring TMJ ankylosis and a complexe latero-facial bone loss on the right side. We performed a reconstruction procedure including the TMJ, the zygomatic arch and the malar bone by mean of custom made composite prosthesis (chrome-cobalt-molybdenum-titanium and polyethylene). Five years postoperatively, mouth opening, nutrition, pain and oral hygiene were significantly improved. Nowadays technical possibilities allow for complex facial alloplastic reconstructions with good medium term results. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

mobilityRERC state of the science: How science influences public policy in seating and mobility.

PubMed

Hostak, Rita S; Edwards, Doran; Sprigle, Stephen

2013-11-01

In the United States (US), wheeled mobility and seating equipment is classified as Durable Medical Equipment (DME). DME includes a wide array of devices including canes, walkers, home oxygen equipment, hospital beds, and wheelchairs. Seating and mobility devices reflect a wide range of DME, from relatively simple standard manual wheelchairs and cushions to highly complex manual and power wheelchairs and custom seating systems. This wide range of complexity results in a wide range of policies that govern the provision of seating and mobility equipment. This article results from a presentation during the Wheeled Mobility Rehabilitation Engineering Research Center's (RERC's) State of the Science Conference in 2012. The presentation was designed to proffer key concepts related to coverage policies and policy decision-making. Topics covered include an introduction to key policy issues impacting seating and mobility equipment, a description of the barriers that prevent or hinder research being used to inform coverage policy decisions, discussion of the challenges surrounding evidence-based policy decisions regarding seating and mobility, and suggestions of strategies for including policy makers and other stakeholders in setting research priorities and in reporting research findings. In the United States, wheeled mobility and seating equipment are classified as Durable Medical Equipments which are governed by a wide range of policies. Researchers should be encouraged to supplement research articles with articles that explicitly address clinical and policy implications of the work. Policy-makers should be encouraged to engage researchers to insure the breadth of knowledge and evidence is represented and understood.

Relationships between Personal Traits, Emotional Intelligence, Internal Marketing, Service Management, and Customer Orientation in Korean Outpatient Department Nurses.

PubMed

Kim, Bogyun; Lee, Jia

2016-03-01

Current increase and complexity of medical tests and surgical procedures at outpatient department (OPD) require OPD nurses to have customer orientation focusing on various customers' interests and needs. The purpose of this study was to identify the factors associated with customer orientation in nurses working at OPD of hospitals. The study used a descriptive correlational design with cross-sectional survey. The study settings were four general hospitals in Seoul and its metropolitan area. Data were collected from 138 OPD nurses from general hospitals. Study variables were personal traits, emotional intelligence, internal marketing, service management and customer orientation. Factors associated with customer orientation were identified as conscientiousness from personal traits (β = .37, p < .001), emotional intelligence from individual characteristics (β = .21, p = .032), and internal marketing from environmental characteristics (β = .21, p = .001). Hospital administrators should support OPD nurses to cultivate sincere and sociable personal traits and emotional intelligence, and to consider employees as internal customers to improve patient-oriented services and satisfaction. Copyright © 2015. Published by Elsevier B.V.

Mapping High Dimensional Sparse Customer Requirements into Product Configurations

NASA Astrophysics Data System (ADS)

Jiao, Yao; Yang, Yu; Zhang, Hongshan

2017-10-01

Mapping customer requirements into product configurations is a crucial step for product design, while, customers express their needs ambiguously and locally due to the lack of domain knowledge. Thus the data mining process of customer requirements might result in fragmental information with high dimensional sparsity, leading the mapping procedure risk uncertainty and complexity. The Expert Judgment is widely applied against that background since there is no formal requirements for systematic or structural data. However, there are concerns on the repeatability and bias for Expert Judgment. In this study, an integrated method by adjusted Local Linear Embedding (LLE) and Naïve Bayes (NB) classifier is proposed to map high dimensional sparse customer requirements to product configurations. The integrated method adjusts classical LLE to preprocess high dimensional sparse dataset to satisfy the prerequisite of NB for classifying different customer requirements to corresponding product configurations. Compared with Expert Judgment, the adjusted LLE with NB performs much better in a real-world Tablet PC design case both in accuracy and robustness.

78 FR 19777 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... executions Electronic complex order QCC executions executions Marketing Marketing Fee/rebate Marketing charge Fee/rebate charge Fee/rebate Marketing charge Fee/rebate charge Customer $0.00 N/A $0.00 N/A $0.00 N/A... cleared by The Options Clearing Corporation (``OCC'') in the customer range, regardless of the exchange on...

Developing custom fire behavior fuel models from ecologically complex fuel structures for upper Atlantic Coastal Plain forests

Treesearch

Bernard R. Parresol; Joe H. Scott; Anne Andreu; Susan Prichard; Laurie Kurth

2012-01-01

Currently geospatial fire behavior analyses are performed with an array of fire behavior modeling systems such as FARSITE, FlamMap, and the Large Fire Simulation System. These systems currently require standard or customized surface fire behavior fuel models as inputs that are often assigned through remote sensing information. The ability to handle hundreds or...

Custom E-Learning Experiences: Working with Profiles for Multiple Content Sources Access and Adaptation

ERIC Educational Resources Information Center

Ferretti, Stefano; Roccetti, Marco; Salomoni, Paola; Mirri, Silvia

2009-01-01

It is a common belief that the problem of extracting learners' profiles to be used for delivering custom learning experiences is a closed case. Yet, practical solutions do not completely cope with the complex issue of capturing all the features of users, especially those of heterogeneous learners, who may have special needs or characteristics…

Assessing the Cost of Large-Scale Power Outages to Residential Customers.

PubMed

Baik, Sunhee; Davis, Alexander L; Morgan, M Granger

2018-02-01

Residents in developed economies depend heavily on electric services. While distributed resources and a variety of new smart technologies can increase the reliability of that service, adopting them involves costs, necessitating tradeoffs between cost and reliability. An important input to making such tradeoffs is an estimate of the value customers place on reliable electric services. We develop an elicitation framework that helps individuals think systematically about the value they attach to reliable electric service. Our approach employs a detailed and realistic blackout scenario, full or partial (20 A) backup service, questions about willingness to pay (WTP) using a multiple bounded discrete choice method, information regarding inconveniences and economic losses, and checks for bias and consistency. We applied this method to a convenience sample of residents in Allegheny County, Pennsylvania, finding that respondents valued a kWh for backup services they assessed to be high priority more than services that were seen as low priority ($0.75/kWh vs. $0.51/kWh). As more information about the consequences of a blackout was provided, this difference increased ($1.2/kWh vs. $0.35/kWh), and respondents' uncertainty about the backup services decreased (Full: $11 to $9.0, Partial: $13 to $11). There was no evidence that the respondents were anchored by their previous WTP statements, but they demonstrated only weak scope sensitivity. In sum, the consumer surplus associated with providing a partial electric backup service during a blackout may justify the costs of such service, but measurement of that surplus depends on the public having accurate information about blackouts and their consequences. © 2017 Society for Risk Analysis.

An analytical approach to customer requirement information processing

NASA Astrophysics Data System (ADS)

Zhou, Zude; Xiao, Zheng; Liu, Quan; Ai, Qingsong

2013-11-01

'Customer requirements' (CRs) management is a key component of customer relationship management (CRM). By processing customer-focused information, CRs management plays an important role in enterprise systems (ESs). Although two main CRs analysis methods, quality function deployment (QFD) and Kano model, have been applied to many fields by many enterprises in the past several decades, the limitations such as complex processes and operations make them unsuitable for online businesses among small- and medium-sized enterprises (SMEs). Currently, most SMEs do not have the resources to implement QFD or Kano model. In this article, we propose a method named customer requirement information (CRI), which provides a simpler and easier way for SMEs to run CRs analysis. The proposed method analyses CRs from the perspective of information and applies mathematical methods to the analysis process. A detailed description of CRI's acquisition, classification and processing is provided.

Pharmacy Interns’ Perception of Their Professional Role

PubMed Central

Vestergaard, Stense; Traulsen, Janine Marie; Kaae, Susanne

2017-01-01

Objective. To determine pharmacy interns' perceptions of the roles of the pharmacist and pharmacy prior to and during the pharmacy internship and to compare their perceptions with those of their supervisors and the pharmacy customers. Methods. Questionnaires were completed and submitted by 395 interns prior to and during their internships. Interns interviewed their supervisors and two to four local customers. Results. Ninety-six supervisors and 285 customers were interviewed. Interns' perceptions were aligned with those of their supervisors in that both groups indicated that a pharmacist's most important role is that of a clinical leader. Furthermore, interns' perception of customers' expectations regarding the pharmacy were well aligned with customers' actual expectations with regard to service. Conclusion. The study illustrates that interns became more aligned in their perceptions due to the pharmacy internship. The study findings imply that the pharmacy internship influences interns' perception of the pharmacy and pharmacist's roles in society through complex individual and social learning processes. PMID:28289300

Management of Customer Service in Terms of Logistics Information Systems

NASA Astrophysics Data System (ADS)

Kampf, Rudolf; Ližbetinová, Lenka; Tišlerová, Kamila

2017-03-01

This paper is focused on perceiving the logistic services as the competition advantage in frame of the ecommerce. Customers consider their purchases in its complexity and all the logistic services should be designed to meet with customers' preferences as much as possible. Our aim was to identify and evaluate of customers perceiving in frame of sales proposals offered by e-shops. Collected data of research were processed with the usage of cluster analysis. The aim of this paper is to present the results and conclusions from this research with focus on the elements of logistics services within e-commerce. These outputs can be used for knowledge base of information systems through which enterprises evaluate their decisions and selection of variants. For the enterprise, it is important to appropriate decisions about resource allocation and design of the structure of logistics services were set based on real customer preferences.

Informational analysis involving application of complex information system

NASA Astrophysics Data System (ADS)

Ciupak, Clébia; Vanti, Adolfo Alberto; Balloni, Antonio José; Espin, Rafael

The aim of the present research is performing an informal analysis for internal audit involving the application of complex information system based on fuzzy logic. The same has been applied in internal audit involving the integration of the accounting field into the information systems field. The technological advancements can provide improvements to the work performed by the internal audit. Thus we aim to find, in the complex information systems, priorities for the work of internal audit of a high importance Private Institution of Higher Education. The applied method is quali-quantitative, as from the definition of strategic linguistic variables it was possible to transform them into quantitative with the matrix intersection. By means of a case study, where data were collected via interview with the Administrative Pro-Rector, who takes part at the elaboration of the strategic planning of the institution, it was possible to infer analysis concerning points which must be prioritized at the internal audit work. We emphasize that the priorities were identified when processed in a system (of academic use). From the study we can conclude that, starting from these information systems, audit can identify priorities on its work program. Along with plans and strategic objectives of the enterprise, the internal auditor can define operational procedures to work in favor of the attainment of the objectives of the organization.

78 FR 78437 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing of Amendment Nos. 1 and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... distinctions between non-Complex Orders on the BOX Book \\8\\ and Complex Orders. COPIP also would preserve the already established execution priority of interest on the BOX Book over Complex Orders \\9\\ by providing that the bids and offers on the BOX Book for the individual legs of a Strategy (``BOX Book Interest...

PantherPix hybrid pixel γ-ray detector for radio-therapeutic applications

NASA Astrophysics Data System (ADS)

Neue, G.; Benka, T.; Havránek, M.; Hejtmánek, M.; Janoška, Z.; Kafka, V.; Korchak, O.; Lednický, D.; Marčišovská, M.; Marčišovský, M.; Popule, J.; Şmarhák, J.; Şvihra, P.; Tomášek, L.; Vrba, V.; Konček, O.; Semmler, M.

2018-02-01

This work focuses on the design of a semiconductor pixelated γ-ray camera with a pixel size of 1 mm2. The cost of semiconductor manufacturing is mainly driven by economies of scale, which makes silicon the cheapest semiconductor material due to its widespread utilization. The energy of γ-photons used in radiation therapy are in a range, in which the dominant interaction mechanism is Compton scattering in every conceivable sensor material. Since the Compton scattering cross section is linearly dependent upon Z, it is less rewarding to utilize high Z sensor materials, than it is in the case of X-ray detectors (X-rays interact also via the photoelectric effect whose cross section scales proportional to Zn, where n is ≈ 4,5). For the stated reasons it was decided to use the low Z material silicon (Z = 14) despite its worse detection efficiency. The proposed detector is designed as a portal detector to be used in radiation cancer therapy. The purpose of the detector is to ensure correct patient alignment, spatial dose monitoring and to provide the feedback necessary for an emergency shutdown should the spatial dose rate profile deviate from the treatment plan. Radiation therapy equipment is complex and thus failure prone and the consequences of malfunction are often life threatening. High spatial resolution and high detection efficiency are not a high design priority. The detector design priorities are focused up on radiation hardness, robustness and the ability to cover a large area cost efficiently. The quintessential idea of the PanterPix detector exploits the relaxed spatial resolution requirement to achieve the stated goals. The detector is composed of submodules, each submodule consisting of a Si sensor with an array of fully depleted detection diodes and 8 miniature custom design readout ASICs collecting and measuring the minuscule charge packets generated due to ionization in the PN junctions.

Transfer of skill engendered by complex task training under conditions of variable priority.

PubMed

Boot, Walter R; Basak, Chandramallika; Erickson, Kirk I; Neider, Mark; Simons, Daniel J; Fabiani, Monica; Gratton, Gabriele; Voss, Michelle W; Prakash, Ruchika; Lee, HyunKyu; Low, Kathy A; Kramer, Arthur F

2010-11-01

We explored the theoretical underpinnings of a commonly used training strategy by examining issues of training and transfer of skill in the context of a complex video game (Space Fortress, Donchin, 1989). Participants trained using one of two training regimens: Full Emphasis Training (FET) or Variable Priority Training (VPT). Transfer of training was assessed with a large battery of cognitive and psychomotor tasks ranging from basic laboratory paradigms measuring reasoning, memory, and attention to complex real-world simulations. Consistent with previous studies, VPT accelerated learning and maximized task mastery. However, the hypothesis that VPT would result in broader transfer of training received limited support. Rather, transfer was most evident in tasks that were most similar to the Space Fortress game itself. Results are discussed in terms of potential limitations of the VPT approach. Copyright © 2010 Elsevier B.V. All rights reserved.

CRM System Implementation in a Multinational Enterprise

NASA Astrophysics Data System (ADS)

Mishra, Alok; Mishra, Deepti

The concept of customer relationship management (CRM) resonates with managers in today's competitive economy. As more and more organizations realize the significance of becoming customer-centric in today's competitive era, they embrace CRM as a core business strategy. CRM an integration of information technology and relationship marketing provides the infrastructure that facilitates long-term relationship building with customers at an enterprise-wide level. Successful CRM implementation is a complex, expensive and rarely technical projects. This paper presents the successful implementation of CRM in a multinational organization. This study will facilitate in understanding transition, constraints and implementation of CRM in multinational enterprises.

Planning the Recreational-Educational Complex of the Alabama Space and Rocket Center.

ERIC Educational Resources Information Center

Burkhalter, Bettye B.; Kartis, Alexia M.

1983-01-01

Planning for the Alabama Space and Rocket Center's new recreational-educational complex included (1) goal establishment, (2) needs assessment (including accessibility for the disabled), (3) environmental impact analysis, (4) formulation of objectives and priorities, and (5) strategy development to meet objectives, as well as preparation of a…

Companies and the customers who hate them.

PubMed

McGovern, Gail; Moon, Youngme

2007-06-01

Why do companies bind customers with contracts, bleed them with fees, and baffle them with fine print? Because bewildered customers, who often make bad purchasing decisions, can be highly profitable. Most firms that profit from customers' confusion are on a slippery slope. Over time, their customer-centric strategies for delivering value have evolved into company-centric strategies for extracting it. Not surprisingly, when a rival comes along with a friendlier alternative, customers defect. Adversarial value-extracting strategies are common in such industries as cell phone service, retail banking, and health clubs. Overly complex product and pricing options, for example, may have been designed to serve various segments. But in fact they take advantage of how difficult it is for customers to predict their needs (such as how many cell phone minutes they'll use each month) and make it hard for them to choose the right product. Similarly, penalties and fees, which may have been instituted to offset the costs of undesirable customer behavior, like bouncing checks, turn out to be very profitable. As a result, companies have no incentive to help customers avoid them. Tactics like these generate bad publicity and fuel customer defections, creating opportunities for competitors. Virgin Mobile USA, for example, has lured millions of angry cell phone customers away from the incumbents by offering a straightforward plan with no hidden fees, no time-of-day restrictions, and no contracts. ING Direct, now the fourth-largest thrift bank in the United States, offers accounts with no fees, no tiered interest rates, and no minimums. In industries where squeezing value from customers is commonplace, companies that dismantle these harmful practices and design a transparent, value-creating offer can head off customer retaliation and spur rapid growth.

Modelling and multi objective optimization of WEDM of commercially Monel super alloy using evolutionary algorithms

NASA Astrophysics Data System (ADS)

Varun, Sajja; Reddy, Kalakada Bhargav Bal; Vardhan Reddy, R. R. Vishnu

2016-09-01

In this research work, development of a multi response optimization technique has been undertaken, using traditional desirability analysis and non-traditional particle swarm optimization techniques (for different customer's priorities) in wire electrical discharge machining (WEDM). Monel 400 has been selected as work material for experimentation. The effect of key process parameters such as pulse on time (TON), pulse off time (TOFF), peak current (IP), wire feed (WF) were on material removal rate (MRR) and surface roughness(SR) in WEDM operation were investigated. Further, the responses such as MRR and SR were modelled empirically through regression analysis. The developed models can be used by the machinists to predict the MRR and SR over a wide range of input parameters. The optimization of multiple responses has been done for satisfying the priorities of multiple users by using Taguchi-desirability function method and particle swarm optimization technique. The analysis of variance (ANOVA) is also applied to investigate the effect of influential parameters. Finally, the confirmation experiments were conducted for the optimal set of machining parameters, and the betterment has been proved.

76 FR 22158 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

... ``Complex Order'' to: (i) Pay a Customer Complex Order Rebate for Adding Liquidity of $0.25 per contract for...'') \\4\\; the PowerShares QQQ Trust (``QQQ'')[supreg]; and Apple, Inc. (``AAPL'') [sic]. The Exchange is... Exchange pays the following Complex Order Rebates for Adding Liquidity in the Select Symbols: Specialist...

The GIS map coloring support decision-making system based on case-based reasoning and simulated annealing algorithm

NASA Astrophysics Data System (ADS)

Deng, Shuang; Xiang, Wenting; Tian, Yangge

2009-10-01

Map coloring is a hard task even to the experienced map experts. In the GIS project, usually need to color map according to the customer, which make the work more complex. With the development of GIS, more and more programmers join the project team, which lack the training of cartology, their coloring map are harder to meet the requirements of customer. From the experience, customers with similar background usually have similar tastes for coloring map. So, we developed a GIS color scheme decision-making system which can select color schemes of similar customers from case base for customers to select and adjust. The system is a BS/CS mixed system, the client side use JSP and make it possible for the system developers to go on remote calling of the colors scheme cases in the database server and communicate with customers. Different with general case-based reasoning, even the customers are very similar, their selection may have difference, it is hard to provide a "best" option. So, we select the Simulated Annealing Algorithm (SAA) to arrange the emergence order of different color schemes. Customers can also dynamically adjust certain features colors based on existing case. The result shows that the system can facilitate the communication between the designers and the customers and improve the quality and efficiency of coloring map.

To the point: medical education, technology, and the millennial learner.

PubMed

Hopkins, Laura; Hampton, Brittany S; Abbott, Jodi F; Buery-Joyner, Samantha D; Craig, LaTasha B; Dalrymple, John L; Forstein, David A; Graziano, Scott C; McKenzie, Margaret L; Pradham, Archana; Wolf, Abigail; Page-Ramsey, Sarah M

2018-02-01

This article, from the "To The Point" series that was prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, provides an overview of the characteristics of millennials and describes how medical educators can customize and reframe their curricula and teaching methods to maximize millennial learning. A literature search was performed to identify articles on generational learning. We summarize the importance of understanding the attitudes, ideas, and priorities of millennials to tailor educational methods to stimulate and enhance learning. Where relevant, a special focus on the obstetrics and gynecology curriculum is highlighted. Copyright © 2017 Elsevier Inc. All rights reserved.

IS THERE A DOWNSIDE TO CUSTOMIZING CARE? IMPLICATIONS OF GENERAL AND PATIENT-SPECIFIC TREATMENT STRATEGIES

PubMed Central

Johnson, Paul E.; O’Connor, Patrick J.

2009-01-01

The use of general clinical guidelines versus customization of patient care presents a dilemma for clinicians managing chronic illness. We propose that the performance of customized strategies for the management of chronic illness depends on accurate patient categorization, and inaccurate categorization can lead to worse performance than that achievable using a general clinical guideline. This paper is based on an analysis of a basic utility model differentiating outcomes between the use of general management strategies and customized strategies. Results of the analysis have four implications regarding the design and use of clinical guidelines and customization of care: (1) the balance between the applications of more general strategies versus customization depends on the specificity and accuracy of the strategies; (2) adoption of clinical guidelines may be stifled as the complexity of guidelines increases to account for growing evidence; (3) clinical inertia (i.e. the failure to intensify an indicated treatment) can be a rational response to strategy specificity and the probability of misapplication; and, (4) current clinical guidelines and other decision-support tools may be improved if they accommodate the need for customization of strategies for some patients while providing support for proper categorization of patients. PMID:20367722

What do District Health Planners in Tanzania think about improving priority setting using 'Accountability for Reasonableness'?

PubMed Central

Mshana, Simon; Shemilu, Haji; Ndawi, Benedict; Momburi, Roman; Olsen, Oystein Evjen; Byskov, Jens; Martin, Douglas K

2007-01-01

Background Priority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD) and cost-effectiveness analysis (CEA), which is helpful, but insufficient because it focuses on a narrow range of values – need and efficiency – and not the full range of relevant values, including legitimacy and fairness. 'Accountability for reasonableness' is a conceptual framework for legitimate and fair priority setting and is empirically based and ethically justified. It connects priority setting to broader, more fundamental, democratic deliberative processes that have an impact on social justice and equity. Can 'accountability for reasonableness' be helpful for improving priority setting in less wealthy countries? Methods In 2005, Tanzanian scholars from the Primary Health Care Institute (PHCI) conducted 6 capacity building workshops with senior health staff, district planners and managers, and representatives of the Tanzanian Ministry of Health to discussion improving priority setting in Tanzania using 'accountability for reasonableness'. The purpose of this paper is to describe this initiative and the participants' views about the approach. Results The approach to improving priority setting using 'accountability for reasonableness' was viewed by district decision makers with enthusiastic favour because it was the first framework that directly addressed their priority setting concerns. High level Ministry of Health participants were also very supportive of the approach. Conclusion Both Tanzanian district and governmental health planners viewed the 'accountability for reasonableness' approach with enthusiastic favour because it was the first framework that directly addressed their concerns. PMID:17997824

Applications of Computer Technology in Complex Craniofacial Reconstruction.

PubMed

Day, Kristopher M; Gabrick, Kyle S; Sargent, Larry A

2018-03-01

To demonstrate our use of advanced 3-dimensional (3D) computer technology in the analysis, virtual surgical planning (VSP), 3D modeling (3DM), and treatment of complex congenital and acquired craniofacial deformities. We present a series of craniofacial defects treated at a tertiary craniofacial referral center utilizing state-of-the-art 3D computer technology. All patients treated at our center using computer-assisted VSP, prefabricated custom-designed 3DMs, and/or 3D printed custom implants (3DPCI) in the reconstruction of craniofacial defects were included in this analysis. We describe the use of 3D computer technology to precisely analyze, plan, and reconstruct 31 craniofacial deformities/syndromes caused by: Pierre-Robin (7), Treacher Collins (5), Apert's (2), Pfeiffer (2), Crouzon (1) Syndromes, craniosynostosis (6), hemifacial microsomia (2), micrognathia (2), multiple facial clefts (1), and trauma (3). In select cases where the available bone was insufficient for skeletal reconstruction, 3DPCIs were fabricated using 3D printing. We used VSP in 30, 3DMs in all 31, distraction osteogenesis in 16, and 3DPCIs in 13 cases. Utilizing these technologies, the above complex craniofacial defects were corrected without significant complications and with excellent aesthetic results. Modern 3D technology allows the surgeon to better analyze complex craniofacial deformities, precisely plan surgical correction with computer simulation of results, customize osteotomies, plan distractions, and print 3DPCI, as needed. The use of advanced 3D computer technology can be applied safely and potentially improve aesthetic and functional outcomes after complex craniofacial reconstruction. These techniques warrant further study and may be reproducible in various centers of care.

Marketing strategy: an essential component of business development for academic health centers.

PubMed

Souba, W W; Haluck, C A; Menezes, M A

2001-02-01

Historically, academic health centers (AHCs) have detached themselves from commercialism and entrepreneurism, viewing these activities as being inconsistent with many of their core academic values. Word-of-mouth promotion was their primary, if not sole, marketing strategy. Less emphasis was placed on preparing, pricing, distributing, and promoting these services to targeted audiences. Understanding customers' needs was not a top priority. The marketing strategies and tools currently being developed and utilized by AHCs were reviewed. In an effort to attract customers and win contracts, AHCs are aggressively marketing themselves by designing new services, promoting those services much more intensely, restructuring the entire distribution system that delivers those services, and crafting pricing strategies that build in flexibility. With growing frequency, these marketing tactics are part and parcel of a carefully crafted data-driven strategic plan designed to meet the business-development goals of the institution. In order to carry out their missions, AHCs have recognized that they can no longer rest on their "ivory tower" laurels. They must learn how to market themselves in a market economy.

Telerehabilitation and emerging virtual reality approaches to stroke rehabilitation.

PubMed

Putrino, David

2014-12-01

Stroke is the leading cause of permanent motor disability in the United States, and the rapidly aging population makes finding large-scale treatment solutions to this problem a national priority. Telerehabilitation is an emerging approach that is being used for the effective treatment of multiple diseases, and is beginning to show promise for stroke. The purpose of this review is to identify and highlight the areas of telerehabilitation that require the most research attention. Although there are many different forms of telerehabilitation approaches being attempted for stroke, the only approach that is currently showing moderate-strong evidence for efficacy is videogame-driven telerehabilitation (VGDT). However, targeted research is still required to determine the feasibility of VGDT: metrics regarding system usability, cost-effectiveness, and data privacy concerns still require major attention. VGDT is an emerging approach that shows enormous promise for stroke rehabilitation. Future studies should focus less on developing custom task controllers and therapy games and more on developing innovative, online data acquisition and analytics pipelines, as well as understanding the patient population so that the rehabilitation experience can be better customized.

Local laser-strengthening: Customizing the forming behavior of car body steel sheets

NASA Astrophysics Data System (ADS)

Wagner, M.; Jahn, A.; Beyer, E.; Balzani, D.

2018-05-01

Future trends in designing lightweight components especially for automotive applications increasingly require complex and delicate structures with highest possible level of capacity [1]. The manufacturing of metallic car body components is primarily realized by deep or stretch drawing. The forming process of especially cold rolled and large-sized components is typically characterized by inhomogeneous stress and strain distributions. As a result, the avoidance of undesirable deep drawing effects like earing and local necking is among the greatest challenges in forming complex car body structures [2]. Hence, a novel local laser-treatment approach with the objective of customizing the forming behavior of car body steel sheets is currently explored.

A comprehensive custom panel design for routine hereditary cancer testing: preserving control, improving diagnostics and revealing a complex variation landscape.

PubMed

Castellanos, Elisabeth; Gel, Bernat; Rosas, Inma; Tornero, Eva; Santín, Sheila; Pluvinet, Raquel; Velasco, Juan; Sumoy, Lauro; Del Valle, Jesús; Perucho, Manuel; Blanco, Ignacio; Navarro, Matilde; Brunet, Joan; Pineda, Marta; Feliubadaló, Lidia; Capellá, Gabi; Lázaro, Conxi; Serra, Eduard

2017-01-04

We wanted to implement an NGS strategy to globally analyze hereditary cancer with diagnostic quality while retaining the same degree of understanding and control we had in pre-NGS strategies. To do this, we developed the I2HCP panel, a custom bait library covering 122 hereditary cancer genes. We improved bait design, tested different NGS platforms and created a clinically driven custom data analysis pipeline. The I2HCP panel was developed using a training set of hereditary colorectal cancer, hereditary breast and ovarian cancer and neurofibromatosis patients and reached an accuracy, analytical sensitivity and specificity greater than 99%, which was maintained in a validation set. I2HCP changed our diagnostic approach, involving clinicians and a genetic diagnostics team from panel design to reporting. The new strategy improved diagnostic sensitivity, solved uncertain clinical diagnoses and identified mutations in new genes. We assessed the genetic variation in the complete set of hereditary cancer genes, revealing a complex variation landscape that coexists with the disease-causing mutation. We developed, validated and implemented a custom NGS-based strategy for hereditary cancer diagnostics that improved our previous workflows. Additionally, the existence of a rich genetic variation in hereditary cancer genes favors the use of this panel to investigate their role in cancer risk.

European Teacher Education: A Fractal Perspective Tackling Complexity

ERIC Educational Resources Information Center

Caena, Francesa; Margiotta, Umberto

2010-01-01

This article takes stock of the complex scenario of the European education space in its past, present and future developments, which highlights the priorities of the modernisation, improvement and convergence of the goals for education and training systems in the knowledge and learning society. The critical case of teacher education is then…

The best motivator priorities parents choose via analytical hierarchy process

NASA Astrophysics Data System (ADS)

Farah, R. N.; Latha, P.

2015-05-01

Motivation is probably the most important factor that educators can target in order to improve learning. Numerous cross-disciplinary theories have been postulated to explain motivation. While each of these theories has some truth, no single theory seems to adequately explain all human motivation. The fact is that human beings in general and pupils in particular are complex creatures with complex needs and desires. In this paper, Analytic Hierarchy Process (AHP) has been proposed as an emerging solution to move towards too large, dynamic and complex real world multi-criteria decision making problems in selecting the most suitable motivator when choosing school for their children. Data were analyzed using SPSS 17.0 ("Statistical Package for Social Science") software. Statistic testing used are descriptive and inferential statistic. Descriptive statistic used to identify respondent pupils and parents demographic factors. The statistical testing used to determine the pupils and parents highest motivator priorities and parents' best priorities using AHP to determine the criteria chosen by parents such as school principals, teachers, pupils and parents. The moderating factors are selected schools based on "Standard Kualiti Pendidikan Malaysia" (SKPM) in Ampang. Inferential statistics such as One-way ANOVA used to get the significant and data used to calculate the weightage of AHP. School principals is found to be the best motivator for parents in choosing school for their pupils followed by teachers, parents and pupils.

Rating Correlations Between Customs Codes and Export Control Lists: Assessing the Needs and Challenges

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

Chatelus, Renaud; Heine, Pete

Correlation tables are the linchpins between the customs codes used to classify commodities in international trade and the control lists used for strategic trade control (STC) purposes. While understanding the customs classification system can help the STC community better understand strategic trade flows, better identify which trade operations require permits, and more effectively detect illegal exports, the two systems are different in scope, philosophy, content, and objectives. Many indications point to the limitations of these correlation tables, and it is important to understand the nature of the limitations and the complex underlying reasons to conceive possible improvements. As part ofmore » its Strategic Trade and Supply Chain Analytics Initiative, Argonne National Laboratory supported a study of a subset of the European Union’s TARIC correlation table. The study included development of a methodology and an approach to rating the quality and relevance of individual correlations. The study was intended as a first step to engage the STC community in deflections and initiatives to improve the conception and use of correlations, and its conclusions illustrate the scope and complex nature of the challenges to overcome. This paper presents the two classification systems, analyzes the needs for correlation tables and the complex challenges associated with them, summarizes key findings, and proposes possible ways forward.« less

Critical reflections on realist review: insights from customizing the methodology to the needs of participatory research assessment.

PubMed

Jagosh, Justin; Pluye, Pierre; Wong, Geoff; Cargo, Margaret; Salsberg, Jon; Bush, Paula L; Herbert, Carol P; Green, Lawrence W; Greenhalgh, Trish; Macaulay, Ann C

2014-06-01

Realist review has increased in popularity as a methodology for complex intervention assessment. Our experience suggests that the process of designing a realist review requires its customization to areas under investigation. To elaborate on this idea, we first describe the logic underpinning realist review and then present critical reflections on our application experience, organized in seven areas. These are the following: (1) the challenge of identifying middle range theory; (2) addressing heterogeneity and lack of conceptual clarity; (3) the challenge of appraising the quality of complex evidence; (4) the relevance of capturing unintended outcomes; (5) understanding the process of context, mechanism, and outcome (CMO) configuring; (6) incorporating middle-range theory in the CMO configuration process; and (7) using middle range theory to advance the conceptualization of outcomes - both visible and seemingly 'hidden'. One conclusion from our experience is that the degree of heterogeneity of the evidence base will determine whether theory can drive the development of review protocols from the outset, or will follow only after an intense period of data immersion. We hope that presenting a critical reflection on customizing realist review will convey how the methodology can be tailored to the often complex and idiosyncratic features of health research, leading to innovative evidence syntheses. Copyright © 2013 John Wiley & Sons, Ltd.

Reducing beam shaper alignment complexity: diagnostic techniques for alignment and tuning

NASA Astrophysics Data System (ADS)

Lizotte, Todd E.

2011-10-01

Safe and efficient optical alignment is a critical requirement for industrial laser systems used in a high volume manufacturing environment. Of specific interest is the development of techniques to align beam shaping optics within a beam line; having the ability to instantly verify by a qualitative means that each element is in its proper position as the beam shaper module is being aligned. There is a need to reduce these types of alignment techniques down to a level where even a newbie to optical alignment will be able to complete the task. Couple this alignment need with the fact that most laser system manufacturers ship their products worldwide and the introduction of a new set of variables including cultural and language barriers, makes this a top priority for manufacturers. Tools and methodologies for alignment of complex optical systems need to be able to cross these barriers to ensure the highest degree of up time and reduce the cost of maintenance on the production floor. Customers worldwide, who purchase production laser equipment, understand that the majority of costs to a manufacturing facility is spent on system maintenance and is typically the largest single controllable expenditure in a production plant. This desire to reduce costs is driving the trend these days towards predictive and proactive, not reactive maintenance of laser based optical beam delivery systems [10]. With proper diagnostic tools, laser system developers can develop proactive approaches to reduce system down time, safe guard operational performance and reduce premature or catastrophic optics failures. Obviously analytical data will provide quantifiable performance standards which are more precise than qualitative standards, but each have a role in determining overall optical system performance [10]. This paper will discuss the use of film and fluorescent mirror devices as diagnostic tools for beam shaper module alignment off line or in-situ. The paper will also provide an overview methodology showing how it is possible to reduce complex alignment directions into a simplified set of instructions for layman service engineers.

Health, safety, and environmental risk assessment of steel production complex in central Iran using TOPSIS.

PubMed

Jozi, S A; Majd, N Moradi

2014-10-01

This research was carried out with the aim of presenting an environmental management plan for steel production complex (SPC) in central Iran. Following precise identification of the plant activities as well as the study area, possible sources of environmental pollution and adverse impacts on the air quality, water, soil, biological environment, socioeconomic and cultural environment, and health and safety of the employees were determined considering the work processes of the steel complex. Afterwards, noise, wastewater, and air pollution sources were measured. Subsequently, factors polluting the steel complex were identified by TOPSIS and then prioritized using Excel Software. Based on the obtained results, the operation of the furnaces in hot rolling process with the score 1, effluent derived from hot rolling process with the score 0.565, nonprincipal disposal and dumping of waste at the plant enclosure with the score 0.335, walking beam process with the score 1.483 respectively allocated themselves the highest priority in terms of air, water, soil and noise pollution. In terms of habitats, land cover and socioeconomic and cultural environment, closeness to the forest area and the existence of four groups of wildlife with the score 1.106 and proximity of villages and residential areas to the plant with the score 3.771 respectively enjoyed the highest priorities while impressibility and occupational accidents with the score 2.725 and cutting and welding operations with score 2.134 had the highest priority among health and safety criteria. Finally, strategies for the control of pollution sources were identified and Training, Monitoring and environmental management plan of the SPC was prepared.

Decision-Making in Management of the Complex Trauma Patient: Changing the Mindset of the non-trauma Surgeon.

PubMed

Sonesson, Linda; Boffard, Kenneth; Lundberg, Lars; Rydmark, Martin; Karlgren, Klas

2018-01-16

European surgeons are frequently subspecialized and trained primarily in elective surgical techniques. As trauma leaders, they may occasionally have to deal with complex polytrauma, advanced management techniques, differing priorities, and the need for multidisciplinary care. There is a lack of expertise, experience, and a low trauma volume, as well as a lack of research, with limited support as to the decision-making and teaching challenges present. We studied what experienced trauma experts describe as the challenges that are specific to the advanced surgical decision-making required, whether civilian, humanitarian, or military. Design-based research using combined methods including interviews, reviews of authentic trauma cases, and video-recorded resuscitations performed at a high-volume civilian academic trauma center. Several educational dilemmas were identified: (1) thinking physiologically, (2) the application of damage control resuscitation and surgery, (3) differing priorities and time management, (4) impact of environment, (5) managing limited resources, (6) lack of general surgical skills, (7) different cultural behavior, and (8) ethical issues. The challenges presented, and the educational domains identified, constitute a basis for improved development of education and training in complex surgical decision-making. This study contributes new knowledge about the mindset required for decision-making in patients with complex multisystem trauma and competing priorities of care. This is, especially important in countries having a low intensity of trauma in both military and civilian environments, and consequential limited skills, and lack of expertise. Guidelines focused on the same decision-making process, using virtual patients and blended learning, can be developed.

ScanImage: flexible software for operating laser scanning microscopes.

PubMed

Pologruto, Thomas A; Sabatini, Bernardo L; Svoboda, Karel

2003-05-17

Laser scanning microscopy is a powerful tool for analyzing the structure and function of biological specimens. Although numerous commercial laser scanning microscopes exist, some of the more interesting and challenging applications demand custom design. A major impediment to custom design is the difficulty of building custom data acquisition hardware and writing the complex software required to run the laser scanning microscope. We describe a simple, software-based approach to operating a laser scanning microscope without the need for custom data acquisition hardware. Data acquisition and control of laser scanning are achieved through standard data acquisition boards. The entire burden of signal integration and image processing is placed on the CPU of the computer. We quantitate the effectiveness of our data acquisition and signal conditioning algorithm under a variety of conditions. We implement our approach in an open source software package (ScanImage) and describe its functionality. We present ScanImage, software to run a flexible laser scanning microscope that allows easy custom design.

Reproductive isolation, evolutionary distinctiveness and setting conservation priorities: The case of European lake whitefish and the endangered North Sea houting (Coregonus spp.)

PubMed Central

2008-01-01

Background Adaptive radiation within fishes of the Coregonus lavaretus complex has created numerous morphs, posing significant challenges for taxonomy and conservation priorities. The highly endangered North Sea houting (C. oxyrhynchus; abbreviated NSH) has been considered a separate species from European lake whitefish (C. lavaretus; abbreviated ELW) due to morphological divergence and adaptation to oceanic salinities. However, its evolutionary and taxonomic status is controversial. We analysed microsatellite DNA polymorphism in nine populations from the Jutland Peninsula and the Baltic Sea, representing NSH (three populations, two of which are reintroduced) and ELW (six populations). The objectives were to: 1) analyse postglacial recolonization of whitefish in the region; 2) assess the evolutionary distinctiveness of NSH, and 3) apply several approaches for defining conservation units towards setting conservation priorities for NSH. Results Bayesian cluster analyses of genetic differentiation identified four major groups, corresponding to NSH and three groups of ELW (Western Jutland, Central Jutland, Baltic Sea). Estimates of historical migration rates indicated recolonization in a north-eastern direction, suggesting that all except the Baltic Sea population predominantly represent postglacial recolonization via the ancient Elbe River. Contemporary gene flow has not occurred between NSH and ELW, with a divergence time within the last 4,000 years suggested from coalescence methods. NSH showed interbreeding with ELW when brought into contact by stocking. Thus, reproductive isolation of NSH was not absolute, although possible interbreeding beyond the F1 level could not be resolved. Conclusion Fishes of the C. lavaretus complex in the Jutland Peninsula originate from the same recolonization event. NSH has evolved recently and its species status may be questioned due to incomplete reproductive isolation from ELW, but it was shown to merit consideration as an independent conservation unit. Yet, application of several approaches for defining conservation units generated mixed outcomes regarding its conservation priority. Within the total species complex, it remains one among many recently evolved unique forms. Its uniqueness and high conservation priority is more evident at a local geographical scale, where conservation efforts will also benefit populations of a number of other endangered species. PMID:18471278

A 3D bioprinting exemplar of the consequences of the regulatory requirements on customized processes.

PubMed

Hourd, Paul; Medcalf, Nicholas; Segal, Joel; Williams, David J

2015-01-01

Computer-aided 3D printing approaches to the industrial production of customized 3D functional living constructs for restoration of tissue and organ function face significant regulatory challenges. Using the manufacture of a customized, 3D-bioprinted nasal implant as a well-informed but hypothetical exemplar, we examine how these products might be regulated. Existing EU and USA regulatory frameworks do not account for the differences between 3D printing and conventional manufacturing methods or the ability to create individual customized products using mechanized rather than craft approaches. Already subject to extensive regulatory control, issues related to control of the computer-aided design to manufacture process and the associated software system chain present additional scientific and regulatory challenges for manufacturers of these complex 3D-bioprinted advanced combination products.

Comprehensive Care

MedlinePlus

... also a priority. Your Whole Health, Your Whole Team: Managing Your Complex MS Symptoms Webinar/telelearning presented ... MS and how to form a comprehensive care team. Watch now Share Smaller Text Larger Text Print ...

Comparative study on the customization of natural language interfaces to databases.

PubMed

Pazos R, Rodolfo A; Aguirre L, Marco A; González B, Juan J; Martínez F, José A; Pérez O, Joaquín; Verástegui O, Andrés A

2016-01-01

In the last decades the popularity of natural language interfaces to databases (NLIDBs) has increased, because in many cases information obtained from them is used for making important business decisions. Unfortunately, the complexity of their customization by database administrators make them difficult to use. In order for a NLIDB to obtain a high percentage of correctly translated queries, it is necessary that it is correctly customized for the database to be queried. In most cases the performance reported in NLIDB literature is the highest possible; i.e., the performance obtained when the interfaces were customized by the implementers. However, for end users it is more important the performance that the interface can yield when the NLIDB is customized by someone different from the implementers. Unfortunately, there exist very few articles that report NLIDB performance when the NLIDBs are not customized by the implementers. This article presents a semantically-enriched data dictionary (which permits solving many of the problems that occur when translating from natural language to SQL) and an experiment in which two groups of undergraduate students customized our NLIDB and English language frontend (ELF), considered one of the best available commercial NLIDBs. The experimental results show that, when customized by the first group, our NLIDB obtained a 44.69 % of correctly answered queries and ELF 11.83 % for the ATIS database, and when customized by the second group, our NLIDB attained 77.05 % and ELF 13.48 %. The performance attained by our NLIDB, when customized by ourselves was 90 %.

Quality evaluation in health care services based on customer-provider relationships.

PubMed

Eiriz, Vasco; Figueiredo, José António

2005-01-01

To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically. Systematic review of the literature. Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non-technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence). This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing-oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.

Setting priorities for teaching and learning: an innovative needs assessment for a new family medicine program in Lao PDR.

PubMed

Kanashiro, Jeanie; Hollaar, Gwen; Wright, Bruce; Nammavongmixay, Khamphong; Roff, Sue

2007-03-01

Lao People's Democratic Republic (Lao PDR) is a small, tropical, landlocked country in southeast Asia. It is one of the least developed countries in the region, and its socioeconomic indicators are among the lowest 25% in the world. The World Health Organization has long called for increased equity in primary health care access around the world. To meet this need in Lao PDR, the Family Medicine Specialist Program was developed, a Lao-generated postgraduate training program designed to produce community-oriented primary care practitioners to serve the rural, remote areas of Lao PDR, where 80% of the population lives. An innovative method of needs assessment was required to determine the health care priorities to be met by this new program. Through the use of a modified Delphi technique, local key leaders in medical education, clinical specialists, and teachers were consulted to develop prioritized objectives for the hospital-based curriculum of the program. By setting priorities for teaching and learning in the unique and needy circumstances of Lao PDR, a novel approach to curriculum planning in a low-income country was explored and ultimately formed the foundation of the new curriculum. This process served to direct the allocation of scarce resources during implementation of this groundbreaking program. More importantly, this model of needs assessment could potentially be used to customize medical curricula in other low-income countries facing challenges similar to those in Lao PDR.

Binge Eating among Women Veterans in Primary Care: Comorbidities and Treatment Priorities.

PubMed

Rosenbaum, Diane L; Kimerling, Rachel; Pomernacki, Alyssa; Goldstein, Karen M; Yano, Elizabeth M; Sadler, Anne G; Carney, Diane; Bastian, Lori A; Bean-Mayberry, Bevanne A; Frayne, Susan M

2016-01-01

Little is known about the clinical profile and treatment priorities of women with binge eating disorder (BED), a diagnosis new to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders. We identified comorbidities and patients' treatment priorities, because these may inform implementation of clinical services. Data were collected from women veteran primary care patients. Analyses compared those who screened positive for BED (BED+), and those without any binge eating symptoms (BED-). Frequencies of comorbid medical and psychological disorders were high in the BED+ group. The BED+ group's self-identified most common treatment priorities were mood concerns (72.2%), weight loss (66.7%), and body image/food issues (50%). Among those with obesity, a greater proportion of the BED+ group indicated body image/food issues was their top treatment priority (12.9% vs. 2.8%; p < .01), suggesting that these patients may be more apt to seek treatment beyond weight management for their problematic eating patterns. Women primary care patients with BED demonstrate high medical and psychological complexity; their subjective treatment priorities often match objective needs. These findings may inform the development of targeted BED screening practices for women with obesity in primary care settings, and the eventual adoption of patient-centered BED treatment resources. Published by Elsevier Inc.

NCAR's Research Data Archive: OPeNDAP Access for Complex Datasets

NASA Astrophysics Data System (ADS)

Dattore, R.; Worley, S. J.

2014-12-01

Many datasets have complex structures including hundreds of parameters and numerous vertical levels, grid resolutions, and temporal products. Making these data accessible is a challenge for a data provider. OPeNDAP is powerful protocol for delivering in real-time multi-file datasets that can be ingested by many analysis and visualization tools, but for these datasets there are too many choices about how to aggregate. Simple aggregation schemes can fail to support, or at least make it very challenging, for many potential studies based on complex datasets. We address this issue by using a rich file content metadata collection to create a real-time customized OPeNDAP service to match the full suite of access possibilities for complex datasets. The Climate Forecast System Reanalysis (CFSR) and it's extension, the Climate Forecast System Version 2 (CFSv2) datasets produced by the National Centers for Environmental Prediction (NCEP) and hosted by the Research Data Archive (RDA) at the Computational and Information Systems Laboratory (CISL) at NCAR are examples of complex datasets that are difficult to aggregate with existing data server software. CFSR and CFSv2 contain 141 distinct parameters on 152 vertical levels, six grid resolutions and 36 products (analyses, n-hour forecasts, multi-hour averages, etc.) where not all parameter/level combinations are available at all grid resolution/product combinations. These data are archived in the RDA with the data structure provided by the producer; no additional re-organization or aggregation have been applied. Since 2011, users have been able to request customized subsets (e.g. - temporal, parameter, spatial) from the CFSR/CFSv2, which are processed in delayed-mode and then downloaded to a user's system. Until now, the complexity has made it difficult to provide real-time OPeNDAP access to the data. We have developed a service that leverages the already-existing subsetting interface and allows users to create a virtual dataset with its own structure (das, dds). The user receives a URL to the customized dataset that can be used by existing tools to ingest, analyze, and visualize the data. This presentation will detail the metadata system and OPeNDAP server that enable user-customized real-time access and show an example of how a visualization tool can access the data.

Using computed tomography and 3D printing to construct custom prosthetics attachments and devices.

PubMed

Liacouras, Peter C; Sahajwalla, Divya; Beachler, Mark D; Sleeman, Todd; Ho, Vincent B; Lichtenberger, John P

2017-01-01

The prosthetic devices the military uses to restore function and mobility to our wounded warriors are highly advanced, and in many instances not publically available. There is considerable research aimed at this population of young patients who are extremely active and desire to take part in numerous complex activities. While prosthetists design and manufacture numerous devices with standard materials and limb assemblies, patients often require individualized prosthetic design and/or modifications to enable them to participate fully in complex activities. Prosthetists and engineers perform research and implement digitally designs in collaboration to generate equipment for their patient's rehabilitation needs. 3D printing allows for these devices to be manufactured from an array of materials ranging from plastic to titanium alloy. Many designs require form fitting to a prosthetic socket or a complex surface geometry. Specialty items can be scanned using computed tomography and digitally reconstructed to produce a virtual 3D model the engineer can use to design the necessary features of the desired prosthetic, device, or attachment. Completed devices are tested for fit and function. Numerous custom prostheses and attachments have been successfully translated from the research domain to clinical reality, in particular, those that feature the use of computed tomography (CT) reconstructions. The purpose of this project is to describe the research pathways to implementation for the following clinical designs: sets of bilateral hockey skates; custom weightlifting prosthetic hands; and a wine glass holder. This article will demonstrate how to incorporate CT imaging and 3D printing in the design and manufacturing process of custom attachments and assistive technology devices. Even though some of these prosthesis attachments may be relatively simple in design to an engineer, they have an enormous impact on the lives of our wounded warriors.

Systems engineering for very large systems

NASA Technical Reports Server (NTRS)

Lewkowicz, Paul E.

1993-01-01

Very large integrated systems have always posed special problems for engineers. Whether they are power generation systems, computer networks or space vehicles, whenever there are multiple interfaces, complex technologies or just demanding customers, the challenges are unique. 'Systems engineering' has evolved as a discipline in order to meet these challenges by providing a structured, top-down design and development methodology for the engineer. This paper attempts to define the general class of problems requiring the complete systems engineering treatment and to show how systems engineering can be utilized to improve customer satisfaction and profit ability. Specifically, this work will focus on a design methodology for the largest of systems, not necessarily in terms of physical size, but in terms of complexity and interconnectivity.

Systems engineering for very large systems

NASA Astrophysics Data System (ADS)

Lewkowicz, Paul E.

Very large integrated systems have always posed special problems for engineers. Whether they are power generation systems, computer networks or space vehicles, whenever there are multiple interfaces, complex technologies or just demanding customers, the challenges are unique. 'Systems engineering' has evolved as a discipline in order to meet these challenges by providing a structured, top-down design and development methodology for the engineer. This paper attempts to define the general class of problems requiring the complete systems engineering treatment and to show how systems engineering can be utilized to improve customer satisfaction and profit ability. Specifically, this work will focus on a design methodology for the largest of systems, not necessarily in terms of physical size, but in terms of complexity and interconnectivity.

Consistent visualizations of changing knowledge

PubMed Central

Tipney, Hannah J.; Schuyler, Ronald P.; Hunter, Lawrence

2009-01-01

Networks are increasingly used in biology to represent complex data in uncomplicated symbolic form. However, as biological knowledge is continually evolving, so must those networks representing this knowledge. Capturing and presenting this type of knowledge change over time is particularly challenging due to the intimate manner in which researchers customize those networks they come into contact with. The effective visualization of this knowledge is important as it creates insight into complex systems and stimulates hypothesis generation and biological discovery. Here we highlight how the retention of user customizations, and the collection and visualization of knowledge associated provenance supports effective and productive network exploration. We also present an extension of the Hanalyzer system, ReOrient, which supports network exploration and analysis in the presence of knowledge change. PMID:21347184

Female feeding priority in bonobos, Pan paniscus, and the question of female dominance.

PubMed

White, Frances J; Wood, Kimberley D

2007-08-01

The question of whether bonobos show feeding priority and female dominance has been proposed and examined, both in the wild and in captive studies, with differing results. The relationship between female dominance and female feeding priority has been best studied in prosimian primates. These studies use established criteria of females consistently evoking submissive behavior from males in dyadic encounters for determining female dominance. Although the relationship is complex, female dominance in prosimians is associated with preferential access to food. Data from studies of wild habituated bonobos in the Lomako Forest, Democratic Republic of the Congo, are examined for evidence of both female feeding priority and female social dominance using similar criteria as used for prosimians. Bonobos showed evidence of female feeding priority in small, but not in large, food patches. Male-male competition for mating opportunities at the start of the food bout was related to some, but not all, differences in time spent feeding between the sexes. Female dominance similar to that seen in prosimians was not observed in these bonobos. Males were consistently dominant in dyadic interactions. Female feeding priority with male dyadic social dominance implies that male deference during feeding cannot be excluded as one explanation of interpretations of female dominance in bonobos. Additionally, dominance of male bonobos by females appears to require the presence of female coalition partners. As in other primates with female feeding priority, bonobo females express this trait where food is economically defendable. Unlike prosimians, however, bonobo female feeding priority may result from male deference and the importance of female coalitions in nondyadic interactions.

Mental health education in occupational therapy professional preparation programs: Alignment between clinician priorities and coverage in university curricula.

PubMed

Scanlan, Justin Newton; Meredith, Pamela J; Haracz, Kirsti; Ennals, Priscilla; Pépin, Geneviève; Webster, Jayne S; Arblaster, Karen; Wright, Shelley

2017-12-01

Occupational therapy programs must prepare graduates for work in mental health. However, this area of practice is complex and rapidly changing. This study explored the alignment between educational priorities identified by occupational therapists practising in mental health and level of coverage of these topics in occupational therapy programs in Australia and New Zealand. Surveys were distributed to heads of all occupational therapy programs across Australia and New Zealand. The survey included educational priorities identified by occupational therapists in mental health from a previous study. Respondents were requested to identify the level of coverage given to each of these priorities within their curriculum. These data were analysed to determine a ranking of educational topics in terms of level of coverage in university programs. Responses were received for 19 programs from 16 universities. Thirty-four topics were given 'High-level coverage' in university programs, and these were compared against the 29 topics classified as 'Essential priorities' by clinicians. Twenty topics were included in both the 'Essential priorities' and 'High-level coverage' categories. Topics considered to be 'Essential priorities' by clinicians which were not given 'High-level coverage' in university programs included the following: mental health fieldwork experiences; risk assessment and management; professional self-care resilience and sensory approaches. While there appears to be overall good alignment between mental health curricula and priorities identified by practising occupational therapists, there are some discrepancies. These discrepancies are described and establish a strong foundation for further discussion between clinicians, academics and university administration to support curriculum review and revision. © 2017 Occupational Therapy Australia.

An information based approach to improving overhead imagery collection

NASA Astrophysics Data System (ADS)

Sourwine, Matthew J.; Hintz, Kenneth J.

2011-06-01

Recent growth in commercial imaging satellite development has resulted in a complex and diverse set of systems. To simplify this environment for both customer and vendor, an information based sensor management model was built to integrate tasking and scheduling systems. By establishing a relationship between image quality and information, tasking by NIIRS can be utilized to measure the customer's required information content. Focused on a reduction in uncertainty about a target of interest, the sensor manager finds the best sensors to complete the task given the active suite of imaging sensors' functions. This is done through determination of which satellite will meet customer information and timeliness requirements with low likelihood of interference at the highest rate of return.

Treatment of Severely Resorbed Maxilla Due to Peri-Implantitis by Guided Bone Regeneration Using a Customized Allogenic Bone Block: A Case Report

PubMed Central

Blume, Oliver; Hoffmann, Lisa; Donkiewicz, Phil; Wenisch, Sabine; Back, Michael; Franke, Jörg; Schnettler, Reinhard

2017-01-01

The objective of this case report is to introduce a customized CAD/CAM freeze-dried bone allograft (FDBA) block for its use in Guided Bone Regeneration (GBR) procedures for severely deficient maxillary bones. Additionally, a special newly developed remote incision technique is presented to avoid wound dehiscence. The results show optimal integration behavior of the FDBA block after six months and the formation of new vital bone. Thus, the results of the present case report confirm the use of the customized CAD/CAM bone block for augmentation of complex defects in the maxillary aesthetic zone as a successful treatment concept. PMID:29065477

Treatment of Severely Resorbed Maxilla Due to Peri-Implantitis by Guided Bone Regeneration Using a Customized Allogenic Bone Block: A Case Report.

PubMed

Blume, Oliver; Hoffmann, Lisa; Donkiewicz, Phil; Wenisch, Sabine; Back, Michael; Franke, Jörg; Schnettler, Reinhard; Barbeck, Mike

2017-10-21

The objective of this case report is to introduce a customized CAD/CAM freeze-dried bone allograft (FDBA) block for its use in Guided Bone Regeneration (GBR) procedures for severely deficient maxillary bones. Additionally, a special newly developed remote incision technique is presented to avoid wound dehiscence. The results show optimal integration behavior of the FDBA block after six months and the formation of new vital bone. Thus, the results of the present case report confirm the use of the customized CAD/CAM bone block for augmentation of complex defects in the maxillary aesthetic zone as a successful treatment concept.

Smart Shop Assistant - Using Semantic Technologies to Improve Online Shopping

NASA Astrophysics Data System (ADS)

Niemann, Magnus; Mochol, Malgorzata; Tolksdorf, Robert

Internet commerce experiences a rising complexity: Not only more and more products become available online but also the amount of information available on a single product has been constantly increasing. Thanks to the Web 2.0 development it is, in the meantime, quite common to involve customers in the creation of product description and extraction of additional product information by offering customers feedback forms and product review sites, users' weblogs and other social web services. To face this situation, one of the main tasks in a future internet will be to aggregate, sort and evaluate this huge amount of information to aid the customers in choosing the "perfect" product for their needs.

Customer satisfaction with patient care: "Where's the Beef?".

PubMed

Vukmir, Rade B

2006-01-01

This was an attempt to present an analysis of the literature examining objective information concerning the subject of customer service, as it applies to the current medical practice. Hopefully this information will be synthesized to generate a cogent approach to correlate customer service with quality. Articles were obtained by an English language search of MEDLINE from January 1976 to July 2005. This computerized search was supplemented with literature from the author's personal collection of peer reviewed articles on customer service in a medical setting. This information was presented in a qualitative fashion. There is a significant lack of objective data correlating customer service objectives, patient satisfaction, and quality of care. Patients present predominantly for the convenience of emergency department care. Specifics of satisfaction are directed to the timing, and amount of "caring." Demographic correlates including symptom presentation, practice style, location, and physician issues directly impact on satisfaction. It is most helpful to develop a productive plan for the "difficult patient" emphasizing communication and empathy. The current emergency medicine customer service dilemmas are a complex interaction of both patient and physician factors specifically targeting both efficiency and patient satisfaction. Awareness of these issues can help to maximize efficiency, minimize subsequent medicolegal risk and improve patient care.

Polytobacco Use and the "Customization Generation"-New Perspectives for Tobacco Control.

PubMed

Horn, Kimberly; Pearson, Jennifer L; Villanti, Andrea C

2016-12-01

In recent years, the United States observed a significant uptake in concurrent use of multiple tobacco products and alternative nicotine delivery devices among youth-a phenomenon identified as polytobacco use-making tobacco control efforts more complex for clinicians, policy makers, and scientists, alike.The present commentary stimulates new perspectives on tobacco control in the context of polytobacco use and a youth culture of customization. This culture-based value of today's youth may inform current patterns of tobacco use. More specifically, the authors hypothesize a concept of tobacco customization-the concurrent use of multiple tobacco products to create personalized tobacco experience matching lifestyle, culture, values, and addiction levels. With a range of experiences made possible through an ever-increasing menu of tobacco products, flavors, and novel devices, the current youth culture of customization may also translate to tobacco customization. Given the predominance of polytobacco use in youth-tobacco users, tobacco control initiatives must be challenged to new perspectives. Should we discover the viability of tobacco customization, tobacco use strategies that target cultural values, harness popular trends, and culture and provide customizable experiences may have a notable impact on tobacco use in this population.

Long-term efficacy of biomodeled polymethyl methacrylate implants for orbitofacial defects.

PubMed

Groth, Michael J; Bhatnagar, Aparna; Clearihue, William J; Goldberg, Robert A; Douglas, Raymond S

2006-01-01

To report the long-term efficacy of custom polymethyl methacrylate implants using high-resolution computed tomographic modeling in the reconstruction of complex orbitofacial defects secondary to trauma. Nine patients with complex orbitofacial bone defects after trauma were evaluated for this retrospective, nonrandomized, noncomparative study. All the patients underwent reconstruction using custom, heat-cured polymethyl methacrylate implants. Patients were followed up postoperatively and evaluated for complications. Nine consecutive patients (5 men and 4 women) aged 28 to 63 years who underwent surgical reconstruction using prefabricated, heat-cured polymethyl methacrylate implants were included in the study. The interval between injury and presentation ranged from 1 month to 40 years. There were no significant complications, including infection, extrusion, or displacement of the implant. In all of the patients, wound healing was uneventful, with antibiotic drugs administered perioperatively. Mean follow-up was 4.3 years from the first visit (range, 6 months to 10 years). Computed tomographic biomodeled, prefabricated, heat-cured polymethyl methacrylate implants are well tolerated in the long term. Their advantages include customized design, long-term biocompatibility, and excellent aesthetic results.

Pharmacy staff perceptions and self-reported behaviors related to providing contraceptive information and counseling.

PubMed

Batra, Peter; Aquilino, Mary L; Farris, Karen B

2015-01-01

To evaluate pharmacy staff perspectives of a 2-year pharmacy intervention aimed at reducing unintended pregnancy in 18- to 30-year-old women. Pharmacy staff completed a 48-item, self-administered paper survey consisting of scaled and open-ended questions. 55 community pharmacies in 12 Iowa counties. All pharmacy staff participated, including pharmacists, pharmacy technicians, and other pharmacy employees. Online continuing education (CE) training was made available to all pharmacy staff. Promotional materials including posters, brochures, and shelf talkers were displayed in all of the pharmacies. Pharmacy staff perceptions and self-reported behaviors related to displaying posters, brochures, and shelf talkers in their pharmacies and providing contraceptive information and counseling to patients/customers. A total of 192 (43% return rate) pharmacy staff responded. Only 44% of respondents consistently provided contraceptive information and counseling, yet more than 90% felt that talking with patients/customers about contraceptives was easy, and more than 50% could do so privately. The study showed increased pharmacy staff desire to make this topic a priority. Community pharmacy staff can play a key role in educating and counseling young adult women about contraceptive health and pregnancy planning. This study indicates that staff are comfortable providing this service and that patients/customers are open to receiving guidance from pharmacists. However, pharmacy staff are missing additional opportunities to provide information and counseling. There is also a need for greater attention to provision of nonprescription contraceptive education.

Multidisciplinary studies of wildlife trade in primates: Challenges and priorities.

PubMed

Blair, Mary E; Le, Minh D; Sterling, Eleanor J

2017-11-01

Wildlife trade is increasingly recognized as an unsustainable threat to primate populations and informing its management is a growing focus and application of primatological research. However, management policies based on ecological research alone cannot address complex socioeconomic or cultural contexts as drivers of wildlife trade. Multidisciplinary research is required to understand trade complexity and identify sustainable management strategies. Here, we define multidisciplinary research as research that combines more than one academic discipline, and highlight how the articles in this issue combine methods and approaches to fill key gaps and offer a more comprehensive understanding of underlying drivers of wildlife trade including consumer demand, enforcement patterns, source population status, and accessibility of targeted species. These articles also focus on how these drivers interact at different scales, how trade patterns relate to ethics, and the potential effectiveness of different policy interventions in reducing wildlife trade. We propose priorities for future research on primate trade including expanding from multidisciplinary to interdisciplinary research questions and approaches co-created by research teams that integrate across different disciplines such as cultural anthropology, ecology, economics, and public policy. We also discuss challenges that limit the integration of information across disciplines to meet these priorities. © 2017 Wiley Periodicals, Inc.

Applying observations from technological transformations in complex adaptive systems to inform health policy on technology adoption.

PubMed

Phillips, Andrew B; Merrill, Jacqueline

2012-01-01

Many complex markets such as banking and manufacturing have benefited significantly from technology adoption. Each of these complex markets experienced increased efficiency, quality, security, and customer involvement as a result of technology transformation in their industry. Healthcare has not benefited to the same extent. We provide initial findings from a policy analysis of complex markets and the features of these transformations that can influence health technology adoption and acceptance.

[Clinical and ossification outcome of custom-made hydroxyapatite prothese for large skull defect].

PubMed

Hardy, H; Tollard, E; Derrey, S; Delcampe, P; Péron, J-M; Fréger, P; Proust, F

2012-02-01

Cranioplasty is an everyday concern in neurosurgery, especially in decompressive craniectomy cases. Our surgical team uses custom-made hydroxyapatite implants for large and/or complex defects. Eight patients had a custom-made prosthesis. Each of them has been reviewed by an independent observer. Each patient described his feeling of satisfaction, using a questionnaire, graduated from "A" (really satisfied) to "D" (unsatisfied). Each of them also underwent a CT-scan (helicoidal acquisition, 0.6mm thick for multiplanar reconstruction) to evaluate qualitatively the ossification graduated from "0" (no ossification) to "5" (continuous ossification). Maximal under-prosthetic bone thickness, intra-prosthetic calcic density were also reported. Supervision delay was 43.7 months [6-99 months], average defect surface was 85.5 cm(2) [27.6-137.6 cm(2)], the craniectomy etiologies were intracranial hypertension (seven patients) and calvarial invasion (one patient). Implant tolerance was reparted in "A" score (50%) and "B" score (50%). Concerning ossification, six patients (75%) had a score of "2" or less and two patients had a score of "3" or "4". Hydroxyapatite custom-made implants for cranioplasty appear to be ideal for good aesthetic and tolerance results, but their ossification is hardly analyzed due to the prosthesis density higher than the bone's density. This is why we recommend them for children and in cases of complex defects such as pterion location. Copyright © 2011. Published by Elsevier Masson SAS.

Exploring stakeholders' views of medical education research priorities: a national survey.

PubMed

Dennis, Ashley A; Cleland, Jennifer A; Johnston, Peter; Ker, Jean S; Lough, Murray; Rees, Charlotte E

2014-11-01

Setting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland. This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed. Views were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education. This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These priority areas are in harmony with a range of current drivers in UK medical education. They provide a platform of evidence on which to base decisions about MER programmes in Scotland and beyond. © 2014 John Wiley & Sons Ltd.

76 FR 57793 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

...). The Exchange had been informed by several Order Flow Providers that the absence of marketing charges for Customer executions in the complex order book was hindering their ability to route complex order flow to the Exchange, particularly since competing exchanges do allow for the collection of marketing...

Effects of training strategies implemented in a complex videogame on functional connectivity of attentional networks.

PubMed

Voss, Michelle W; Prakash, Ruchika Shaurya; Erickson, Kirk I; Boot, Walter R; Basak, Chandramallika; Neider, Mark B; Simons, Daniel J; Fabiani, Monica; Gratton, Gabriele; Kramer, Arthur F

2012-01-02

We used the Space Fortress videogame, originally developed by cognitive psychologists to study skill acquisition, as a platform to examine learning-induced plasticity of interacting brain networks. Novice videogame players learned Space Fortress using one of two training strategies: (a) focus on all aspects of the game during learning (fixed priority), or (b) focus on improving separate game components in the context of the whole game (variable priority). Participants were scanned during game play using functional magnetic resonance imaging (fMRI), both before and after 20 h of training. As expected, variable priority training enhanced learning, particularly for individuals who initially performed poorly. Functional connectivity analysis revealed changes in brain network interaction reflective of more flexible skill learning and retrieval with variable priority training, compared to procedural learning and skill implementation with fixed priority training. These results provide the first evidence for differences in the interaction of large-scale brain networks when learning with different training strategies. Our approach and findings also provide a foundation for exploring the brain plasticity involved in transfer of trained abilities to novel real-world tasks such as driving, sport, or neurorehabilitation. Copyright © 2011 Elsevier Inc. All rights reserved.

Management Knowledge and Skills Required in the Health Care System of the Federation Bosnia and Herzegovina

PubMed Central

Slipicevic, Osman; Masic, Izet

2012-01-01

Extremely complex health care organizations, by their structure and organization, operate in a constantly changing business environment, and such situation implies and requires complex and demanding health management. Therefore, in order to manage health organizations in a competent manner, health managers must possess various managerial skills and be familiar with problems in health care. Research, identification, analysis, and assessment of health management education and training needs are basic preconditions for the development and implementation of adequate programs to meet those needs. Along with other specific activities, this research helped to determine the nature, profile, and level of top-priority needs for education. The need for knowledge of certain areas in health management, as well as the need for mastering concrete managerial competencies has been recognized as top-priorities requiring additional improvement and upgrading. PMID:23922519

Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project

PubMed Central

Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

2017-01-01

Background There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. Objective The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. Methodology An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Results Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. Conclusion The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges. PMID:28579793

Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project.

PubMed

Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

2017-01-01

There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Three categories emerged from the analysis: "Balancing complex situations" clarified the complexity regarding senior employees; "Working with a proactive approach" indicated the need for working with a new proactive approach supporting sustainable health; and "Collaborate internally and externally" showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges.

How the 'warped' relationships between nurses' emotions, attitudes, social support and perceived organizational conditions impact customer orientation.

PubMed

Gountas, Sandra; Gountas, John

2016-02-01

Much research focuses on organizational culture and its impact on customer orientation or emotional states and their impact on job satisfaction and well-being. This study aims to combine the complex roles of nurses' emotion states and job satisfaction in a model that identifies the effects of standards for service delivery (organizational culture), supervisor and co-worker support and the development of customer orientation. A previous study examined the relationships between nurses' personal resources, job satisfaction and customer orientation. This study examines how these variables relate to organizational standards and social support. A cross-sectional survey using a self-completion questionnaire with validated, existing scales to measure standards for service delivery, supervisor and co-worker support, job satisfaction, empathic concern, emotional exhaustion and customer orientation. Nurses (159) completed the questionnaire in 2010. The data were analysed using WarpPLS, a structural equation modelling software package. The results indicate that the final model fits the data well and explains 84% of the variance in customer orientation. The findings show the importance of standard for service delivery (organizational culture), supervisor and co-worker support on customer orientation. Nurses' personal resources interact with these, particularly supervisor and co-worker support, to develop staff job satisfaction and empathy. The need for support mechanisms in stressful times is discussed. We propose that training in compassion and empathy would help leaders to model desirable attributes that contribute towards customer orientation. © 2015 John Wiley & Sons Ltd.

Evaluation of health care service quality in Poland with the use of SERVQUAL method at the specialist ambulatory health care center.

PubMed

Manulik, Stanisław; Rosińczuk, Joanna; Karniej, Piotr

2016-01-01

Service quality and customer satisfaction are very important components of competitive advantage in the health care sector. The SERVQUAL method is widely used for assessing the quality expected by patients and the quality of actually provided services. The main purpose of this study was to determine if patients from state and private health care facilities differed in terms of their qualitative priorities and assessments of received services. The study included a total of 412 patients: 211 treated at a state facility and 201 treated at a private facility. Each of the respondents completed a 5-domain, 22-item SERVQUAL questionnaire. The actual quality of health care services in both types of facilities proved significantly lower than expected. All the patients gave the highest scores to the domains constituting the core aspects of health care services. The private facility respondents had the highest expectations with regard to equipment, and the state facility ones regarding contacts with the medical personnel. Health care quality management should be oriented toward comprehensive optimization in all domains, rather than only within the domain identified as the qualitative priority for patients of a given facility.

Priority Determination for Higher Education Strategic Planning Using Balanced Scorecard, FAHP and TOPSIS (Case study: XYZ University)

NASA Astrophysics Data System (ADS)

Yudatama, Uky; Sarno, Riyanarto

2016-01-01

The process of strategic planning is needed by a higher education in some cases, especially in preparing to face the challenges and competition. The results of strategic planning will help the higher education to provide a framework for achieving a competitive advantage as well as determine the direction of future policy in accordance with the desired objectives. In recent decades, the Balanced Scorecard has been applied in the field of information technology as a very popular tool and is used extensively, because it is a model that can explain between information technologies with "Business Objectives" in a comprehensive manner. This study uses 4 perspectives in the Balanced Scorecard and 7 standards in higher education quality assessment as sub-criteria. Fuzzy AHP and Fuzzy TOPSIS are used to determine the priority as making strategic policy recommendations in a higher education. The final result of this research shows the score of Customer Perspective 0.35365 is higher than other perspective, while the score in Research and Student Affairs gains significant score when compared with the others, namely 0.69753948 is also higher. This means that both of them get very serious attention as a strategic planning basis for policy making.

A Multi-organisational Approach to Service Delivery

NASA Astrophysics Data System (ADS)

Purchase, Valerie; Mills, John; Parry, Glenn

Who is involved in delivering a service? There has been growing recognition in a wide variety of contexts that service is increasingly being delivered by multi-rather than single-organisational entities. Such recognition is evident not only in our experience but in a number of areas of literature including strategy development, core competence analysis, operations and supply chain management, and is reflected in and further facilitated by ICT developments. Customers have always been involved in some degree in the process of value delivery and such involvement is increasing to include complex co-creation of value. Such interactions are challenging when they involve individual customers, however, this becomes ever more challenging when the 'customer' is another organisation or when there are multiple 'customers'. Within this chapter we will consider some of the key drivers for a multi-organisational approach to service delivery; examine the ways in which the parties involved in service co-creation have expanded to include multiple service providers and customers; and finally, identify some of the challenges created by a multi-organisational approach to service delivery.

Advances and Future Directions for Tuberous Sclerosis Complex Research: Recommendations from the 2015 Strategic Planning Conference

PubMed Central

Sahin, Mustafa; Henske, Elizabeth P.; Manning, Brendan D.; Ess, Kevin C.; Bissler, John J.; Klann, Eric; Kwiatkowski, David J.; Roberds, Steven L.; Silva, Alcino J.; Hillaire-Clarke, Coryse St.; Young, Lisa R.; Zervas, Mark; Mamounas, Laura A.

2016-01-01

On March 10–12, 2015, the National Institute of Neurological Disorders and Stroke and the Tuberous Sclerosis Alliance sponsored a workshop in Bethesda, Maryland to assess progress and new opportunities for research in tuberous sclerosis complex with the goal of updating the 2003 Research Plan for Tuberous Sclerosis (http://www.ninds.nih.gov/about_ninds/plans/tscler_research_plan.htm). In addition to the National Institute of Neurological Disorders and Stroke and Tuberous Sclerosis Alliance, participants in the strategic planning effort and workshop included representatives from six other Institutes of the National Institutes of Health, the Department of Defense Tuberous Sclerosis Complex Research Program and a broad cross-section of basic scientists and clinicians with expertise in tuberous sclerosis complex along with representatives from the pharmaceutical industry. This review summarizes outcomes from the extensive pre-meeting deliberations and final workshop recommendations, and includes: 1) progress in the field since publication of the initial 2003 research plan for tuberous sclerosis complex; 2) the key gaps, needs and challenges that hinder progress in tuberous sclerosis complex research; and 3) a new set of research priorities along with specific recommendations for addressing the major challenges in each priority area. The new research plan is organized around both short-term and long-term goals with the expectation that progress toward specific objectives can be achieved within a five- to ten-year timeframe. PMID:27267556

Early and School-Age Care in Santa Monica: Current System, Policy Options, and Recommendations

ERIC Educational Resources Information Center

Pierson, Ashley; Karoly, Lynn A.; Zellman, Gail L.; Beckett, Megan K.

2014-01-01

The landscape of early learning and out-of-school-time programs in the City of Santa Monica is complex, with numerous providers and funding streams. This complexity reflects its evolution in response to changes in federal, state, and local priorities and initiatives. Future shifts in funding levels, program auspices, and other features are likely.…

Rapid research and implementation priority setting for wound care uncertainties.

PubMed

Gray, Trish A; Dumville, Jo C; Christie, Janice; Cullum, Nicky A

2017-01-01

People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services. We solicited practitioner and manager uncertainties in wound care and held a priority setting workshop to facilitate a collaborative approach to prioritising wound care-related uncertainties. We recruited healthcare professionals who regularly cared for patients with complex wounds, were wound care specialists or managed wound care services. Participants submitted up to five wound care uncertainties in consultation with their colleagues, via an on-line survey and attended a priority setting workshop. Submitted uncertainties were collated, sorted and categorised according professional group. On the day of the workshop, participants were divided into four groups depending on their profession. Uncertainties submitted by their professional group were viewed, discussed and amended, prior to the first of three individual voting rounds. Participants cast up to ten votes for the uncertainties they judged as being high priority. Continuing in the professional groups, the top 10 uncertainties from each group were displayed, and the process was repeated. Groups were then brought together for a plenary session in which the final priorities were individually scored on a scale of 0-10 by participants. Priorities were ranked and results presented. Nominal group technique was used for generating the final uncertainties, voting and discussions. Thirty-three participants attended the workshop comprising; 10 specialist nurses, 10 district nurses, seven podiatrists and six managers. Participants had been qualified for a mean of 20.7 years with a mean of 16.8 years of wound care experience. One hundred and thirty-nine uncertainties were submitted electronically and a further 20 were identified on the day of the workshop following lively, interactive group discussions. Twenty-five uncertainties from the total of 159 generated made it to the final prioritised list. These included six of the 20 new uncertainties. The uncertainties varied in focus, but could be broadly categorised into three themes: service delivery and organisation, patient centred care and treatment options. Specialist nurses were more likely to vote for service delivery and organisation topics, podiatrists for patient centred topics, district nurses for treatment options and operational leads for a broad range. This collaborative priority setting project is the first to engage front-line clinicians in prioritising research and implementation topics in wound care. We have shown that it is feasible to conduct topic prioritisation in a short time frame. This project has demonstrated that with careful planning and rigor, important questions that are raised in the course of clinicians' daily decision making can be translated into meaningful research and implementation initiatives that could make a difference to service delivery and patient care.

Rapid research and implementation priority setting for wound care uncertainties

PubMed Central

Dumville, Jo C.; Christie, Janice; Cullum, Nicky A.

2017-01-01

Introduction People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services. We solicited practitioner and manager uncertainties in wound care and held a priority setting workshop to facilitate a collaborative approach to prioritising wound care-related uncertainties. Methods We recruited healthcare professionals who regularly cared for patients with complex wounds, were wound care specialists or managed wound care services. Participants submitted up to five wound care uncertainties in consultation with their colleagues, via an on-line survey and attended a priority setting workshop. Submitted uncertainties were collated, sorted and categorised according professional group. On the day of the workshop, participants were divided into four groups depending on their profession. Uncertainties submitted by their professional group were viewed, discussed and amended, prior to the first of three individual voting rounds. Participants cast up to ten votes for the uncertainties they judged as being high priority. Continuing in the professional groups, the top 10 uncertainties from each group were displayed, and the process was repeated. Groups were then brought together for a plenary session in which the final priorities were individually scored on a scale of 0–10 by participants. Priorities were ranked and results presented. Nominal group technique was used for generating the final uncertainties, voting and discussions. Results Thirty-three participants attended the workshop comprising; 10 specialist nurses, 10 district nurses, seven podiatrists and six managers. Participants had been qualified for a mean of 20.7 years with a mean of 16.8 years of wound care experience. One hundred and thirty-nine uncertainties were submitted electronically and a further 20 were identified on the day of the workshop following lively, interactive group discussions. Twenty-five uncertainties from the total of 159 generated made it to the final prioritised list. These included six of the 20 new uncertainties. The uncertainties varied in focus, but could be broadly categorised into three themes: service delivery and organisation, patient centred care and treatment options. Specialist nurses were more likely to vote for service delivery and organisation topics, podiatrists for patient centred topics, district nurses for treatment options and operational leads for a broad range. Conclusions This collaborative priority setting project is the first to engage front-line clinicians in prioritising research and implementation topics in wound care. We have shown that it is feasible to conduct topic prioritisation in a short time frame. This project has demonstrated that with careful planning and rigor, important questions that are raised in the course of clinicians’ daily decision making can be translated into meaningful research and implementation initiatives that could make a difference to service delivery and patient care. PMID:29206884

[Priority setting of health interventions. Review of criteria, approaches and role of assessment agencies].

PubMed

Varela-Lema, Leonor; Atienza-Merino, Gerardo; López-García, Marisa

This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting. An exhaustive review of the literature was carried out. For this purpose, a search of the main biomedical databases was performed and assessment agency websites were reviewed, among other sources. In general terms, it was found that there are no standardised criteria for priority setting, although some consensus and common trends have been identified regarding key elements (criteria, models and strategies, key actors, etc.). Globally, 8 key domains were identified: 1) need for intervention; 2) health outcomes; 3) type of benefit of the intervention; 4) economic consequences; 5) existing knowledge on the intervention/quality of and uncertainties regarding the evidence; 6) implementation and complexity of the intervention/feasibility; 7) priority, justice and ethics; and 8) overall context. The review provides a thorough analysis of the relevant issues and offers key recommendations regarding considerations for developing a national prioritisation framework. Findings are envisioned to be useful for different public organisations that are aiming to establish healthcare priorities. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Configurable product design considering the transition of multi-hierarchical models

NASA Astrophysics Data System (ADS)

Ren, Bin; Qiu, Lemiao; Zhang, Shuyou; Tan, Jianrong; Cheng, Jin

2013-03-01

The current research of configurable product design mainly focuses on how to convert a predefined set of components into a valid set of product structures. With the scale and complexity of configurable products increasing, the interdependencies between customer demands and product structures grow up as well. The result is that existing product structures fails to satisfy the individual customer requirements and hence product variants are needed. This paper is aimed to build a bridge between customer demands and product structures in order to make demand-driven fast response design feasible. First of all, multi-hierarchical models of configurable product design are established with customer demand model, technical requirement model and product structure model. Then, the transition of multi-hierarchical models among customer demand model, technical requirement model and product structure model is solved with fuzzy analytic hierarchy process (FAHP) and the algorithm of multi-level matching. Finally, optimal structure according to the customer demands is obtained with the calculation of Euclidean distance and similarity of some cases. In practice, the configuration design of a clamping unit of injection molding machine successfully performs an optimal search strategy for the product variants with reasonable satisfaction to individual customer demands. The proposed method can automatically generate a configuration design with better alternatives for each product structures, and shorten the time of finding the configuration of a product.

Recent Weather Technologies Delivered to America's Space Program by the Applied Meteorology Unit

NASA Technical Reports Server (NTRS)

Bauman, WIlliam, H., III; Crawford, Winifred

2009-01-01

The Applied Meteorology Unit (AMU) is a unique joint venture of NASA, the Air Force and the National Weather Service (NWS) and has been supporting the Space Program for nearly two decades. The AMU acts as a bridge between the meteorological research community and operational forecasters by developing, evaluating and transitioning new technology and techniques to improve weather support to spaceport operations at the Eastern Range (ER) and Kennedy Space Center. Its primary customers are the 45th Weather Squadron at Cape Canaveral Air Force Station (CCAFS), the Spaceflight Meteorology Group at Johnson Space Center and the National Weather Service Office in Melbourne, FL. Its products are used to support NASA's Shuttle and ELV programs as well as Department of Defense and commercial launches from the ER. Shuttle support includes landing sites beyond the ER. The AMU is co-located with the Air Force operational forecasters at CCAFS to facilitate continuous two-way interaction between the AMU and its operational customers. It is operated under a NASA, Air Force, and NWS Memorandum of Understanding (MOU) by a competitively-selected contractor. The contract, which is funded and managed by NASA, provides five full time professionals with degrees in meteorology or related fields, some of whom also have operational experience. NASA provides a Ph.D.- level NASA civil service scientist as Chief of the AMU. The AMU is tasked by its customers through a unique, nationally recognized process. The tasks are limited to development, evaluation and operational transition of technology to improve weather support to spaceport operations and providing expert advice to the customers. The MOU expressly forbids using the AMU resources to conduct operations or do basic research. The presentation will provide a brief overview of the AMU and how it is tasked by its customers to provide high priority products and services. The balance of the presentation will cover a sampling of products delivered over the last 18 years that are currently in operational use. Each example will describe the problem to be solved, the solution provided, and the operational benefits of implementing that solution.

Development and validation of a strategic repositioning model for defense and aerospace contractors

NASA Astrophysics Data System (ADS)

Bers, John A.

Strategic repositioning refers to the organized efforts of defense contractors to "reposition" a technology that they have developed for a defense sector customer into a civilian or commercial market. The strategic repositioning model developed here is a structural model: it seeks to isolate the factors that influence choice of strategy, which in turn influences the organization's performance. The model draws from the prior experience of contractors (through interviews and surveys) and companies in other sectors (through a review of the relevant published research). (1) Over all, the model accounted for 55% of the variance in financial performance of the sample and 35% for the underlying population. (2) Key success factors include a rigorous planning process, a target market in the growth (vs. incubation) stage, a priority on market leadership as well as financial return, the ability to operate in an ambiguous business environment, and a relatively short time horizon but strong corporate support. (3) The greatest challenges that a contractor is likely to encounter are understanding his new customers' buying practices, strong competition, and adapting his technology to their needs and price expectations. (4) To address these issues contractors often involve partners in their entry strategy, but partnerships of equals tend to be more difficult to bring off than direct entry strategies. (5) The two major target market categories--government and commercial--present different challenges. Commercial customers are more likely to resist doing business with the contractor, while contractors entering government and other noncommercial markets are more likely to encounter price resistance, low technical sophistication among customers, and difficulties reaching their customer base. (6) Despite these differences across markets, performance is not influenced by the target market category, nor by the type of product or service or the contractor's functional orientation (marketing, technology, or operations). (7) The absence of a difference in performance may be partly due to natural selection. Noncommercial markets tend to attract contractors with more deliberative, consultative, and process-oriented corporate cultures, while commercial markets tend to attract contractors with results-oriented, opportunistic cultures.

NOAA tools to support CSC and LCC regional climate science priorities in the western Gulf of Mexico

NASA Astrophysics Data System (ADS)

Brown, D. P.; Marcy, D.; Robbins, K.; Shafer, M.; Stiller, H.

2012-12-01

The National Oceanic and Atmospheric Administration (NOAA) is an active regional partner with the Department of Interior (DOI) in supplying and supporting the delivery of climate science and services. A primary mechanism for NOAA-DOI coordination at the regional scale is the Landscape Conservation Cooperative (LCC) network, which is supported in part by DOI Climate Science Centers (CSC). Together, the CSCs and LCCs provide a framework to identify landscape-scale science and services priorities for conservation and management. As a key partner of the CSCs and an active member of many LCCs, NOAA is working to ensure its own regional product and service delivery efforts will help address these conservation and management challenges. Two examples of NOAA's regional efforts are highlighted here, with a focus on the coastal and interior geographies of the western Gulf of Mexico where NOAA partners with the South Central CSC and participates as a member of the Gulf Coast Prairie LCC. Along the Texas coastline, a sea level rise and coastal flooding impacts viewer, produced by NOAA's Coastal Services Center and available via its Digital Coast interface, allows constituents to visualize estimates of sea level rise, measures of uncertainty, flood frequencies, and environmental (e.g., marsh migration) and socioeconomic (e.g., tidal flooding of built environments) impacts. In the interior of Texas and Louisiana, NOAA's Southern Regional Climate Center is leading a consortium of partners in the development of a unified source of regional water reservoir information, including current conditions, a historical database, and web-based visualization tools to illustrate spatio-temporal variations in water availability to a broad array of hydrological, agricultural, and other customers. These two examples of NOAA products can, in their existing forms, support regional conservation and management priorities for CSCs and LCCs by informing vulnerability assessments and adaptation planning. Enhancements to these and other efforts can be achieved through a robust collaboration between NOAA and DOI that links regional science priorities to regional service delivery.

Advancing a Complex Systems Approach to Personalized Learning Communities: Bandwidth, Sightlines, and Teacher Generativity

ERIC Educational Resources Information Center

Hamilton, Eric

2015-01-01

Educational technologies have advanced one of the most important visions of educational reformers, to customize formal and informal learning to individuals. The application of a complex systems framework to the design of learning ecologies suggests that each of a series of ten desirable and malleable features stimulates or propels the other ten,…

78 FR 39429 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Order Granting Approval To Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

... public customer, broker-dealer, or any other entity (a ``PIXL Order'') against principal interest or... Auction for simple orders). \\5\\ A Complex Order is defined as ``an order involving the simultaneous... ``Complex Order PAN responses'') and trading interest at a price or prices that improve the stop price to a...

Families’ Priorities Regarding Hospital-to-Home Transitions for Children With Medical Complexity

PubMed Central

O’Brien, Emily R.; Leslie, Laurel K.; Lindenauer, Peter K.; Mangione-Smith, Rita M.

2017-01-01

BACKGROUND: National health care policy recommends that patients and families be actively involved in discharge planning. Although children with medical complexity (CMC) account for more than half of pediatric readmissions, scalable, family-centered methods to effectively engage families of CMC in discharge planning are lacking. We aimed to systematically examine the scope of preferences, priorities, and goals of parents of CMC regarding planning for hospital-to-home transitions and to ascertain health care providers’ perceptions of families’ transitional care goals and needs. METHODS: We conducted semistructured interviews with parents and health care providers at a tertiary care hospital. Interviews were continued until thematic saturation was reached. Interviews were audio recorded, transcribed verbatim, and analyzed to identify emergent themes via a general inductive approach. RESULTS: Thirty-nine in-depth interviews were conducted, including 23 with family caregivers of CMC and 16 with health care providers. Families’ priorities, preferences, and goals for hospital-to-home transitions aligned with 7 domains: effective engagement with health care providers, respect for families’ discharge readiness, care coordination, timely and efficient discharge processes, pain and symptom control, self-efficacy to support recovery and ongoing child development, and normalization and routine. These domains also emerged in interviews with health care providers, although there were minor differences in themes discussed. CONCLUSIONS: Although CMC have diverse transitional care needs, their families’ priorities, preferences, and goals aligned with 7 domains that bridged their hospital admission with reestablishment of a home routine. This research provides essential foundational data to engage families in discharge planning, guiding the operationalization of national health policy recommendations. PMID:27940509

Comparison and alignment of an academic medical center's strategic goals with ASHP initiatives.

PubMed

Engels, Melanie J; Chaffee, Bruce W; Clark, John S

2015-12-01

An academic medical center's strategic goals were compared and aligned with the 2015 ASHP Health-System Pharmacy Initiative and the Pharmacy Practice Model Initiative (PPMI). The department's pharmacy practice model steering committee identified potential solutions to narrow prioritized gaps using a modified nominal group technique and a multivoting dot technique. Five priority solutions were identified and assigned to work groups to develop business plans, which included admission medication history and reconciliation for high-risk patients and those with complex medication regimens, pharmacist provision of discharge counseling to high-risk patients and those with complex medication regimens, improved measurement and reporting of the impact of PPMI programs on patient outcomes, implementation of a departmentwide formalized peer review and evaluation process, and the greeting of every patient at some time during his or her visit by a pharmacy team member. Stakeholders evaluated the business plans based on feasibility, financial return on investment, and anticipated safety enhancements. The solution that received the highest priority ranking and was subsequently implemented was "improved measurement and reporting of the impact of PPMI programs on patient outcomes." A defined process was followed for identifying gaps among current practices at an academic medical center and the 2015 ASHP Health-System Pharmacy Initiative and the PPMI. A key priority to better document the impact of pharmacists on patient care was identified for our department by using a nominal group technique brainstorming process and a multivoting dot technique and creating standardized business plans for five potential priority projects. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Genetics Home Reference: trichothiodystrophy

MedlinePlus

... trichothiodystrophy and Cockayne syndrome: a complex genotype-phenotype relationship. Neuroscience. 2007 Apr 14;145(4):1388-96. ... for Links Data Files & API Site Map Subscribe Customer Support USA.gov Copyright Privacy Accessibility FOIA Viewers & ...

29 CFR 541.402 - Executive and administrative computer employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... planning, scheduling, and coordinating activities required to develop systems to solve complex business, scientific or engineering problems of the employer or the employer's customers. Similarly, a senior or lead...

Federal budget process: An overview

NASA Astrophysics Data System (ADS)

Frizzell, Virgil A., Jr.

Much geophysical research funding originates from the federal government, and many who obtain federal funding consider the executive branch to be its source. In fact, the federal budget results from a complex ballet between the executive and legislative branches. Because it is both little understood and essential to our work, this report will review the fundamentals of the three-year budgetary process.The Constitution assigns the power of the purse to the Congress. Before the 1920s, executive branch agencies and departments submitted their own separate budgets to Congress, and deliberate planning and priority setting was minimal. In 1921 Congress empowered the president to submit an executive branch budget reflecting his priorities for the next fiscal year. Following this protocol, former President Reagan submitted his budget for Fiscal Year 1990 in January, and President Bush outlined his FY'90 priorities in February.

Strengthening fairness, transparency and accountability in health care priority setting at district level in Tanzania

PubMed Central

Maluka, Stephen Oswald

2011-01-01

Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are not considered by conventional priority-setting tools. In a five-year EU-supported project, which started in 2006, ways of strengthening fairness and accountability in priority setting in district health management were studied. This review is based on a PhD thesis that aimed to analyse health care organisation and management systems, and explore the potential and challenges of implementing Accountability for Reasonableness (A4R) approach to priority setting in Tanzania. A qualitative case study in Mbarali district formed the basis of exploring the sociopolitical and institutional contexts within which health care decision making takes place. The study also explores how the A4R intervention was shaped, enabled and constrained by the contexts. Key informant interviews were conducted. Relevant documents were also gathered and group priority-setting processes in the district were observed. The study revealed that, despite the obvious national rhetoric on decentralisation, actual practice in the district involved little community participation. The assumption that devolution to local government promotes transparency, accountability and community participation, is far from reality. The study also found that while the A4R approach was perceived to be helpful in strengthening transparency, accountability and stakeholder engagement, integrating the innovation into the district health system was challenging. This study underscores the idea that greater involvement and accountability among local actors may increase the legitimacy and fairness of priority-setting decisions. A broader and more detailed analysis of health system elements, and socio-cultural context is imperative in fostering sustainability. Additionally, the study stresses the need to deal with power asymmetries among various actors in priority-setting contexts. PMID:22072991

Attention Priority Map of Face Images in Human Early Visual Cortex.

PubMed

Mo, Ce; He, Dongjun; Fang, Fang

2018-01-03

Attention priority maps are topographic representations that are used for attention selection and guidance of task-related behavior during visual processing. Previous studies have identified attention priority maps of simple artificial stimuli in multiple cortical and subcortical areas, but investigating neural correlates of priority maps of natural stimuli is complicated by the complexity of their spatial structure and the difficulty of behaviorally characterizing their priority map. To overcome these challenges, we reconstructed the topographic representations of upright/inverted face images from fMRI BOLD signals in human early visual areas primary visual cortex (V1) and the extrastriate cortex (V2 and V3) based on a voxelwise population receptive field model. We characterized the priority map behaviorally as the first saccadic eye movement pattern when subjects performed a face-matching task relative to the condition in which subjects performed a phase-scrambled face-matching task. We found that the differential first saccadic eye movement pattern between upright/inverted and scrambled faces could be predicted from the reconstructed topographic representations in V1-V3 in humans of either sex. The coupling between the reconstructed representation and the eye movement pattern increased from V1 to V2/3 for the upright faces, whereas no such effect was found for the inverted faces. Moreover, face inversion modulated the coupling in V2/3, but not in V1. Our findings provide new evidence for priority maps of natural stimuli in early visual areas and extend traditional attention priority map theories by revealing another critical factor that affects priority maps in extrastriate cortex in addition to physical salience and task goal relevance: image configuration. SIGNIFICANCE STATEMENT Prominent theories of attention posit that attention sampling of visual information is mediated by a series of interacting topographic representations of visual space known as attention priority maps. Until now, neural evidence of attention priority maps has been limited to studies involving simple artificial stimuli and much remains unknown about the neural correlates of priority maps of natural stimuli. Here, we show that attention priority maps of face stimuli could be found in primary visual cortex (V1) and the extrastriate cortex (V2 and V3). Moreover, representations in extrastriate visual areas are strongly modulated by image configuration. These findings extend our understanding of attention priority maps significantly by showing that they are modulated, not only by physical salience and task-goal relevance, but also by the configuration of stimuli images. Copyright © 2018 the authors 0270-6474/18/380149-09$15.00/0.

Genetics Home Reference: xeroderma pigmentosum

MedlinePlus

... trichothiodystrophy and Cockayne syndrome: a complex genotype-phenotype relationship. Neuroscience. 2007 Apr 14;145(4):1388-96. ... for Links Data Files & API Site Map Subscribe Customer Support USA.gov Copyright Privacy Accessibility FOIA Viewers & ...

Consensus recommendations for cancer rehabilitation: research and education priorities

PubMed Central

McEwen, S.; Egan, M.; Chasen, M.; Fitch, M.

2013-01-01

As cancer survivorship increases, there is a need for additional and more complex rehabilitation services. The Partners in Cancer Rehabilitation Research group held a 3-day invitational working meeting aimed at defining the state of the science in cancer rehabilitation research and identifying key areas for development of research and education. In May 2012, 29 participants gathered to present their current work, review a synthesis of the current literature, generate ideas about research and education gaps, and develop consensus on priority areas. The conclusion of the meeting was that a main research priority is to develop and test personalized rehabilitation interventions and brief measures to identify the presence and severity of disabling sequelae. The education consensus statement concluded that a clear description of cancer rehabilitation and its mandate should be developed as a precursor to education activities, including both a conceptualization of complex interdisciplinary rehabilitation and the roles of individual professions, and further, that there is a great need to increase awareness among health professionals, patients, and families of the need for and general effectiveness of cancer rehabilitation. Numerous specific recommendations were also put forward, and it is hoped that those recommendations will provide the foundation for a new and productive era of research and will play a role in the improvement of functional health and participation outcomes for cancer survivors.

A prioritization and analysis strategy for environmental surveillance results.

PubMed

Shyr, L J; Herrera, H; Haaker, R

1997-11-01

DOE facilities are required to conduct environmental surveillance to verify that facility operations are operated within the approved risk envelope and have not caused undue risk to the public and the environment. Given a reduced budget, a strategy for analyzing environmental surveillance data was developed to set priorities for sampling needs. The radiological and metal data collected at Sandia National Laboratories, New Mexico, were used to demonstrate the analysis strategy. Sampling locations were prioritized for further investigation and the needs for routine sampling. The process of data management, analysis, prioritization, and presentation has been automated through a custom-designed computer tool. Data collected over years can be analyzed and summarized in a short table format for prioritization and decision making.

New type of standalone gas sensors based on dye, thin films, and subwavelength structures

NASA Astrophysics Data System (ADS)

Schnieper, Marc; Davoine, Laurent; Holgado, Miguel; Casquel del Campo, Rafael; Barranco, Angel

2009-02-01

A new gas sensor was developed to enable visual indication of a contamination by specific gases like NO2, SO2, UV, etc. The sensor works with a combination of subwavelength structures and specific active dye thin film layers. The objective is to use the optical changes of the dye thin films after exposure and a custom designed subwavelength structure, a suited combination of both will produce a strong color change. The indication should be visible for the human eye. To enhance this visual aspect, we used a reference sensor sealed into a non-contaminated atmosphere. This work was realized within the PHODYE STREP Project, a collaboration of the 6th Framework Program Priority Information Society Technologies.

UOE Pipe Numerical Model: Manufacturing Process And Von Mises Residual Stresses Resulted After Each Technological Step

NASA Astrophysics Data System (ADS)

Delistoian, Dmitri; Chirchor, Mihael

2017-12-01

Fluid transportation from production areas to final customer is effectuated by pipelines. For oil and gas industry, pipeline safety and reliability represents a priority. From this reason, pipe quality guarantee directly influence pipeline designed life, but first of all protects environment. A significant number of longitudinally welded pipes, for onshore/offshore pipelines, are manufactured by UOE method. This method is based on cold forming. In present study, using finite element method is modeled UOE pipe manufacturing process and is obtained von Mises stresses for each step. Numerical simulation is performed for L415 MB (X60) steel plate with 7,9 mm thickness, length 30 mm and width 1250mm, as result it is obtained a DN 400 pipe.

Decision-making styles of business and industry: Five insights to improving your sales success

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

Bramson, R.M.

1996-04-01

Corporations, like people, have styles-even personalities-that in varied but vital ways affect every decision made at every level in the organization. This report describes five key organizational styles, methods for assessing which style a utility sales representative might encounter, and practical strategies that increase the odds of proposal acceptance. Each style is defined by its (1) goals and priorities, (2) administrative/communicative network, (3) key players, (4) events or circumstances prompting decisions, and (5) typical decision barriers, biases, and selling points. Written in highly readable style, this report provides tools that will help utility representatives proactively overcome organizational sales barriers, shortenmore » selling cycles, reduce sales expense, increase revenue and enhance customer loyalty.« less

Applying dynamic priority scheduling scheme to static systems of pinwheel task model in power-aware scheduling.

PubMed

Seol, Ye-In; Kim, Young-Kuk

2014-01-01

Power-aware scheduling reduces CPU energy consumption in hard real-time systems through dynamic voltage scaling (DVS). In this paper, we deal with pinwheel task model which is known as static and predictable task model and could be applied to various embedded or ubiquitous systems. In pinwheel task model, each task's priority is static and its execution sequence could be predetermined. There have been many static approaches to power-aware scheduling in pinwheel task model. But, in this paper, we will show that the dynamic priority scheduling results in power-aware scheduling could be applied to pinwheel task model. This method is more effective than adopting the previous static priority scheduling methods in saving energy consumption and, for the system being still static, it is more tractable and applicable to small sized embedded or ubiquitous computing. Also, we introduce a novel power-aware scheduling algorithm which exploits all slacks under preemptive earliest-deadline first scheduling which is optimal in uniprocessor system. The dynamic priority method presented in this paper could be applied directly to static systems of pinwheel task model. The simulation results show that the proposed algorithm with the algorithmic complexity of O(n) reduces the energy consumption by 10-80% over the existing algorithms.

Applying Dynamic Priority Scheduling Scheme to Static Systems of Pinwheel Task Model in Power-Aware Scheduling

PubMed Central

2014-01-01

Power-aware scheduling reduces CPU energy consumption in hard real-time systems through dynamic voltage scaling (DVS). In this paper, we deal with pinwheel task model which is known as static and predictable task model and could be applied to various embedded or ubiquitous systems. In pinwheel task model, each task's priority is static and its execution sequence could be predetermined. There have been many static approaches to power-aware scheduling in pinwheel task model. But, in this paper, we will show that the dynamic priority scheduling results in power-aware scheduling could be applied to pinwheel task model. This method is more effective than adopting the previous static priority scheduling methods in saving energy consumption and, for the system being still static, it is more tractable and applicable to small sized embedded or ubiquitous computing. Also, we introduce a novel power-aware scheduling algorithm which exploits all slacks under preemptive earliest-deadline first scheduling which is optimal in uniprocessor system. The dynamic priority method presented in this paper could be applied directly to static systems of pinwheel task model. The simulation results show that the proposed algorithm with the algorithmic complexity of O(n) reduces the energy consumption by 10–80% over the existing algorithms. PMID:25121126

[The contribution of oncology nursing to the Swiss Research Agenda for Nursing - SRAN].

PubMed

Shaha, Maya; Schmid-Büchi, Silvia; Abt, Judith; Mathis-Jäggi, Franziska; Holdener, Eveline; Riederer, Evelyn; Stoll, Hans Ruedi; Fliedner, Monica; Imhof, Lorenz

2008-12-01

Worldwide, cancer remains the second most frequent cause of death in adults and children. A cancer diagnosis often marks the beginning of therapies that may continue over months and years. These therapies frequently consist in surgical interventions in combination with chemotherapy and radiotherapy. For all healthcare professionals involved, cancer also signifies a very complex illness with high demands. It is therefore important to identify research priorities in order to successfully and comprehensively address these demands and to provide high quality patient care. In order to identify research priorities in oncology care in Switzerland, a systematic review of literature was conducted. A total of 30 research priorities emerged from the literature. In accordance with SRAN guidelines, 25 were passed on to the SRAN. The systematic identification of research priorities in oncology nursing has, for the first time, resulted in a list of topics in need of investigation in Switzerland. Completing the list of research priorities for oncology nursing with an updated systematic review of literature and presenting it to a larger and more representative group of oncology nurses, experts, and nurse scientists with oncology nursing experience for assessment and valuation, will be crucial for any future revision of the SRAN. In the future, it will be indispensable to include patients and their families in the process.

[Factors associated with the satisfaction of prescribers of blood products in Burkina Faso].

PubMed

Sawadogo, S; Kafando, E; Nébié, K; Ouédraogo, A-S; Ouattara, S; Dahourou, H; Fretz, C; Deneys, V

2017-11-01

The National Blood Transfusion Centre, unique operator of blood transfusion in Burkina Faso is engaged into the quality process according to ISO 9001. Therefore, the assessment of customer satisfaction is a main part of its system. Our study conceives "customer satisfaction" as dependant to the perceived service quality based on SERVQUAL model. To identify factors associated with the satisfaction of blood products prescribers in order to help decision-makers for continuous improvement of services. We conducted a cross-sectional survey among prescribers of blood components in Ouagadougou, between February 27 and April 30, 2015. We used an anonymous self-administered questionnaire, including 13 items associated to the 5 dimensions of SERVQUAL model. The different satisfaction gaps were calculated and linear regression was used to determine statistical associations with a significance level of 5%. The return rate was 94.5% about the 256 questionnaires distributed. A total of 30% of respondents were satisfied to very satisfied. The overall global gap of satisfaction was -5.74. The product delivery time, the efficacy and safety of blood products, the medical and clinical support, the pro-activity of the communication, the management of blood products reservation and the satisfaction of needs in blood products were the factors associated with the prescribers' satisfaction. This first study in blood transfusion services in our context was been useful to assess customer satisfaction and identify the main axes on which targeting priority actions in order to effectively use available resources. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014

PubMed Central

Coleman, Anne-Marie; Hermstad, April K.; Honeycutt, Sally; Munoz, Jennifer; Loh, Lorna; Brown, Agnes F.; Shipley, Rebecca; Kegler, Michelle C.

2016-01-01

Background Ecological models of health suggest that to effectively prevent chronic disease, community food environments must support healthy eating behaviors. However, disparities in access to healthy foods persist in the United States. Community Context The Farm Fresh Market (FFM) was a fruit and vegetable market that sold low-cost fresh produce in Cobb County, Georgia in 2014. Methods This case study describes the development of the FFM through a community engagement process and presents evaluation results from the project’s pilot implementation. Community engagement strategies included forming a community advisory board, conducting a needs assessment, and contracting with a community-based organization to implement the FFM. Outcome In the pilot year, the FFM served an average of 28.7 customers and generated an average of $140.20 in produce sales per market day. Most returning customers lived in the local community and reported a range of socioeconomic backgrounds. Most returning customers strongly agreed that the FFM made it easier (69.0%) and less expensive (79.0%) for them to buy fresh fruits and vegetables, reported that they ate more vegetables (65.0%) and fruit (55.0%) as a result of the FFM, and reported that they were very satisfied with the FFM overall (92.0%). Interpretation Results from this community case study underscore the importance of engaging communities in the development of community food environment interventions. Results also suggest that the FFM initiative was a feasible and acceptable way to respond to the community-identified public health priority of increasing access to healthy foods. PMID:26963860

Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014.

PubMed

Woodruff, Rebecca C; Coleman, Anne-Marie; Hermstad, April K; Honeycutt, Sally; Munoz, Jennifer; Loh, Lorna; Brown, Agnes F; Shipley, Rebecca; Kegler, Michelle C

2016-03-10

Ecological models of health suggest that to effectively prevent chronic disease, community food environments must support healthy eating behaviors. However, disparities in access to healthy foods persist in the United States. The Farm Fresh Market (FFM) was a fruit and vegetable market that sold low-cost fresh produce in Cobb County, Georgia in 2014. This case study describes the development of the FFM through a community engagement process and presents evaluation results from the project's pilot implementation. Community engagement strategies included forming a community advisory board, conducting a needs assessment, and contracting with a community-based organization to implement the FFM. In the pilot year, the FFM served an average of 28.7 customers and generated an average of $140.20 in produce sales per market day. Most returning customers lived in the local community and reported a range of socioeconomic backgrounds. Most returning customers strongly agreed that the FFM made it easier (69.0%) and less expensive (79.0%) for them to buy fresh fruits and vegetables, reported that they ate more vegetables (65.0%) and fruit (55.0%) as a result of the FFM, and reported that they were very satisfied with the FFM overall (92.0%). Results from this community case study underscore the importance of engaging communities in the development of community food environment interventions. Results also suggest that the FFM initiative was a feasible and acceptable way to respond to the community-identified public health priority of increasing access to healthy foods.

Analysis of Food Hub Commerce and Participation Using Agent-Based Modeling: Integrating Financial and Social Drivers.

PubMed

Krejci, Caroline C; Stone, Richard T; Dorneich, Michael C; Gilbert, Stephen B

2016-02-01

Factors influencing long-term viability of an intermediated regional food supply network (food hub) were modeled using agent-based modeling techniques informed by interview data gathered from food hub participants. Previous analyses of food hub dynamics focused primarily on financial drivers rather than social factors and have not used mathematical models. Based on qualitative and quantitative data gathered from 22 customers and 11 vendors at a midwestern food hub, an agent-based model (ABM) was created with distinct consumer personas characterizing the range of consumer priorities. A comparison study determined if the ABM behaved differently than a model based on traditional economic assumptions. Further simulation studies assessed the effect of changes in parameters, such as producer reliability and the consumer profiles, on long-term food hub sustainability. The persona-based ABM model produced different and more resilient results than the more traditional way of modeling consumers. Reduced producer reliability significantly reduced trade; in some instances, a modest reduction in reliability threatened the sustainability of the system. Finally, a modest increase in price-driven consumers at the outset of the simulation quickly resulted in those consumers becoming a majority of the overall customer base. Results suggest that social factors, such as desire to support the community, can be more important than financial factors. An ABM of food hub dynamics, based on human factors data gathered from the field, can be a useful tool for policy decisions. Similar approaches can be used for modeling customer dynamics with other sustainable organizations. © 2015, Human Factors and Ergonomics Society.

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

Phillips, Monica

Monica Phillips discuss her role as an engineer at Savannah River National Laboratory. Her mission is to provide support to various customers on-site through engineered equipment and solutions, along with solving complex problems to help them meet their needs.

Bandwidth Efficient Modulation and Coding Techniques for NASA's Existing Ku/Ka-Band 225 MHz Wide Service

NASA Technical Reports Server (NTRS)

Gioannini, Bryan; Wong, Yen; Wesdock, John

2005-01-01

The National Aeronautics and Space Administration (NASA) has recently established the Tracking and Data Relay Satellite System (TDRSS) K-band Upgrade Project (TKUP), a project intended to enhance the TDRSS Ku-band and Ka-band Single Access Return 225 MHz (Ku/KaSAR-225) data service by adding the capability to process bandwidth efficient signal design and to replace the White Sand Complex (WSC) KSAR high data rate ground equipment and high rate switches which are nearing obsolescence. As a precursor to this project, a modulation and coding study was performed to identify signal structures which maximized the data rate through the Ku/KaSAR-225 channel, minimized the required customer EIRP and ensured acceptable hardware complexity on the customer platform. This paper presents the results and conclusions of the TKUP modulation and coding study.

Developing a new stochastic competitive model regarding inventory and price

NASA Astrophysics Data System (ADS)

Rashid, Reza; Bozorgi-Amiri, Ali; Seyedhoseini, S. M.

2015-09-01

Within the competition in today's business environment, the design of supply chains becomes more complex than before. This paper deals with the retailer's location problem when customers choose their vendors, and inventory costs have been considered for retailers. In a competitive location problem, price and location of facilities affect demands of customers; consequently, simultaneous optimization of the location and inventory system is needed. To prepare a realistic model, demand and lead time have been assumed as stochastic parameters, and queuing theory has been used to develop a comprehensive mathematical model. Due to complexity of the problem, a branch and bound algorithm has been developed, and its performance has been validated in several numerical examples, which indicated effectiveness of the algorithm. Also, a real case has been prepared to demonstrate performance of the model for real world.

AAC technologies for young children with complex communication needs: state of the science and future research directions.

PubMed

Light, Janice; Drager, Kathryn

2007-09-01

Augmentative and alternative communication (AAC) technologies offer the potential to provide children who have complex communication needs with access to the magic and power of communication. This paper is intended to (a) summarize the research related to AAC technologies for young children who have complex communication needs; and (b) define priorities for future research to improve AAC technologies and interventions for children with complex communication needs. With the realization of improved AAC technologies, young children with complex communication needs will have better tools to maximize their development of communication, language, and literacy skills, and attain their full potential.

Customer satisfaction.

PubMed

Vukmir, Rade B

2006-01-01

This paper seeks to present an analysis of the literature examining objective information concerning the subject of customer service, as it applies to the current medical practice. Hopefully, this information will be synthesized to generate a cogent approach to correlate customer service with quality. Articles were obtained by an English language search of MEDLINE from January 1976 to July 2005. This computerized search was supplemented with literature from the author's personal collection of peer-reviewed articles on customer service in a medical setting. This information was presented in a qualitative fashion. There is a significant lack of objective data correlating customer service objectives, patient satisfaction and quality of care. Patients present predominantly for the convenience of emergency department care. Specifics of satisfaction are directed to the timing, and amount of "caring". Demographic correlates including symptom presentation, practice style, location and physician issues directly impact on satisfaction. It is most helpful to develop a productive plan for the "difficult patient", emphasizing communication and empathy. Profiling of the customer satisfaction experience is best accomplished by examining the specifics of satisfaction, nature of the ED patient, demographic profile, symptom presentation and physician interventions emphasizing communication--especially with the difficult patient. The current emergency medicine customer service dilemmas are a complex interaction of both patient and physician factors specifically targeting both efficiency and patient satisfaction. Awareness of these issues particular to the emergency patient can help to maximize efficiency, minimize subsequent medicolegal risk and improve patient care if a tailored management plan is formulated.

78 FR 29420 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

... solicit comments on the proposed rule change from interested persons. \\1\\ 15 U.S.C. 78s(b)(1). \\2\\ 17 CFR... Public Customer complex orders, including those that trade against simple (non-complex) orders (excluding... rebate for all Maker simple orders (excluding trades on the open, for which no fees are assessed or...

Integrated Decision Strategies for Skin Sensitization Hazard

EPA Science Inventory

One of the top priorities of the Interagency Coordinating Committee for the Validation of Alternative Methods (ICCVAM) is the identification and evaluation of non-animal alternatives for skin sensitization testing. Although skin sensitization is a complex process, the key biologi...

Situational Awareness Geospatial Application (iSAGA)

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

Sher, Benjamin

Situational Awareness Geospatial Application (iSAGA) is a geospatial situational awareness software tool that uses an algorithm to extract location data from nearly any internet-based, or custom data source and display it geospatially; allows user-friendly conduct of spatial analysis using custom-developed tools; searches complex Geographic Information System (GIS) databases and accesses high resolution imagery. iSAGA has application at the federal, state and local levels of emergency response, consequence management, law enforcement, emergency operations and other decision makers as a tool to provide complete, visual, situational awareness using data feeds and tools selected by the individual agency or organization. Feeds may bemore » layered and custom tools developed to uniquely suit each subscribing agency or organization. iSAGA may similarly be applied to international agencies and organizations.« less

Advances and Future Directions for Tuberous Sclerosis Complex Research: Recommendations From the 2015 Strategic Planning Conference.

PubMed

Sahin, Mustafa; Henske, Elizabeth P; Manning, Brendan D; Ess, Kevin C; Bissler, John J; Klann, Eric; Kwiatkowski, David J; Roberds, Steven L; Silva, Alcino J; Hillaire-Clarke, Coryse St; Young, Lisa R; Zervas, Mark; Mamounas, Laura A

2016-07-01

On March 10 to March 12, 2015, the National Institute of Neurological Disorders and Stroke and the Tuberous Sclerosis Alliance sponsored a workshop in Bethesda, Maryland, to assess progress and new opportunities for research in tuberous sclerosis complex with the goal of updating the 2003 Research Plan for Tuberous Sclerosis (http://www.ninds.nih.gov/about_ninds/plans/tscler_research_plan.htm). In addition to the National Institute of Neurological Disorders and Stroke and Tuberous Sclerosis Alliance, participants in the strategic planning effort and workshop included representatives from six other Institutes of the National Institutes of Health, the Department of Defense Tuberous Sclerosis Complex Research Program, and a broad cross-section of basic scientists and clinicians with expertise in tuberous sclerosis complex along with representatives from the pharmaceutical industry. Here we summarize the outcomes from the extensive premeeting deliberations and final workshop recommendations, including (1) progress in the field since publication of the initial 2003 research plan for tuberous sclerosis complex, (2) the key gaps, needs, and challenges that hinder progress in tuberous sclerosis complex research, and (3) a new set of research priorities along with specific recommendations for addressing the major challenges in each priority area. The new research plan is organized around both short-term and long-term goals with the expectation that progress toward specific objectives can be achieved within a five to ten year time frame. Copyright © 2016 Elsevier Inc. All rights reserved.

Intervention complexity--a conceptual framework to inform priority-setting in health.

PubMed Central

Gericke, Christian A.; Kurowski, Christoph; Ranson, M. Kent; Mills, Anne

2005-01-01

Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals. PMID:15868020

Intervention complexity--a conceptual framework to inform priority-setting in health.

PubMed

Gericke, Christian A; Kurowski, Christoph; Ranson, M Kent; Mills, Anne

2005-04-01

Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals.

Factors influencing efficient structure of fuel and energy complex

NASA Astrophysics Data System (ADS)

Sidorova, N. G.; Novikova, S. A.

2017-10-01

The development of the Russian fuel-energy complex is a priority for the national economic policy, and the Far East is a link between Russia and the Asia-Pacific region. Large-scale engineering of numerous resources of the Far East will force industrial development, increase living standard and strengthen Russia’s position in the global energy market. So, revealing the factors which influence rational structure of the fuel-energy complex is very urgent nowadays. With the use of depth analysis of development tendencies of the complex and its problems the authors show ways of its efficiency improvement.

Getting the most out of all your customers.

PubMed

Thomas, Jacquelyn S; Reinartz, Werner; Kumar, V

2004-01-01

Companies spend billions of dollars on direct marketing, targeting individual customers with ever more accuracy. Yet despite the power of the myriad data-collecting and analytical tools at their disposal, they're still having trouble optimizing their direct-marketing investments. Many marketers try to minimize costs by pursuing only those customers who are cheap to find and cheap to keep. Others try to get the most customers they possibly can and keep all of them for as long as they can. But a customer need not be loyal to be highly profitable, and many loyal customers turn out to be highly unprofitable. Companies can get more out of direct marketing if they see it as a single system for generating profits than if they try to maximize performance measures at each stage of the process. This article describes a tool for doing just that. Called ARPRO (Allocating Resources for Profits), the tool is essentially a complex regression analysis that can estimate the impact of a company's direct-marketing investments on the profitability of its customer pool. With data that companies already gather, the tool can show managers how much to spend on acquisition versus retention and even what percentage of their funds they should allocate to the different direct-marketing channels. Using the model, companies can easily see that even small deviations from the optimal levels of customer profitability are expensive. Applying it to one catalog retailer showed, for instance, that a 10% reduction in marketing costs would lead to a 1.8 million dollar drop in long-term customer profits. Conversely, spending 69% less on marketing would actually increase average customer profitability at one B2B service provider by 42%. What's more, the tool can show that finding the optimal balance between investments in acquisition and retention can be more important than finding the optimum amount to invest overall.

DIY 3D printing of custom orthopaedic implants: a proof of concept study.

PubMed

Frame, Mark; Leach, William

2014-03-01

3D printing is an emerging technology that is primarily used for aiding the design and prototyping of implants. As this technology has evolved it has now become possible to produce functional and definitive implants manufactured using a 3D printing process. This process, however, previously required a large financial investment in complex machinery and professionals skilled in 3D product design. Our pilot study's aim was to design and create a 3D printed custom orthopaedic implant using only freely available consumer hardware and software.

A Case Study of Reverse Engineering Integrated in an Automated Design Process

NASA Astrophysics Data System (ADS)

Pescaru, R.; Kyratsis, P.; Oancea, G.

2016-11-01

This paper presents a design methodology which automates the generation of curves extracted from the point clouds that have been obtained by digitizing the physical objects. The methodology is described on a product belonging to the industry of consumables, respectively a footwear type product that has a complex shape with many curves. The final result is the automated generation of wrapping curves, surfaces and solids according to the characteristics of the customer's foot, and to the preferences for the chosen model, which leads to the development of customized products.

Murine cell glycolipids customization by modular expression of glycosyltransferases.

PubMed

Cid, Emili; Yamamoto, Miyako; Buschbeck, Marcus; Yamamoto, Fumiichiro

2013-01-01

Functional analysis of glycolipids has been hampered by their complex nature and combinatorial expression in cells and tissues. We report an efficient and easy method to generate cells with specific glycolipids. In our proof of principle experiments we have demonstrated the customized expression of two relevant glycosphingolipids on murine fibroblasts, stage-specific embryonic antigen 3 (SSEA-3), a marker for stem cells, and Forssman glycolipid, a xenoantigen. Sets of genes encoding glycosyltansferases were transduced by viral infection followed by multi-color cell sorting based on coupled expression of fluorescent proteins.

Space Mission Operations Ground Systems Integration Customer Service

NASA Technical Reports Server (NTRS)

Roth, Karl

2014-01-01

The facility, which is now the Huntsville Operations Support Center (HOSC) at Marshall Space Flight Center in Huntsville, AL, has provided continuous space mission and related services for the space industry since 1961, from Mercury Redstone through the International Space Station (ISS). Throughout the long history of the facility and mission support teams, the HOSC has developed a stellar customer support and service process. In this era, of cost cutting, and providing more capability and results with fewer resources, space missions are looking for the most efficient way to accomplish their objectives. One of the first services provided by the facility was fax transmission of documents to, then, Cape Canaveral in Florida. The headline in the Marshall Star, the newspaper for the newly formed Marshall Space Flight Center, read "Exact copies of Documents sent to Cape in 4 minutes." The customer was Dr. Wernher von Braun. Currently at the HOSC we are supporting, or have recently supported, missions ranging from simple ISS payloads requiring little more than "bentpipe" telemetry access, to a low cost free-flyer Fast, Affordable, Science and Technology Satellite (FASTSAT), to a full service ISS payload Alpha Magnetic Spectrometer 2 (AMS2) supporting 24/7 operations at three operations centers around the world with an investment of over 2 billion dollars. The HOSC has more need and desire than ever to provide fast and efficient customer service to support these missions. Here we will outline how our customer-centric service approach reduces the cost of providing services, makes it faster and easier than ever for new customers to get started with HOSC services, and show what the future holds for our space mission operations customers. We will discuss our philosophy concerning our responsibility and accessibility to a mission customer as well as how we deal with the following issues: initial contact with a customer, reducing customer cost, changing regulations and security, and cultural differences, to ensure an efficient response to customer issues using a small Customer Service Team (CST) and adaptability, constant communication with customers, technical expertise and knowledge of services, and dedication to customer service. The HOSC Customer Support Team has implemented a variety of processes, and procedures that help to mitigate the potential problems that arise when integrating ground system services for a variety of complex missions and the lessons learned from this experience will lead the future of customer service in the space operations industry.

Tsunami vertical-evacuation planning in the U.S. Pacific Northwest as a geospatial, multi-criteria decision problem

USGS Publications Warehouse

Wood, Nathan; Jones, Jeanne; Schelling, John; Schmidtlein, Mathew

2014-01-01

Tsunami vertical-evacuation (TVE) refuges can be effective risk-reduction options for coastal communities with local tsunami threats but no accessible high ground for evacuations. Deciding where to locate TVE refuges is a complex risk-management question, given the potential for conflicting stakeholder priorities and multiple, suitable sites. We use the coastal community of Ocean Shores (Washington, USA) and the local tsunami threat posed by Cascadia subduction zone earthquakes as a case study to explore the use of geospatial, multi-criteria decision analysis for framing the locational problem of TVE siting. We demonstrate a mixed-methods approach that uses potential TVE sites identified at community workshops, geospatial analysis to model changes in pedestrian evacuation times for TVE options, and statistical analysis to develop metrics for comparing population tradeoffs and to examine influences in decision making. Results demonstrate that no one TVE site can save all at-risk individuals in the community and each site provides varying benefits to residents, employees, customers at local stores, tourists at public venues, children at schools, and other vulnerable populations. The benefit of some proposed sites varies depending on whether or not nearby bridges will be functioning after the preceding earthquake. Relative rankings of the TVE sites are fairly stable under various criteria-weighting scenarios but do vary considerably when comparing strategies to exclusively protect tourists or residents. The proposed geospatial framework can serve as an analytical foundation for future TVE siting discussions.

Why entrepreneurs don't scale.

PubMed

Hamm, John

2002-12-01

It's well known that many executives who excel at starting businesses or projects fizzle out--in other words, they fail to "scale"--as their ventures grow. But the reasons have remained fuzzy. In this article, leadership coach John Hamm identifies four management tendencies that work for small-company or business-unit leaders but become Achilles' heels as those individuals try to run larger organizations. The first tendency is loyalty to comrades. In entrepreneurial mode, you need to lead as though you're in charge of a combat unit on the wrong side of enemy lines. But blind loyalty can become a liability in managing a complex organization. The second tendency, task orientation, is critical in driving toward a big product launch, but excessive attention to detail can cause a large organization to lose sight of its long-term goals. The third tendency, single-mindedness, is important in a visionary unleashing a revolutionary product or service on the world but can limit the company's potential as it grows. And the fourth tendency, working in isolation, is fine for the brilliant scientist focused on an ingenious idea. But it's disastrous for a leader whose expanding organization increasingly relies on many other people. Leaders who scale deal honestly with problems and quickly weed out nonperformers. They see past distractions and establish strategic priorities. They learn how to deal effectively with diverse employees, customers, and external constituencies. And, most important, they make the company's continuing health and welfare their top concern.

The ReACH Collaborative--improving quality home care.

PubMed

Boyce, Patricia Simino; Pace, Karen B; Lauder, Bonnie; Solomon, Debra A

2007-08-01

Research on quality of care has shown that vigorous leadership, clear goals, and compatible incentive systems are critical factors in influencing successful change (Institute of Medicine, 2001). Quality improvement is a complex process, and clinical quality improvement applications are more likely to be effective in organizations that are ready for change and have strong leaders, who are committed to creating and reinforcing a work environment that supports quality goals (Shortell, 1998). Key leadership roles include providing clear and sustained direction, articulating a coherent set of values and incentives to guide group and individual activities, aligning and integrating improvement efforts into organizational priorities, obtaining or freeing up resources to implement improvement activities, and creating a culture of "continuous improvement" that encourages and rewards the pursuit and achievement of shared quality aims (Institute of Medicine, 2001, 70-71). In summary, home health care is a significant and growing sector of the health care system that provides care to millions of vulnerable patients. There seems little doubt that home health agencies want to focus on quality of care issues and provide optimal care to home-based patients. Furthermore, there is a growing awareness of the value for adapting innovative, effective models for improving the culture of home care practice. This awareness stems from the notion that some agencies see quality improvement activities as a way for them to distinguish themselves not only to regulators and customers, but also to meet the cultural and transformational needs to remain viable in a constantly evolving and competitive health care industry.

Development of a new model to engage patients and clinicians in setting research priorities.

PubMed

Pollock, Alex; St George, Bridget; Fenton, Mark; Crowe, Sally; Firkins, Lester

2014-01-01

Equitable involvement of patients and clinicians in setting research and funding priorities is ethically desirable and can improve the quality, relevance and implementation of research. Survey methods used in previous priority setting projects to gather treatment uncertainties may not be sufficient to facilitate responses from patients and their lay carers for some health care topics. We aimed to develop a new model to engage patients and clinicians in setting research priorities relating to life after stroke, and to explore the use of this model within a James Lind Alliance (JLA) priority setting project. We developed a model to facilitate involvement through targeted engagement and assisted involvement (FREE TEA model). We implemented both standard surveys and the FREE TEA model to gather research priorities (treatment uncertainties) from people affected by stroke living in Scotland. We explored and configured the number of treatment uncertainties elicited from different groups by the two approaches. We gathered 516 treatment uncertainties from stroke survivors, carers and health professionals. We achieved approximately equal numbers of contributions; 281 (54%) from stroke survivors/carers; 235 (46%) from health professionals. For stroke survivors and carers, 98 (35%) treatment uncertainties were elicited from the standard survey and 183 (65%) at FREE TEA face-to-face visits. This contrasted with the health professionals for whom 198 (84%) were elicited from the standard survey and only 37 (16%) from FREE TEA visits. The FREE TEA model has implications for future priority setting projects and user-involvement relating to populations of people with complex health needs. Our results imply that reliance on standard surveys may result in poor and unrepresentative involvement of patients, thereby favouring the views of health professionals.

Research Priorities in Geriatric Palliative Care: Multimorbidity

PubMed Central

Zulman, Donna M.

2013-01-01

Abstract With global aging and scientific advances extending survival, the number of adults experiencing multiple chronic conditions has grown substantially and is projected to increase by another third between 2000 and 2030. Among the many challenges posed by multimorbidity, some of the most pressing include how to characterize and measure comorbid conditions, understand symptoms and illness burden, and provide person-centered care in the context of competing health care priorities and increasing complexity. In this white paper emanating from a National Institute on Aging supported conference to discuss research gaps at the geriatrics–palliative care interface, the authors review common definitions of multimorbidity; describe the association between multimorbidity and quality of life, functional status, quality of care, and health care utilization; note content and methodological gaps in multimorbidity evidence; and make recommendations regarding research priorities in this area of expanding public health impact. PMID:23777331

Genetics Home Reference: familial adenomatous polyposis

MedlinePlus

... Järvinen HJ, Peltomäki P. The complex genotype-phenotype relationship in familial adenomatous polyposis. Eur J Gastroenterol Hepatol. ... for Links Data Files & API Site Map Subscribe Customer Support USA.gov Copyright Privacy Accessibility FOIA Viewers & ...

Multivariate Models for Prediction of Human Skin Sensitization Hazard.

EPA Science Inventory

One of the lnteragency Coordinating Committee on the Validation of Alternative Method's (ICCVAM) top priorities is the development and evaluation of non-animal approaches to identify potential skin sensitizers. The complexity of biological events necessary to produce skin sensiti...

Standby power generation under utility curtailment contract agreements

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

Nolan, G.J.; Puccio, V.J.; Calhoun, C.W.

1995-12-31

Many utilities in the US offer large industrial and commercial customers power sales contracts which have attractive rates under a curtailment requirement. This curtailment requirement allows the utility to require the customer to reduce its power demand to a predetermined level within a specific time period. If the required curtailment is not achieved by the customer within the allocated time period, stiff financial penalties are usually enforced by the utility. The attractiveness of the contract rates usually is proportional to the amount of curtailment required. To take advantage of these attractive rates, a customer must be able to withstand themore » curtailment without supplemental generation or must add standby generation to meet its needs. Obviously, the cost of the curtailments to the customer should not exceed the economic benefits of reduced rates. This paper reviews the alternatives faced by a curtailment contract customer together with potential load shedding and standby generation system designs. An example of implementing a curtailment contract at an existing industrial facility is presented. The example facility, Boeing Helicopters of Philadelphia, Pennsylvania required both load shedding and standby generation. The load shedding scheme is fairly complex and is controlled by a programmable logic controller (PLC). The standby generation and load shedding systems for the example facility are examined in detail. Also, lessons learned from implementing the required modifications to the example facility are discussed.« less

A conjoint analysis to consumer choice in Brazil: Defining device attributes for recognizing customized foods characteristics.

PubMed

Calegari, L P; Barbosa, J; Marodin, G A; Fettermann, D C

2018-07-01

the availability of information about food products may be an essential factor in the consumer's value perception in their purchasing decision. As the food product becomes personalized, the customization of this information becomes complex due to the possible combinations of product components. The use of smart technology in devices is one way to provide customers with customized food information. In the following research five attributes were identified in the composition of these devices: (A) portability; (B) precision; (C) diet customization; (D) food quality analysis; and (E) price. This study aims to identify the appropriate combination of possible functionalities or attributes that must be present in a device in order to detect the food composition of customized foods and their relation to market characteristics. One experiment used fractional factorial project to present the attributes in the form of scenarios following the Choice-Based Conjoint Analysis (CBCA) method. The data collection was done using survey methodology, through online questionnaire, with some 303 Brazilian respondents. So, the Logistic Regression was applied to data analysis. The moderating variables-gender, age, gluten restriction, lactose restriction and other restrictions-were also added to verify potential interactions with the primary attributes. From the results obtained, it was possible to observe higher significance for the primary attributes of diet personalization and quality food analyzes function. Our study contributes to the literature by enhancing the understanding about what the attributes should be in a technological device that has the purpose of recognizing food characteristics and is capable of generating information about customized food products. Furthermore, this device can enabler the production of mass customized food with the nutritional labels for each possible combination. Copyright © 2018 Elsevier Ltd. All rights reserved.

Customized a Ti6Al4V Bone Plate for Complex Pelvic Fracture by Selective Laser Melting.

PubMed

Wang, Di; Wang, Yimeng; Wu, Shibiao; Lin, Hui; Yang, Yongqiang; Fan, Shicai; Gu, Cheng; Wang, Jianhua; Song, Changhui

2017-01-04

In pelvic fracture operations, bone plate shaping is challenging and the operation time is long. To address this issue, a customized bone plate was designed and produced using selective laser melting (SLM) technology. The key steps of this study included designing the customized bone plate, metal 3D printing, vacuum heat treatment, surface post-processing, operation rehearsal, and clinical application and evaluation. The joint surface of the bone plate was placed upwards with respect to the build platform to keep it away from the support and to improve the quality of the joint surface. Heat conduction was enhanced by adding a cone-type support beneath the bone plate to prevent low-quality fabrication due to poor heat conductivity of the Ti-6Al-4V powder. The residual stress was eliminated by exposing the SLM-fabricated titanium-alloy bone plate to a vacuum heat treatment. Results indicated that the bone plate has a hardness of HV1 360-HV1 390, an ultimate tensile strength of 1000-1100 MPa, yield strength of 900-950 MPa, and an elongation of 8%-10%. Pre-operative experiments and operation rehearsal were performed using the customized bone plate and the ABC-made pelvic model. Finally, the customized bone plate was clinically applied. The intraoperative C-arm and postoperative X-ray imaging results indicated that the customized bone plate matched well to the damaged pelvis. The customized bone plate fixed the broken bone and guides pelvis restoration while reducing operation time to about two hours. The customized bone plate eliminated the need for preoperative titanium plate pre-bending, thereby greatly reducing surgical wounds and operation time.

Customized a Ti6Al4V Bone Plate for Complex Pelvic Fracture by Selective Laser Melting

PubMed Central

Wang, Di; Wang, Yimeng; Wu, Shibiao; Lin, Hui; Yang, Yongqiang; Fan, Shicai; Gu, Cheng; Wang, Jianhua; Song, Changhui

2017-01-01

In pelvic fracture operations, bone plate shaping is challenging and the operation time is long. To address this issue, a customized bone plate was designed and produced using selective laser melting (SLM) technology. The key steps of this study included designing the customized bone plate, metal 3D printing, vacuum heat treatment, surface post-processing, operation rehearsal, and clinical application and evaluation. The joint surface of the bone plate was placed upwards with respect to the build platform to keep it away from the support and to improve the quality of the joint surface. Heat conduction was enhanced by adding a cone-type support beneath the bone plate to prevent low-quality fabrication due to poor heat conductivity of the Ti-6Al-4V powder. The residual stress was eliminated by exposing the SLM-fabricated titanium-alloy bone plate to a vacuum heat treatment. Results indicated that the bone plate has a hardness of HV1 360–HV1 390, an ultimate tensile strength of 1000–1100 MPa, yield strength of 900–950 MPa, and an elongation of 8%–10%. Pre-operative experiments and operation rehearsal were performed using the customized bone plate and the ABC-made pelvic model. Finally, the customized bone plate was clinically applied. The intraoperative C-arm and postoperative X-ray imaging results indicated that the customized bone plate matched well to the damaged pelvis. The customized bone plate fixed the broken bone and guides pelvis restoration while reducing operation time to about two hours. The customized bone plate eliminated the need for preoperative titanium plate pre-bending, thereby greatly reducing surgical wounds and operation time. PMID:28772395

Priority setting partnership to identify the top 10 research priorities for the management of Parkinson's disease.

PubMed

Deane, Katherine H O; Flaherty, Helen; Daley, David J; Pascoe, Roland; Penhale, Bridget; Clarke, Carl E; Sackley, Catherine; Storey, Stacey

2014-12-14

This priority setting partnership was commissioned by Parkinson's UK to encourage people with direct and personal experience of the condition to work together to identify and prioritise the top 10 evidential uncertainties that impact on everyday clinical practice for the management of Parkinson's disease (PD). The UK. Anyone with experience of PD including: people with Parkinson's (PwP), carers, family and friends, healthcare and social care professionals. Non-clinical researchers and employees of pharmaceutical or medical devices companies were excluded. 1000 participants (60% PwP) provided ideas on research uncertainties, 475 (72% PwP) initially prioritised them and 27 (37% PwP) stakeholders agreed a final top 10. Using a modified nominal group technique, participants were surveyed to identify what issues for the management of PD needed research. Unique research questions unanswered by current evidence were identified and participants were asked to identify their top 10 research priorities from this list. The top 26 uncertainties were presented to a consensus meeting with key stakeholders to agree the top 10 research priorities. 1000 participants provided 4100 responses, which contained 94 unique unanswered research questions that were initially prioritised by 475 participants. A consensus meeting with 27 stakeholders agreed the top 10 research priorities. The overarching research aspiration was an effective cure for PD. The top 10 research priorities for PD management included the need to address motor symptoms (balance and falls, and fine motor control), non-motor symptoms (sleep and urinary dysfunction), mental health issues (stress and anxiety, dementia and mild cognitive impairments), side effects of medications (dyskinesia) and the need to develop interventions specific to the phenotypes of PD and better monitoring methods. These research priorities identify crucial gaps in the existing evidence to address everyday practicalities in the management of the complexities of PD. 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.

Priority setting partnership to identify the top 10 research priorities for the management of Parkinson's disease

PubMed Central

Deane, Katherine H O; Flaherty, Helen; Daley, David J; Pascoe, Roland; Penhale, Bridget; Clarke, Carl E; Sackley, Catherine; Storey, Stacey

2014-01-01

Objectives This priority setting partnership was commissioned by Parkinson's UK to encourage people with direct and personal experience of the condition to work together to identify and prioritise the top 10 evidential uncertainties that impact on everyday clinical practice for the management of Parkinson's disease (PD). Setting The UK. Participants Anyone with experience of PD including: people with Parkinson's (PwP), carers, family and friends, healthcare and social care professionals. Non-clinical researchers and employees of pharmaceutical or medical devices companies were excluded. 1000 participants (60% PwP) provided ideas on research uncertainties, 475 (72% PwP) initially prioritised them and 27 (37% PwP) stakeholders agreed a final top 10. Methods Using a modified nominal group technique, participants were surveyed to identify what issues for the management of PD needed research. Unique research questions unanswered by current evidence were identified and participants were asked to identify their top 10 research priorities from this list. The top 26 uncertainties were presented to a consensus meeting with key stakeholders to agree the top 10 research priorities. Results 1000 participants provided 4100 responses, which contained 94 unique unanswered research questions that were initially prioritised by 475 participants. A consensus meeting with 27 stakeholders agreed the top 10 research priorities. The overarching research aspiration was an effective cure for PD. The top 10 research priorities for PD management included the need to address motor symptoms (balance and falls, and fine motor control), non-motor symptoms (sleep and urinary dysfunction), mental health issues (stress and anxiety, dementia and mild cognitive impairments), side effects of medications (dyskinesia) and the need to develop interventions specific to the phenotypes of PD and better monitoring methods. Conclusions These research priorities identify crucial gaps in the existing evidence to address everyday practicalities in the management of the complexities of PD. PMID:25500772

Evaluation of health care service quality in Poland with the use of SERVQUAL method at the specialist ambulatory health care center

PubMed Central

Manulik, Stanisław; Rosińczuk, Joanna; Karniej, Piotr

2016-01-01

Introduction Service quality and customer satisfaction are very important components of competitive advantage in the health care sector. The SERVQUAL method is widely used for assessing the quality expected by patients and the quality of actually provided services. Objectives The main purpose of this study was to determine if patients from state and private health care facilities differed in terms of their qualitative priorities and assessments of received services. Materials and methods The study included a total of 412 patients: 211 treated at a state facility and 201 treated at a private facility. Each of the respondents completed a 5-domain, 22-item SERVQUAL questionnaire. The actual quality of health care services in both types of facilities proved significantly lower than expected. Results All the patients gave the highest scores to the domains constituting the core aspects of health care services. The private facility respondents had the highest expectations with regard to equipment, and the state facility ones regarding contacts with the medical personnel. Conclusion Health care quality management should be oriented toward comprehensive optimization in all domains, rather than only within the domain identified as the qualitative priority for patients of a given facility. PMID:27536075

Development and Application of a Taiwan Domestic Generalized Water Supply Model

NASA Astrophysics Data System (ADS)

Ho, C. C.; Chang, L. C.

2016-12-01

Water allocation in Taiwan is more complicated than other countries because high river turbidity caused by rainstorm, reservoir management governed by different organization and conjunctive use of inter-basin reservoirs and dams. Those properties cause water resource planners need make extra effort on developing customized model to simulate the impact of water supply strategies on water resources. Hence, the study develops a Generalized Water Supply Model (GWSM) to analysis Multi-reservoirs water allocation in Taiwan for advancing the planning process. The model has following functions: (1) considering reservoirs operating rule curve. (2) considering the rule of multi-reservoir operation. Such as setting supply priority of different reservoirs or using "index balance" rule. (3) considering optimal hydroelectric power operation. (4) estimating the impact of high river turbidity on water supply. (5) considering the supply priority of different water use. (6) considering irrigation supply under special constraint. Such as the maximum irrigation supply is subject to natural inflow without reservoir storage. (7) considering two-way conduit transport. (8) considering environmental flow reservation. Conjunctive use Taan and Dajia Rivers was selected to demonstrate the ability of GWSM. The results also can be provided to different authorities to realize the impact of different strategies and that is good for negotiation and reaching a consensus.

Implementation of supply chain business application through business model canvas and waterfall framework collaborations for fish farmers SMEs in ulekan market bandung

NASA Astrophysics Data System (ADS)

Priyadi, Y.; Prasetio, A.

2018-03-01

This research resulted in the development of e-SCM application, in small-scale group of fish farmers based on Open Source technology in Ulekan Market Bandung, by collaborating the implementation of e-SCM and Data Management. Then proceed with the application of supply chain business through collaboration Business Model Canvas and Waterfall Framework. For the design of business process reengineering in this activity, it produces a context diagram called e-SCM SME Fish consisting of five entities directly involved with the system, namely: fish shop supervisor, fish shop retailer, employees, fish farmers, and customers. Referring to the Context Diagram, decomposition process of Level 0 e-SCM SMEs Fish. The decomposition results in Data Flow Diagram Level 1 for four sub processes, namely: business partners, transactions, retailer stock, and documentation. Result of nine blocks on Business Model Canvas on e-SCM activity, its category consist of Priority 1, Priority 2, Direct, Indirect, Purchase/e-SCM, Transactional, Community, Asset Sale, Physical Asset, Human, Production, Strategic Alliance -competitors, Coopetition, Buyer supplier relationship, Fixed Cost, Variable Cost. For integration of data management on Localhost Server media on e-SCM using http://whyphi: 8080 address, as prototype which will soon be adopted by farmer fish farmer.

A pilot study of an online workplace nutrition program: the value of participant input in program development.

PubMed

Cousineau, Tara; Houle, Brian; Bromberg, Jonas; Fernandez, Kathrine C; Kling, Whitney C

2008-01-01

Tailored nutrition Web programs constitute an emerging trend in obesity prevention. Initial investment in innovative technology necessitates that the target population be well understood. This pilot study's purpose was to determine the feasibility of a workplace nutrition Web program. Formative research was conducted with gaming industry employees and benefits managers to develop a consensus on workplace-specific nutrition needs. A demonstration Web program was piloted with stakeholders to determine feasibility. Indiana, Mississippi, Nevada, and New Jersey gaming establishments. 86 employees, 18 benefits managers. Prototype Web program. Concept mapping; 16-item nutrition knowledge test; satisfaction. Concept mapping was used to aggregate importance ratings on programmatic content, which informed Web program curriculum. Chi-square tests were performed postintervention to determine knowledge improvement. (1) Employees and benefits managers exhibited moderate agreement about content priorities for the program (r = 0.48). (2) There was a significant increase in employees' nutrition knowledge scores postintervention (t = 7.16, df = 36, P < .001); those with less knowledge exhibited the greatest gains in knowledge scores (r = -0.647, P < .001). Employees and benefit managers do not necessarily agree on the priority of nutrition-related content, suggesting a need for programs to appeal to various stakeholders. Computer-based approaches can address various stakeholder health concerns via tailored, customized programming.

Custom-made, root-analogue direct laser metal forming implant: a case report.

PubMed

Mangano, Francesco Guido; Cirotti, Bruno; Sammons, Rachel Lilian; Mangano, Carlo

2012-11-01

In the last few years, the application of digital technology in dentistry has become widespread with the introduction of cone beam computed tomography (CBCT) scan technology, and considerable progress has been made in the development of computer-aided design/ computer-aided manufacturing (CAD/CAM) techniques, including direct laser metal forming (DLMF). DLMF is a technology which allows solids with complex geometry to be produced by annealing metal powder microparticles in a focused laser beam, according to a computer-generated three-dimensional (3D) model. For dental implants, the fabrication process involves the laser-induced fusion of titanium microparticles, in order to build, layer by layer, the desired object. At present, the combined use of CBCT 3D data and CAD/CAM technology makes it possible to manufacture custom-made, root-analogue implants (RAI) with sufficient precision. This report demonstrates the successful clinical use of a custom-made, root-analogue DLMF implant. CBCT images of a non-restorable right maxillary first premolar were acquired and transformed into a 3D model. From this model, a custom-made, root-analogue DLMF implant was fabricated. Immediately after tooth extraction, the RAI with a pre-operatively designed abutment was placed in the extraction socket and restored with a single crown. At the 1-year follow-up examination, the RAI showed a good functional and aesthetic integration. The introduction of DLMF technology signals the start of a new revolutionary era for implant dentistry as its immense potential for producing highly complex macro- and microstructures is receiving vast interest in different medical fields.

Comparison of Customized Abutments Made from Titanium and a Machinable Precious Alloy.

PubMed

Lee, Jee-Ho; Park, Ji-Man; Park, Eun-Jin; Koak, Jai-Young; Kim, Seong-Kyun; Heo, Seong-Joo

2016-01-01

To investigate the clinical usefulness, a customized abutment produced with the Pd-Ag-In alloy was compared with a customized abutment produced with the conventional titanium alloy for discoloration and mechanical accuracy. Discoloration and resistance to corrosion of the Pd-Ag-In alloy were evaluated using chemical solutions. Marginal adaptation of internal-type implants and abutments was compared using 10 titanium abutments and 10 Pd-Ag-In abutments using a surface measuring system. A detorque test was performed on 12 implant-abutment complexes of each control and experimental group to investigate screw joint stability. Cyclic loading simulating a human's mastication movement for 1 year was applied after 30 Ncm initial tightening, and the removal torque was measured using a digital torque gauge. The noninferiority test was conducted to compare the Pd-Ag-In alloy with a titanium abutment with a 10% margin. The Pd-Ag-In alloy had a warm yellow color and displayed stable resistance to discoloration and corrosion, resulting in an advantageous esthetic property. When compared to the titanium alloy, it did not show noninferiority with respect to the gap between the implant and the abutment; the gap was approximately 13.3 μm on average, which was not significantly different from those observed in previous studies. After long-term use, it displayed statistically significant noninferiority in the removal torque value compared to the titanium group. The Pd-Ag-In alloy-based customized abutment had good mechanical properties of the implant-abutment complex as well as a superior esthetic property, and can provide favorable outcomes in anterior implant restoration.

Others' anger makes people work harder not smarter: the effect of observing anger and sarcasm on creative and analytic thinking.

PubMed

Miron-Spektor, Ella; Efrat-Treister, Dorit; Rafaeli, Anat; Schwarz-Cohen, Orit

2011-09-01

The authors examine whether and how observing anger influences thinking processes and problem-solving ability. In 3 studies, the authors show that participants who listened to an angry customer were more successful in solving analytic problems, but less successful in solving creative problems compared with participants who listened to an emotionally neutral customer. In Studies 2 and 3, the authors further show that observing anger communicated through sarcasm enhances complex thinking and solving of creative problems. Prevention orientation is argued to be the latent variable that mediated the effect of observing anger on complex thinking. The present findings help reconcile inconsistent findings in previous research, promote theory about the effects of observing anger and sarcasm, and contribute to understanding the effects of anger in the workplace. PsycINFO Database Record (c) 2011 APA, all rights reserved

Expectations Among Academic Clinicians of Inpatient Imaging Turnaround Time: Does it Correlate with Satisfaction?

PubMed

Chan, Keith T; Carroll, Tamara; Linnau, Ken F; Lehnert, Bruce

2015-11-01

Imaging report turnaround time (RTAT) is an important measure of radiology performance and has become the leading priority in customer satisfaction surveys conducted among nonradiologists, who may not be familiar with the imaging workflow. Our aim was to assess physicians' expected RTAT for commonly ordered studies and determine if satisfaction correlates with met expectations. Retrospective review of inpatient imaging was conducted at a single academic institution, and RTAT for 18,414 studies was calculated. Examinations were grouped by study type, priority, and time of day. A cross-sectional survey instrument was completed by 48 internal medicine and surgery resident physicians with questions regarding RTAT and their level of satisfaction with various examinations. Actual RTAT ranged from 1.6 to 26.0 hours, with chest radiographs and computed tomographies generally faster than magnetic resonance images and ultrasounds. Urgent (STAT) examinations and those ordered during business hours have shorter RTAT. The time for image interpretation largely contributed to the RTAT because of the lack of night-time radiology coverage. Referring physician expectations were consistently shorter than actual RTAT, ranging from 30 minutes to 24 hours. Overall satisfaction scores were inversely correlated with RTAT, with a strong correlation to the time from study order to imaging (r(2) = 0.63) and a weak correlation to the image interpretation time (r(2) = 0.17). Satisfaction scores did not correlate with whether the actual RTAT met expectations (r(2) = 0.06). Referring physician satisfaction is likely multifactorial. Although RTAT has been reported as a priority, shortening turnaround time alone may not directly improve clinician satisfaction. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

A combined approach of simulation and analytic hierarchy process in assessing production facility layouts

NASA Astrophysics Data System (ADS)

Ramli, Razamin; Cheng, Kok-Min

2014-07-01

One of the important areas of concern in order to obtain a competitive level of productivity in a manufacturing system is the layout design and material transportation system (conveyor system). However, changes in customers' requirements have triggered the need to design other alternatives of the manufacturing layout for existing production floor. Hence, this paper discusses effective alternatives of the process layout specifically, the conveyor system layout. Subsequently, two alternative designs for the conveyor system were proposed with the aims to increase the production output and minimize space allocation. The first proposed layout design includes the installation of conveyor oven in the particular manufacturing room based on priority, and the second one is the one without the conveyor oven in the layout. Simulation technique was employed to design the new facility layout. Eventually, simulation experiments were conducted to understand the performance of each conveyor layout design based on operational characteristics, which include predicting the output of layouts. Utilizing the Analytic Hierarchy Process (AHP), the newly and improved layout designs were assessed before the final selection was done. As a comparison, the existing conveyor system layout was included in the assessment process. Relevant criteria involved in this layout design problem were identified as (i) usage of space of each design, (ii) operator's utilization rates, (iii) return of investment (ROI) of the layout, and (iv) output of the layout. In the final stage of AHP analysis, the overall priority of each alternative layout was obtained and thus, a selection for final use by the management was made based on the highest priority value. This efficient planning and designing of facility layout in a particular manufacturing setting is able to minimize material handling cost, minimize overall production time, minimize investment in equipment, and optimize utilization of space.

Incorporating public priorities in the Ocean Health Index: Canada as a case study.

PubMed

Daigle, Rémi M; Archambault, Philippe; Halpern, Benjamin S; Stewart Lowndes, Julia S; Côté, Isabelle M

2017-01-01

The Ocean Health Index (OHI) is a framework to assess ocean health by considering many benefits (called 'goals') provided by the ocean provides to humans, such as food provision, tourism opportunities, and coastal protection. The OHI framework can be used to assess marine areas at global or regional scales, but how various OHI goals should be weighted to reflect priorities at those scales remains unclear. In this study, we adapted the framework in two ways for application to Canada as a case study. First, we customized the OHI goals to create a national Canadian Ocean Health Index (COHI). In particular, we altered the list of iconic species assessed, added methane clathrates and subsea permafrost as carbon storage habitats, and developed a new goal, 'Aboriginal Needs', to measure access of Aboriginal people to traditional marine hunting and fishing grounds. Second, we evaluated various goal weighting schemes based on preferences elicited from the general public in online surveys. We quantified these public preferences in three ways: using Likert scores, simple ranks from a best-worst choice experiment, and model coefficients from the analysis of elicited choice experiment. The latter provided the clearest statistical discrimination among goals, and we recommend their use because they can more accurately reflect both public opinion and the trade-offs faced by policy-makers. This initial iteration of the COHI can be used as a baseline against which future COHI scores can be compared, and could potentially be used as a management tool to prioritise actions on a national scale and predict public support for these actions given that the goal weights are based on public priorities.

Getting offshoring right.

PubMed

Aron, Ravi; Singh, Jitendra V

2005-12-01

The prospect of offshoring and outsourcing business processes has captured the imagination of CEOs everywhere. In the past five years, a rising number of companies in North America and Europe have experimented with this strategy, hoping to reduce costs and gain strategic advantage. But many businesses have had mixed results. According to several studies, half the organizations that have shifted processes offshore have failed to generate the expected financial benefits. What's more, many of them have faced employee resistance and consumer dissatisfaction. Clearly, companies have to rethink how they formulate their offshoring strategies. A three-part methodology can help. First, companies need to prioritize their processes, ranking each based on two criteria: the value it creates for customers and the degree to which the company can capture some of that value. Companies will want to keep their core (highest-priority) processes in-house and consider outsourcing their commodity (low-priority) processes; critical (moderate-priority) processes are up for debate and must be considered carefully. Second, businesses should analyze all the risks that accompany offshoring and look systematically at their critical and commodity processes in terms of operational risk (the risk that processes won't operate smoothly after being offshored) and structural risk (the risk that relationships with service providers may not work as expected). Finally, companies should determine possible locations for their offshore efforts, as well as the organizational forms--such as captive centers and joint ventures--that those efforts might take. They can do so by examining each process's operational and structural risks side by side. This article outlines the tools that will help companies choose the right processes to offshore. It also describes a new organizational structure called the extended organization, in which companies specify the quality of services they want and work alongside providers to get that quality.

Incorporating public priorities in the Ocean Health Index: Canada as a case study

PubMed Central

Archambault, Philippe; Halpern, Benjamin S.; Stewart Lowndes, Julia S.; Côté, Isabelle M.

2017-01-01

The Ocean Health Index (OHI) is a framework to assess ocean health by considering many benefits (called ‘goals’) provided by the ocean provides to humans, such as food provision, tourism opportunities, and coastal protection. The OHI framework can be used to assess marine areas at global or regional scales, but how various OHI goals should be weighted to reflect priorities at those scales remains unclear. In this study, we adapted the framework in two ways for application to Canada as a case study. First, we customized the OHI goals to create a national Canadian Ocean Health Index (COHI). In particular, we altered the list of iconic species assessed, added methane clathrates and subsea permafrost as carbon storage habitats, and developed a new goal, 'Aboriginal Needs', to measure access of Aboriginal people to traditional marine hunting and fishing grounds. Second, we evaluated various goal weighting schemes based on preferences elicited from the general public in online surveys. We quantified these public preferences in three ways: using Likert scores, simple ranks from a best-worst choice experiment, and model coefficients from the analysis of elicited choice experiment. The latter provided the clearest statistical discrimination among goals, and we recommend their use because they can more accurately reflect both public opinion and the trade-offs faced by policy-makers. This initial iteration of the COHI can be used as a baseline against which future COHI scores can be compared, and could potentially be used as a management tool to prioritise actions on a national scale and predict public support for these actions given that the goal weights are based on public priorities. PMID:28542394

Multivariate Models for Prediction of Skin Sensitization Hazard in Humans

EPA Science Inventory

One of ICCVAM’s highest priorities is the development and evaluation of non-animal approaches to identify potential skin sensitizers. The complexity of biological events necessary for a substance to elicit a skin sensitization reaction suggests that no single alternative me...

Benefits and challenges of using LCA to advance sustainable wasteand materials management

EPA Science Inventory

MSW management can be complex and involve many unit processes that can vary based on needs of urban, rural, and suburbia to safely manage waste and to optimize energy and resource recovery while considering local infrastructure and priorities.

Multivariate models for skin sensitization hazard and potency

EPA Science Inventory

One of the top priorities being addressed by ICCVAM is the identification and validation of non-animal alternatives for skin sensitization testing. Although skin sensitization is a complex process, the key biological events have been well characterized in an adverse outcome pathw...

Multivariate Models for Prediction of Human Skin Sensitization Hazard

EPA Science Inventory

One of ICCVAM’s top priorities is the development and evaluation of non-animal approaches to identify potential skin sensitizers. The complexity of biological events necessary for a substance to elicit a skin sensitization reaction suggests that no single alternative method...

Innovation management based on proactive engagement of customers: A case study on LEGO Group. Part I: Innovation Management at Lego Group

NASA Astrophysics Data System (ADS)

Rusu, G.; Avasilcăi, S.

2015-11-01

Customers' proactive engagement in the innovation process represents a business priority for companies which adopt the open innovation business model. In such a context, it is of outmost importance for companies to use the online environment and social media, in order to create an interactive and open dialogue with customers and other important external stakeholders, achieving to gather creative solutions and innovative ideas by involving them in the process of co-creating value. Thus, the current paper is based on a case study approach, which aims to highlight the open innovation business model of the LEGO Group, one of the most successful and active company in engaging customers in submitting ideas and creative solutions for developing new products and new technologies, through online platforms. The study then proceeds to analyze the innovation management at LEGO Group, emphasizing the most important elements regarding the management team, the success and failures, the evolution of the LEGO products focusing on the innovation efforts of the company, its mission, vision, and values, emphasizing the innovation terms which guide the actions and objectives of the LEGO Group. Also, the research based on the case study approach, outlines the most important policies and strategies of the company, the organizational structure consisting of flat structures which facilitate the orientation of the team management on the innovation process and the proactive involvement of consumers and other external stakeholders in product development, highlighting also the most important activities developed by the management team in exploring the new opportunities which may occur on the market, involving customers in sharing their ideas at festivals, participating to discussions of adult fans on web-based platforms and establishing partnerships with the external stakeholders in order to create value. Moreover, the paper is focused on identifying the company's concerns regarding the competitive strategies, new technologies developed for sustainable development and innovation, emphasizing also the concerns of the LEGO Group for a long-term orientation strategy which implies developing innovative products, made by ecological materials, reducing the negative impact on the environment. In addition, the company aims to foster innovation maintaining a clear vision, multiple contacts with the internal and external environment, and the flat structures which enable the communication between innovative management teams and top management team. Consequently, the study provides the insights regarding the innovation management of the LEGO Group, emphasizing the role of engaging customers and other external stakeholders in the co-creation of value.

[Design and fabrication of the custom-made titanium condyle by selective laser melting technology].

PubMed

Chen, Jianyu; Luo, Chongdai; Zhang, Chunyu; Zhang, Gong; Qiu, Weiqian; Zhang, Zhiguang

2014-10-01

To design and fabricate the custom-made titanium mandibular condyle by the reverse engineering technology combined with selective laser melting (SLM) technology and to explore the mechanical properties of the SLM-processed samples and the application of the custom-made condyle in the temporomandibular joint (TMJ) reconstruction. The three-dimensional model of the mandibular condyle was obtained from a series of CT databases. The custom-made condyle model was designed by the reverse engineering software. The mandibular condyle was made of titanium powder with a particle size of 20-65 µm as the basic material and the processing was carried out in an argon atmosphere by the SLM machine. The yield strength, ultimate strength, bending strength, hardness, surface morphology and roughness were tested and analyzed. The finite element analysis (FEA) was used to analyze the stress distribution. The complex geometry and the surface of the custom-made condyle can be reproduced precisely by the SLM. The mechanical results showed that the yield strength, ultimate strength, bending strength and hardness were (559±14) MPa, (659±32) MPa, (1 067±42) MPa, and (212±4)HV, respectively. The surface roughness was reduced by sandblast treatment. The custom-made titanium condyle can be fabricated by SLM technology which is time-saving and highly digitized. The mechanical properties of the SLM sample can meet the requirements of surgical implant material in the clinic. The possibility of fabricating custom-made titanium mandibular condyle combined with the FEA opens new interesting perspectives for TMJ reconstruction.

Generating Customized Verifiers for Automatically Generated Code

NASA Technical Reports Server (NTRS)

Denney, Ewen; Fischer, Bernd

2008-01-01

Program verification using Hoare-style techniques requires many logical annotations. We have previously developed a generic annotation inference algorithm that weaves in all annotations required to certify safety properties for automatically generated code. It uses patterns to capture generator- and property-specific code idioms and property-specific meta-program fragments to construct the annotations. The algorithm is customized by specifying the code patterns and integrating them with the meta-program fragments for annotation construction. However, this is difficult since it involves tedious and error-prone low-level term manipulations. Here, we describe an annotation schema compiler that largely automates this customization task using generative techniques. It takes a collection of high-level declarative annotation schemas tailored towards a specific code generator and safety property, and generates all customized analysis functions and glue code required for interfacing with the generic algorithm core, thus effectively creating a customized annotation inference algorithm. The compiler raises the level of abstraction and simplifies schema development and maintenance. It also takes care of some more routine aspects of formulating patterns and schemas, in particular handling of irrelevant program fragments and irrelevant variance in the program structure, which reduces the size, complexity, and number of different patterns and annotation schemas that are required. The improvements described here make it easier and faster to customize the system to a new safety property or a new generator, and we demonstrate this by customizing it to certify frame safety of space flight navigation code that was automatically generated from Simulink models by MathWorks' Real-Time Workshop.

3D printing for health & wealth: Fabrication of custom-made medical devices through additive manufacturing

NASA Astrophysics Data System (ADS)

Colpani, Alessandro; Fiorentino, Antonio; Ceretti, Elisabetta

2018-05-01

Additive Manufacturing (AM) differs from traditional manufacturing technologies by its ability to handle complex shapes with great design flexibility. These features make the technique suitable to fabricate customized components, particularly answering specific custom needs. Although AM mainly referred to prototyping, nowadays the interest in direct manufacturing of actual parts is growing. This article shows the application of AM within the project 3DP-4H&W (3D Printing for Health & Wealth) which involves engineers and physicians for developing pediatric custom-made medical devices to enhance the fulfilling of the patients specific needs. In the project, two types of devices made of a two-component biocompatible silicone are considered. The first application (dental field) consists in a device for cleft lip and palate. The second one (audiological field) consists in an acoustic prosthesis. The geometries of the devices are based on the anatomy of the patient that is obtained through a 3D body scan process. For both devices, two different approaches were planned, namely direct AM and indirect Rapid Tooling (RT). In particular, direct AM consists in the FDM processing of silicone, while RT consists in molds FDM fabrication followed by silicone casting. This paper presents the results of the RT method that is articulated in different phases: the acquisition of the geometry to be realized, the design of the molds taking into account the casting feasibility (as casting channel, vents, part extraction), the realization of molds produced through AM, molds surface chemical finishing, pouring and curing of the silicone. The fabricated devices were evaluated by the physicians team that confirmed the effectiveness of the proposed procedure in fabricating the desired devices. Moreover, the procedure can be used as a general method to extend the range of applications to any custom-made device for anatomic districts, especially where complex shapes are present (as tracheal or maxillary prostheses).

Complex Light

NASA Astrophysics Data System (ADS)

Secor, Jeff; Alfano, Robert; Ashrafi, Solyman

2017-01-01

The emerging field of complex light-the study and application of custom light beams with tailored intensity, polarization or phase-is a focal point for fundamental breakthroughs in optical science. As this review will show, those advances in fundamental understanding, coupled with the latest developments in complex light generation, are translating into a range of diverse and cross-disciplinary applications that span microscopy, high-data-rate communications, optical trapping and quantum optics. We can expect more twists along the way, too, as researchers seek to manipulate and control the propagation speed of complex light beams, while others push the more exotic possibilities afforded by complex light in quantum-entanglement experiments.

Hospitals as complex adaptive systems: A case study of factors influencing priority setting practices at the hospital level in Kenya.

PubMed

Barasa, Edwine W; Molyneux, Sassy; English, Mike; Cleary, Susan

2017-02-01

There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations of PSRA practices in case study hospitals over a period of 7 months. In this paper, we apply complex adaptive system (CAS) theory to examine the factors that influence PSRA practices. We found that PSRA practices in the case hospitals were influenced by, 1) inadequate financing level and poorly designed financing arrangements, 2) limited hospital autonomy and decision space, and 3) inadequate management and leadership capacity in the hospital. The case study hospitals exhibited properties of complex adaptive systems (CASs) that exist in a dynamic state with multiple interacting agents. Weaknesses in system 'hardware' (resource scarcity) and 'software' (including PSRA guidelines that reduced hospitals decision space, and poor leadership skills) led to the emergence of undesired properties. The capacity of hospitals to set priorities should be improved across these interacting aspects of the hospital organizational system. Interventions should however recognize that hospitals are CAS. Rather than rectifying isolated aspects of the system, they should endeavor to create conditions for productive emergence. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Prioritizing strategies for comprehensive liver cancer control in Asia: a conjoint analysis.

PubMed

Bridges, John F P; Dong, Liming; Gallego, Gisselle; Blauvelt, Barri M; Joy, Susan M; Pawlik, Timothy M

2012-10-30

Liver cancer is a complex and burdensome disease, with Asia accounting for 75% of known cases. Comprehensive cancer control requires the use of multiple strategies, but various stakeholders may have different views as to which strategies should have the highest priority. This study identified priorities across multiple strategies for comprehensive liver cancer control (CLCC) from the perspective of liver cancer clinical, policy, and advocacy stakeholders in China, Japan, South Korea and Taiwan. Concordance of priorities was assessed across the region and across respondent roles. Priorities for CLCC were examined as part of a cross-sectional survey of liver cancer experts. Respondents completed several conjoint-analysis choice tasks to prioritize 11 strategies. In each task, respondents judged which of two competing CLCC plans, consisting of mutually exclusive and exhaustive subsets of the strategies, would have the greatest impact. The dependent variable was the chosen plan, which was then regressed on the strategies of different plans. The restricted least squares (RLS) method was utilized to compare aggregate and stratified models, and t-tests and Wald tests were used to test for significance and concordance, respectively. Eighty respondents (69.6%) were eligible and completed the survey. Their primary interests were hepatitis (26%), hepatocellular carcinoma (HCC) (58%), metastatic liver cancer (10%) and transplantation (6%). The most preferred strategies were monitoring at-risk populations (p<0.001), clinician education (p<0.001), and national guidelines (p<0.001). Most priorities were concordant across sites except for three strategies: transplantation infrastructure (p=0.009) was valued lower in China, measuring social burden (p=0.037) was valued higher in Taiwan, and national guidelines (p=0.025) was valued higher in China. Priorities did not differ across stakeholder groups (p=0.438). Priorities for CLCC in Asia include monitoring at-risk populations, clinician education, national guidelines, multidisciplinary management, public awareness and centers of excellence. As most priorities are relatively concordant across the region, multilateral approaches to addressing comprehensive liver cancer would be beneficial. However, where priorities are discordant among sites, such as transplantation infrastructure, strategies should be tailored to local needs.

Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.

PubMed

Turner, S; Ollerhead, E; Cook, A

2017-10-09

In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified. The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods. A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others contributed further potential topic areas instead. Delphi-like survey methods are practical and productive as a means of obtaining opinions from a wide number of relevant experts identifying potential priority topic areas for research; however, this method is less appropriate for framing tractable research questions.

Performance assessment and optimisation of a large information system by combined customer relationship management and resilience engineering: a mathematical programming approach

NASA Astrophysics Data System (ADS)

Azadeh, A.; Foroozan, H.; Ashjari, B.; Motevali Haghighi, S.; Yazdanparast, R.; Saberi, M.; Torki Nejad, M.

2017-10-01

ISs and ITs play a critical role in large complex gas corporations. Many factors such as human, organisational and environmental factors affect IS in an organisation. Therefore, investigating ISs success is considered to be a complex problem. Also, because of the competitive business environment and the high amount of information flow in organisations, new issues like resilient ISs and successful customer relationship management (CRM) have emerged. A resilient IS will provide sustainable delivery of information to internal and external customers. This paper presents an integrated approach to enhance and optimise the performance of each component of a large IS based on CRM and resilience engineering (RE) in a gas company. The enhancement of the performance can help ISs to perform business tasks efficiently. The data are collected from standard questionnaires. It is then analysed by data envelopment analysis by selecting the optimal mathematical programming approach. The selected model is validated and verified by principle component analysis method. Finally, CRM and RE factors are identified as influential factors through sensitivity analysis for this particular case study. To the best of our knowledge, this is the first study for performance assessment and optimisation of large IS by combined RE and CRM.

Student satisfaction as an element of education quality monitoring in innovative higher education institution

NASA Astrophysics Data System (ADS)

Razinkina, Elena; Pankova, Ludmila; Trostinskaya, Irina; Pozdeeva, Elena; Evseeva, Lidiya; Tanova, Anna

2018-03-01

Topicality of the research is confirmed by increasing student involvement into the educational process, when not only the academic staff and administration participate in the improvement of higher education institution's activity, but also education customers - students. This adds a new dimension to the issue of monitoring education quality and student satisfaction with higher education. This issue echoes the ideas of M. Weber about the relationship between such components as cognitive motivation, personal development and student satisfaction with higher education. Besides, it is essential to focus on the approach of R. Barnet to defining the quality of education with the emphasis on a priority of development of an educational institution as the system that meets customers' needs. Monitoring student satisfaction with education quality has become an integral part of the educational process not only in a number of European universities, which have used this monitoring for decades, but also in Russian universities, which are interested in education quality improvement. Leading universities in Russia, including Peter the Great St. Petersburg Polytechnic University, are implementing policies targeted at increasing student satisfaction with higher education quality. Education quality monitoring as a key element in the system of providing feedback to students contributes greatly to this process.

Revamping EAGLE-I and experiences during Hurricanes Harvey and Irma

NASA Astrophysics Data System (ADS)

Sanyal, J.; Chinthavali, S.; Myers, A.; Newby, S.; Redmon, D.

2017-12-01

EAGLE-I, the Environment for Analysis of Geo-Located Energy Information) is an operational system for the U.S. Department of Energy's Office of Electricity Delivery and Energy Reliability (OE), Infrastructure Security and Energy Restoration (ISER) division to provide near real-time situational awareness of the nation's energy sector. The system geospatially maps energy assets and systems in electricity, oil and natural gas, petroleum, and coal, and tie together a variety of data sources into one visualization platform. The system serves the needs of the ESF#12 (Emergency Support Function - Energy) community and has users from FEMA, USDA, DHS, and other federal and state emergency response agencies. During the hurricane season, the EAGLE-I team improved the coverage of electric customers in areas where the hurricanes were expected to make landfall, provided custom reports for Puerto Rico using whatever data was available, and supported various requests for data during the events. Various attempts were also made to establish a direct contact with utilities. Acute shortage of information was felt as utility systems went down, particularly in the territories, which led to considerations of using indirect mechanisms such as processing night lights imagery. As the EAGLE-I system undergoes a significant modernization, these experiences have helped understand and guide priorities in the modernization.

Solidarity and cost management: Swiss citizens' reasons for priorities regarding health insurance coverage.

PubMed

Schindler, Mélinée; Danis, Marion; Goold, Susan D; Hurst, Samia A

2018-04-14

Approaches to priority-setting for scarce resources have shifted to public deliberation as trade-offs become more difficult. We report results of a qualitative analysis of public deliberation in Switzerland, a country with high health-care costs, an individual health insurance mandate and a strong tradition of direct democracy with frequent votes related to health care. We adapted the Choosing Healthplans All Together (CHAT) tool, an exercise developed to transform complex health-care allocation decisions into easily understandable choices, for use in Switzerland. We conducted focus groups in twelve Swiss cities, recruiting from a range of socio-economic backgrounds in the three language regions. Participants developed strategic arguments based on the importance of basic coverage for all, and of cost-benefit evaluation. They also expressed arguments relying on a principle of solidarity, in particular the importance of protection for vulnerable groups, and on the importance of medical care. They struggled with the place of personal responsibility in coverage decisions. In commenting on the exercise, participants found the degree of consensus despite differing opinions surprising and valuable. The Swiss population is particularly attentive to the costs of health care and means of reducing these costs. Swiss citizens are capable of making trade-offs and setting priorities for complex health issues. © 2018 The Authors Health Expectations published by John Wiley & Sons Ltd.

Satellite control of electric power distribution

NASA Technical Reports Server (NTRS)

Bergen, L.

1981-01-01

An L-band frequencies satellite link providing the medium for direct control of electrical loads at individual customer sites from remote central locations is described. All loads supplied under interruptible-service contracts are likely condidates for such control, and they can be cycled or switched off to reduce system loads. For every kW of load eliminated or deferred to off-peak hours, the power company reduces its need for additional generating capacity. In addition, the satellite could switch meter registers so that their readings automatically reflected the time of consumption. The system would perform load-shedding operations during emergencies, disconnecting large blocks of load according to predetermined priorities. Among the distribution operations conducted by the satellite in real time would be: load reconfiguration, voltage regulation, fault isolation, and capacitor and feeder load control.

Drivers and barriers to e-invoicing adoption in Greek large scale manufacturing industries

NASA Astrophysics Data System (ADS)

Marinagi, Catherine; Trivellas, Panagiotis; Reklitis, Panagiotis; Skourlas, Christos

2015-02-01

This paper attempts to investigate the drivers and barriers that large-scale Greek manufacturing industries experience in adopting electronic invoices (e-invoices), based on three case studies with organizations having international presence in many countries. The study focuses on the drivers that may affect the increase of the adoption and use of e-invoicing, including the customers demand for e-invoices, and sufficient know-how and adoption of e-invoicing in organizations. In addition, the study reveals important barriers that prevent the expansion of e-invoicing, such as suppliers' reluctance to implement e-invoicing, and IT infrastructures incompatibilities. Other issues examined by this study include the observed benefits from e-invoicing implementation, and the financial priorities of the organizations assumed to be supported by e-invoicing.

MDPHnet: Secure, Distributed Sharing of Electronic Health Record Data for Public Health Surveillance, Evaluation, and Planning

PubMed Central

Vogel, Joshua; Brown, Jeffrey S.; Land, Thomas; Platt, Richard

2014-01-01

Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance. Clinical practices’ security, privacy, and proprietary concerns, however, have limited their willingness to share these data with public health agencies. We describe a novel distributed network for public health surveillance called MDPHnet. The system allows the Massachusetts Department of Public Health (MDPH) to initiate custom queries against participating practices’ electronic health records while the data remain behind each practice’s firewall. Practices can review proposed queries before execution and approve query results before releasing them to the health department. MDPH is using the system for routine surveillance for priority conditions and to evaluate the impact of public health interventions. PMID:25322301

The World Starts With Me: using intervention mapping for the systematic adaptation and transfer of school-based sexuality education from Uganda to Indonesia.

PubMed

Leerlooijer, Joanne N; Ruiter, Robert A C; Reinders, Jo; Darwisyah, Wati; Kok, Gerjo; Bartholomew, L Kay

2011-06-01

Evidence-based health promotion programmes, including HIV/AIDS prevention and sexuality education programmes, are often transferred to other cultures, priority groups and implementation settings. Challenges in this process include the identification of retaining core elements that relate to the programme's effectiveness while making changes that enhances acceptance in the new context and for the new priority group. This paper describes the use of a systematic approach to programme adaptation using a case study as an example. Intervention Mapping, a protocol for the development of evidence-based behaviour change interventions, was used to adapt the comprehensive school-based sexuality education programme 'The World Starts With Me'. The programme was developed for a priority population in Uganda and adapted to a programme for Indonesian secondary school students. The approach helped to systematically address the complexity and challenges of programme adaptation and to find a balance between preservation of essential programme elements (i.e. logic models) that may be crucial to the programme's effectiveness, including key objectives and theoretical behaviour change methods, and the adaptation of the programme to be acceptable to the new priority group and the programme implementers.

Characterization of a custom-built RF coil for a high-resolution phase-contrast magnetic resonance velocimeter

NASA Astrophysics Data System (ADS)

Yang, Byungkuen; Cho, Jee-Hyun; Song, Simon

2016-11-01

For the use of clinical purpose magnetic resonance velocimeter (MRV) is a versatile flow visualization technique in that it allows opaque flow, complex geometry, no use of tracer particles and facile fast non-invasive measurements of 3 dimensional and 3 component velocity vectors. However, the spatial resolution of a commercial MR machine is lower than optics-based techniques like PIV. On the other hand, the use of MRV for clinical purposes like cardiovascular flow visualization requires accurate measurements or estimations on wall shear stress (WSS) with a high spatial resolution. We developed a custom-built solenoid RF coil for phase-contrast (PC) MRV to improve its resolution. We compared signal-to-noise ratio, WSS estimations, partial volume effects near wall between the custom RF coil and a commercial coil. Also, a Hagen-Poiseuille flow was analyzed with the custom RF coil. This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korea government (MSIP) (No. 2016R1A2B3009541).

An Economic Evalution of Demand-side Energy Storage Systems by using a Multi-agent based Electricity Market

NASA Astrophysics Data System (ADS)

Furusawa, Ken; Sugihara, Hideharu; Tsuji, Kiichiro

Opened wholesale electric power market in April 2005, deregulation of electric power industry in Japan has faced a new competitive environment. In the new environment, Independent Power Producer (: IPP), Power Producer and Supplier (: PPS), Load Service Entity (: LSE) and electric utility can trade electric energy through both bilateral contracts and single-price auction at the electricity market. In general, the market clearing price (: MCP) is largely changed by amount of total load demand in the market. The influence may cause price spike, and consequently the volatility of MCP will make LSEs and their customers to face a risk of revenue and cost. DSM is attracted as a means of load leveling, and has effect on decreasing MCP at peak load period. Introducing Energy Storage systems (: ES) is one of DSM in order to change demand profile at customer-side. In case that customers decrease their own demand at jumped MCP, a bidding strategy of generating companies may be changed their strategy. As a result, MCP is changed through such complex mechanism. In this paper the authors evaluate MCP by multi-agent. It is considered that customer-side ES has an effect on MCP fluctuation. Through numerical examples, this paper evaluates the influence on MCP by controlling customer-side ES corresponding to variation of MCP.

Is the price squeeze doctrine still viable in fully-regulated energy markets

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

Spiwak, L.J.

Simply stated, a price squeeze occurs when a firm with monopoly power on the primary, or wholesale, level engages in a prolonged price increase that drives competitors out of the secondary, or retail level, and thereby extends its monopoly power to the secondary market. A price squeeze will not be found, however, for any short-term exercise in market power. Rather, because anticompetitive effects of a price squeeze are indirect, the price squeeze must last long enough and be severe enough to produce effects on actual or potential competition in the secondary market. In regulated electric industries, a price squeeze claimmore » usually arises from the complex relationship between the supplier, the wholesale customer, the retail customer, and the federal and state regulators. The supplier sells electric power to both wholesale and retail customers. Wholesale transactions are regulated by federal regulators, and retail transactions are regulated at the state level. The wholesale customers in turn sell power to their retail customers. Over the last several years, there have been substantial developments in the application of the price squeeze doctrine to fully-regulated electric utilities. This article will examine the current developments in this area, and attempt to highlight the burdens potential litigants, both plaintiffs and defendants, must overcome to succeed.« less

B-CAN: a resource sharing platform to improve the operation, visualization and integrated analysis of TCGA breast cancer data.

PubMed

Wen, Can-Hong; Ou, Shao-Min; Guo, Xiao-Bo; Liu, Chen-Feng; Shen, Yan-Bo; You, Na; Cai, Wei-Hong; Shen, Wen-Jun; Wang, Xue-Qin; Tan, Hai-Zhu

2017-12-12

Breast cancer is a high-risk heterogeneous disease with myriad subtypes and complicated biological features. The Cancer Genome Atlas (TCGA) breast cancer database provides researchers with the large-scale genome and clinical data via web portals and FTP services. Researchers are able to gain new insights into their related fields, and evaluate experimental discoveries with TCGA. However, it is difficult for researchers who have little experience with database and bioinformatics to access and operate on because of TCGA's complex data format and diverse files. For ease of use, we build the breast cancer (B-CAN) platform, which enables data customization, data visualization, and private data center. The B-CAN platform runs on Apache server and interacts with the backstage of MySQL database by PHP. Users can customize data based on their needs by combining tables from original TCGA database and selecting variables from each table. The private data center is applicable for private data and two types of customized data. A key feature of the B-CAN is that it provides single table display and multiple table display. Customized data with one barcode corresponding to many records and processed customized data are allowed in Multiple Tables Display. The B-CAN is an intuitive and high-efficient data-sharing platform.

Understand and Advocate for Communities First

ERIC Educational Resources Information Center

Khalifa, Muhammad; Arnold, Noelle Witherspoon; Newcomb, Whitney

2015-01-01

Culturally responsive parent-school relationships require educators to consider the cultural practices and understandings of families as a necessary condition of greater academic achievement. The establishment of healthy parent-school relationships is a complex and dynamic process. A school-community overlap, with a priority given to community…

Learning Communities and the Completion Agenda

ERIC Educational Resources Information Center

Johnson, Kathy E.

2013-01-01

Learning communities are widely recognized as a powerful pedagogy that promotes deep learning and student engagement, while also addressing a range of challenges that plague higher education. The Completion Agenda represents a complex set of intersecting priorities advocated by federal and state government, nonprofit organizations, colleges, and…

Civil Society, Adult Learning and Action in India.

ERIC Educational Resources Information Center

Tandon, Rajesh

2000-01-01

Five case studies of individual and collective learning projects in India demonstrate that (1) the impetus for civic action arises from local conditions; (2) transformative action requires sustained adult learning; and (3) civil society is a complex concept reflecting diverse priorities and perspectives. (SK)

Machine Learning Approaches for Predicting Human Skin Sensitization Hazard

EPA Science Inventory

One of ICCVAM’s top priorities is the development and evaluation of non-animal approaches to identify potential skin sensitizers. The complexity of biological events necessary for a substance to elicit a skin sensitization reaction suggests that no single in chemico, in vit...

Micron R&D: Global Scope and Nano-Scale in N-Dimensions

NASA Astrophysics Data System (ADS)

Durcan, Mark

2006-03-01

The Globalization of world markets and the globally dispersed manufacturing that supports them, drives complexity in managing today's leading edge R&D organizations beyond that historically experienced. The dimensions involve not only location, but time, economics, government relations, complex supply and customer chains, and Intellectual Property strategy. Each must be contemplated and optimized in light of the nature of worldwide 24 hour a day competition.

Risk assessment in the upstream crude oil supply chain: Leveraging analytic hierarchy process

NASA Astrophysics Data System (ADS)

Briggs, Charles Awoala

For an organization to be successful, an effective strategy is required, and if implemented appropriately the strategy will result in a sustainable competitive advantage. The importance of decision making in the oil industry is reflected in the magnitude and nature of the industry. Specific features of the oil industry supply chain, such as its longer chain, the complexity of its transportation system, its complex production and storage processes, etc., pose challenges to its effective management. Hence, understanding the risks, the risk sources, and their potential impacts on the oil industry's operations will be helpful in proposing a risk management model for the upstream oil supply chain. The risk-based model in this research uses a three-level analytic hierarchy process (AHP), a multiple-attribute decision-making technique, to underline the importance of risk analysis and risk management in the upstream crude oil supply chain. Level 1 represents the overall goal of risk management; Level 2 is comprised of the various risk factors; and Level 3 represents the alternative criteria of the decision maker as indicated on the hierarchical structure of the crude oil supply chain. Several risk management experts from different oil companies around the world were surveyed, and six major types of supply chain risks were identified: (1) exploration and production, (2) environmental and regulatory compliance, (3) transportation, (4) availability of oil, (5) geopolitical, and (6) reputational. Also identified are the preferred methods of managing risks which include; (1) accept and control the risks, (2) avoid the risk by stopping the activity, or (3) transfer or share the risks to other companies or insurers. The results from the survey indicate that the most important risk to manage is transportation risk with a priority of .263, followed by exploration/production with priority of .198, with an overall inconsistency of .03. With respect to major objectives the most preferred risk management policy option based on the result of the composite score is accept and control risk with a priority of .446, followed by transfer or share risk with a priority of .303. The least likely option is to terminate or forgo activity with a priority of .251.

DiffPy-CMI-Python libraries for Complex Modeling Initiative

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

Billinge, Simon; Juhas, Pavol; Farrow, Christopher

2014-02-01

Software to manipulate and describe crystal and molecular structures and set up structural refinements from multiple experimental inputs. Calculation and simulation of structure derived physical quantities. Library for creating customized refinements of atomic structures from available experimental and theoretical inputs.

Getting Personalization Right!

ERIC Educational Resources Information Center

DeWaters, Carrie

2017-01-01

In today's differentiated classroom, each individual student receives from their teacher student-centered instruction and customized assignments to reflect their skills and knowledge. Teachers differentiate their assignments so each of their students may access the Common Core State Standards, interact with complex nonfiction texts, integrate…

Systemic Action and Learning in Public Services

ERIC Educational Resources Information Center

Rigg, Clare

2011-01-01

Complex, systemic issues continue to challenge public services without respect for organisational and professional boundaries. In practice, collaborative working with others who have differing professional cultural norms and systems confront members with the need to learn about each other's values, priorities and practices. This paper explores the…

Mass Notification for Higher Education

ERIC Educational Resources Information Center

Schneider, Tod

2010-01-01

Mass notification is a high priority in educational institutions. As the number of electronic communication devices has diversified, so has the complexity of designing an effective mass notification system. Picking the right system, with the right features, support services and price, can be daunting. This publication, updated quarterly due to…

Approaches for Development of Nutrient Criteria in Oregon Estuaries

EPA Science Inventory

Development of nutrient criteria for all water body types of the US remains a top priority for EPA. Estuaries in the Pacific Northwest receive nutrients from both the watershed and the coastal ocean, and thus are particularly complex systems in which to establish water quality c...

Sensory evaluation based fuzzy AHP approach for material selection in customized garment design and development process

NASA Astrophysics Data System (ADS)

Hong, Y.; Curteza, A.; Zeng, X.; Bruniaux, P.; Chen, Y.

2016-06-01

Material selection is the most difficult section in the customized garment product design and development process. This study aims to create a hierarchical framework for material selection. The analytic hierarchy process and fuzzy sets theories have been applied to mindshare the diverse requirements from the customer and inherent interaction/interdependencies among these requirements. Sensory evaluation ensures a quick and effective selection without complex laboratory test such as KES and FAST, using the professional knowledge of the designers. A real empirical application for the physically disabled people is carried out to demonstrate the proposed method. Both the theoretical and practical background of this paper have indicated the fuzzy analytical network process can capture expert's knowledge existing in the form of incomplete, ambiguous and vague information for the mutual influence on attribute and criteria of the material selection.

A new Ti-5Ag alloy for customized prostheses by three-dimensional printing (3DP).

PubMed

Hong, S B; Eliaz, N; Leisk, G G; Sach, E M; Latanision, R M; Allen, S M

2001-03-01

Three important considerations in the fabrication of customized cranio-maxillofacial prostheses are geometric precision, material strength, and biocompatibility. Three-dimensional printing (3DP) is a rapid part-fabrication process that can produce complex parts with high precision. The aim of this study was to design, synthesize by 3DP, and characterize a new Ti-5Ag (wt%) alloy. Silver nitrate was found to be an appropriate inorganic binder for the Ti powder-based skeleton, and the optimum sintering parameters for full densification were determined. The hardness of the Ti-5Ag alloy was shown to be much higher than that of a pure titanium sample. Potentiodynamic measurements, carried out in saline solution at body temperature, showed that the Ti-5Ag alloy had good passivation behavior, similar to that of pure titanium. It is concluded that the Ti-Ag system may be suitable for fabrication of customized prostheses by 3DP.

Using quality function deployment to capture the voice of the customer and translate it into the voice of the provider.

PubMed

Chaplin, E; Bailey, M; Crosby, R; Gorman, D; Holland, X; Hippe, C; Hoff, T; Nawrocki, D; Pichette, S; Thota, N

1999-06-01

Health care has a number of historical barriers to capturing the voice of the customer and to incorporating customer wants into health care services, whether the customer is a patient, an insurer, or a community. Quality function deployment (QFD) is a set of tools and practices that can help overcome these barriers to form a process for the planning and design or redesign of products and services. The goal of the project was to increase referral volume and to improve a rehabilitation hospital's capacity to provide comprehensive medical and/or legal evaluations for people with complex and catastrophic injuries or illnesses. HIGH-LEVEL VIEW OF QFD AS A PROCESS: The steps in QFD are as follows: capture of the voice of the customer, quality deployment, functions deployment, failure mode deployment, new process deployment, and task deployment. The output of each step becomes the input to a matrix tool or table of the next step of the process. In 3 1/2 months a nine-person project team at Continental Rehabilitation Hospital (San Diego) used QFD tools to capture the voice of the customer, use these data as the basis for a questionnaire on important qualities of service from the customer's perspective, obtain competitive data on how the organization was perceived to be meeting the demanded qualities, identify measurable dimensions and targets of these qualities, and incorporate the functions and tasks into the delivery of service which are necessary to meet the demanded qualities. The future of providing health care services will belong to organizations that can adapt to a rapidly changing environment and to demands for new products and services that are produced and delivered in new ways.

How you slice it: smarter segmentation for your sales force.

PubMed

Waaser, Ernest; Dahneke, Marshall; Pekkarinen, Michael; Weissel, Michael

2004-03-01

Three years ago, 70-year-old Hill-Rom Incorporated was in a position familiar to many mature businesses: The company was strong but needed to be stronger. It was a top producer of hospital beds and specialty mattresses, its core product lines. It also had competitive complementary lines of stretchers, furniture, and architectural equipment. It had an extensive customer base, a respected sales force, and solid profit margins. But by the time Ernest Waaser took over as chief executive in early 2001, revenue growth had been slowing, and competition was on the rise. To secure Hill-Rom's place in the market, Waaser decided to focus first on the sales organization--partly because the cost of sales had risen gradually over the past five years and partly because acquisitions and other initiatives had made the sales organization more complex. The CEO took several steps to restructure the sales force. First, the company changed its customer segments to better reflect customers' demands and financial status, ultimately targeting two main groups: key and prime customers. It then changed the overall structure of the sales organization so it could tailor its approach to these two segments; key customers received more specialized service than prime customers. Finally, Hill-Rom adjusted the sales force after the company took an in-depth look at historical data on products and services and sales completed. Reasons for staffing changes were carefully communicated to the sales force. Because of Hill-Rom's initiatives, the cost of sales is down, short-term revenue growth is up, the outlook for long-term revenue growth looks bright, sales and profit margins are up, and customer satisfaction has increased. Best practice, indeed.

Economic Analysis Case Studies of Battery Energy Storage with SAM

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

DiOrio, Nicholas; Dobos, Aron; Janzou, Steven

2015-11-01

Interest in energy storage has continued to increase as states like California have introduced mandates and subsidies to spur adoption. This energy storage includes customer sited behind-the-meter storage coupled with photovoltaics (PV). This paper presents case study results from California and Tennessee, which were performed to assess the economic benefit of customer-installed systems. Different dispatch strategies, including manual scheduling and automated peak-shaving were explored to determine ideal ways to use the storage system to increase the system value and mitigate demand charges. Incentives, complex electric tariffs, and site specific load and PV data were used to perform detailed analysis. Themore » analysis was performed using the free, publically available System Advisor Model (SAM) tool. We find that installation of photovoltaics with a lithium-ion battery system priced at $300/kWh in Los Angeles under a high demand charge utility rate structure and dispatched using perfect day-ahead forecasting yields a positive net-present value, while all other scenarios cost the customer more than the savings accrued. Different dispatch strategies, including manual scheduling and automated peak-shaving were explored to determine ideal ways to use the storage system to increase the system value and mitigate demand charges. Incentives, complex electric tariffs, and site specific load and PV data were used to perform detailed analysis. The analysis was performed using the free, publically available System Advisor Model (SAM) tool. We find that installation of photovoltaics with a lithium-ion battery system priced at $300/kWh in Los Angeles under a high demand charge utility rate structure and dispatched using perfect day-ahead forecasting yields a positive net-present value, while all other scenarios cost the customer more than the savings accrued.« less

Novel, customizable scoring functions, parameterized using N-PLS, for structure-based drug discovery.

PubMed

Catana, Cornel; Stouten, Pieter F W

2007-01-01

The ability to accurately predict biological affinity on the basis of in silico docking to a protein target remains a challenging goal in the CADD arena. Typically, "standard" scoring functions have been employed that use the calculated docking result and a set of empirical parameters to calculate a predicted binding affinity. To improve on this, we are exploring novel strategies for rapidly developing and tuning "customized" scoring functions tailored to a specific need. In the present work, three such customized scoring functions were developed using a set of 129 high-resolution protein-ligand crystal structures with measured Ki values. The functions were parametrized using N-PLS (N-way partial least squares), a multivariate technique well-known in the 3D quantitative structure-activity relationship field. A modest correlation between observed and calculated pKi values using a standard scoring function (r2 = 0.5) could be improved to 0.8 when a customized scoring function was applied. To mimic a more realistic scenario, a second scoring function was developed, not based on crystal structures but exclusively on several binding poses generated with the Flo+ docking program. Finally, a validation study was conducted by generating a third scoring function with 99 randomly selected complexes from the 129 as a training set and predicting pKi values for a test set that comprised the remaining 30 complexes. Training and test set r2 values were 0.77 and 0.78, respectively. These results indicate that, even without direct structural information, predictive customized scoring functions can be developed using N-PLS, and this approach holds significant potential as a general procedure for predicting binding affinity on the basis of in silico docking.

Rabbit Calvarial Defect Model for Customized 3D-Printed Bone Grafts.

PubMed

Lee, Kang-Gon; Lee, Kang-Sik; Kang, Yu-Jeoung; Hwang, Jong-Hyun; Lee, Se-Hwan; Park, Sang-Hyug; Park, Yongdoo; Cho, Young-Sam; Lee, Bu-Kyu

2018-05-01

Bone graft materials are commonly used to regenerate various bone defects, but their application is often limited because of the complex defect shape in various clinical conditions. Hence, customized bone grafts using three-dimensional (3D) printing techniques have been developed. However, conventional simple bone defect models are limited for evaluating the benefits and manufacturing accuracy of 3D-printed customized bone grafts. Thus, the aim of the present study was to develop a complex-shaped bone defect model. We designed an 8-shaped bony defect that consists of two simple circles attached to the rabbit calvarium. To determine the critical-sized defect (CSD) of the 8-shaped defects, 5.6- and 7-mm-diameter trephine burs were tested, and the 7-mm-diameter bur could successfully create a CSD, which was easily reproducible on the rabbit calvarium. The rate of new bone formation was 28.65% ± 8.63% at 16 weeks following creation of the defect. To confirm its efficacy for clinical use, the 8-shaped defect was created on a rabbit calvarium and 3D computed tomography (CT) was performed. A stereolithography file was produced using the CT data, and a 3D-printed polycaprolactone graft was fabricated. Using our 8-shaped defect model, we were able to modify the tolerances of the bone graft and calvarial defect to fabricate a more precise bone graft. Customized characteristics of the bone graft were then used to improve the accuracy of the bone graft. In addition, we confirmed the fitting ability of the 3D-printed graft during implantation of the graft. Our 8-shaped defect model on the rabbit calvarium using a 7.0-mm trephine bur may be a useful CSD model for evaluating 3D-printed graft materials.

Routinely collected data as a strategic resource for research: priorities for methods and workforce.

PubMed

Jorm, Louisa

2015-09-30

In the era of 'big data', research using routinely collected data offers greater potential than ever before to drive health system effectiveness and efficiency, and population health improvement. In Australia, the policy environment, and emerging frameworks and processes for data governance and access, increasingly support the use of routinely collected data for research. Capitalising on this strategic resource requires investment in both research methods and research workforce. Priorities for methods development include validation studies, techniques for analysing complex longitudinal data, exploration of bias introduced through linkage error, and a robust toolkit to evaluate policies and programs using 'natural experiments'. Priorities for workforce development include broadening the skills base of the existing research workforce, and the formation of new, larger, interdisciplinary research teams to incorporate capabilities in computer science, partnership research, research translation and the 'business' aspects of research. Large-scale, long-term partnership approaches involving government, industry and researchers offer the most promising way to maximise returns on investment in research using routinely collected data.

Suitability of Unidata Metapps for Incorporation in Platform-Independent User-Customized Aviation Weather Products Generation Software

DTIC Science & Technology

2002-03-08

Figure 7. Standard, simplified view of the Facade software design pattern. Adapted from an original diagram by Shalloway and Trott (Shalloway...and Trott , 2002). 31 set of interfaces. The motivation behind using this design pattern is that it helps reduce complexity and minimizes the...libraries and in turn built more complex components. Although brave and innovative , these forays into the cutting edge of geophysical

Integrated methodology for standard-setting norms of innovative product in the new competitive environment

NASA Astrophysics Data System (ADS)

Polyakova, Marina; Rubin, Gennadiy

2017-07-01

Modern theory of technological and economical development is based on long-term cycles. So far it has been proved that the technological structure of the economy can be subdivided into groups of technological complexes, which are inter-related with each other by similar technological links, so called technological modes. Technological mode is defined as a complex of interrelated production units of similar technological level, which develop simultaneously. In order to provide competitiveness of products in the new changing conditions, it is necessary to make sure that they meet all the regulatory requirements specified in standards. But the existing and the fast changing situation on the merchandise markets causes disbalance between the growing customer requirements and the technological capabilities of the manufacturer. This makes the issue of standardization development even more urgent both from the point of view of establishing the current positions and from the point of view of possible promising development trends in technology. In the paper scientific and engineering principles of developing standardization as a science are described. It is shown that further development of standardization is based on the principles of advanced standardization the main idea of which is to set up the prospective requirements to the innovative product. Modern approaches of advanced standardization are shown in this paper. The complexity of the negotiation procedure between customer and manufacturer as a whole and achieving of consensus, in particular, make it necessary to find conceptually new approaches to developing mathematical models. The developed methodology picture the process of achieving the consensus between customer and manufacturer while developing the standard norms in the form of decreasing S-curve diagram. It means that in the end of the negotiation process, there is no difference between customer and manufacturer positions. It makes it possible to provide the basics of the assessment using the differential equation of the relationship between the rate of change of quality assessment and the distance of the estimated parameter value from the best value to the worst one. The obtained mathematical model can be used in the practice of standardization decreasing time of setting standard norms.

Generation of political priority for global surgery: a qualitative policy analysis.

PubMed

Shawar, Yusra Ribhi; Shiffman, Jeremy; Spiegel, David A

2015-08-01

Despite the high burden of surgical conditions, the provision of surgical services has been a low global health priority. We examined factors that have shaped priority for global surgical care. We undertook semi-structured interviews by telephone with members of global surgical networks and ministries of health to explore the challenges and opportunities surgeons, anaesthesiologists, and other proponents face in increasing global priority for surgery. We did a literature review and collected information from reports from organisations involved in surgery. We used a policy framework consisting of four categories-actor power, ideas, political contexts, and characteristics of the issue itself-to analyse factors that have shaped global political priority for surgery. We did a thematic analysis on the collected information. Several factors hinder the acquisition of attention and resources for global surgery. With respect to actor power, the global surgery community is fragmented, does not have unifying leadership, and is missing guiding institutions. Regarding ideas, community members disagree on how to address and publicly position the problem. With respect to political contexts, the community has made insufficient efforts to capitalise on political opportunities such as the Millennium Development Goals. Regarding issue characteristics, data on the burden of surgical diseases are limited and public misperceptions surrounding the cost and complexity of surgery are widespread. However, the community has several strengths that portend well for the acquisition of political support. These include the existence of networks deeply committed to the cause, the potential to link with global health priorities, and emerging research on the cost-effectiveness of some procedures. To improve global priority for surgery, proponents will need to create an effective governance structure that facilitates achievement of collective goals, generate consensus on solutions, and find an effective public positioning of the issue that attracts political support. None. Copyright © 2015 Shawar et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by Elsevier Ltd.. All rights reserved.

Analysis of capacity and traffic operations impacts of the World Trade Bridge in Laredo

DOT National Transportation Integrated Search

2001-07-01

Project 0-1800 pioneered the use of modern micro-simulation software to analyze the complex procedures involved in international border crossings. The animated models simulate the entire southbound commercial traffic flow, starting with U.S. Customs ...

Identifying priority healthcare trainings in frozen conflict situations: The case of Nagorno Karabagh.

PubMed

Thompson, Michael E; Dorian, Alina H; Harutyunyan, Tsovinar L

2010-12-09

Health care in post-war situations, where the system's human and fixed capital are depleted, is challenging. The addition of a frozen conflict situation, where international recognition of boundaries and authorities are lacking, introduces further complexities. Nagorno Karabagh (NK) is an ethnically Armenian territory locked within post-Soviet Azerbaijan and one such frozen conflict situation. This article highlights the use of evidence-based practice and community engagement to determine priority areas for health care training in NK. Drawing on the precepts of APEXPH (Assessment Protocol for Excellence in Public Health) and MAPP (Mobilizing for Action through Planning and Partnerships), this first-of-its-kind assessment in NK relied on in-depth interviews and focus group discussions supplemented with expert assessments and field observations. Training options were evaluated against a series of ethical and pragmatic principles. A unique factor among the ethical and pragmatic considerations when prioritizing among alternatives was NK's ambiguous political status and consequent sponsor constraints. Training priorities differed across the region and by type of provider, but consensus prioritization emerged for first aid, clinical Integrated Management of Childhood Illnesses, and Adult Disease Management. These priorities were then incorporated into the training programs funded by the sponsor. Programming responsive to both the evidence-base and stakeholder priorities is always desirable and provides a foundation for long-term planning and response. In frozen conflict, low resource settings, such an approach is critical to balancing the community's immediate humanitarian needs with sponsor concerns and constraints.

Preload, Coefficient of Friction, and Thread Friction in an Implant-Abutment-Screw Complex.

PubMed

Wentaschek, Stefan; Tomalla, Sven; Schmidtmann, Irene; Lehmann, Karl Martin

To examine the screw preload, coefficient of friction (COF), and tightening torque needed to overcome the thread friction of an implant-abutment-screw complex. In a customized load frame, 25 new implant-abutment-screw complexes including uncoated titanium alloy screws were torqued and untorqued 10 times each, applying 25 Ncm. Mean preload values decreased significantly from 209.8 N to 129.5 N according to the number of repetitions. The overall COF increased correspondingly. There was no comparable trend for the thread friction component. These results suggest that the application of a used implant-abutment-screw complex may be unfavorable for obtaining optimal screw preload.

Olly Olly Oxen Free (or Ally Ally in Free): Playing Hide and Seek in Allocating Resources for Child and Youth Health.

PubMed

Hiltz, Mary-Ann; Mitton, Craig; Smith, Neale; Dowling, Laura; Campbell, Matthew; Magee, J Fergall; Gibson, Jennifer L; Gujar, Shashi Ashok; Levy, Adrian

2015-01-01

There are powerful arguments for increased investment in child and youth health. But the extent to which these benefits can be realized is shaped by health institutions' priority setting processes. We asked, "What are the unique features of a pediatric care setting that should influence choice and implementation of a formal priority setting and resource allocation process?" Based on multiple sources of data, we created a "made-for-child-health" lens containing three foci reflective of the distinct features of pediatric care settings: the diversity of child and youth populations, the challenges in measuring outcomes and the complexity of patient and public engagement.

Dissociations among judgments do not reflect cognitive priority: an associative explanation of memory for frequency information in contingency learning.

PubMed

Vadillo, Miguel A; Luque, David

2013-03-01

Previous research on causal learning has usually made strong claims about the relative complexity and temporal priority of some processes over others based on evidence about dissociations between several types of judgments. In particular, it has been argued that the dissociation between causal judgments and trial-type frequency information is incompatible with the general cognitive architecture proposed by associative models. In contrast with this view, we conduct an associative analysis of this process showing that this need not be the case. We conclude that any attempt to gain a better insight on the cognitive architecture involved in contingency learning cannot rely solely on data about these dissociations.

Meyer Children's Rehabilitation Institute: Annual Report 1975 - 76.

ERIC Educational Resources Information Center

Nebraska Univ. Medical Center, Omaha. Meyer Children's Rehabilitation Inst.

Presented is the 1975 - 76 annual report of the Meyer Children's Rehabilitation Institute, a diagnostic, evaluation, and treatment center for children with complex handicaps in the state of Nebraska and Western Iowa. Priority goals of the institute are noted to be providing an interdisciplinary education and training program for personnel needed…

Peptide arrays for kinome analysis of livestock species

USDA-ARS?s Scientific Manuscript database

The kinases that mediate protein phosphorylation events have taken on a central priority within human medicine. This is evidenced by the number of kinase inhibitors that are currently in use as drugs as well as those advancing through clinical trials. There is also a trend to understand complex biol...

Post-Its and Priorities: A Participatory Exercise for Understanding Perspectives of Diverse Stakeholders

ERIC Educational Resources Information Center

LaChance, James; Hunter, Mitch; Finney, Denise

2015-01-01

We describe a participatory co-learning exercise that can help elucidate and navigate the unique perspectives of farmers, researchers, Extension personnel, and other agricultural professionals engaged in managing complex systems. We developed the exercise to help a diverse advisory panel collaboratively identify and prioritize ecosystem services…

A Longitudinal Integration of Identity Styles and Educational Identity Processes in Adolescence

ERIC Educational Resources Information Center

Negru-Subtirica, Oana; Pop, Eleonora Ioana; Crocetti, Elisabetta

2017-01-01

Identity formation is a main adolescent psychosocial developmental task. The complex interconnection between different processes that are at the basis of one's identity is a research and applied intervention priority. In this context, the identity style model focuses on social-cognitive strategies (i.e., informational, normative, and…

ADVANCES IN SAMPLING, SEPARATION, DETECTION AND IDENTIFICATION THAT ADDRESS UNMET NEEDS OF OSWER AND THE REGIONS

EPA Science Inventory

The Office of Solid Waste and Emergency Response (OSWER) has identified the development of improved methods for measuring, monitoring, and characterizing complex wastes in soils, sediments, biota, and groundwater as a priority under GOAL 3: LAND PRESERVATION AND RESTORATION:Prese...

Functional Dissection: The Nemesis of Coexistence.

ERIC Educational Resources Information Center

Alloway, James A.

A former New Jersey local official discusses the complex organizational structures in universities, government, and businesses that have developed to serve the needs of citizens. Each of these specialized structures developed a rather high level of efficiency, and each set its own priorities, criteria, and cost factors. Now this functional…

Fundamentals of Outdoor Enjoyment.

ERIC Educational Resources Information Center

Mitchell, Jim; Fear, Gene

The purpose of this preventive search and rescue teachers guide is to help high school aged youth understand the complexities and priorities necessary to manage a human body in outdoor environments and the value of planning ahead to have on hand the skills and equipment needed for outdoor survival, comfort, and enjoyment. Separate sections present…

Color Terms and Color Concepts

ERIC Educational Resources Information Center

Davidoff, Jules

2006-01-01

In their lead articles, both Kowalski and Zimiles (2006) and O'Hanlon and Roberson (2006) declare a general relation between color term knowledge and the ability to conceptually represent color. Kowalski and Zimiles, in particular, argue for a priority for the conceptual representation in color term acquisition. The complexities of the interaction…

Reference Condition Approach for Numeric Nutrient Criteria for Oregon Estuaries

EPA Science Inventory

Development of nutrient criteria for all water body types of the US remains a top priority for EPA. Estuaries in the Pacific Northwest receive nutrients from both the watershed and the coastal ocean, and thus are particularly complex systems in which to establish water quality c...

The Relationship of Principal's Leadership Priorities and Teachers' Classroom Management Skills.

ERIC Educational Resources Information Center

Galligan, Betsy J.

Investigating the interaction of a number of complex variables, this study looked at whether the relationship between principal and teacher behavior involved an interaction among salient situational characteristics and principal leadership, as is proposed by the Path-Goal Theory. Specifically, researchers asked whether the relationship between the…

A New Priority: Comprehension Intervention in the Primary Grades

ERIC Educational Resources Information Center

Dougherty Stahl, Katherine A.

2016-01-01

Teachers in primary classrooms who are emphasizing high-level comprehension of complex texts are seeing young children hit comprehension thresholds that were previously only visible among older readers. However, most primary level reading interventions focus on word recognition skills or reading increasingly difficult leveled texts. This article…

Local wavelet transform: a cost-efficient custom processor for space image compression

NASA Astrophysics Data System (ADS)

Masschelein, Bart; Bormans, Jan G.; Lafruit, Gauthier

2002-11-01

Thanks to its intrinsic scalability features, the wavelet transform has become increasingly popular as decorrelator in image compression applications. Throuhgput, memory requirements and complexity are important parameters when developing hardware image compression modules. An implementation of the classical, global wavelet transform requires large memory sizes and implies a large latency between the availability of the input image and the production of minimal data entities for entropy coding. Image tiling methods, as proposed by JPEG2000, reduce the memory sizes and the latency, but inevitably introduce image artefacts. The Local Wavelet Transform (LWT), presented in this paper, is a low-complexity wavelet transform architecture using a block-based processing that results in the same transformed images as those obtained by the global wavelet transform. The architecture minimizes the processing latency with a limited amount of memory. Moreover, as the LWT is an instruction-based custom processor, it can be programmed for specific tasks, such as push-broom processing of infinite-length satelite images. The features of the LWT makes it appropriate for use in space image compression, where high throughput, low memory sizes, low complexity, low power and push-broom processing are important requirements.

Wicked Problems in Large Organizations: Why Pilot Retention Continues to Challenge the Air Force

DTIC Science & Technology

2017-05-25

ABSTRACT This monograph in military studies investigates the makeup of and approach to complex problems, with a case study on the Air Force’s...priorities, as well as a short, recent history of the pilot retention problem. Following that is a case study on the work done by the Air Staff in...Lonsberry, USAF, 38 pages. This monograph in military studies investigates the makeup of and approach to complex problems, with a case study on the

The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study.

PubMed

Barasa, Edwine W; Cleary, Susan; English, Mike; Molyneux, Sassy

2016-09-30

Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long's actor interface analysis and VeneKlasen and Miller's expressions of power framework to examine and interpret our findings RESULTS: The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could improve priority setting practices. This should however, be accompanied by measures to empower stakeholders to contribute to decision making. Strengthening soft leadership skills of hospital managers could also contribute to managing the power dynamics among actors in hospital priority setting processes.

CMS Innovation Center Health Care Innovation Awards

PubMed Central

Berry, Sandra H.; Concannon, Thomas W.; Morganti, Kristy Gonzalez; Auerbach, David I.; Beckett, Megan K.; Chen, Peggy G.; Farley, Donna O.; Han, Bing; Harris, Katherine M.; Jones, Spencer S.; Liu, Hangsheng; Lovejoy, Susan L.; Marsh, Terry; Martsolf, Grant R.; Nelson, Christopher; Okeke, Edward N.; Pearson, Marjorie L.; Pillemer, Francesca; Sorbero, Melony E.; Towe, Vivian; Weinick, Robin M.

2013-01-01

Abstract The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children's Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g., those eligible for Medicare and Medicaid and complex patients) who have unique characteristics or health care needs that could be related to poor outcomes. In addition, the initiative seeks to identify new models of workforce development and deployment, as well as models that can be rapidly deployed and have the promise of sustainability. This article describes a strategy for evaluating the results. The goal for the evaluation design process is to create standardized approaches for answering key questions that can be customized to similar groups of awardees and that allow for rapid and comparable assessment across awardees. The evaluation plan envisions that data collection and analysis will be carried out on three levels: at the level of the individual awardee, at the level of the awardee grouping, and as a summary evaluation that includes all awardees. Key dimensions for the evaluation framework include implementation effectiveness, program effectiveness, workforce issues, impact on priority populations, and context. The ultimate goal is to identify strategies that can be employed widely to lower cost while improving care. PMID:28083297

A system-wide analysis using a senior-friendly hospital framework identifies current practices and opportunities for improvement in the care of hospitalized older adults.

PubMed

Wong, Ken S; Ryan, David P; Liu, Barbara A

2014-11-01

Older adults are vulnerable to hospital-associated complications such as falls, pressure ulcers, functional decline, and delirium, which can contribute to prolonged hospital stay, readmission, and nursing home placement. These vulnerabilities are exacerbated when the hospital's practices, services, and physical environment are not sufficiently mindful of the complex, multidimensional needs of frail individuals. Several frameworks have emerged to help hospitals examine how organization-wide processes can be customized to avoid these complications. This article describes the application of one such framework-the Senior-Friendly Hospital (SFH) framework adopted in Ontario, Canada-which comprises five interrelated domains: organizational support, processes of care, emotional and behavioral environment, ethics in clinical care and research, and physical environment. This framework provided the blueprint for a self-assessment of all 155 adult hospitals across the province of Ontario. The system-wide analysis identified practice gaps and promising practices within each domain of the SFH framework. Taken together, these results informed 12 recommendations to support hospitals at all stages of development in becoming friendly to older adults. Priorities for system-wide action were identified, encouraging hospitals to implement or further develop their processes to better address hospital-acquired delirium and functional decline. These recommendations led to collaborative action across the province, including the development of an online toolkit and the identification of accountability indicators to support hospitals in quality improvement focusing on senior-friendly care. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

A Typology Framework of Loyalty Reward Programs

NASA Astrophysics Data System (ADS)

Cao, Yuheng; Nsakanda, Aaron Luntala; Mann, Inder Jit Singh

Loyalty reward programs (LRPs), initially developed as marketing programs to enhance customer retention, have now become an important part of customer-focused business strategy. With the proliferation and increasing economy impact of the programs, the management complexity in the programs has also increased. However, despite widespread adoption of LRPs in business, academic research in the field seems to lag behind its practical application. Even the fundamental questions such as what LRPs are and how to classify them have not yet been fully addressed. In this paper, a comprehensive framework for LRP classification is proposed, which provides a foundation for further study of LRP design and planning issues.

The "doctor-customer" relationship: Hippocrates in the modern marketplace.

PubMed

Mulhall, Kevin J; Ahmed, Aftab; Masterson, Eric

2002-01-01

We performed a consecutive survey of 100 people presenting to a hospital injury clinic to ascertain their attitude to terminology currently used to describe them in our own institution and in the international literature. The results of this demonstrated that the subjects significantly preferred the traditional assignation "patient" rather than terms such as client or customer. This finding reflects the need to remember peoples' attitudes and expectations from their consultation with their doctor. Although business models undoubtedly help in the provision of an efficient health care service, remaining at the centre of this encounter is a doctor-patient relationship that involves a more complex interaction than simply a market transaction.

Assessment of Customer Service in Academic Health Care Libraries (ACSAHL): an instrument for measuring customer service*†

PubMed Central

Crossno, Jon E.; Berkins, Brenda; Gotcher, Nancy; Hill, Judith L.; McConoughey, Michelle; Walters, Mitchel

2001-01-01

Objectives: In a pilot study, the library had good results using SERVQUAL, a respected and often-used instrument for measuring customer satisfaction. The SERVQUAL instrument itself, however, received some serious and well-founded criticism from the respondents to our survey. The purpose of this study was to test the comparability of the results of SERVQUAL with a revised and shortened instrument modeled on SERVQUAL. The revised instrument, the Assessment of Customer Service in Academic Health Care Libraries (ACSAHL), was designed to better assess customer service in academic health care libraries. Methods: Surveys were sent to clients who had used the document delivery services at three academic medical libraries in Texas over the previous twelve to eighteen months. ACSAHL surveys were sent exclusively to clients at University of Texas (UT) Southwestern, while the client pools at the two other institutions were randomly divided and provided either SERVQUAL or ACSAHL surveys. Results: Results indicated that more respondents preferred the shorter ACSAHL instrument to the longer and more complex SERVQUAL instrument. Also, comparing the scores from both surveys indicated that ACSAHL elicited comparable results. Conclusions: ACSAHL appears to measure the same type of data in similar settings, but additional testing is recommended both to confirm the survey's results through data replication and to investigate whether the instrument applies to different service areas. PMID:11337948

Improving Customer Waiting Time at a DMV Center Using Discrete-Event Simulation

NASA Technical Reports Server (NTRS)

Arnaout, Georges M.; Bowling, Shannon

2010-01-01

Virginia's Department of Motor Vehicles (DMV) serves a customer base of approximately 5.6 million licensed drivers and ID card holders and 7 million registered vehicle owners. DMV has more daily face-to-face contact with Virginia's citizens than any other state agency [1]. The DMV faces a major difficulty in keeping up with the excessively large customers' arrival rate. The consequences are queues building up, stretching out to the entrance doors (and sometimes even outside) and customers complaining. While the DMV state employees are trying to serve at their fastest pace, the remarkably large queues indicate that there is a serious problem that the DMV faces in its services, which must be dealt with rapidly. Simulation is considered as one of the best tools for evaluating and improving complex systems. In this paper, we use it to model one of the DMV centers located in Norfolk, VA. The simulation model is modeled in Arena 10.0 from Rockwell systems. The data used is collected from experts of the DMV Virginia headquarter located in Richmond. The model created was verified and validated. The intent of this study is to identify key problems causing the delays at the DMV centers and suggest possible solutions to minimize the customers' waiting time. In addition, two tentative hypotheses aiming to improve the model's design are tested and validated.

A novel root analogue dental implant using CT scan and CAD/CAM: selective laser melting technology.

PubMed

Figliuzzi, M; Mangano, F; Mangano, C

2012-07-01

Direct laser metal forming (DLMF) is a new technique which allows solids with complex geometry to be produced by annealing metal powder microparticles in a focused laser beam, according to a computer-generated three-dimensional (3D) model. For dental implants, the fabrication process involves the laser-induced fusion of titanium microparticles, in order to build, layer by layer, the desired object. Modern computed tomography (CT) acquisition and 3D image conversion, combined with the DLMF process, allows the fabrication of custom-made, root-analogue implants (RAI), perfect copies of the radicular units that need replacing. This report demonstrates the successful clinical use of a custom-made, root-analogue DLMF implant. CT images of the residual non-restorable root of a right maxillary premolar were acquired and modified with specific software into a 3D model. From this model, a custom-made, root-analogue, DLMF implant was fabricated. Immediately after tooth extraction, the root-analogue implant was placed in the extraction socket and restored with a single crown. At the 1-year follow-up examination, the custom-made implant showed almost perfect functional and aesthetic integration. The possibility of fabricating custom-made, root-analogue DLMF implants opens new interesting perspectives for immediate placement of dental implants. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Customized silicone implant for the correction of acquired and congenital chest wall deformities: A valuable option with pectus excavatum.

PubMed

Soccorso, Giampiero; Parikh, Dakshesh H; Worrollo, Steve

2015-07-01

Surgical remodeling and correction of congenital and acquired chest wall deformities (CWD) is undertaken many times for cosmesis. Although reportedly minimally invasive, commonly used Nuss procedure for correction of pectus excavatum (PE) is not without complications. Nuss procedure is also not suitable for complex deformities and Poland syndrome cases. Insertion of custom-made silicone implants for the reconstruction of defects has been adopted from adult plastic reconstructive surgery as primary repair of CWD or rescue procedure for recurrence of PE after recurrence or residual deformity. We present our experience with CWD reconstruction in children with customized silicone prosthesis made from a surgically implantable liquid silicone rubber (NuSil MED-4805, Ca). Since 2006 we treated 26 patients with CWD: six were children (age <17years, median 14.6) with PE. Implants were custom made for each patient's chest. The implants were inserted under general anesthesia. Postoperatively all patients were fully satisfied with the cosmetic result and subjective patient satisfaction remained excellent at follow-up in all the children. Only one child developed postoperative complications (seroma). Customized silicone implant for PE in the pediatric age is an alternative therapeutic method, as primary or rescue treatment, with equally good cosmetic outcome, fewer significant complications, less postoperative pain and a faster recovery. Copyright © 2015 Elsevier Inc. All rights reserved.

B-CAN: a resource sharing platform to improve the operation, visualization and integrated analysis of TCGA breast cancer data

PubMed Central

Wen, Can-Hong; Ou, Shao-Min; Guo, Xiao-Bo; Liu, Chen-Feng; Shen, Yan-Bo; You, Na; Cai, Wei-Hong; Shen, Wen-Jun; Wang, Xue-Qin; Tan, Hai-Zhu

2017-01-01

Breast cancer is a high-risk heterogeneous disease with myriad subtypes and complicated biological features. The Cancer Genome Atlas (TCGA) breast cancer database provides researchers with the large-scale genome and clinical data via web portals and FTP services. Researchers are able to gain new insights into their related fields, and evaluate experimental discoveries with TCGA. However, it is difficult for researchers who have little experience with database and bioinformatics to access and operate on because of TCGA’s complex data format and diverse files. For ease of use, we build the breast cancer (B-CAN) platform, which enables data customization, data visualization, and private data center. The B-CAN platform runs on Apache server and interacts with the backstage of MySQL database by PHP. Users can customize data based on their needs by combining tables from original TCGA database and selecting variables from each table. The private data center is applicable for private data and two types of customized data. A key feature of the B-CAN is that it provides single table display and multiple table display. Customized data with one barcode corresponding to many records and processed customized data are allowed in Multiple Tables Display. The B-CAN is an intuitive and high-efficient data-sharing platform. PMID:29312567

Customer-centered careflow modeling based on guidelines.

PubMed

Huang, Biqing; Zhu, Peng; Wu, Cheng

2012-10-01

In contemporary society, customer-centered health care, which stresses customer participation and long-term tailored care, is inevitably becoming a trend. Compared with the hospital or physician-centered healthcare process, the customer-centered healthcare process requires more knowledge and modeling such a process is extremely complex. Thus, building a care process model for a special customer is cost prohibitive. In addition, during the execution of a care process model, the information system should have flexibility to modify the model so that it adapts to changes in the healthcare process. Therefore, supporting the process in a flexible, cost-effective way is a key challenge for information technology. To meet this challenge, first, we analyze various kinds of knowledge used in process modeling, illustrate their characteristics, and detail their roles and effects in careflow modeling. Secondly, we propose a methodology to manage a lifecycle of the healthcare process modeling, with which models could be built gradually with convenience and efficiency. In this lifecycle, different levels of process models are established based on the kinds of knowledge involved, and the diffusion strategy of these process models is designed. Thirdly, architecture and prototype of the system supporting the process modeling and its lifecycle are given. This careflow system also considers the compatibility of legacy systems and authority problems. Finally, an example is provided to demonstrate implementation of the careflow system.

Enhanced compressed sensing for visual target tracking in wireless visual sensor networks

NASA Astrophysics Data System (ADS)

Qiang, Guo

2017-11-01

Moving object tracking in wireless sensor networks (WSNs) has been widely applied in various fields. Designing low-power WSNs for the limited resources of the sensor, such as energy limitation, energy restriction, and bandwidth constraints, is of high priority. However, most existing works focus on only single conflicting optimization criteria. An efficient compressive sensing technique based on a customized memory gradient pursuit algorithm with early termination in WSNs is presented, which strikes compelling trade-offs among energy dissipation for wireless transmission, certain types of bandwidth, and minimum storage. Then, the proposed approach adopts an unscented particle filter to predict the location of the target. The experimental results with a theoretical analysis demonstrate the substantially superior effectiveness of the proposed model and framework in regard to the energy and speed under the resource limitation of a visual sensor node.

The Clinical and Occupational Correlates of Work Productivity Loss Among Employed Patients With Depression

PubMed Central

Lerner, Debra; Adler, David A.; Chang, Hong; Berndt, Ernst R.; Irish, Julie T.; Lapitsky, Leueen; Hood, Maggie Y.; Reed, John; Rogers, William H.

2014-01-01

Employers who are developing strategies to reduce health-related productivity loss may benefit from aiming their interventions at the employees who need them most. We determined whether depression’s negative productivity impact varied with the type of work employees performed. Subjects (246 with depression and 143 controls) answered the Work Limitations Questionnaire and additional work questions. Occupational requirements were measured objectively. In multiple regression analyses, productivity was most influenced by depression severity (P < 0.01 in 5/5 models). However, certain occupations also significantly increased employee vulnerability to productivity loss. Losses increased when employees had occupations requiring proficiency in decision-making and communication and/or frequent customer contact (P < 0.05 in 3/5 models). The Work Limitations Questionnaire can help employers to reduce productivity loss by identifying health and productivity improvement priorities. PMID:15194895

Optimal Sizing Tool for Battery Storage in Grid Applications

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

2015-09-24

The battery storage sizing tool developed at Pacific Northwest National Laboratory can be used to evaluate economic performance and determine the optimal size of battery storage in different use cases considering multiple power system applications. The considered use cases include i) utility owned battery storage, and ii) battery storage behind customer meter. The power system applications from energy storage include energy arbitrage, balancing services, T&D deferral, outage mitigation, demand charge reduction etc. Most of existing solutions consider only one or two grid services simultaneously, such as balancing service and energy arbitrage. ES-select developed by Sandia and KEMA is able tomore » consider multiple grid services but it stacks the grid services based on priorities instead of co-optimization. This tool is the first one that provides a co-optimization for systematic and local grid services.« less

Drivers and barriers to e-invoicing adoption in Greek large scale manufacturing industries

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

Marinagi, Catherine, E-mail: marinagi@teihal.gr, E-mail: ptrivel@yahoo.com, E-mail: preklitis@yahoo.com; Trivellas, Panagiotis, E-mail: marinagi@teihal.gr, E-mail: ptrivel@yahoo.com, E-mail: preklitis@yahoo.com; Reklitis, Panagiotis, E-mail: marinagi@teihal.gr, E-mail: ptrivel@yahoo.com, E-mail: preklitis@yahoo.com

2015-02-09

This paper attempts to investigate the drivers and barriers that large-scale Greek manufacturing industries experience in adopting electronic invoices (e-invoices), based on three case studies with organizations having international presence in many countries. The study focuses on the drivers that may affect the increase of the adoption and use of e-invoicing, including the customers demand for e-invoices, and sufficient know-how and adoption of e-invoicing in organizations. In addition, the study reveals important barriers that prevent the expansion of e-invoicing, such as suppliers’ reluctance to implement e-invoicing, and IT infrastructures incompatibilities. Other issues examined by this study include the observed benefitsmore » from e-invoicing implementation, and the financial priorities of the organizations assumed to be supported by e-invoicing.« less

Using exercises to identify Veterans Health Administration priorities for disaster response: findings from the New Madrid Earthquake training exercise.

PubMed

Gin, June L; Chan, Edward W; Brewster, Pete; Mitchell, Michael N; Ricci, Karen A; Afable, Melissa K; Dobalian, Aram

2013-01-01

Emergency managers are often charged with prioritizing the relative importance of key issues and tasks associated with disaster response. However, little work has been done to identify specific ways that the decision-making process can be improved. This exercise was conducted with 220 employees of the US Department of Veterans Affairs, who were asked to assign priority rankings to a list of possible options of the most important issues to address after a hypothetical disaster scenario impacting a Veterans Affairs Medical Center. We found that groups that were assigned to represent perspectives farther from the impacted site had less agreement in their identification of the top priorities than those assigned to the impacted facility. These findings suggest that greater geographic and administrative proximity to the impacted site may generate greater clarity and certainty about priority setting. Given the complex structure of many organizations, and the multiple levels of group decision making and coordination likely to be needed during disasters, research to better understand training needs with respect to decision making is essential to improve preparedness. Relatively simple modifications to exercises, as outlined here, could provide valuable information to better understand emergency management decision making across multiple organizational levels.

Specific transfer effects following variable priority dual-task training in older adults.

PubMed

Lussier, Maxime; Bugaiska, Aurélia; Bherer, Louis

2017-01-01

Past divided attention training studies in older adults have suggested that variable priority training (VPT) tends to show larger improvement than fixed priority training (FPT). However, it remains unclear whether VPT leads to larger transfer effects. In this study, eighty-three older adults aged between 55 and 65 received five 1-hour sessions of VPT, FPT or of an active placebo. VPT and FPT subjects trained on a complex dual-task condition with variable stimulus timings in order to promote more flexible and self-guided strategies with regard to attentional priority devoted to the concurrent tasks. Real-time individualized feedback was provided to encourage improvement. The active placebo group attended computer classes. Near and far modality transfer tasks were used to assess the generalization of transfer effects. Results showed that VPT induced significantly larger transfer effects than FPT on a near modality transfer task. Evidence for larger transfer effects in VPT than FPT on a far modality transfer task was also observed. Furthermore, the superiority of VPT on FPT in transfer effects was specific to the ability to coordinate two concurrent tasks. Results of this study help better understand the benefits of VPT attentional training on transfer effects, which is an essential outcome for cognitive training effectiveness and relevancy.

Contextual marketing--the real business of the Internet.

PubMed

Kenny, D; Marshall, J F

2000-01-01

The painful truth is that the Internet has been a letdown for most companies--largely because the dominant model for Internet commerce, the destination Web site, doesn't suit the needs of those companies or their customers. Most consumer product companies don't provide enough value or dynamic information to induce customers to make the repeat visits--and disclose the detailed information--that make such sites profitable. In this article, David Kenny and John F. Marshall suggest that companies discard the notion that a Web site equals an Internet strategy. Instead of trying to create destinations that people will come to, companies need to use the power and reach of the Internet to deliver tailored messages and information to customers. Companies have to become what the authors call "contextual marketers." Delivering the most relevant information possible to consumers in the most timely manner possible will become feasible, the authors say, as access moves beyond the PC to shopping malls, retail stores, airports, bus stations, and even cars. The authors describe how the ubiquitous Internet will hasten the demise of the destination Web site--and open up scads of opportunities to reach customers through marketing "mobilemediaries," such as smart cards, e-wallets, and bar code scanners. The companies that master the complexity of the ubiquitous Internet will gain significant advantages: they'll gain greater intimacy with customers and target market segments more efficiently. The ones that don't will be dismissed as nuisances, the authors conclude. They suggest ways to become welcome additions--not unwelcome intrusions--to customers' lives.

A new custom made bioceramic implant for the repair of large and complex craniofacial bone defects.

PubMed

Brie, Joël; Chartier, Thierry; Chaput, Christophe; Delage, Cyrille; Pradeau, Benjamin; Caire, François; Boncoeur, Marie-Paule; Moreau, Jean-Jacques

2013-07-01

Neurosurgery and Maxillofacial Surgery Departments of Limoges University Hospital Centre have developed a new concept of a custom made ceramic implant in hydroxyapatite (HA) for the reconstruction of large and complex craniofacial bone defects (more than 25 cm(2)). The manufacturing process of the implants used a stereolithography technique that produces implants with three-dimensional shapes derived directly from the scan file of the patient's skull without moulding or machining. Eight patients received 8 implants between 2005 and 2008. The surgical procedure is simple and fast. The post-operative follow-up was 12 months. No major complications (infection or fracture of the implant) were observed. The cosmetic result was considered satisfactory by both patients and surgeons. These new implants are well suited for reconstruction of large craniofacial bone defects (greater than 25 cm(2)) in adults and children over 8 years. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Gene gymnastics

PubMed Central

Vijayachandran, Lakshmi S; Thimiri Govinda Raj, Deepak B; Edelweiss, Evelina; Gupta, Kapil; Maier, Josef; Gordeliy, Valentin; Fitzgerald, Daniel J; Berger, Imre

2013-01-01

Most essential activities in eukaryotic cells are catalyzed by large multiprotein assemblies containing up to ten or more interlocking subunits. The vast majority of these protein complexes are not easily accessible for high resolution studies aimed at unlocking their mechanisms, due to their low cellular abundance and high heterogeneity. Recombinant overproduction can resolve this bottleneck and baculovirus expression vector systems (BEVS) have emerged as particularly powerful tools for the provision of eukaryotic multiprotein complexes in high quality and quantity. Recently, synthetic biology approaches have begun to make their mark in improving existing BEVS reagents by de novo design of streamlined transfer plasmids and by engineering the baculovirus genome. Here we present OmniBac, comprising new custom designed reagents that further facilitate the integration of heterologous genes into the baculovirus genome for multiprotein expression. Based on comparative genome analysis and data mining, we herein present a blueprint to custom design and engineer the entire baculovirus genome for optimized production properties using a bottom-up synthetic biology approach. PMID:23328086

Advanced consequence management program: challenges and recent real-world implementations

NASA Astrophysics Data System (ADS)

Graser, Tom; Barber, K. S.; Williams, Bob; Saghir, Feras; Henry, Kurt A.

2002-08-01

The Enhanced Consequence Management, Planning and Support System (ENCOMPASS) was developed under DARPA's Advanced Consequence Management program to assist decision-makers operating in crisis situations such as terrorist attacks using conventional and unconventional weapons and natural disasters. ENCOMPASS provides the tools for first responders, incident commanders, and officials at all levels to share vital information and consequently, plan and execute a coordinated response to incidents of varying complexity and size. ENCOMPASS offers custom configuration of components with capabilities ranging from map-based situation assessment, situation-based response checklists, casualty tracking, and epidemiological surveillance. Developing and deploying such a comprehensive system posed significant challenges for DARPA program management, due to an inherently complex domain, a broad spectrum of customer sites and skill sets, an often inhospitable runtime environment, demanding development-to-deployment transition requirements, and a technically diverse and geographically distributed development team. This paper introduces ENCOMPASS and explores these challenges, followed by an outline of selected ENCOMPASS deployments, demonstrating how ENCOMPASS can enhance consequence management in a variety real world contexts.

A System for Planning Ahead

NASA Technical Reports Server (NTRS)

2002-01-01

A software system that uses artificial intelligence techniques to help with complex Space Shuttle scheduling at Kennedy Space Center is commercially available. Stottler Henke Associates, Inc.(SHAI), is marketing its automatic scheduling system, the Automated Manifest Planner (AMP), to industries that must plan and project changes many different times before the tasks are executed. The system creates optimal schedules while reducing manpower costs. Using information entered into the system by expert planners, the system automatically makes scheduling decisions based upon resource limitations and other constraints. It provides a constraint authoring system for adding other constraints to the scheduling process as needed. AMP is adaptable to assist with a variety of complex scheduling problems in manufacturing, transportation, business, architecture, and construction. AMP can benefit vehicle assembly plants, batch processing plants, semiconductor manufacturing, printing and textiles, surface and underground mining operations, and maintenance shops. For most of SHAI's commercial sales, the company obtains a service contract to customize AMP to a specific domain and then issues the customer a user license.

A Pilot Study of an Online Workplace Nutrition Program: The Value of Participant Input in Program Development

PubMed Central

Cousineau, Tara; Houle, Brian; Bromberg, Jonas; Fernandez, Kathrine C.; Kling, Whitney C.

2008-01-01

Objective Tailored nutrition Web programs constitute an emerging trend in obesity prevention. Initial investment in innovative technology necessitates that the target population be well understood. This pilot study’s purpose was to determine the feasibility of a workplace nutrition Web program. Design Formative research was conducted with gaming industry employees and benefits managers to develop a consensus on workplace-specific nutrition needs. A demonstration Web program was piloted with stakeholders to determine feasibility. Setting Indiana, Mississippi, Nevada, and New Jersey gaming establishments. Participants 86 employees, 18 benefits managers. Intervention Prototype Web program. Main Outcome Measures Concept mapping; 16-item nutrition knowledge test; satisfaction. Analysis Concept mapping was used to aggregate importance ratings on programmatic content, which informed Web program curriculum. Chi-square tests were performed postintervention to determine knowledge improvement. Results (1) Employees and benefits managers exhibited moderate agreement about content priorities for the program (r = 0.48). (2) There was a significant increase in employees’ nutrition knowledge scores postintervention (t = 7.16, df = 36, P < .001); those with less knowledge exhibited the greatest gains in knowledge scores (r = −0.647, P < .001). Conclusions and Implications Employees and benefit managers do not necessarily agree on the priority of nutrition-related content, suggesting a need for programs to appeal to various stakeholders. Computer-based approaches can address various stakeholder health concerns via tailored, customized programming. PMID:18457784

Strategy and the art of reinventing value.

PubMed

van der Heijden, K; Maccoby, M; Hama, N; Lundquist, J T; Collis, D J; Zeithaml, C; Martin, J E; Carroll, V P; Lurie, R

1993-01-01

In "From Value Chain to Value Constellation: Designing Interactive Strategy" (July-August 1993), Richard Normann and Rafael Ramírez argue that successful companies increasingly do not just add value, they reinvent it. The key strategic task is to reconfigure roles and relationships among a constellation of actors--suppliers, business partners, customers--in order to mobilize the creation of value in new forms and by new players. What is so different about this new logic of value? It breaks down the distinction between products and services and combines them into activity-based "offerings" from which customers can create value for themselves. But as potential offerings become more complex, so do the relationships necessary to create them. As a result, a company's strategic task becomes the reconfiguration and integration of its compentencies and customers. Normann and Ramírez provide three illustrations of these new rules of strategy. IKEA has blossomed into the world's largest retailer of home furnishings by redefining the relationships and organizational pratices of the furniture business. Danish pharmacies and their national organization have used the opportunity of health care reform to reconfigure their relationships with customers, doctors, hospitals, drug manufacturers, and with Danish and international health organizations.(ABSTRACT TRUNCATED AT 250 WORDS)

Care maps for children with medical complexity.

PubMed

Adams, Sherri; Nicholas, David; Mahant, Sanjay; Weiser, Natalie; Kanani, Ronik; Boydell, Katherine; Cohen, Eyal

2017-12-01

Children with medical complexity require multiple providers and services to keep them well and at home. A care map is a patient/family-created diagram that pictorially maps out this complex web of services. This study explored what care maps mean for families and healthcare providers to inform potential for clinical use. Parents (n=15) created care maps (hand drawn n=10 and computer-generated n=5) and participated in semi-structured interviews about the process of developing care maps and their perceived impact. Healthcare providers (n=30) reviewed the parent-created care maps and participated in semi-structured interviews. Data were analysed for themes and emerging theory using a grounded theory analytical approach. Data analysis revealed 13 overarching themes that were further categorized into three domains: features (characteristics of care maps), functions (what care maps do), and emerging outcomes (benefits of care map use). These domains further informed a definition and a theoretical model of how care maps work. Our findings suggest that care maps may be a way of supporting patient- and family-centred care by graphically identifying and integrating experiences of the family as well as priorities for moving forward. Care maps were endorsed as a useful tool by families and providers. They help healthcare providers better understand parental priorities for care. Parents can create care maps to demonstrate the complex burden of care. They are a unique visual way to incorporate narrative medicine into practice. © 2017 Mac Keith Press.

Enhancing The National Map Through Tactical Planning and Performance Monitoring

USGS Publications Warehouse

,

2008-01-01

Tactical planning and performance monitoring are initial steps toward improving 'the way The National Map works' and supporting the U.S. Geological Survey (USGS) Science Strategy. This Tactical Performance Planning Summary for The National Map combines information from The National Map 2.0 Tactical Plan and The National Map Performance Milestone Matrix. The National Map 2.0 Tactical Plan is primarily a working document to guide The National Map program's execution, production, and metrics monitoring for fiscal years (FY) 2008 and 2009. The Tactical Plan addresses data, products, and services, as well as supporting and enabling activities. The National Map's 2-year goal for FY 2008 and FY 2009 is to provide a range of geospatial products and services that further the National Spatial Data Infrastructure and underpin USGS science. To do this, the National Geospatial Program will develop a renewed understanding during FY 2008 of key customer needs and requirements, develop the infrastructure to support The National Map business model, modernize its business processes, and reengineer its workforce. Priorities for The National Map will be adjusted if necessary to respond to changes to the project that may impact resources, constrain timeframes, or change customer needs. The supporting and enabling activities that make it possible to produce the products and services of The National Map will include partnership activities, improved compatibility of systems, outreach, and integration of data themes.

Advancing organizational health literacy in health care organizations serving high-needs populations: a case study.

PubMed

Weaver, Nancy L; Wray, Ricardo J; Zellin, Stacie; Gautam, Kanak; Jupka, Keri

2012-01-01

Health care organizations, well positioned to address health literacy, are beginning to shift their systems and policies to support health literacy efforts. Organizations can identify barriers, emphasize and leverage their strengths, and initiate activities that promote health literacy-related practices. The current project employed an open-ended approach to conduct a needs assessment of rural federally qualified health center clinics. Using customized assessment tools, the collaborators were then able to determine priorities for changing organizational structures and policies in order to support continued health literacy efforts. Six domains of organizational health literacy were measured with three methods: environmental assessments, patient interviews, and key informant interviews with staff and providers. Subsequent strategic planning was conducted by collaborators from the academic and clinic teams and resulted in a focused, context-appropriate action plan. The needs assessment revealed several gaps in organizational health literacy practices, such as low awareness of health literacy within the organization and variation in perceived values of protocols, interstaff communication, and patient communication. Facilitators included high employee morale and patient satisfaction. The resulting targeted action plan considered the organization's culture as revealed in the interviews, informing a collaborative process well suited to improving organizational structures and systems to support health literacy best practices. The customized needs assessment contributed to an ongoing collaborative process to implement organizational changes that aided in addressing health literacy needs.

Problem analysis: application in the development of market strategies for health care organizations.

PubMed

Martin, J

1988-03-01

The problem analysis technique is an approach to understanding salient customer needs that is especially appropriate under complex market conditions. The author demonstrates the use of the approach in segmenting markets and conducting competitive analysis for positioning strategy decisions in health care.

Front End Software for Online Database Searching. Part 2: The Marketplace.

ERIC Educational Resources Information Center

Levy, Louise R.; Hawkins, Donald T.

1986-01-01

This article analyzes the front end software marketplace and discusses some of the complex forces influencing it. Discussion covers intermediary market; end users (library customers, scientific and technical professionals, corporate business specialists, consumers); marketing strategies; a British front end development firm; competitive pressures;…

Quality Assurance in the Political Context: In the Midst of Different Expectations and Conflicting Goals

ERIC Educational Resources Information Center

Beerkens, Maarja

2015-01-01

Higher education quality assurance systems develop within a complex political environment where national level goals and priorities interact with European and global developments. Furthermore, quality assurance is influenced by broader processes in the public sector that set expectations with respect to accountability, legitimacy and regulatory…

Global Corporate Priorities and Demand-Led Learning Strategies

ERIC Educational Resources Information Center

Dealtry, Richard

2008-01-01

Purpose: The purpose of this article is to start the process of exploring how to optimise connections between the strategic needs of an organisation as directed by top management and its learning management structures and strategies. Design/methodology/approach: The article takes a broad brush approach to a complex and large subject area that is…

Taking a Democratic Stance toward Knowledge

ERIC Educational Resources Information Center

Traugh, Cecelia

2009-01-01

One of the major priorities that should guide teacher education programs in preparing teachers for their work in a democratic society is to develop a commitment to knowledge that embraces complexity and to place this knowledge into competition with the mainstream vision, which results from a deep reliance on standardized testing and controls much…

The Inherent Vulnerability of the Australian Curriculum's Cross-Curriculum Priorities

ERIC Educational Resources Information Center

Salter, Peta; Maxwell, Jacinta

2016-01-01

National curriculum development is a complex and contested process. By its very function, a national curriculum serves to organise diverse interests into a common framework, a task fraught with cultural and political tensions and compromises. In the emergent Australian Curriculum these tensions are manifest in and around the cross-curriculum…

The Top and Bottom of Leadership and Change

ERIC Educational Resources Information Center

Hargreaves, Andy; Ainscow, Mel

2015-01-01

All versions of top-down reform have an Achilles heel: Their focus on delivering the details of two or three measurable priorities is suitable only for systems pursuing traditional and comparatively narrow achievement goals. A digital age of complex skills, cultural diversity, and high-speed change calls for more challenging educational goals and…

The Cultural Roots of Teacher Associations: A Case Study from India

ERIC Educational Resources Information Center

Padwad, Amol

2016-01-01

Teacher associations (TAs) are communities located in complex cultural spaces that may affect their functioning, vision, priorities, and policies. This case study of the English Language Teachers' Association of India (ELTAI) attempts to examine the relationship between the Association and the cultural space it inhabits, with specific reference to…

[Concomitant influence of occupational and social risk factors on health of workers engaged into powder metallurgy].

PubMed

Shur, P Z; Zaĭtseva, N V; Kostarev, V G; Lebedeva-Nesevria, N A; Shliapnikov, D M

2012-01-01

Results of health risk evaluation in workers engaged into powder metallurgy, using complex of hygienic, medical, epidemiologic and sociologic studies, enable to define priority occupational and social risk factors, to assess degree of their influence on the workers' health and to identify occupationally induced diseases.

Campus Police Benefit by Automating Training Records

ERIC Educational Resources Information Center

Galvin, Bob

2008-01-01

Making sure law enforcement officers are current with their professional training has always been a top priority of police departments whether they must protect a city or a college campus. However, as training has expanded with many new certification categories, tracking all of these for each officer has grown more complex. This has prompted many…

An integrated approach for identifying priority contaminant in the Great Lakes Basin -Investigations in the Lower Green Bay/Fox River and Milwaukee Estuary areas of concern

EPA Science Inventory

Environmental assessment of complex mixtures typically requires integration of chemical and biological measurements. This study demonstrates the use of a combination of instrumental chemical analyses, effects-based monitoring, and bio-effects prediction approaches to help identi...

76 FR 80905 - TRICARE Evaluation of Centers for Medicare & Medicaid Services Approved Laboratory Developed...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... potential high utilization and potential high clinical impact on TRICARE beneficiaries. If no submission is... reviewed in numerical order beginning with the test listed as having the highest priority. Those selected... laboratories that use LDTs as well as FDA approved tests. Laboratories performing moderate or high complexity...

A matter of taste: Improving flavor of fresh potatoes

USDA-ARS?s Scientific Manuscript database

Breeding for improved potato flavor has not been a high priority in US breeding programs. It is a difficult trait to breed for because it cannot be done in a high throughput manner and it requires an understanding of the complex biochemistry of flavor compounds and effects of cooking on those compou...

Birmingham Rep, Youth and Community, and the Products and Possibilities of Precarity

ERIC Educational Resources Information Center

Cochrane, Claire

2017-01-01

Birmingham Rep, a leading producing theatre based in the UK's "second city", has historically had a complex relationship with the cultural priorities of its home city. In recent years, Birmingham City Council has faced multiple challenges represented by debt burden, government-imposed cuts in public funding, scandals linked to failing…

Approaches for Development of Nutrient Criteria in Oregon Estuaries With a Focus on Tillamook Estuary

EPA Science Inventory

Development of nutrient criteria for all water body types of the US remains a top priority for EPA. Estuaries in the Pacific Northwest receive nutrients from both the watershed and the coastal ocean, and thus are particularly complex systems in which to establish water quality c...

Understanding the Undertow: Innovative Responses to Labour Market Disadvantage and VET

ERIC Educational Resources Information Center

Bretherton, Tanya

2011-01-01

An Australian Government priority is to increase productivity by moving people from welfare into employment. Policy on this issue is difficult to develop because of the complexities surrounding both under- and unemployment. This report considers underutilisation from two different perspectives. Not only does it contemplate the issue from the…

Self-Paced Prioritized Curriculum Learning With Coverage Penalty in Deep Reinforcement Learning.

PubMed

Ren, Zhipeng; Dong, Daoyi; Li, Huaxiong; Chen, Chunlin; Zhipeng Ren; Daoyi Dong; Huaxiong Li; Chunlin Chen; Dong, Daoyi; Li, Huaxiong; Chen, Chunlin; Ren, Zhipeng

2018-06-01

In this paper, a new training paradigm is proposed for deep reinforcement learning using self-paced prioritized curriculum learning with coverage penalty. The proposed deep curriculum reinforcement learning (DCRL) takes the most advantage of experience replay by adaptively selecting appropriate transitions from replay memory based on the complexity of each transition. The criteria of complexity in DCRL consist of self-paced priority as well as coverage penalty. The self-paced priority reflects the relationship between the temporal-difference error and the difficulty of the current curriculum for sample efficiency. The coverage penalty is taken into account for sample diversity. With comparison to deep Q network (DQN) and prioritized experience replay (PER) methods, the DCRL algorithm is evaluated on Atari 2600 games, and the experimental results show that DCRL outperforms DQN and PER on most of these games. More results further show that the proposed curriculum training paradigm of DCRL is also applicable and effective for other memory-based deep reinforcement learning approaches, such as double DQN and dueling network. All the experimental results demonstrate that DCRL can achieve improved training efficiency and robustness for deep reinforcement learning.

Nursing care complexity in a psychiatric setting: results of an observational study.

PubMed

Petrucci, C; Marcucci, G; Carpico, A; Lancia, L

2014-02-01

For nurses working in mental health service settings, it is a priority to perform patient assessments to identify patients' general and behavioural risks and nursing care complexity using objective criteria, to meet the demand for care and to improve the quality of service by reducing health threat conditions to the patients' selves or to others (adverse events). This study highlights that there is a relationship between the complexity of psychiatric patient care, which was assigned a numerical value after the nursing assessment, and the occurrence of psychiatric adverse events in the recent histories of the patients. The results suggest that nursing supervision should be enhanced for patients with high care complexity scores. © 2013 John Wiley & Sons Ltd.

Photonic crystals, light manipulation, and imaging in complex nematic structures

NASA Astrophysics Data System (ADS)

Ravnik, Miha; Å timulak, Mitja; Mur, Urban; Čančula, Miha; Čopar, Simon; Žumer, Slobodan

2016-03-01

Three selected approaches for manipulation of light by complex nematic colloidal and non-colloidal structures are presented using different own custom developed theoretical and modelling approaches. Photonic crystals bands of distorted cholesteric liquid crystal helix and of nematic colloidal opals are presented, also revealing distinct photonic modes and density of states. Light propagation along half-integer nematic disclinations is shown with changes in the light polarization of various winding numbers. As third, simulated light transmission polarization micrographs of nematic torons are shown, offering a new insight into the complex structure characterization. Finally, this work is a contribution towards using complex soft matter in optics and photonics for advanced light manipulation.

Fit for purpose? Introducing a rational priority setting approach into a community care setting.

PubMed

Cornelissen, Evelyn; Mitton, Craig; Davidson, Alan; Reid, Colin; Hole, Rachelle; Visockas, Anne-Marie; Smith, Neale

2016-06-20

Purpose - Program budgeting and marginal analysis (PBMA) is a priority setting approach that assists decision makers with allocating resources. Previous PBMA work establishes its efficacy and indicates that contextual factors complicate priority setting, which can hamper PBMA effectiveness. The purpose of this paper is to gain qualitative insight into PBMA effectiveness. Design/methodology/approach - A Canadian case study of PBMA implementation. Data consist of decision-maker interviews pre (n=20), post year-1 (n=12) and post year-2 (n=9) of PBMA to examine perceptions of baseline priority setting practice vis-à-vis desired practice, and perceptions of PBMA usability and acceptability. Findings - Fit emerged as a key theme in determining PBMA effectiveness. Fit herein refers to being of suitable quality and form to meet the intended purposes and needs of the end-users, and includes desirability, acceptability, and usability dimensions. Results confirm decision-maker desire for rational approaches like PBMA. However, most participants indicated that the timing of the exercise and the form in which PBMA was applied were not well-suited for this case study. Participant acceptance of and buy-in to PBMA changed during the study: a leadership change, limited organizational commitment, and concerns with organizational capacity were key barriers to PBMA adoption and thereby effectiveness. Practical implications - These findings suggest that a potential way-forward includes adding a contextual readiness/capacity assessment stage to PBMA, recognizing organizational complexity, and considering incremental adoption of PBMA's approach. Originality/value - These insights help us to better understand and work with priority setting conditions to advance evidence-informed decision making.

Healthcare and Research Priorities of Adolescents and Young Adults with Systemic Lupus Erythematosus: A Mixed-methods Study.

PubMed

Tunnicliffe, David J; Singh-Grewal, Davinder; Craig, Jonathan C; Howell, Martin; Tugwell, Peter; Mackie, Fiona; Lin, Ming-Wei; O'Neill, Sean G; Ralph, Angelique F; Tong, Allison

2017-04-01

Managing juvenile-onset systemic lupus erythematosus (SLE) is particularly challenging. The disease may be severe, adolescent patients have complex medical and psychosocial needs, and patients must navigate the transition to adult services. To inform patient-centered care, we aimed to identify the healthcare and research priorities of young patients with SLE and describe the reasons underpinning their priorities. Face-to-face, semistructured interviews and focus groups were conducted with patients with SLE, aged from 14 to 26 years, from 5 centers in Australia. For each of the 5 allocation exercises, participants allocated 10 votes to (1) research topics; research questions on (2) medical management, (3) prevention and diagnosis, (4) lifestyle and psychosocial; and (5) healthcare specialties, and discussed the reasons for their choices. Descriptive statistics were calculated for votes and qualitative data were analyzed thematically. The 26 participants prioritized research that alleviated the psychological burden of SLE. They allocated their votes toward medical and mental health specialties in the management of SLE, while fewer votes were given to physiotherapy/occupational therapy and dietetics. The following 7 themes underpinned the participants' priorities: improving service shortfalls, strengthening well-being, ensuring cost efficiency, minimizing family/community burden, severity of comorbidity or complications, reducing lifestyle disruption, and fulfilling future goals. Young patients with SLE value comprehensive care with greater coordination among specialties. They prioritized research focused on alleviating poor psychological outcomes. The healthcare and research agenda for patients with SLE should include everyone involved, to ensure that the agenda aligns with patient priorities, needs, and values.

Challenges and priorities for modelling livestock health and pathogens in the context of climate change

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

Özkan, Şeyda

Climate change has the potential to impair livestock health, with consequences for animal welfare, productivity, greenhouse gas emissions, and human livelihoods and health. Modelling has an important role in assessing the impacts of climate change on livestock systems and the efficacy of potential adaptation strategies, to support decision making for more efficient, resilient and sustainable production. However, a coherent set of challenges and research priorities for modelling livestock health and pathogens under climate change has not previously been available. To identify such challenges and priorities, researchers from across Europe were engaged in a horizon-scanning study, involving workshop and questionnaire basedmore » exercises and focussed literature reviews. Eighteen key challenges were identified and grouped into six categories based on subject-specific and capacity building requirements. Across a number of challenges, the need for inventories relating model types to different applications (e.g. the pathogen species, region, scale of focus and purpose to which they can be applied) was identified, in order to identify gaps in capability in relation to the impacts of climate change on animal health. The need for collaboration and learning across disciplines was highlighted in several challenges, e.g. to better understand and model complex ecological interactions between pathogens, vectors, wildlife hosts and livestock in the context of climate change. Collaboration between socio-economic and biophysical disciplines was seen as important for better engagement with stakeholders and for improved modelling of the costs and benefits of poor livestock health. The need for more comprehensive validation of empirical relationships, for harmonising terminology and measurements, and for building capacity for under-researched nations, systems and health problems indicated the importance of joined up approaches across nations. The challenges and priorities identified can help focus the development of modelling capacity and future research structures in this vital field. Well-funded networks capable of managing the long-term development of shared resources are required in order to create a cohesive modelling community equipped to tackle the complex challenges of climate change. - Highlights: • Experts identified challenges for health and pathogen modelling under climate change. • Eighteen key challenges and associated research priorities were identified. • Increasing capacity will require improved organisation and sharing knowledge. • Better communication across the diverse topics and approaches in this field is needed.« less

Optimal service using Matlab - simulink controlled Queuing system at call centers

NASA Astrophysics Data System (ADS)

Balaji, N.; Siva, E. P.; Chandrasekaran, A. D.; Tamilazhagan, V.

2018-04-01

This paper presents graphical integrated model based academic research on telephone call centres. This paper introduces an important feature of impatient customers and abandonments in the queue system. However the modern call centre is a complex socio-technical system. Queuing theory has now become a suitable application in the telecom industry to provide better online services. Through this Matlab-simulink multi queuing structured models provide better solutions in complex situations at call centres. Service performance measures analyzed at optimal level through Simulink queuing model.

A Multitasking General Executive for Compound Continuous Tasks

ERIC Educational Resources Information Center

Salvucci, Dario D.

2005-01-01

As cognitive architectures move to account for increasingly complex real-world tasks, one of the most pressing challenges involves understanding and modeling human multitasking. Although a number of existing models now perform multitasking in real-world scenarios, these models typically employ customized executives that schedule tasks for the…

U.S./Arab Reflections on Our Tolerance for Ambiguity

ERIC Educational Resources Information Center

Bright, Larry K.; Mahdi, Ghada S.

2012-01-01

As the authors, a Midwestern American educational administration professor and a Middle Eastern Iraqi doctoral candidate, have continued to interact over the past 3 years, both have come to appreciate the importance of increasing their tolerance for ambiguity--ambiguities in examining cultural, linguistic, and religious customs and complexities in…

The complexities of discussing soil vapor extraction techniques with non-scientists

USDA-ARS?s Scientific Manuscript database

The Centre County Kepone Site is approximately 32.2 acres on which a chemical manufacturing plant and a portion of the Spring Creek watershed are located. Kepone and mirex, were custom manufactured between 1959 and 1974. Earthen lagoons were used to manage onsite waste disposal. Concrete lagoons w...

Polytobacco Use and the "Customization Generation"--New Perspectives for Tobacco Control

ERIC Educational Resources Information Center

Horn, Kimberly; Pearson, Jennifer L.; Villanti, Andrea C.

2016-01-01

In recent years, the United States observed a significant uptake in concurrent use of multiple tobacco products and alternative nicotine delivery devices among youth--a phenomenon identified as polytobacco use--making tobacco control efforts more complex for clinicians, policy makers, and scientists, alike.The present commentary stimulates new…

Sci-Vis Framework

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

Arthur Bleeker, PNNL

2015-03-11

SVF is a full featured OpenGL 3d framework that allows for rapid creation of complex visualizations. The SVF framework handles much of the lifecycle and complex tasks required for a 3d visualization. Unlike a game framework SVF was designed to use fewer resources, work well in a windowed environment, and only render when necessary. The scene also takes advantage of multiple threads to free up the UI thread as much as possible. Shapes (actors) in the scene are created by adding or removing functionality (through support objects) during runtime. This allows a highly flexible and dynamic means of creating highlymore » complex actors without the code complexity (it also helps overcome the lack of multiple inheritance in Java.) All classes are highly customizable and there are abstract classes which are intended to be subclassed to allow a developer to create more complex and highly performant actors. There are multiple demos included in the framework to help the developer get started and shows off nearly all of the functionality. Some simple shapes (actors) are already created for you such as text, bordered text, radial text, text area, complex paths, NURBS paths, cube, disk, grid, plane, geometric shapes, and volumetric area. It also comes with various camera types for viewing that can be dragged, zoomed, and rotated. Picking or selecting items in the scene can be accomplished in various ways depending on your needs (raycasting or color picking.) The framework currently has functionality for tooltips, animation, actor pools, color gradients, 2d physics, text, 1d/2d/3d textures, children, blending, clipping planes, view frustum culling, custom shaders, and custom actor states« less

Hybridity as a process of technology's 'translation': customizing a national Electronic Patient Record.

PubMed

Petrakaki, Dimitra; Klecun, Ela

2015-01-01

This paper explores how national Electronic Patient Record (EPR) systems are customized in local settings and, in particular, how the context of their origin plays out with the context of their use. It shows how representations of healthcare organizations and of local clinical practice are built into EPR systems within a complex context whereby different stakeholder groups negotiate to produce an EPR package that aims to meet both local and generic needs. The paper draws from research into the implementation of the National Care Record Service, a part of the National Programme for Information Technology (NPfIT), in the English National Health Service (NHS). The paper makes two arguments. First, customization of national EPR is a distributed process that involves cycles of 'translation', which span across geographical, cultural and professional boundaries. Second, 'translation' is an inherently political process during which hybrid technology gets consolidated. The paper concludes, that hybrid technology opens up possibilities for standardization of healthcare. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ideas for Future GPS Timing Improvements

NASA Technical Reports Server (NTRS)

Hutsell, Steven T.

1996-01-01

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

Handheld emissions detector (HED): overview and development

NASA Astrophysics Data System (ADS)

Valentino, George J.; Schimmel, David

2009-05-01

Nova Engineering, Cincinnati OH, a division of L-3 Communications (L-3 Nova), under the sponsorship of Program Manager Soldier Warrior (PM-SWAR), Fort Belvoir, VA, has developed a Soldier portable, light-weight, hand-held, geolocation sensor and processing system called the Handheld Emissions Detector (HED). The HED is a broadband custom receiver and processor that allows the user to easily sense, direction find, and locate a broad range of emitters in the user's surrounding area. Now in its second design iteration, the HED incorporates a set of COTS components that are complemented with L-3 Nova custom RF, power, digital, and mechanical components, plus custom embedded and application software. The HED user interfaces are designed to provide complex information in a readily-understandable form, thereby providing actionable results for operators. This paper provides, where possible, the top-level characteristics of the HED as well as the rationale behind its design philosophy along with its applications in both DOD and Commercial markets.

Two Seating Systems' Effects on an Adolescent With Cerebral Palsy and Severe Scoliosis.

PubMed

Lephart, Kim; Kaplan, Sandra L

2015-01-01

To compare physiological functioning, communication switch activation, and response accuracy in a 19-year-old young man with quadriplegic cerebral palsy and neurological scoliosis using 2 seating systems within the school setting. Prospective single-subject alternating treatment design with 2 conditions: baseline phase with standard planar inserts (A1), custom-molded back with original seat (B), and return to baseline (A2). Measures included oxygen saturation (SaO2), heart rate (HR), respiration rate (RR), body temperature (BT), processing time to activate switches, and response accuracy. SaO2 levels increased from "distressed" to "normal"; variability decreased. HR, RR, and BT fluctuations decreased with the custom-molded back. Processing time decreased with increased variability, affected by subject's motivation; accuracy improved slightly. Reported social approachability and student-initiated communication increased. SaO2 increased and HR, RR, and BT fluctuations decreased with a custom-molded back. Graphing data may help determine seating effect with complex clients.

Modeling of beam customization devices in the pencil-beam splitting algorithm for heavy charged particle radiotherapy.

PubMed

Kanematsu, Nobuyuki

2011-03-07

A broad-beam-delivery system for radiotherapy with protons or ions often employs multiple collimators and a range-compensating filter, which offer complex and potentially useful beam customization. It is however difficult for conventional pencil-beam algorithms to deal with fine structures of these devices due to beam-size growth during transport. This study aims to avoid the difficulty with a novel computational model. The pencil beams are initially defined at the range-compensating filter with angular-acceptance correction for upstream collimation followed by stopping and scattering. They are individually transported with possible splitting near the aperture edge of a downstream collimator to form a sharp field edge. The dose distribution for a carbon-ion beam was calculated and compared with existing experimental data. The penumbra sizes of various collimator edges agreed between them to a submillimeter level. This beam-customization model will be used in the greater framework of the pencil-beam splitting algorithm for accurate and efficient patient dose calculation.

How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS

PubMed Central

2012-01-01

Background Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders′ perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. Methods A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Results Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify priorities and inform sector-wide planning, whereby health service statistics were used to rank the burden of disease. However, many respondents remarked that health system challenges are not captured by such statistics. In all countries funding for health was reported to fall short of requirements and a need for further priority setting to match actual resource availability was identified. Pooled health sector funds have been established to some extent, but development partners′ lack of flexibility in the allocation of funds according to country-generated priorities was identified as a major constraint. Conclusions Although we found consensus on health priorities across all levels in the study countries, current funding falls short of addressing these identified areas. The nature of external funding, as well as programme-specific investment, was found to distort priority setting. There are signs that existing interventions have had limited effects beyond meeting the needs of disease-specific programmes. A need for more comprehensive health system strengthening (HSS) was identified, which requires a strong vision as to what the term means, coupled with a clear strategy and commitment from national and international decision makers in order to achieve stated goals. Prospective studies and action research, accompanied by pilot programmes, are recommended as deliberate strategies for HSS. PMID:23231820

How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS.

PubMed

Jenniskens, Françoise; Tiendrebeogo, Georges; Coolen, Anne; Blok, Lucie; Kouanda, Seni; Sataru, Fuseini; Ralisimalala, Andriamampianina; Mwapasa, Victor; Kiyombo, Mbela; Plummer, David

2012-12-11

Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders' perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify priorities and inform sector-wide planning, whereby health service statistics were used to rank the burden of disease. However, many respondents remarked that health system challenges are not captured by such statistics.In all countries funding for health was reported to fall short of requirements and a need for further priority setting to match actual resource availability was identified. Pooled health sector funds have been established to some extent, but development partners' lack of flexibility in the allocation of funds according to country-generated priorities was identified as a major constraint. Although we found consensus on health priorities across all levels in the study countries, current funding falls short of addressing these identified areas. The nature of external funding, as well as programme-specific investment, was found to distort priority setting. There are signs that existing interventions have had limited effects beyond meeting the needs of disease-specific programmes. A need for more comprehensive health system strengthening (HSS) was identified, which requires a strong vision as to what the term means, coupled with a clear strategy and commitment from national and international decision makers in order to achieve stated goals. Prospective studies and action research, accompanied by pilot programmes, are recommended as deliberate strategies for HSS.

The importance of measuring customer satisfaction in palliative care.

PubMed

Turriziani, Adriana; Attanasio, Gennaro; Scarcella, Francesco; Sangalli, Luisa; Scopa, Anna; Genualdo, Alessandra; Quici, Stefano; Nazzicone, Giulia; Ricciotti, Maria Adelaide; La Commare, Francesco

2016-03-01

In the last decades, palliative care has been more and more focused on the evaluation of patients' and families' satisfaction with care. However, the evaluation of customer satisfaction in palliative care presents a number of issues such as the presence of both patients and their families, the frail condition of the patients and the complexity of their needs, and the lack of standard quality indicators and appropriate measurement tools. In this manuscript, we critically review existing evidence and literature on the evaluation of satisfaction in the palliative care context. Moreover, we provide - as a practical example - the preliminary results of our experience in this setting with the development of a dedicated tool for the measurement of satisfaction.

Complex Deployed Responsive Service

NASA Astrophysics Data System (ADS)

Parry, Glenn; McLening, Marc; Caldwell, Nigel; Thompson, Rob

A pizza restaurant must provide product, in the form of the food and drink, and service in the way this is delivered to the customer. Providing this has distinct operational challenges, but what if the restaurant also provides a home delivery service? The service becomes deployed as the customer is no-longer co-located with the production area. The business challenge is complicated as service needs to be delivered within a geographic region, to time or the pizza will be cold, and within a cost that is not ­prohibitive. It must also be responsive to short term demand; needing to balance the number of staff it has available to undertake deliveries against a forecast of demand.

Best face forward.

PubMed

Rayport, Jeffrey F; Jaworski, Bernard J

2004-12-01

Most companies serve customers through a broad array of interfaces, from retail sales clerks to Web sites to voice-response telephone systems. But while the typical company has an impressive interface collection, it doesn't have an interface system. That is, the whole set does not add up to the sum of its parts in its ability to provide service and build customer relationships. Too many people and too many machines operating with insufficient coordination (and often at cross-purposes) mean rising complexity, costs, and customer dissatisfaction. In a world where companies compete not on what they sell but on how they sell it, turning that liability into an asset is what separates winners from losers. In this adaptation of their forthcoming book by the same title, Jeffrey Rayport and Bernard Jaworski explain how companies must reengineer their customer interface systems for optimal efficiency and effectiveness. Part of that transformation, they observe, will involve a steady encroachment by machine interfaces into areas that have long been the sacred province of humans. Managers now have opportunities unprecedented in the history of business to use machines, not just people, to credibly manage their interactions with customers. Because people and machines each have their strengths and weaknesses, company executives must identify what people do best, what machines do best, and how to deploy them separately and together. Front-office reengineering subjects every current and potential service interface to an analysis of opportunities for substitution (using machines instead of people), complementarity (using a mix of machines and people), and displacement (using networks to shift physical locations of people and machines), with the twin objectives of compressing costs and driving top-line growth through increased customer value.

Growth outside the core.

PubMed

Zook, Chris; Allen, James

2003-12-01

Growth in an adjacent market is tougher than it looks; three-quarters of the time, the effort fails. But companies can change those odds dramatically. Results from a five-year study of corporate growth conducted by Bain & Company reveal that adjacency expansion succeeds only when built around strong core businesses that have the potential to become market leaders. And the best place to look for adjacency opportunities is inside a company's strongest customers. The study also found that the most successful companies were able to consistently, profitably outgrow their rivals by developing a formula for pushing out the boundaries of their core businesses in predictable, repeatable ways. Companies use their repeatability formulas to expand into any number of adjacencies. Some companies make repeated geographic moves, as Vodafone has done in expanding from one geographic market to another over the past 13 years, building revenues from $1 billion in 1990 to $48 billion in 2003. Others apply a superior business model to new segments. Dell, for example, has repeatedly adapted its direct-to-customer model to new customer segments and new product categories. In other cases, companies develop hybrid approaches. Nike executed a series of different types of adjacency moves: it expanded into adjacent customer segments, introduced new products, developed new distribution channels, and then moved into adjacent geographic markets. The successful repeaters in the study had two common characteristics. First, they were extraordinarily disciplined, applying rigorous screens before they made an adjacency move. This discipline paid off in the form of learning curve benefits, increased speed, and lower complexity. And second, in almost all cases, they developed their repeatable formulas by studying their customers and their customers' economics very, very carefully.

Customization of Curriculum Materials in Science: Motives, Challenges, and Opportunities

NASA Astrophysics Data System (ADS)

Romine, William L.; Banerjee, Tanvi

2012-02-01

Exemplary science instructors use inquiry to tailor content to student's learning needs; traditional textbooks treat science as a set of facts and a rigid curriculum. Publishers now allow instructors to compile pieces of published and/or self-authored text to make custom textbooks. This brings numerous advantages, including the ability to produce smaller, cheaper text and added flexibility on the teaching models used. Moreover, the internet allows instructors to decentralize textbooks through easy access to educational objects such as audiovisual simulations, individual textbook chapters, and scholarly research articles. However, these new opportunities bring with them new problems. With educational materials easy to access, manipulate and duplicate, it is necessary to define intellectual property boundaries, and the need to secure documents against unlawful copying and use is paramount. Engineers are developing and enhancing information embedding technologies, including steganography, cryptography, watermarking, and fingerprinting, to label and protect intellectual property. While these are showing their utility in securing information, hackers continue to find loop holes in these protection schemes, forcing engineers to constantly assess the algorithms to make them as secure as possible. As newer technologies rise, people still question whether custom publishing is desirable. Many instructors see the process as complex, costly, and substandard in comparison to using traditional text. Publishing companies are working to improve attitudes through advertising. What lacks is peer reviewed evidence showing that custom publishing improves learning. Studies exploring the effect of custom course materials on student attitude and learning outcomes are a necessary next step.

From value chain to value constellation: designing interactive strategy.

PubMed

Normann, R; Ramírez, R

1993-01-01

In today's fast-changing competitive environment, strategy is no longer a matter of positioning a fixed set of activities along that old industrial model, the value chain. Successful companies increasingly do not just add value, they reinvent it. The key strategic task is to reconfigure roles and relationships among a constellation of actors--suppliers, partners, customers--in order to mobilize the creation of value by new combinations of players. What is so different about this new logic of value? It breaks down the distinction between products and services and combines them into activity-based "offerings" from which customers can create value for themselves. But as potential offerings grow more complex, so do the relationships necessary to create them. As a result, a company's strategic task becomes the ongoing reconfiguration and integration of its competencies and customers. The authors provide three illustrations of these new rules of strategy. IKEA has blossomed into the world's largest retailer of home furnishings by redefining the relationships and organizational practices of the furniture business. Danish pharmacies and their national association have used the opportunity of health care reform to reconfigure their relationships with customers, doctors, hospitals, drug manufacturers, and with Danish and international health organizations to enlarge their role, competencies, and profits. French public-service concessionaires have mastered the art of conducting a creative dialogue between their customers--local governments in France and around the world--and a perpetually expanding set of infrastructure competencies.

Prioritizing Healthcare Delivery in a Conflict Zone Comment on "TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo".

PubMed

Wood, Robin; Richardson, Eugene T

2013-09-01

Nowhere are the barriers to a functional health infrastructure more clearly on display than in the Goma region of Democratic Republic of Congo. Kaboru et al. report poorly integrated services for HIV and TB in this war-torn region. Priorities in conflict zones include provision of security, shelter, food, clean water and prevention of sexual violence. In Goma, immediate health priorities include emergency treatment of cholera, malaria, respiratory illnesses, provision of maternal care, millions of measles vaccinations, and management of an ongoing rabies epidemic. It is a daunting task to determine an essential package of medical services in a setting where there are so many competing priorities, where opportunity costs are limited and epidemiologic information is scarce. Non-governmental agencies sometimes add to the challenge via an insidious reduction of state sovereignty and the creation of new levels of income inequality. Kaboru et al. have successfully highlighted many of the complexities of rebuilding and prioritizing healthcare in a conflict zone.

Research priorities in cancer cachexia: The University of Rochester Cancer Center NCI Community Oncology Research Program Research Base Symposium on Cancer Cachexia and Sarcopenia.

PubMed

Dunne, Richard F; Mustian, Karen M; Garcia, Jose M; Dale, William; Hayward, Reid; Roussel, Breton; Buschmann, Mary M; Caan, Bette J; Cole, Calvin L; Fleming, Fergal J; Chakkalakal, Joe V; Linehan, David C; Hezel, Aram F; Mohile, Supriya G

2017-12-01

Cancer cachexia remains understudied and there are no standard treatments available despite the publication of an international consensus definition and the completion of several large phase III intervention trials in the past 6 years. In September 2015, The University of Rochester Cancer Center NCORP Research Base led a Symposium on Cancer Cachexia and Sarcopenia with goals of reviewing the state of the science, identifying knowledge gaps, and formulating research priorities in cancer cachexia through active discussion and consensus. Research priorities that emerged from the discussion included the implementation of morphometrics into clinical decision making, establishing specific diagnostic criteria for the stages of cachexia, expanding patient selection in intervention trials, identifying clinically meaningful trial endpoints, and the investigation of exercise as an intervention for cancer cachexia. Standardizing how we define and measure cancer cachexia, targeting its complex biologic mechanisms, enrolling patients early in their disease course, and evaluating exercise, either alone or in combination, were proposed as initiatives that may ultimately result in the improved design of cancer cachexia therapeutic trials.

ArrayInitiative - a tool that simplifies creating custom Affymetrix CDFs

PubMed Central

2011-01-01

Background Probes on a microarray represent a frozen view of a genome and are quickly outdated when new sequencing studies extend our knowledge, resulting in significant measurement error when analyzing any microarray experiment. There are several bioinformatics approaches to improve probe assignments, but without in-house programming expertise, standardizing these custom array specifications as a usable file (e.g. as Affymetrix CDFs) is difficult, owing mostly to the complexity of the specification file format. However, without correctly standardized files there is a significant barrier for testing competing analysis approaches since this file is one of the required inputs for many commonly used algorithms. The need to test combinations of probe assignments and analysis algorithms led us to develop ArrayInitiative, a tool for creating and managing custom array specifications. Results ArrayInitiative is a standalone, cross-platform, rich client desktop application for creating correctly formatted, custom versions of manufacturer-provided (default) array specifications, requiring only minimal knowledge of the array specification rules and file formats. Users can import default array specifications, import probe sequences for a default array specification, design and import a custom array specification, export any array specification to multiple output formats, export the probe sequences for any array specification and browse high-level information about the microarray, such as version and number of probes. The initial release of ArrayInitiative supports the Affymetrix 3' IVT expression arrays we currently analyze, but as an open source application, we hope that others will contribute modules for other platforms. Conclusions ArrayInitiative allows researchers to create new array specifications, in a standard format, based upon their own requirements. This makes it easier to test competing design and analysis strategies that depend on probe definitions. Since the custom array specifications are easily exported to the manufacturer's standard format, researchers can analyze these customized microarray experiments using established software tools, such as those available in Bioconductor. PMID:21548938

Outsourcing data processing: planning for the disentanglement.

PubMed

Moss, M E; Gordon, M L

1993-06-01

Outsourcing data processing operations may be considered a conventional acquisition transaction between a customer and supplier. The most distinctive feature of a DP outsourcing contract is that it involves complex issues relating to computer software and technology and, frequently, intense issues relating to employees. But, one must do more in order to provide for preservation of the integrity (and, therefore, the value) of the data center. The contract must include not just the sale of a facility to a supplier who will take over the operations, but also terms for reconveying the facility at a future date. Getting out of the arrangement can be very complex. Disentanglement can be made less complex however, if the customer and the supplier negotiate all or part of the disentanglement procedures during the original contract proposal. Know ahead of time the possible scenarios for when disentanglement may take place and know what to do during the contract negotiations and during the length of the agreement to keep track of each other's properties. Know also the risks involved in outsourcing DP operations, such as what happens when the supplier's business fails. Having the supplier set up a separate profit entity for your contracted business or using a lien on the data center properties may help avoid loss if such failure occurs.

[Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis].

PubMed

Medenica, Ivica; Luković, Milan; Radoicić, Dragan

2010-02-01

The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score--7.1). We performed total rearthroplasty by a custom-made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score--87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specificaly for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

Sub-national assessment of aid effectiveness: A case study of post-conflict districts in Uganda.

PubMed

Ssengooba, Freddie; Namakula, Justine; Kawooya, Vincent; Fustukian, Suzanne

2017-06-13

In post-conflict settings, many state and non-state actors interact at the sub-national levels in rebuilding health systems by providing funds, delivering vital interventions and building capacity of local governments to shoulder their roles. Aid relationships among actors at sub-national level represent a vital lever for health system development. This study was undertaken to assess the aid-effectiveness in post-conflict districts of northern Uganda. This was a three district cross sectional study conducted from January to April 2013. A two stage snowball approach used to construct a relational-network for each district. Managers of organizations (ego) involved service delivery were interviewed and asked to list the external organizations (alters) that contribute to three key services. For each inter-organizational relationship (tie) a custom-made tool designed to reflect the aid-effectiveness in the Paris Declaration was used. Three hundred eighty four relational ties between the organizations were generated from a total of 85 organizations interviewed. Satisfaction with aid relationships was mostly determined by 1) the extent ego was able to negotiate own priorities, 2) ego's awareness of expected results, and 3) provision of feedback about ego's performance. Respectively, the B coefficients were 16%, 38% and 19%. Disaggregated analysis show that satisfaction of fund-holders was also determined by addressing own priorities (30%), while provider satisfaction was mostly determined by awareness of expected results (66%) and feedback on performance (23%). All results were significant at p-value of 0.05. Overall, the regression models in these analyses accounted for 44% to 62% of the findings. Sub-national assessment of aid effectiveness is feasible with indicators adapted from the global parameters. These findings illustrate the focus on "results" domain and less on "ownership" and "resourcing" domains. The capacity and space for sub-national level authorities to negotiate local priorities requires more attention especially for health system development in post-conflict settings.

How have systematic priority setting approaches influenced policy making? A synthesis of the current literature.

PubMed

Kapiriri, Lydia; Razavi, Donya

2017-09-01

There is a growing body of literature on systematic approaches to healthcare priority setting from various countries and different levels of decision making. This paper synthesizes the current literature in order to assess the extent to which program budgeting and marginal analysis (PBMA), burden of disease & cost-effectiveness analysis (BOD/CEA), multi-criteria decision analysis (MCDA), and accountability for reasonableness (A4R), are reported to have been institutionalized and influenced policy making and practice. We searched for English language publications on health care priority setting approaches (2000-2017). Our sources of literature included PubMed and Ovid databases (including Embase, Global Health, Medline, PsycINFO, EconLit). Of the four approaches PBMA and A4R were commonly applied in high income countries while BOD/CEA was exclusively applied in low income countries. PBMA and BOD/CEA were most commonly reported to have influenced policy making. The explanations for limited adoption of an approach were related to its complexity, poor policy maker understanding and resource requirements. While systematic approaches have the potential to improve healthcare priority setting; most have not been adopted in routine policy making. The identified barriers call for sustained knowledge exchange between researchers and policy-makers and development of practical guidelines to ensure that these frameworks are more accessible, applicable and sustainable in informing policy making. Copyright © 2017 Elsevier B.V. All rights reserved.

Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership

PubMed Central

Stocks, Susan Jill; Alam, Rahul; Taylor, Sian; Rolfe, Carly; Glover, Steven William; Whitcombe, Joanne; Campbell, Stephen M

2018-01-01

Objectives To identify the top 10 unanswered research questions for primary care patient safety research. Design A modified nominal group technique. Setting UK. Participants Anyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions. Main outcomes A top 10, and top 30, future research questions for primary care patient safety. Results 443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality. Conclusions This study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety. PMID:29490970

Reframing as a Best Practice: The Priority of Process in Highly Adaptive Decision Making

ERIC Educational Resources Information Center

Peters, Gary B.

2008-01-01

The development and practice of a well-defined process in which decisions are fully contemplated is needed in education today. The complexity of societal issues requires new depths of understanding, appreciation, and communication. Framing refers to the way a situation is described or viewed; reframing is the process of expanding and enriching the…

Research Priorities for School Nursing in the United Arab Emirates (UAE)

ERIC Educational Resources Information Center

Al-Yateem, Nabeel; Docherty, Charles; Brenner, Maria; Alhosany, Jameela; Altawil, Hanan; Al-Tamimi, Muna

2017-01-01

School nurses are challenged with more children having complex conditions, who are now surviving into school age. This is paralleled by a shift in focus of health systems toward primary care, and national efforts to develop the health-care services, especially those offered to vulnerable populations. Being at the forefront of this change, school…

Time Well Spent: Making Choices and Setting Priorities in Adult Numeracy Instruction

ERIC Educational Resources Information Center

Braaten, Melissa

2017-01-01

In her Forum piece, "What's an Adult Numeracy Teacher to Teach? Negotiating the Complexity of Adult Numeracy Instruction," Lynda Ginsburg set the stage of the current problem (poor numeracy levels in American adults) and the bevy of standards, legislation, and new exams that have recently been developed to address it. Ginsburg also…

What's an Adult Numeracy Teacher to Teach? Negotiating the Complexity of Adult Numeracy Instruction

ERIC Educational Resources Information Center

Ginsburg, Lynda

2017-01-01

In this Forum article, the author addresses how to assist adults in improving mathematics and numeracy literacy. Ginsburg observes educators who strive to address their learners' educational gaps and needs are finding themselves in an environment of competing priorities and expectations that can be expressed as mathematics numeracy education. What…

Seven Defense Priorities for the New Administration

DTIC Science & Technology

2016-12-01

building consume human and financial military resources for decades. New weapons like cyber and autonomous systems are aimed at the heart of the U.S...information infrastructure enables for adversaries and for the U.S.; 5. Anticipating intelligent systems and autonomy including numbers and...challenging in a complex electromagnetic environment ...............................................37 Space and the global positioning system play a

Creating a Culture: How School Leaders Can Optimise Behaviour

ERIC Educational Resources Information Center

Bennett, Tom

2017-01-01

The national picture of school behaviour is complex, but numerous indicators suggest that it can be better in a great number of schools and contexts. Every leader should consciously aspire to the very best behaviour possible in their schools as a matter of priority. There are a number of strategies that schools with outstanding behaviour use…

Your Mouth: A Window to Your Overall Health

ERIC Educational Resources Information Center

Blende, David M.

2008-01-01

Meeting the needs of a loved one with a disability or complex medical condition presents challenges everyday, and it becomes very easy for a parent or caregiver to allow concerns such as dental health to fall by the wayside in the face of other priorities. However, healthy teeth and gums are necessary for overall health. People with special needs…

The Priorities and Challenges of Primary Teachers' Knowledge in Their Mathematics Planning

ERIC Educational Resources Information Center

Davidson, Aylie

2016-01-01

There is growing consensus that the process of planning mathematics lessons is as complex as teaching them, yet there is limited research on this. This paper reports on one aspect of a project examining issues in primary teachers' mathematics planning. The results, taken from a questionnaire completed by 62 primary teachers, indicate that when…

Design Thinking in Integrated STEAM Learning: Surveying the Landscape and Exploring Exemplars in Elementary Grades

ERIC Educational Resources Information Center

Cook, Kristin L.; Bush, Sarah B.

2018-01-01

Complementing the aims of problem-based inquiry, a pedagogical approach called design thinking (DT) has students grapple with issues that require a creative redefinition and reimagining of solutions akin to professional skills of designers, who consider conflicting priorities and complex negotiations to arrive at a solution to an ill-defined…

Web Site Development Support

NASA Technical Reports Server (NTRS)

Abdul, Hameed

2016-01-01

This summer I assisted the RPT Program Office in developing a design plan to update their existing website to current NASA web standards. The finished website is intended for the general public, specifically potential customers interested in learning about NASA's chemical rocket test facility capabilities and test assignment process. The goal of the website is to give the public insight about the purpose and function of the RPT Program. Working on this project gave me the opportunity to learn skills necessary for effective project management. The RPT Program Office manages numerous facilities so they are required to travel often to other sites for meetings throughout the year. Maneuvering around the travel schedule of the office and the workload priority of the IT Department proved to be quite the challenge. I overcame the travel schedule of the office by frequently communicating and checking in with my mentor via email and telephone.

Certification trails for data structures

NASA Technical Reports Server (NTRS)

Sullivan, Gregory F.; Masson, Gerald M.

1993-01-01

Certification trails are a recently introduced and promising approach to fault detection and fault tolerance. The applicability of the certification trail technique is significantly generalized. Previously, certification trails had to be customized to each algorithm application; trails appropriate to wide classes of algorithms were developed. These certification trails are based on common data-structure operations such as those carried out using these sets of operations such as those carried out using balanced binary trees and heaps. Any algorithms using these sets of operations can therefore employ the certification trail method to achieve software fault tolerance. To exemplify the scope of the generalization of the certification trail technique provided, constructions of trails for abstract data types such as priority queues and union-find structures are given. These trails are applicable to any data-structure implementation of the abstract data type. It is also shown that these ideals lead naturally to monitors for data-structure operations.

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

Klise, Katherine A.; Hart, David; Moriarty, Dylan Michael

Drinking water systems face multiple challenges, including aging infrastructure, water quality concerns, uncertainty in supply and demand, natural disasters, environmental emergencies, and cyber and terrorist attacks. All of these have the potential to disrupt a large portion of a water system causing damage to infrastructure and outages to customers. Increasing resilience to these types of hazards is essential to improving water security. As one of the United States (US) sixteen critical infrastructure sectors, drinking water is a national priority. The National Infrastructure Advisory Council defined infrastructure resilience as “the ability to reduce the magnitude and/or duration of disruptive events. Themore » effectiveness of a resilient infrastructure or enterprise depends upon its ability to anticipate, absorb, adapt to, and/or rapidly recover from a potentially disruptive event”. Being able to predict how drinking water systems will perform during disruptive incidents and understanding how to best absorb, recover from, and more successfully adapt to such incidents can help enhance resilience.« less

Case Study of Online Banking in India: User Behaviors and Design Guidelines

NASA Astrophysics Data System (ADS)

Iyengar, Jhumkee; Belvalkar, Manisha

This paper documents online banking trends, behaviors and expectations of Indian consumers and banks. It is based on excerpts of a large industry case study of users from 4 leading banks. While banks view online banking essentially as a technology solution, it is a relatively new area for Indian consumers and not yet self-supporting. Being a savings based culture still, Indian consumers are cautious about their financial assets. They are also relatively recent entrants to internet based services. Design of these systems must therefore be based on an understanding of these users' outlook and priorities through task centric, security assured and service oriented solutions minus the technological challenges. Design lessons suggest viewing online banking not just as a convenience alone anymore but beyond it, to provide service, simplicity and security. This will create satisfied online banking customers and therefore profitability for the bank.

Satellite-instrument system engineering best practices and lessons

NASA Astrophysics Data System (ADS)

Schueler, Carl F.

2009-08-01

This paper focuses on system engineering development issues driving satellite remote sensing instrumentation cost and schedule. A key best practice is early assessment of mission and instrumentation requirements priorities driving performance trades among major instrumentation measurements: Radiometry, spatial field of view and image quality, and spectral performance. Key lessons include attention to technology availability and applicability to prioritized requirements, care in applying heritage, approaching fixed-price and cost-plus contracts with appropriate attention to risk, and assessing design options with attention to customer preference as well as design performance, and development cost and schedule. A key element of success either in contract competition or execution is team experience. Perhaps the most crucial aspect of success, however, is thorough requirements analysis and flowdown to specifications driving design performance with sufficient parameter margin to allow for mistakes or oversights - the province of system engineering from design inception to development, test and delivery.

Component Prioritization Schema for Achieving Maximum Time and Cost Benefits from Software Testing

NASA Astrophysics Data System (ADS)

Srivastava, Praveen Ranjan; Pareek, Deepak

Software testing is any activity aimed at evaluating an attribute or capability of a program or system and determining that it meets its required results. Defining the end of software testing represents crucial features of any software development project. A premature release will involve risks like undetected bugs, cost of fixing faults later, and discontented customers. Any software organization would want to achieve maximum possible benefits from software testing with minimum resources. Testing time and cost need to be optimized for achieving a competitive edge in the market. In this paper, we propose a schema, called the Component Prioritization Schema (CPS), to achieve an effective and uniform prioritization of the software components. This schema serves as an extension to the Non Homogenous Poisson Process based Cumulative Priority Model. We also introduce an approach for handling time-intensive versus cost-intensive projects.

The servant leader: a higher calling for dental professionals.

PubMed

Certosimo, Fred

2009-09-01

The dental profession is guided by normative principles that provide guidance to our leaders and practicing dentists in addressing the needs of patients and the profession, yet there is room for incorporating new ideas that help dental professionals meet their professional obligations. The purpose of this essay is to discuss the concept of "servant leadership," especially in contrast with "self-serving leaders," and to suggest that servant leadership is consistent with the high ethical and professional ideals of the dental profession. The servant leader is the antithesis of the self-serving leader, who incessantly seeks more power and acquisition of material possessions. The servant leader's highest priority is the people (patients/students/customers) he or she serves. The concept of the servant-leader can take us away from self-serving, top-down leadership and encourage us to think harder about how to respect, value, and motivate people and ultimately provide better service to our patients.

Why do neighbors have different environmental priorities? Analysis of environmental risk perception in a Beirut neighborhood.

PubMed

El-Zein, Abbas; Nasrallah, Rola; Nuwayhid, Iman; Kai, Lea; Makhoul, Jihad

2006-04-01

Differences in environmental priorities within an urban neighborhood of Beirut are analyzed. The explanatory capabilities of five categories of contextual variables are compared: socioeconomic status, locality, health, behavior, and environmental beliefs. Semi-structured interviews with key individuals in the community and residents were first conducted. Four environmental issues of concern were identified. A survey was carried out to identify the relative priority accorded by respondents to these four issues, and to measure variables likely to explain differences of opinion. Bivariate and multivariate logistic regression analyses were conducted for each of the four problems. The 99% confidence interval (CI) of the odds ratio (OR) was used as a test of significance. Respondents suffering from a respiratory disease (OR = 6.94, 99%CI = 1.54-31.25), those living in less crowded houses (OR = 4.88, 99%CI = 1.38-17.24), and those not living close to the neighborhood's industrial street (OR=5.26, 99%CI = 1.01-27.78) are significantly more likely to rank poor air quality first. Significant associations are found between poor water quality as first priority and nonpresence of a smoker in the household (OR = 6.12, 99%CI = 1.84-20.32) and perception of water salinity as a problem (OR = 7.46, 99%CI = 1.50-37.03). Males (OR = 6.94, 99%CI = 1.02-47.62) and tenants versus owners (OR = 10.49, 99%CI = 1.36-80.61) are significantly more likely to rank the residential-industrial mix first. Socioeconomic variables retain their explanatory capability in the studied neighborhood, despite relatively small income disparities. Behavioral variables, such as smoking, may be causative factors of priorities. Analyzing relative priorities, rather than "concern" or lack of it, reveals more complex patterns of association. Identifying environmental-perception divide lines can help develop a more inclusive and effective participatory environmental management.

The ambiguities of loyalty.

PubMed

Condon, Barbara Backer

2013-10-01

Loyalty is a complex notion. Recognizing moments of loyalty in nursing can encourage pride in the profession and thereby assist in elevating nursing as a profession. If nurses can appreciate the complexities involved in loyalty, this knowing might assist them in understanding personal struggles with loyalty when they arise and may also help in the understandings-misunderstandings that can occur when a breach of loyalty is felt. In this column, this complexity is discussed. Loyalty as a part of living quality is also highlighted in that loyalty is always choosing value priorities in co-creating living quality. Furthermore, the principles of humanbecoming are used as a guide to teaching-learning as well as recognizing loyalty in the nursing profession.

Integrated In-space Transportation Plan

NASA Technical Reports Server (NTRS)

Farris, B.; Eberle, B.; Woodcock, G.; Negast, B.; Johnson, Les (Technical Monitor)

2002-01-01

The purpose of this report is to provide the reader with a readily accessible reference volume and history for the Integrated In-Space Transportation Plan (IISTP) phase I effort. This report was prepared by Gray Research, Inc. as a partial fulfillment of the Integrated Technology Assessment Center subcontract No. 4400037135 in support of the IISTP phase I effort within the In-Space Investment Area of the Advanced Space Transportation Program managed at Marshall Space Flight Center, Huntsville, Alabama. Much of the data used in the preparation of this report was taken from analyses, briefings, and reports prepared by the vast number of dedicated engineers and scientists who participated in the IISTP phase I effort. The opinions and ideas expressed in this report are solely those of the authors and do not necessarily reflect those of NASA in whole or in part. Reaching the outer solar system is a struggle against time and distance. The most distant planets are 4.5 to 6 billion kilometers from the Sun and to reach them in any reasonable time requires much higher values of specific impulse than can be achieved with conventional chemical rockets. In addition, the few spacecraft that have reached beyond Jupiter have used gravity assist, mainly by Jupiter, that is only available for a few months' period every 13 or so years. This permits only very infrequent missions and mission planners are very reluctant to accept travel times greater than about ten years since this is about the maximum for which one can have a realistic program plan. Advanced In-Space Propulsion (ISP) technologies will enable much more effective exploration of our Solar System and will permit mission designers to plan missions to "fly anytime, anywhere and complete a host of science objectives at the destinations' with greater reliability and safety. With a wide range of possible missions and candidate propulsion technologies with very diverse characteristics, the question of which technologies are "best" for future missions is a difficult one. The primary focus of the IISTP Phase I efforts were to: Develop, iterate and baseline future NASA requirements for In-Space Transportation; Define preliminary integrated architectures utilizing advanced ISP technologies; Identify and prioritize ISP technologies. The primary efforts of the IISTP Phase I process was to: Address Customer defined missions, mission priorities, mission requirements and technology preferences. Provide a forum for Technologists to advocate and have sufficiently considered any ISP technology for any mission of interest defined by the customer. Perform Systems analyses of the customer defined prioritized mission set to the degree necessary to support evaluation and prioritization of each technology advocated by the technologists. Perform Cost analyses on each of the technologies that were determined by systems analyses to be viable candidates for the customer defined mission set. Integrate all customers, technologists, systems, cost, program and project inputs into the final IISTP Prioritized set of technologies. The primary products of the IISTP Phase I effort were: Prioritized set of advanced ISP technologies that meet customer-provided requirements for customer prioritized mission sets; Recommendations of relative technology payoffs to guide augmentation investments.

Integrated In-Space Transportation Plan

NASA Astrophysics Data System (ADS)

Farris, B.; Eberle, B.; Woodcock, G.; Negast, B.

2002-10-01

The purpose of this report is to provide the reader with a readily accessible reference volume and history for the Integrated In-Space Transportation Plan (IISTP) phase I effort. This report was prepared by Gray Research, Inc. as a partial fulfillment of the Integrated Technology Assessment Center subcontract No. 4400037135 in support of the IISTP phase I effort within the In-Space Investment Area of the Advanced Space Transportation Program managed at Marshall Space Flight Center, Huntsville, Alabama. Much of the data used in the preparation of this report was taken from analyses, briefings, and reports prepared by the vast number of dedicated engineers and scientists who participated in the IISTP phase I effort. The opinions and ideas expressed in this report are solely those of the authors and do not necessarily reflect those of NASA in whole or in part. Reaching the outer solar system is a struggle against time and distance. The most distant planets are 4.5 to 6 billion kilometers from the Sun and to reach them in any reasonable time requires much higher values of specific impulse than can be achieved with conventional chemical rockets. In addition, the few spacecraft that have reached beyond Jupiter have used gravity assist, mainly by Jupiter, that is only available for a few months' period every 13 or so years. This permits only very infrequent missions and mission planners are very reluctant to accept travel times greater than about ten years since this is about the maximum for which one can have a realistic program plan. Advanced In-Space Propulsion (ISP) technologies will enable much more effective exploration of our Solar System and will permit mission designers to plan missions to "fly anytime, anywhere and complete a host of science objectives at the destinations' with greater reliability and safety. With a wide range of possible missions and candidate propulsion technologies with very diverse characteristics, the question of which technologies are "best" for future missions is a difficult one. The primary focus of the IISTP Phase I efforts were to: Develop, iterate and baseline future NASA requirements for In-Space Transportation; Define preliminary integrated architectures utilizing advanced ISP technologies; Identify and prioritize ISP technologies. The primary efforts of the IISTP Phase I process was to: Address Customer defined missions, mission priorities, mission requirements and technology preferences. Provide a forum for Technologists to advocate and have sufficiently considered any ISP technology for any mission of interest defined by the customer. Perform Systems analyses of the customer defined prioritized mission set to the degree necessary to support evaluation and prioritization of each technology advocated by the technologists. Perform Cost analyses on each of the technologies that were determined by systems analyses to be viable candidates for the customer defined mission set. Integrate all customers, technologists, systems, cost, program and project inputs into the final IISTP Prioritized set of technologies. The primary products of the IISTP Phase I effort were: Prioritized set of advanced ISP technologies that meet customer-provided requirements for customer prioritized mission sets; Recommendations of relative technology payoffs to guide augmentation investments.

The effect of requirements prioritization on avionics system conceptual design

NASA Astrophysics Data System (ADS)

Lorentz, John

This dissertation will provide a detailed approach and analysis of a new collaborative requirements prioritization methodology that has been used successfully on four Coast Guard avionics acquisition and development programs valued at $400M+. A statistical representation of participant study results will be discussed and analyzed in detail. Many technically compliant projects fail to deliver levels of performance and capability that the customer desires. Some of these systems completely meet "threshold" levels of performance; however, the distribution of resources in the process devoted to the development and management of the requirements does not always represent the voice of the customer. This is especially true for technically complex projects such as modern avionics systems. A simplified facilitated process for prioritization of system requirements will be described. The collaborative prioritization process, and resulting artifacts, aids the systems engineer during early conceptual design. All requirements are not the same in terms of customer priority. While there is a tendency to have many thresholds inside of a system design, there is usually a subset of requirements and system performance that is of the utmost importance to the design. These critical capabilities and critical levels of performance typically represent the reason the system is being built. The systems engineer needs processes to identify these critical capabilities, the associated desired levels of performance, and the risks associated with the specific requirements that define the critical capability. The facilitated prioritization exercise is designed to collaboratively draw out these critical capabilities and levels of performance so they can be emphasized in system design. Developing the purpose, scheduling and process for prioritization events are key elements of systems engineering and modern project management. The benefits of early collaborative prioritization flow throughout the project schedule, resulting in greater success during system deployment and operational testing. This dissertation will discuss the data and findings from participant studies, present a literature review of systems engineering and design processes, and test the hypothesis that the prioritization process had no effect on stakeholder sentiment related to the conceptual design. In addition, the "Requirements Rationalization" process will be discussed in detail. Avionics, like many other systems, has transitioned from a discrete electronics engineering, hard engineering discipline to incorporate software engineering as a core process of the technology development cycle. As with other software-based systems, avionics now has significant soft system attributes that must be considered in the design process. The boundless opportunities that exist in software design demand prioritization to focus effort onto the critical functions that the software must provide. This has been a well documented and understood phenomenon in the software development community for many years. This dissertation will attempt to link the effect of software integrated avionics to the benefits of prioritization of requirements in the problem space and demonstrate the sociological and technical benefits of early prioritization practices.

Partnerships Designed to Meet Customer Needs

ERIC Educational Resources Information Center

Dingeldein, Mike

2007-01-01

It is nearly impossible for one individual or a small committee to understand the complex needs of an entire school system and its community. Only by partnering with local business and community leaders, parents, teachers and third-party experts can local boards of education and school administrators grasp the unique needs of their community. Only…

Designing Search: Effective Search Interfaces for Academic Library Web Sites

ERIC Educational Resources Information Center

Teague-Rector, Susan; Ghaphery, Jimmy

2008-01-01

Academic libraries customize, support, and provide access to myriad information systems, each with complex graphical user interfaces. The number of possible information entry points on an academic library Web site is both daunting to the end-user and consistently challenging to library Web site designers. Faced with the challenges inherent in…

Simple Solutions to Complex Problems--MOOCs as a Panacea?

ERIC Educational Resources Information Center

Bass, Scott A.

2014-01-01

This article is critical of the implementation of massive open online courses (MOOCs) by institutions seeking the deep student learning often found in general education learning outcomes. Customized student interaction with an expert in the field is rendered impossible by the scale of mooc enrollment. Concerns are also raised about the economic…

Curriculum Complexities: The Chair's and Dean's Agenda.

ERIC Educational Resources Information Center

Able, Jean Ann; And Others

As the newest college in the 10-member Maricopa Community College System, Arizona's Estrella Mountain Community College Center (EMCCC) is highly capable of innovation since it does not have to battle years of tradition. As part of its emphasis on innovation, EMCCC operates under the relatively new paradigm of being a customer-driven organization.…

Illustrating Business Marketing Concepts through the Value Chain Game

ERIC Educational Resources Information Center

Liao-Troth, Sara; Thomas, Stephanie P.; Webb, G. Scott

2015-01-01

The Value Chain Game is an activity that helps students to develop a holistic understanding of the processes and challenges in managing the value chain so that customer needs are met. Competing value chains work to produce and sell two products. Seasonal demand, quality defects, transportation delays, and audits offer complexities that represent…

Assessment of Consumers' Satisfaction with the Automotive Product Quality

ERIC Educational Resources Information Center

Amineh, Hadi; Kosach, Nataliya

2016-01-01

Relevance of article is caused by the fact that customer's satisfaction currently serves as the mechanism allowing the carmakers to be competitive in the market. The paper describes issues of assessment of the quality of products manufactured by automobile companies. The assessment is based on widely applicable complex characteristics of the…

47 CFR 68.213 - Installation of other than “fully protected” non-system simple customer premises wiring.

Code of Federal Regulations, 2010 CFR

2010-10-01

... only to “unprotected” premises wiring used with simple installations of wiring for up to four line residential and business telephone service. More complex installations of wiring for multiple line services... requirements, for installation and maintenance of wiring on the subscriber's side of the demarcation point...

How to Personalize Learning in K-12 Schools: Five Essential Design Features

ERIC Educational Resources Information Center

Lee, Dabae

2014-01-01

Personalized learning (PL) is spotlighted as a way to transform K-12 educational systems. PL customizes learning pace, instructional methods, and learning content to individual students. As much as PL sounds promising and complex, little guidance is available to educators and policymakers about how to effectively design PL. Five essential features…

Communication Strategies for Developing Trust in the Salesperson/Prospect Exchange.

ERIC Educational Resources Information Center

Cochran, Daniel S.; Gibson, C. Kendrick

A review of literature in the sales area reveals that the communication process between salespeople and their customers is a complex one offering a wide range of relationships. To develop a feeling of trust between the two parties, salespeople can use practical communication skills emphasizing their expertness, reliability, and dynamism. Sales…

77 FR 10016 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-21

... attractive to members and their customers. The Exchange believes that adopting maker/taker fees and rebates... Exchange believes it remains an attractive venue for market participants to trade complex orders as its... proposed fee change, the Exchange believes it remains an attractive venue for market participants to trade...

Middle Schoolers and the Blues

ERIC Educational Resources Information Center

Harris, Renard B.

2004-01-01

American culture stems from a multitude of the diverse perspectives, customs, and habits of the vast groups that have made the United States their home. This nation's complexity of diverse cultures and its ability to strive for common values seem almost over-whelming. Nonetheless, from the cultures of many, one culture can emerge. Through sharing…

The role of public policy in emerging green power markets: An analysis of marketer preferences

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

Wiser, R.

1999-08-01

Green power marketing has been heralded by some as a means to create a private market for renewable energy that is driven by customer demand for green products. This report challenges the premise--sometimes proffered in debates over green markets--that profitable, sizable, credible markets for green products will evolve naturally without supportive public policies. Relying primarily on surveys and interviews of US green power marketers, the article examines the role of specific regulatory and legislative policies in enabling the green market, and searches for those policies that are believed by marketers to be the most conducive or detrimental to the expansionmore » of the green market. The authors find that marketers: (1) believe that profitable green power markets will only develop if a solid foundation of supportive policies exists; (2) believe that establishing overall price competition and encouraging customer switching are the top priorities; (3) are somewhat leery of government-sponsored or mandated public information programs; and (4) oppose three specific renewable energy policies that are frequently advocated by renewable energy enthusiasts, but that may have negative impacts on the green marketers' profitability. The stated preferences of green marketers shed light on ways to foster renewables by means of the green market. Because the interests of marketers do not coincide perfectly with those of society, however, the study also recognizes other normative perspectives and highlights policy tensions at the heart of current debates related to green markets. By examining these conflicts, they identify three key policy questions that should direct future research: (1) to what extent should price competition and customer switching be encouraged at the expense of cost shifting; (2) what requirements should be imposed to ensure credibility in green products and marketing; and (3) how should the green power market and broader renewable energy policies interact?« less

Modernizing Distribution System Restoration to Achieve Grid Resiliency Against Extreme Weather Events: An Integrated Solution

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

Chen, Chen; Wang, Jianhui; Ton, Dan

Recent severe power outages caused by extreme weather hazards have highlighted the importance and urgency of improving the resilience of the electric power grid. As the distribution grids still remain vulnerable to natural disasters, the power industry has focused on methods of restoring distribution systems after disasters in an effective and quick manner. The current distribution system restoration practice for utilities is mainly based on predetermined priorities and tends to be inefficient and suboptimal, and the lack of situational awareness after the hazard significantly delays the restoration process. As a result, customers may experience an extended blackout, which causes largemore » economic loss. On the other hand, the emerging advanced devices and technologies enabled through grid modernization efforts have the potential to improve the distribution system restoration strategy. However, utilizing these resources to aid the utilities in better distribution system restoration decision-making in response to extreme weather events is a challenging task. Therefore, this paper proposes an integrated solution: a distribution system restoration decision support tool designed by leveraging resources developed for grid modernization. We first review the current distribution restoration practice and discuss why it is inadequate in response to extreme weather events. Then we describe how the grid modernization efforts could benefit distribution system restoration, and we propose an integrated solution in the form of a decision support tool to achieve the goal. The advantages of the solution include improving situational awareness of the system damage status and facilitating survivability for customers. The paper provides a comprehensive review of how the existing methodologies in the literature could be leveraged to achieve the key advantages. The benefits of the developed system restoration decision support tool include the optimal and efficient allocation of repair crews and resources, the expediting of the restoration process, and the reduction of outage durations for customers, in response to severe blackouts due to extreme weather hazards.« less

A new three-dimensional manufacturing service composition method under various structures using improved Flower Pollination Algorithm

NASA Astrophysics Data System (ADS)

Zhang, Wenyu; Yang, Yushu; Zhang, Shuai; Yu, Dejian; Chen, Yong

2018-05-01

With the growing complexity of customer requirements and the increasing scale of manufacturing services, how to select and combine the single services to meet the complex demand of the customer has become a growing concern. This paper presents a new manufacturing service composition method to solve the multi-objective optimization problem based on quality of service (QoS). The proposed model not only presents different methods for calculating the transportation time and transportation cost under various structures but also solves the three-dimensional composition optimization problem, including service aggregation, service selection, and service scheduling simultaneously. Further, an improved Flower Pollination Algorithm (IFPA) is proposed to solve the three-dimensional composition optimization problem using a matrix-based representation scheme. The mutation operator and crossover operator of the Differential Evolution (DE) algorithm are also used to extend the basic Flower Pollination Algorithm (FPA) to improve its performance. Compared to Genetic Algorithm, DE, and basic FPA, the experimental results confirm that the proposed method demonstrates superior performance than other meta heuristic algorithms and can obtain better manufacturing service composition solutions.

Challenges of assuring crew safety in space shuttle missions with international cargoes.

PubMed

Vongsouthy, C; Stenger-Nguyen, P A; Nguyen, H V; Nguyen, P H; Huang, M C; Alexander, R G

2004-02-01

The top priority in America's manned space flight program is the assurance of crew and vehicle safety. This priority gained greater focus during and after the Space Shuttle return-to-flight mission (STS-26). One of the interesting challenges has been to assure crew safety and adequate protection of the Space Shuttle, as a national resource, from increasingly diverse cargoes and operations. The control of hazards associated with the deployment of complex payloads and cargoes has involved many international participants. These challenges are examined in some detail along with examples of how crew safety has evolved in the manned space program and how the international partners have addressed various scenarios involving control and mitigation of potential hazards to crew and vehicle safety. c2003 Published by Elsevier Ltd.

Weighted Fuzzy Risk Priority Number Evaluation of Turbine and Compressor Blades Considering Failure Mode Correlations

NASA Astrophysics Data System (ADS)

Gan, Luping; Li, Yan-Feng; Zhu, Shun-Peng; Yang, Yuan-Jian; Huang, Hong-Zhong

2014-06-01

Failure mode, effects and criticality analysis (FMECA) and Fault tree analysis (FTA) are powerful tools to evaluate reliability of systems. Although single failure mode issue can be efficiently addressed by traditional FMECA, multiple failure modes and component correlations in complex systems cannot be effectively evaluated. In addition, correlated variables and parameters are often assumed to be precisely known in quantitative analysis. In fact, due to the lack of information, epistemic uncertainty commonly exists in engineering design. To solve these problems, the advantages of FMECA, FTA, fuzzy theory, and Copula theory are integrated into a unified hybrid method called fuzzy probability weighted geometric mean (FPWGM) risk priority number (RPN) method. The epistemic uncertainty of risk variables and parameters are characterized by fuzzy number to obtain fuzzy weighted geometric mean (FWGM) RPN for single failure mode. Multiple failure modes are connected using minimum cut sets (MCS), and Boolean logic is used to combine fuzzy risk priority number (FRPN) of each MCS. Moreover, Copula theory is applied to analyze the correlation of multiple failure modes in order to derive the failure probabilities of each MCS. Compared to the case where dependency among multiple failure modes is not considered, the Copula modeling approach eliminates the error of reliability analysis. Furthermore, for purpose of quantitative analysis, probabilities importance weight from failure probabilities are assigned to FWGM RPN to reassess the risk priority, which generalize the definition of probability weight and FRPN, resulting in a more accurate estimation than that of the traditional models. Finally, a basic fatigue analysis case drawn from turbine and compressor blades in aeroengine is used to demonstrate the effectiveness and robustness of the presented method. The result provides some important insights on fatigue reliability analysis and risk priority assessment of structural system under failure correlations.

Scale-dependent complementarity of climatic velocity and environmental diversity for identifying priority areas for conservation under climate change.

PubMed

Carroll, Carlos; Roberts, David R; Michalak, Julia L; Lawler, Joshua J; Nielsen, Scott E; Stralberg, Diana; Hamann, Andreas; Mcrae, Brad H; Wang, Tongli

2017-11-01

As most regions of the earth transition to altered climatic conditions, new methods are needed to identify refugia and other areas whose conservation would facilitate persistence of biodiversity under climate change. We compared several common approaches to conservation planning focused on climate resilience over a broad range of ecological settings across North America and evaluated how commonalities in the priority areas identified by different methods varied with regional context and spatial scale. Our results indicate that priority areas based on different environmental diversity metrics differed substantially from each other and from priorities based on spatiotemporal metrics such as climatic velocity. Refugia identified by diversity or velocity metrics were not strongly associated with the current protected area system, suggesting the need for additional conservation measures including protection of refugia. Despite the inherent uncertainties in predicting future climate, we found that variation among climatic velocities derived from different general circulation models and emissions pathways was less than the variation among the suite of environmental diversity metrics. To address uncertainty created by this variation, planners can combine priorities identified by alternative metrics at a single resolution and downweight areas of high variation between metrics. Alternately, coarse-resolution velocity metrics can be combined with fine-resolution diversity metrics in order to leverage the respective strengths of the two groups of metrics as tools for identification of potential macro- and microrefugia that in combination maximize both transient and long-term resilience to climate change. Planners should compare and integrate approaches that span a range of model complexity and spatial scale to match the range of ecological and physical processes influencing persistence of biodiversity and identify a conservation network resilient to threats operating at multiple scales. © 2017 The Authors. Global Change Biology Published by John Wiley & Sons Ltd.

Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study.

PubMed

O'Donnell, Patrick; Tierney, Edel; O'Carroll, Austin; Nurse, Diane; MacFarlane, Anne

2016-12-03

The involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care. This Participatory Learning and Action (PLA) research study involved 21 members of various marginalised groups who contributed their views about access to primary care. Using a series of PLA techniques for data generation and co-analysis, we explored barriers and facilitators to primary healthcare access from the perspective of migrants, Irish Travellers, homeless people, drug users, sex workers and people living in deprivation, and identified their priorities for action with regard to primary care provision. Four overarching themes were identified: the home environment, the effects of the 'two-tier' healthcare system on engagement, healthcare encounters, and the complex health needs of many in those groups. The study demonstrates that there are many complicated personal and structural barriers to accessing primary healthcare for marginalised groups. There were shared and differential experiences across the groups. Participants also expressed shared priorities for action in the planning and running of primary care services. Members of marginalised groups have shared priorities for action to improve their access to primary care. If steps are taken to address these, there is scope to impact on more than one marginalised group and to address the existing health inequities.

Patient Response to an Integrated Orthotic and Rehabilitation Initiative for Traumatic Injuries: The PRIORITI-MTF Study.

PubMed

Hsu, Joseph R; Owens, Johnny G; DeSanto, Jennifer; Fergason, John R; Kuhn, Kevin M; Potter, Benjamin K; Stinner, Daniel J; Sheu, Robert G; Waggoner, Sandra L; Wilken, Jason M; Huang, Yanjie; Scharfstein, Daniel O; MacKenzie, Ellen J

2017-04-01

Although limb salvage is now possible for many high-energy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy-storing carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high-intensity, sports medicine-based approach to rehabilitation. It builds on earlier studies by testing the program at military treatment facilities beyond the Brooke Army Medical Center and the Center for the Intrepid where the device was developed. The PRIORITI-MTF study is a multicenter before-after program evaluation where participants at least 1 year out from a traumatic lower extremity injury serve as their own controls. Participants are evaluated before receiving the IDEO, immediately after 4 weeks of physical therapy with the IDEO and at 6 and 12 months after the completion of physical therapy. Primary outcomes include functional performance, measured using well-validated assessments of speed, agility, power, and postural stability and self-reported functioning using the Short Musculoskeletal Function Assessment (SMFA) and the Veterans Health Survey (VR-12). Secondary outcomes include pain, depression, posttraumatic stress, and satisfaction with the IDEO.